A Paramedics First Aid Kit

4x4Lamm · 09-21-2009, 12:56 PM

A few people have asked me for advice on what to carry as far as medical kits for off-road, camping and general use. You have to build your kit to your own specific needs but I think mine does a pretty good job of covering all the bases. Obviously you should have appropriate food/water and clothing for the trip so those are not included.

I have been doing fire and EMS since I was in high school and have worked/work in wilderness, rural and urban settings. Aside from being a paramedic I have ACLS, ITLS, PALS and BLS certs. I also used to teach first aid and survival courses too if any of that matters to you.

Here is my kit,

Airway Kit:
2 Magil forceps, 1 small, 1 large
1 pocket mask (high quality)
1 CPR mask, (low quality)
1 bulb syringe
1 manual suction device with catheter
1 Asherman chest seal
1 oral airway set
1 nasal airway set
Surgical lube packets
3 16 GA. IV catheters
1 pair sterile gloves

Tools:
Misc. sterile surgical blades
Misc. splinter removal needles
1 disposable body staple kit with remover (Adventure Medical)
1 Wound closure kit (Adventure Medical)
1 pair trauma sheers
1 pair bandage scissors
1 hemostat clamp
Misc. safety pins and small needles
1 BP cuff
1stethascope with spare parts kit
1 LED penlight
Misc. pens, sharpie marker
1 Paper pad
1 “Vital Stats” notebook
1 pediatric trauma/meds guide
1 magnifying glass
Misc. q-tips
1 small mirror
1 window punch
2 pair tweezers
1 N95 mask
1 thermometer with extra covers
1 space blanket
1 emergency poncho
Misc. tongue depressors

Medications/Ointments:
1 hydrogen peroxide gel
1 activated charcoal
2 instant glucose tubes
1 Vaseline lip balm
1 bottle Motrin
1 bottle Imodium
1 bottle ipecac syrup
1 bottle sterile eye wash
1 tube of Rolaids
1 Primatene mist inhaler
3 packets of oral hydration salts (Adventure Medical)
Misc. packets multi symptom cold medicine
Misc. packets nasal decongestant
Misc. packets aspirin
Misc. packets electrolyte tablets
Misc. antiseptic, alcohol, iodine wipes
Misc. packets orajel
Misc. packets loratadine tablets
Misc. Pepto Bismol tablets
Misc. packets cortisone cream
Misc. packets Technu ivy cleanser
Misc. Benadryl, tablets and strips
Misc. ammonia inhalants
Misc. packets burn gel
Misc. amps of sting relief
1 packet of cough suppressant strips (dextro)
Misc. packets Goody’s pain relief drink mix
Misc. packets antibiotic ointment/Neosporin
1 packet Stay Alert caffeine gum

Bandaging/Trauma:
1 large packet of Quick Clot
2 triangular bandages
1 tourniquet
2 finger splints, 1 small, 1 large
1 “Extractor” snake/insect bite kit
2 rolls of tape, ½” and 1” (waterproof)
Handful of 4x4s
1 ACE bandage
1 roll of 2” Kling
1 SAM splint
Handful of 2x2s
Dozen large Band-Aids
1 small baggie of Misc. small Band-Aids
1 2” roll gauze
1 4” roll gauze
Misc. Moleskin
Misc. occlusive dressings
2 small packets of Quick Clot
1 multi trauma dressing
Half dozen 3x5 ABD pads (can use sterile napkins too)
1 sterile burn sheet
Misc. rubber/latex gloves

Here are the two Pelican Cases everything is in.

The small case hold supplies for airway and breathing management.

This is the airway case opened and the equipment stored in it.

This is the main EMS case.

Here is what you see when you open it up.

Except for the burn sheet and multi trauma dressings it is 100% contained in 2 Pelican cases. The airway kit is in a 1200 series box and the rest rides in a 1500 EMS series case.

IMPORTANT NOTE: Some things can do more harm than good if you do not know what you are doing. Unless you are trained as EMS or military (combat lifesaver) please don't do a needle decompression on me or something like that

If you are unsure of what something on the list is or what it's for chances are you don't need to be carrying it but that does not mean you can't save a life with other items. Also, training is more important than anything on this list, the best return you can get on your time and money is a good first aid and CPR or even EMT-B class. EMT-B is only a few hundred bucks and about 120 hours of class in most areas, a real bargin if you ask me.

Enjoy and feel free to ask questions.
4x4Lamm

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**4x4Fink** · 09-24-2009, 04:26 PM

I'm literally putting my kit together as we speak.
I've got the 1500EMS and the 1200.

The airway kit was easy and is already put together, I still need to get the manual suction.
I've already got three bulb syringes in various sizes.

Would you mind shooting a pic of the second layer of the plastic organizer in the 1500 case?
I'm trying to get everything organized and I can't decide how I want to arrange it all.

I'm about to make a run to Walgreens to get the band-aid and general bandaging/dressing stuff.

Mine will be strictly a BLS kit since I can't do all the cool stuff that Paramedics can.

I'll post mine up when I get done - it will be very similar to Lamm's though.

Thanks Lamm!

Fink

22RUCRAZY · 09-24-2009, 04:40 PM

Saftey first hell yah i would include a survival kit you know knife matches meals ready to eat that sort of thing oh and morphine

**aviator** · 09-24-2009, 05:10 PM

Morphine can be dangerous and AFAIK it's also a schedule 1 controlled narcotic. In other words unless you have a scrip. don't have it on you when the cops stop you 22R.

Hope everyone reads your note Lamm some of your goodies could do more harm then good if folks don't know what they're doing. I was trained to do some advanced things as an EMS Pilot so I could "assist the medic" in situations where the patient was going sour... [never had to us it yet] but I still would'nt try to use half those things.
If you're going into the serious back country take Lamm's advice and get some training.

**4x4Fink** · 09-24-2009, 05:58 PM

Quote:

Originally Posted by aviator

Morphine can be dangerous and AFAIK it's also a schedule 1 controlled narcotic. In other words unless you have a scrip. don't have it on you when the cops stop you 22R.

Hope everyone reads your note Lamm some of your goodies could do more harm then good if folks don't know what they're doing. I was trained to do some advanced things as an EMS Pilot so I could "assist the medic" in situations where the patient was going sour... [never had to us it yet] but I still would'nt try to use half those things.
If you're going into the serious back country take Lamm's advice and get some training.

You are absolutely right, Paul.

CPR is the most helpful thing a civilian can get trained on and perform when needed.
Fact is, in most situations you are just going to be rendering life-saving care (CPR/airway maintenance and maybe a severe bleed) until ALS arrives.
Secondary injuries (small abrasions, lacerations, minor fractures, etc...) will all be stabilized/assessed while en route to the hospital and may not even be messed with until the patient is transferred to definitive care depending on how critical the patient is.

It's as easy as ABC - airway, breathing, circulation.

CPR classes are often times free at local fire departments or community colleges, the more people we have effectively trained the better off each community will be.

I'm off my soapbox now.

Fink

muddpigg · 09-24-2009, 10:53 PM

You guys ought to look into a BVM to throw into your kits. A face mask is good but can huff yourself to exhuastion quickly. I BVM w/o O2 is still 21%. Shoot if your offroad it may take quite a while for FD, EMS, or medivac to reach you.

I don't carry any meds other than topical.

Fink: your 100% right ACLS is pushing good CPR over any med.

I like the 60CC non luer loc syringe with an NPA placed on the end for suction. You can trim the ends to get better bore for the "chunky stuff"

Ya'll ought to look at the Isreali dressing, its like the trauma bandage attached to an acewrap. Awesome for pressure dressings and getting those hard to bandage wounds like ingenial and armpit, takes some creativity and practice but very doable.

They took the quick clot away from us and reissued another coag bandabe packed in gauze. Quick clot burns the tissue and can cause more damage. Plus the powder is great in the lab but has a tendency to blow in the wind. You don't want it in your eyes. I'd get rid of the stapler too, we don't want to close anything in the field that is what ER but perferribly ORs are for. I'd toss in another tournique too, as you know one is never released and occasions do arrise that ones just no enough. Though I am a fan of cravaets a CAT is so much easier. Ippecacc has fallen out of favor.

Its getting late and I'm tired. Don't intend on starting a firestorm but I see concerns in your kit. I don't work for you system. I didn't go into much of the med list, its late. I do agree that an EMT class is a good investment. If you feel you need me to post my acrynyms I will.

**4x4Fink** · 09-25-2009, 05:49 AM

Quote:

Originally Posted by muddpigg

You guys ought to look into a BVM to throw into your kits. A face mask is good but can huff yourself to exhuastion quickly. I BVM w/o O2 is still 21%. Shoot if your offroad it may take quite a while for FD, EMS, or medivac to reach you.

I don't carry any meds other than topical.

Fink: your 100% right ACLS is pushing good CPR over any med.

I like the 60CC non luer loc syringe with an NPA placed on the end for suction. You can trim the ends to get better bore for the "chunky stuff"

Ya'll ought to look at the Isreali dressing, its like the trauma bandage attached to an acewrap. Awesome for pressure dressings and getting those hard to bandage wounds like ingenial and armpit, takes some creativity and practice but very doable.

They took the quick clot away from us and reissued another coag bandabe packed in gauze. Quick clot burns the tissue and can cause more damage. Plus the powder is great in the lab but has a tendency to blow in the wind. You don't want it in your eyes. I'd get rid of the stapler too, we don't want to close anything in the field that is what ER but perferribly ORs are for. I'd toss in another tournique too, as you know one is never released and occasions do arrise that ones just no enough. Though I am a fan of cravaets a CAT is so much easier. Ippecacc has fallen out of favor.

Its getting late and I'm tired. Don't intend on starting a firestorm but I see concerns in your kit. I don't work for you system. I didn't go into much of the med list, its late. I do agree that an EMT class is a good investment. If you feel you need me to post my acrynyms I will.

As far as a BVM goes, for your average urban application I don't see the need for it not to mention the probability of having O2 with you or finding somebody who does is next to none.
In a typical urban setting you're looking at a response time of 2-6mins - doing a breath every 6-8 seconds as you would with a BVM isn't going to kill you with a pocket mask until ALS arrives.

Plus, with a BVM in order to really utilize it you would need a second rescuer who is trained on it and the odds of that are next to none.

However, if the scenario only called for breathing for the patient then a BVM would be a good choice.
Or, if you mean after CPR has been done or an AED has been used and you have moved onto solely breathing then yes, I can see the BVM being a good choice.

In reality though, it's a royal PITA to maintain a patent airway (head-tilt or jaw-thrust) while also getting a good seal on the mask and breathing adequately without a second rescuer there.

As far as the Israeli bandage goes, I have a 6" one in my kit as we speak and a 4" that is on backorder and should be here Monday.

Only downside is they are very bulky and not easily stored in a case that is already stuffed full with other goodies.

I'll be making a trip to my local drug store today, as soon as my check clears, to get the other odds and ends stuff that I need.
I may also get enough to stock my Adventure Medical Weekender kit as a quick jump kit in addition to the main BLS kit - we'll see what I find at the med store today.

Time for sleep - just got off work an hour ago...I need my beauty rest.

Fink

22RUCRAZY · 09-25-2009, 06:04 AM

When your really in the middle of no where like 6 hours from help youll be glad youv got some morphine (pill form) I dont recomend this for the mall type city trucks that never see the trail but in the real world away from the city we dont have shiny fire trucks to come help you . Be prepared or die

muddpigg · 09-25-2009, 07:16 AM

I disagree, a bvm is a lifesaver. No you do not have to have O2 to operate it. If your talking trauma and trying to rescue solo wouldn't want to be that guy. As for size the it is colapsable. No if it is at the point of injury huffing on someone till EMS gets there in 4-8min is doable. But for an offroad situation where you my have to render aide and sustain it for any length of time. No. The reason we place NPA is provide a passage for air to pass through, shoot I'm going to place two one in each nostril. Once an airway is placed an you get go raise and fall the need for holding chin lift jaw thrust is not as important as C-spine. Believe me this is an item that I'll carry in an aide bag that is smaller that those pelican cases.

22ru- I've heard this aurgument from people before " its a good thing that I had (vicodin/percocet/diluadid/morphine/etc) cause I fell and it hurt. I couldn't have done it without whatever pain med" I really think it is an excuse to pop pills. There are several instances were pain meds are going to worsen or mask life threatening conditions. Besides if your pateint is complaining of pain it gives you a good assessment tool.

**aviator** · 09-25-2009, 08:52 AM

Exactly one of my points mudd... if you do need to carry a pain killer you are generally far better off with plain old ASA [aspirin] or Tylenol just remember each has it's own problems. Tylenol is very hard on the liver and may have allergy issues. ASA is generally not an issue allergy wise but is a blood thinner and so may cause problems with blood clotting but on the other hand it is also an anti-inflammatory and may aid recovery from sprains/strains and other soft tissue injuries. While both of these OTC drugs may have side effect/drug interaction/reaction issues either of them would be a better choice then the hard scrip pain killers. In a survival situation another option you can try is a placebo [ie sugar pill] tell the patient it is {morphine/vicodin/percocet/ whatever} and really "sell it" and you may be surprised what the human mind can do.
In any case if you are in an urban/rural setting where EMS services are available within say... an hour response time you should not administer any drugs unless advised to do so by a doc./medic/poison control centre... concentrate on the ABCs, and try to control any bleeding and wait for trained EMS to arrive. If you do give any kind of drug make a note of what, how much, and when you gave it EMS will need this info to prevent over dosing and to aid treatment.

If you are in the back country or a disaster situation [ie Katrina] and EMS may be several hours or even days away you may need to do more but again avoid giving meds unless advised to do so by a competent professional. Remember if you act on your own and give the wrong drug/treatment you can be successfully sued no matter what the outcome, if you are acting on the direction of a medical professional you have a defense, without it you are SOL.

Also don't forget CPR certs. need to be renewed once a year to stay current.
Make First Aid/CPR training part of your seasonal preparation the same as getting the rig ready for the trail.

**4x4Fink** · 09-25-2009, 05:16 PM

Quote:

Originally Posted by 22RUCRAZY

When your really in the middle of no where like 6 hours from help youll be glad youv got some morphine (pill form) I dont recomend this for the mall type city trucks that never see the trail but in the real world away from the city we dont have shiny fire trucks to come help you . Be prepared or die

Again, morphine is considered a narcotic and you cannot get it unless you have a prescription for it.
Even then, that prescription would be in your name - as soon as you administer or let somebody else take that drug you have then committed a crime.
Rules like that can vary state-to-state however I don't see it being legal in many.

Similar to carrying O2, some states are more lax about it than others - in some you have to have a script or medical direction.

Quote:

Originally Posted by muddpigg

I disagree, a bvm is a lifesaver. No you do not have to have O2 to operate it. If your talking trauma and trying to rescue solo wouldn't want to be that guy. As for size the it is colapsable. No if it is at the point of injury huffing on someone till EMS gets there in 4-8min is doable. But for an offroad situation where you my have to render aide and sustain it for any length of time. No. The reason we place NPA is provide a passage for air to pass through, shoot I'm going to place two one in each nostril. Once an airway is placed an you get go raise and fall the need for holding chin lift jaw thrust is not as important as C-spine. Believe me this is an item that I'll carry in an aide bag that is smaller that those pelican cases.

22ru- I've heard this aurgument from people before " its a good thing that I had (vicodin/percocet/diluadid/morphine/etc) cause I fell and it hurt. I couldn't have done it without whatever pain med" I really think it is an excuse to pop pills. There are several instances were pain meds are going to worsen or mask life threatening conditions. Besides if your pateint is complaining of pain it gives you a good assessment tool.

If you're talking about a lengthy response time then yes, a BVM would be a good choice.
I was merely saying that your average Joe, 9-5'er going to and from work that may or may not roll up on a wreck once a year does not need to carry one.

If you're looking at a 10min+ ALS response time then yeah, you're going to be hurting.

Also, I agree that I would not want to be a sole rescuer on a trauma patient.
However, I'm not going to assume that there will be other people around that are willing to help, much less be trained or have the know-how to.

I'm not saying it's a bad idea to carry one, ask anybody that knows me, I carry way more than I need to and I am all about preparedness.
If you have the room and the funds to buy it, why not?
I will carry one eventually I'm sure.

I also completely agree with you about the medications.
Medications being administered or "offered" by somebody who is not a licensed Paramedic is a very bad idea.

In most states the "Good Samaritan" act/law will protect you but you have to be very careful with it.
Don't just rip open some Benadryl and offer it to somebody because they are swelling up a little bit and might have been bitten by something or eaten something they're allergic to.
There could be a million different variables that you are simply not aware of.

Sure, if you gave them the drug and they instantly felt better and they were back to normal they will give you some respect and a pat on the back.
But, if you gave them the drug and they had a violent reaction or it made their condition worse and they died you might be getting a, "You got a purty mouth..." in jail versus the pat on the back.

Quote:

Originally Posted by aviator

Exactly one of my points mudd... if you do need to carry a pain killer you are generally far better off with plain old ASA [aspirin] or Tylenol just remember each has it's own problems. Tylenol is very hard on the liver and may have allergy issues. ASA is generally not an issue allergy wise but is a blood thinner and so may cause problems with blood clotting but on the other hand it is also an anti-inflammatory and may aid recovery from sprains/strains and other soft tissue injuries. While both of these OTC drugs may have side effect/drug interaction/reaction issues either of them would be a better choice then the hard scrip pain killers. In a survival situation another option you can try is a placebo [ie sugar pill] tell the patient it is {morphine/vicodin/percocet/ whatever} and really "sell it" and you may be surprised what the human mind can do.
In any case if you are in an urban/rural setting where EMS services are available within say... an hour response time you should not administer any drugs unless advised to do so by a doc./medic/poison control centre... concentrate on the ABCs, and try to control any bleeding and wait for trained EMS to arrive. If you do give any kind of drug make a note of what, how much, and when you gave it EMS will need this info to prevent over dosing and to aid treatment.

If you are in the back country or a disaster situation [ie Katrina] and EMS may be several hours or even days away you may need to do more but again avoid giving meds unless advised to do so by a competent professional. Remember if you act on your own and give the wrong drug/treatment you can be successfully sued no matter what the outcome, if you are acting on the direction of a medical professional you have a defense, without it you are SOL.

Also don't forget CPR certs. need to be renewed once a year to stay current.
Make First Aid/CPR training part of your seasonal preparation the same as getting the rig ready for the trail.

You hit the nail on the head Paul and beat me to it - an attempt at a placebo is a fantastic idea.
The mind, as Paul said is an amazingly powerful thing and can have a bigger impact on a patients status than any medication you can buy other than maybe anesthesia.

Feeling pain is a good thing, in moderation.
If you can see that they have a severe arterial bleed in their leg due to a bad laceration and they can't feel it, you may have a much bigger problem on your hands than just bleed control.

Remember the ABC's and focus on that - that is what saves lives.

Fink

muddpigg · 09-26-2009, 02:18 AM

tickticktick I'd like to say holy . Oops I said it.

**4x4Fink** · 09-26-2009, 02:57 AM

Quote:

Originally Posted by muddpigg

tickticktick I'd like to say holy . Oops I said it.

muddpigg · 09-26-2009, 12:10 PM

Quote:

Originally Posted by 4x4Fink

Feeling pain is a good thing, in moderation.
If you can see that they have a severe arterial bleed in their leg due to a bad laceration and they can't feel it, you may have a much bigger problem on your hands than just bleed control.

Remember the ABC's and focus on that - that is what saves lives.

Fink

If someone can verbalize their pain or lack of it. You assessed the airway and breathing (airway has to open to speack and air movement over the vocal cord produce sound). If their speech is apropriate then thein mentating meaning the brain is getting oxygen so circulation is assess. But if you don't stop arterial bleeding you are not going to have to worry about the ABC's.

I can make an airway
I can breath for them
I can circulate their blood
but I can not put blood they've lost back into the body.
I can save a life without pain meds

Pain doesn't kill people but it does become a distraction to us and not having the expereince to not be distracted cause life threatening injuries to do get overlooked. our equipment can become a distraction so keep it simple. As far as meds go, only a provider can prescribe them (DR, PA Nurse practicioner). I paramedic is not a provider so they are acting under a providers licence, thats why they are protocals and directives.

As long as they are complaining about pain they're making my job easier as I can constantly assess the ABC's without touching them. Its when they are not complaining that things get hairy.

I don't give a damn it you carry an intire trauma bay in the back of your truck. If you lack the basic skills and expereince its all useless. Text book answers are great for test.

**aviator** · 09-26-2009, 12:14 PM

Quote:

Originally Posted by muddpigg

tickticktick I'd like to say holy . Oops I said it.

What????

muddpigg this is aviator actual your communication received but not understood please clarify and re-transmit...

**aviator** · 09-26-2009, 12:26 PM

Good points on the ABC assessment mudd... if they're complaining they're breathing ok... aside from controlling bleeding another thing that needs to be watched for that has'nt come up yet is shock.
Shock needs to be watched for because it can kill. Even with a relatively minor injury. Management and prevention can be a simple as keeping the victim calm and wrapped or covered with a blanket. If you don't have a blanket you can use a coat or a tarp or even an unrolled tent.
Try to keep the victim conscious and awake by talking to them, any topic is good... cheating F1 teams, football, weather, family, anything.

**4x4Fink** · 09-26-2009, 01:24 PM

These are all good points but I just realized how far off-topic we have taken Lamm's thread.

Lamm, if you want any of our discussion deleted or taken out of view to clean up your thread just ask and I'll do it.
It's a good discussion regardless.

Fink

muddpigg · 09-26-2009, 08:02 PM

X2 on the off topic.

Aviator, I was shaking my head at the example given.

**aviator** · 09-27-2009, 01:18 PM

x3 on the off topic

at least us perps are fessin' up

mudd thanks for the clarification... I figured it was something like that or else you had a sudden case of daddy brain...

muddpigg · 09-27-2009, 05:09 PM

I can come across much more harsh on this subject than what is needed. I'm still toned down from some that taught me. I have had some unique expereinces and been very fortunate to have worked along side trauma surgeons and ER docs on a first name basis, though the NCO in me would not let me do such madness

Perhaps we should start a new thread on this or similar subject.

4x4Lamm · 09-28-2009, 11:35 AM

Jeez, I leave for a few days and look what happens

I think it's important to understand the intended idea and application of your medical kit. One kit is not necessarily the end all be all med kit. The fact that I am a paramedic does not change the type of first aid I would do for friends, family and loved ones at home, on an outdoor excursion or the like.

MOST of the items in my kit are not for LIFESAVING, I can't recall the last patient I brought back with 400 mg of Motrin but it's really nice at the end of a long day of snowboarding when your legs are sore as all get out. The thing to remember is that as a municipal or military medic your efforts will be for lifesaving most of the time. When you are the "first aid" guy in your group your objectives may be a bit different.

Aside from the things you should not be without and other "basics" the stuff in my kit is selected from my experience in Boy Scouts and later working at the "health officer" at a very large scout ranch.

No need to "scrub" the thread though. Discussion is healthy and entertaining

4x4Lamm

**aviator** · 09-28-2009, 02:11 PM

No worries mudd... we are all products of our training and experiences...
I did'nt think you were pushing the envelope at all... just stating your position.

Good points Lamm... it all depends on what your definition/purpose of the first aid kit is. You can offer the medications to the person but they must be the ones to accept them after an informed choice is made by them. You can't just say, "here take this" or force something down them. The one exception to this rule would perhaps be the ipecac or something else as directed by the poison control centre or giving them one of their own nitro pills or epi-pens.

off topic but I just had a thought... I wonder who was the first doc to think... "This patient is having a heart attack... I know! I'll give him a shot of high explosive! that'll fix him!"

muddpigg · 09-28-2009, 04:46 PM

Lamm I disagree with you on more areas than one. An Army medic is the Dr, nurse, counsoller, public health, well alot of stuff but this is only if the medic is worth their salt. If they are they are called Doc if not they just don't get called.

What are you going to save with a wound stapler. I have never closed a wound unless it is 100% clean, nothing in a wilderness setting is clean. We give Abx at the point of injury. Staples can not properly close a deep wound. So you close a wound an abscess forms which can turn to infection and infection to sepsis. If its that bad and a higher level of care is not availible for a prolonged time. I'm going to go with secondary intension so I can monitor and prevent infection.

Charcoal has fallen out of favor. An NG with suction is the standard of care. What does charcoal do? absorbs, yes quite a bit comes right back up but what doesn't continues through the digestive tract. What does the intestines particlury (sp?) lg intestines do? Reabsorbsion. This will release the toxins into the blood system. Not to mention if your off duty and charcaol is in you onduty practice, you use it and the pt aspirates. You now have a person that was sick but now is FTD (fixing to die). Same with the ipicac but it also has coronary risk in some people.

H2O2 has also fallen out of favor as it damages cells and prolongs healing. Clorohexidine glucogen is the standard.

Immodiom can cause issues as if the cause of diarrhea is not known them it stops the bodies nature response to parasites. As the nasties now stay in the bowel the GI lining becomes more permiable to the toxins and causitive agents. This leads to sepsis.

So you talk of life saving but the only ASA you carry is in the Goody's which has caffeniene too. 81 to 325mg ASA is standard for a heart attack but the last thing a stuggling heart needs is a neuro stimulant.

I carry IV fluids too, but am reserved to only using them on military, family, or close friends. If its really bad I'm going to gain IV access in my secondary ABC sweep. As the body starts to compensate the periphere vessels shunt so only a central line will need to be placed. Way out of my scope. Though a venous cutdown to gain access is but I'm not confident nor compident in such things, yet.

I got things to go do so will have to pick this up later. I do agree that the first aide kit should be tailored to your needs. Please look the things I've said up if I'm wrong well it won't be the first time, but I'm not. If this is your personal aide setup the legalities and consequences of using such things could cost you more than a reputation.

**4x4Fink** · 09-28-2009, 09:44 PM

Quote:

Originally Posted by muddpigg

Lamm I disagree with you on more areas than one. An Army medic is the Dr, nurse, counsoller, public health, well alot of stuff but this is only if the medic is worth their salt. If they are they are called Doc if not they just don't get called.

What are you going to save with a wound stapler. I have never closed a wound unless it is 100% clean, nothing in a wilderness setting is clean. We give Abx at the point of injury. Staples can not properly close a deep wound. So you close a wound an abscess forms which can turn to infection and infection to sepsis. If its that bad and a higher level of care is not availible for a prolonged time. I'm going to go with secondary intension so I can monitor and prevent infection.

Charcoal has fallen out of favor. An NG with suction is the standard of care. What does charcoal do? absorbs, yes quite a bit comes right back up but what doesn't continues through the digestive tract. What does the intestines particlury (sp?) lg intestines do? Reabsorbsion. This will release the toxins into the blood system. Not to mention if your off duty and charcaol is in you onduty practice, you use it and the pt aspirates. You now have a person that was sick but now is FTD (fixing to die). Same with the ipicac but it also has coronary risk in some people.

H2O2 has also fallen out of favor as it damages cells and prolongs healing. Clorohexidine glucogen is the standard.

Immodiom can cause issues as if the cause of diarrhea is not known them it stops the bodies nature response to parasites. As the nasties now stay in the bowel the GI lining becomes more permiable to the toxins and causitive agents. This leads to sepsis.

So you talk of life saving but the only ASA you carry is in the Goody's which has caffeniene too. 81 to 325mg ASA is standard for a heart attack but the last thing a stuggling heart needs is a neuro stimulant.

I carry IV fluids too, but am reserved to only using them on military, family, or close friends. If its really bad I'm going to gain IV access in my secondary ABC sweep. As the body starts to compensate the periphere vessels shunt so only a central line will need to be placed. Way out of my scope. Though a venous cutdown to gain access is but I'm not confident nor compident in such things, yet.

I got things to go do so will have to pick this up later. I do agree that the first aide kit should be tailored to your needs. Please look the things I've said up if I'm wrong well it won't be the first time, but I'm not. If this is your personal aide setup the legalities and consequences of using such things could cost you more than a reputation.

I think a lot of treatment is based on personal experiences and the training one has received.
What we do on the street is all part of whatever protocols our individual services/agencies have/follow.

Certain agencies still use certain products/medications/techniques which are all based on individual medical direction - on-line or off-line.

If you feel confident using a product or have had success with a certain product then use it, as long as it is within your scope/standard then there's not a problem.

Lamm,

When you get a chance can you take some more pics of what you have stored where?
I'm still having a hard time getting all my crap organized.

Thanks!

Fink

muddpigg · 09-29-2009, 09:16 AM

Quote:

Originally Posted by 4x4Fink

I think a lot of treatment is based on personal experiences and the training one has received.
What we do on the street is all part of whatever protocols our individual services/agencies have/follow.

Certain agencies still use certain products/medications/techniques which are all based on individual medical direction - on-line or off-line.

If you feel confident using a product or have had success with a certain product then use it, as long as it is within your scope/standard then there's not a problem.

Lamm,

When you get a chance can you take some more pics of what you have stored where?
I'm still having a hard time getting all my crap organized.

Thanks!

Fink

Fink you can do what you please and I'm sure someone somewhere is still practicing blood letting. But if something goes wrong you are liable. Me personally, I think that the worst thing I can do is cause harm to someone who trusted me to help. You should check into swankhealth.com sign up and get your ccu's or broaden your knowledge base.

The reason things fallout of favor from being a standard of care is for a reason, sometimes those reasons are learned the hardway. Its hard enough to stay on top of a field that is constantly changing. But if you choose to ignore it and not maintain your knowledge base than you are willingly endangering people.

Yes some system are a bit dated and not just small systems. It is our personal responsiblity to do everything in our power to make things better not to simply follow the status quo. Some systems fall to a form of knowlegde incest, knowledge like the gene pool suffers when it gets to shallow.

09-24-2009, 04:26 PM	#2 (permalink)
4x4Fink Super Moderator Staff Join Date: Jul 2003 Location: Centerton, AR Posts: 5,952	I'm literally putting my kit together as we speak. I've got the 1500EMS and the 1200. The airway kit was easy and is already put together, I still need to get the manual suction. I've already got three bulb syringes in various sizes. Would you mind shooting a pic of the second layer of the plastic organizer in the 1500 case? I'm trying to get everything organized and I can't decide how I want to arrange it all. I'm about to make a run to Walgreens to get the band-aid and general bandaging/dressing stuff. Mine will be strictly a BLS kit since I can't do all the cool stuff that Paramedics can. I'll post mine up when I get done - it will be very similar to Lamm's though. Thanks Lamm! Fink __________________ 1985 4Runner 22RE 4WD "Ratchet" 2007 Tacoma Double Cab SB 4x4 V6 TRD Sport AR-TTORA "My work number is 9-1-1."

09-24-2009, 05:10 PM	#4 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Morphine can be dangerous and AFAIK it's also a schedule 1 controlled narcotic. In other words unless you have a scrip. don't have it on you when the cops stop you 22R. Hope everyone reads your note Lamm some of your goodies could do more harm then good if folks don't know what they're doing. I was trained to do some advanced things as an EMS Pilot so I could "assist the medic" in situations where the patient was going sour... [never had to us it yet] but I still would'nt try to use half those things. If you're going into the serious back country take Lamm's advice and get some training. __________________ Silver 1994 Hilux Xtra cab 4x4 3.0 K&N cone filter, ported MAF, advanced timing, oversize exhaust, free flow cat, "rumble" muffler custom covered SR5 seats, map lights, factory AC tv4184 style black interior conversion started mods to come... header, custom centre console, stereo upgrade tinted windows Founding member 1972TLC fan club - Get well soon Mary Toyota Hilux... Get in or Get out of the way.

09-24-2009, 10:53 PM	#6 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	You guys ought to look into a BVM to throw into your kits. A face mask is good but can huff yourself to exhuastion quickly. I BVM w/o O2 is still 21%. Shoot if your offroad it may take quite a while for FD, EMS, or medivac to reach you. I don't carry any meds other than topical. Fink: your 100% right ACLS is pushing good CPR over any med. I like the 60CC non luer loc syringe with an NPA placed on the end for suction. You can trim the ends to get better bore for the "chunky stuff" Ya'll ought to look at the Isreali dressing, its like the trauma bandage attached to an acewrap. Awesome for pressure dressings and getting those hard to bandage wounds like ingenial and armpit, takes some creativity and practice but very doable. They took the quick clot away from us and reissued another coag bandabe packed in gauze. Quick clot burns the tissue and can cause more damage. Plus the powder is great in the lab but has a tendency to blow in the wind. You don't want it in your eyes. I'd get rid of the stapler too, we don't want to close anything in the field that is what ER but perferribly ORs are for. I'd toss in another tournique too, as you know one is never released and occasions do arrise that ones just no enough. Though I am a fan of cravaets a CAT is so much easier. Ippecacc has fallen out of favor. Its getting late and I'm tired. Don't intend on starting a firestorm but I see concerns in your kit. I don't work for you system. I didn't go into much of the med list, its late. I do agree that an EMT class is a good investment. If you feel you need me to post my acrynyms I will. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

09-25-2009, 07:16 AM	#9 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	I disagree, a bvm is a lifesaver. No you do not have to have O2 to operate it. If your talking trauma and trying to rescue solo wouldn't want to be that guy. As for size the it is colapsable. No if it is at the point of injury huffing on someone till EMS gets there in 4-8min is doable. But for an offroad situation where you my have to render aide and sustain it for any length of time. No. The reason we place NPA is provide a passage for air to pass through, shoot I'm going to place two one in each nostril. Once an airway is placed an you get go raise and fall the need for holding chin lift jaw thrust is not as important as C-spine. Believe me this is an item that I'll carry in an aide bag that is smaller that those pelican cases. 22ru- I've heard this aurgument from people before " its a good thing that I had (vicodin/percocet/diluadid/morphine/etc) cause I fell and it hurt. I couldn't have done it without whatever pain med" I really think it is an excuse to pop pills. There are several instances were pain meds are going to worsen or mask life threatening conditions. Besides if your pateint is complaining of pain it gives you a good assessment tool. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

09-25-2009, 08:52 AM	#10 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Exactly one of my points mudd... if you do need to carry a pain killer you are generally far better off with plain old ASA [aspirin] or Tylenol just remember each has it's own problems. Tylenol is very hard on the liver and may have allergy issues. ASA is generally not an issue allergy wise but is a blood thinner and so may cause problems with blood clotting but on the other hand it is also an anti-inflammatory and may aid recovery from sprains/strains and other soft tissue injuries. While both of these OTC drugs may have side effect/drug interaction/reaction issues either of them would be a better choice then the hard scrip pain killers. In a survival situation another option you can try is a placebo [ie sugar pill] tell the patient it is {morphine/vicodin/percocet/ whatever} and really "sell it" and you may be surprised what the human mind can do. In any case if you are in an urban/rural setting where EMS services are available within say... an hour response time you should not administer any drugs unless advised to do so by a doc./medic/poison control centre... concentrate on the ABCs, and try to control any bleeding and wait for trained EMS to arrive. If you do give any kind of drug make a note of what, how much, and when you gave it EMS will need this info to prevent over dosing and to aid treatment. If you are in the back country or a disaster situation [ie Katrina] and EMS may be several hours or even days away you may need to do more but again avoid giving meds unless advised to do so by a competent professional. Remember if you act on your own and give the wrong drug/treatment you can be successfully sued no matter what the outcome, if you are acting on the direction of a medical professional you have a defense, without it you are SOL. Also don't forget CPR certs. need to be renewed once a year to stay current. Make First Aid/CPR training part of your seasonal preparation the same as getting the rig ready for the trail. __________________ Silver 1994 Hilux Xtra cab 4x4 3.0 K&N cone filter, ported MAF, advanced timing, oversize exhaust, free flow cat, "rumble" muffler custom covered SR5 seats, map lights, factory AC tv4184 style black interior conversion started mods to come... header, custom centre console, stereo upgrade tinted windows Founding member 1972TLC fan club - Get well soon Mary Toyota Hilux... Get in or Get out of the way. Last edited by aviator; 09-25-2009 at 08:56 AM.

09-24-2009, 04:40 PM	#3 (permalink)
22RUCRAZY Registered User Join Date: Sep 2009 Location: northern california Posts: 113	Saftey first hell yah i would include a survival kit you know knife matches meals ready to eat that sort of thing oh and morphine

09-25-2009, 06:04 AM	#8 (permalink)
22RUCRAZY Registered User Join Date: Sep 2009 Location: northern california Posts: 113	When your really in the middle of no where like 6 hours from help youll be glad youv got some morphine (pill form) I dont recomend this for the mall type city trucks that never see the trail but in the real world away from the city we dont have shiny fire trucks to come help you . Be prepared or die

09-26-2009, 02:18 AM	#12 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	tickticktick I'd like to say holy . Oops I said it. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

09-26-2009, 12:26 PM	#16 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Good points on the ABC assessment mudd... if they're complaining they're breathing ok... aside from controlling bleeding another thing that needs to be watched for that has'nt come up yet is shock. Shock needs to be watched for because it can kill. Even with a relatively minor injury. Management and prevention can be a simple as keeping the victim calm and wrapped or covered with a blanket. If you don't have a blanket you can use a coat or a tarp or even an unrolled tent. Try to keep the victim conscious and awake by talking to them, any topic is good... cheating F1 teams, football, weather, family, anything. __________________ Silver 1994 Hilux Xtra cab 4x4 3.0 K&N cone filter, ported MAF, advanced timing, oversize exhaust, free flow cat, "rumble" muffler custom covered SR5 seats, map lights, factory AC tv4184 style black interior conversion started mods to come... header, custom centre console, stereo upgrade tinted windows Founding member 1972TLC fan club - Get well soon Mary Toyota Hilux... Get in or Get out of the way.

09-26-2009, 01:24 PM	#17 (permalink)
4x4Fink Super Moderator Staff Join Date: Jul 2003 Location: Centerton, AR Posts: 5,952	These are all good points but I just realized how far off-topic we have taken Lamm's thread. Lamm, if you want any of our discussion deleted or taken out of view to clean up your thread just ask and I'll do it. It's a good discussion regardless. Fink __________________ 1985 4Runner 22RE 4WD "Ratchet" 2007 Tacoma Double Cab SB 4x4 V6 TRD Sport AR-TTORA "My work number is 9-1-1."

09-26-2009, 08:02 PM	#18 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	X2 on the off topic. Aviator, I was shaking my head at the example given. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

09-27-2009, 01:18 PM	#19 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	x3 on the off topic at least us perps are fessin' up mudd thanks for the clarification... I figured it was something like that or else you had a sudden case of daddy brain... __________________ Silver 1994 Hilux Xtra cab 4x4 3.0 K&N cone filter, ported MAF, advanced timing, oversize exhaust, free flow cat, "rumble" muffler custom covered SR5 seats, map lights, factory AC tv4184 style black interior conversion started mods to come... header, custom centre console, stereo upgrade tinted windows Founding member 1972TLC fan club - Get well soon Mary Toyota Hilux... Get in or Get out of the way.

09-27-2009, 05:09 PM	#20 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	I can come across much more harsh on this subject than what is needed. I'm still toned down from some that taught me. I have had some unique expereinces and been very fortunate to have worked along side trauma surgeons and ER docs on a first name basis, though the NCO in me would not let me do such madness Perhaps we should start a new thread on this or similar subject. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

09-28-2009, 11:35 AM	#21 (permalink)
4x4Lamm Registered User Join Date: Nov 2003 Location: Canton, Ohio Posts: 2,573	Jeez, I leave for a few days and look what happens I think it's important to understand the intended idea and application of your medical kit. One kit is not necessarily the end all be all med kit. The fact that I am a paramedic does not change the type of first aid I would do for friends, family and loved ones at home, on an outdoor excursion or the like. MOST of the items in my kit are not for LIFESAVING, I can't recall the last patient I brought back with 400 mg of Motrin but it's really nice at the end of a long day of snowboarding when your legs are sore as all get out. The thing to remember is that as a municipal or military medic your efforts will be for lifesaving most of the time. When you are the "first aid" guy in your group your objectives may be a bit different. Aside from the things you should not be without and other "basics" the stuff in my kit is selected from my experience in Boy Scouts and later working at the "health officer" at a very large scout ranch. No need to "scrub" the thread though. Discussion is healthy and entertaining 4x4Lamm __________________ -1992 4Runner SR5, Destroyed by fire. Lots of mods. I will miss it. -1995 4Runner SR5 Limited, Also known as the money pit. Becoming a trail rig now. -2004 Tacoma SR5 TRD, My new daily driver. I love this truck! Last edited by 4x4Lamm; 09-28-2009 at 11:41 AM.

09-28-2009, 02:11 PM	#22 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	No worries mudd... we are all products of our training and experiences... I did'nt think you were pushing the envelope at all... just stating your position. Good points Lamm... it all depends on what your definition/purpose of the first aid kit is. You can offer the medications to the person but they must be the ones to accept them after an informed choice is made by them. You can't just say, "here take this" or force something down them. The one exception to this rule would perhaps be the ipecac or something else as directed by the poison control centre or giving them one of their own nitro pills or epi-pens. off topic but I just had a thought... I wonder who was the first doc to think... "This patient is having a heart attack... I know! I'll give him a shot of high explosive! that'll fix him!" __________________ Silver 1994 Hilux Xtra cab 4x4 3.0 K&N cone filter, ported MAF, advanced timing, oversize exhaust, free flow cat, "rumble" muffler custom covered SR5 seats, map lights, factory AC tv4184 style black interior conversion started mods to come... header, custom centre console, stereo upgrade tinted windows Founding member 1972TLC fan club - Get well soon Mary Toyota Hilux... Get in or Get out of the way. Last edited by aviator; 09-28-2009 at 02:15 PM.

09-28-2009, 04:46 PM	#23 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	Lamm I disagree with you on more areas than one. An Army medic is the Dr, nurse, counsoller, public health, well alot of stuff but this is only if the medic is worth their salt. If they are they are called Doc if not they just don't get called. What are you going to save with a wound stapler. I have never closed a wound unless it is 100% clean, nothing in a wilderness setting is clean. We give Abx at the point of injury. Staples can not properly close a deep wound. So you close a wound an abscess forms which can turn to infection and infection to sepsis. If its that bad and a higher level of care is not availible for a prolonged time. I'm going to go with secondary intension so I can monitor and prevent infection. Charcoal has fallen out of favor. An NG with suction is the standard of care. What does charcoal do? absorbs, yes quite a bit comes right back up but what doesn't continues through the digestive tract. What does the intestines particlury (sp?) lg intestines do? Reabsorbsion. This will release the toxins into the blood system. Not to mention if your off duty and charcaol is in you onduty practice, you use it and the pt aspirates. You now have a person that was sick but now is FTD (fixing to die). Same with the ipicac but it also has coronary risk in some people. H2O2 has also fallen out of favor as it damages cells and prolongs healing. Clorohexidine glucogen is the standard. Immodiom can cause issues as if the cause of diarrhea is not known them it stops the bodies nature response to parasites. As the nasties now stay in the bowel the GI lining becomes more permiable to the toxins and causitive agents. This leads to sepsis. So you talk of life saving but the only ASA you carry is in the Goody's which has caffeniene too. 81 to 325mg ASA is standard for a heart attack but the last thing a stuggling heart needs is a neuro stimulant. I carry IV fluids too, but am reserved to only using them on military, family, or close friends. If its really bad I'm going to gain IV access in my secondary ABC sweep. As the body starts to compensate the periphere vessels shunt so only a central line will need to be placed. Way out of my scope. Though a venous cutdown to gain access is but I'm not confident nor compident in such things, yet. I got things to go do so will have to pick this up later. I do agree that the first aide kit should be tailored to your needs. Please look the things I've said up if I'm wrong well it won't be the first time, but I'm not. If this is your personal aide setup the legalities and consequences of using such things could cost you more than a reputation. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

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