A Paramedics First Aid Kit - Page 2

muddpigg · 09-29-2009, 09:18 AM

Oh I made a mistake on my earlier post its Chlorohexidine gluconate not glucogon. Hit me lastnight when I layed down.

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**aviator** · 09-29-2009, 05:31 PM

Whoa boys serious technical discussions going on here, way way above the level of the average reader here...
you probably lost most of them at charcoal and staples... let alone Chlorohexidine Gluconate lol...

You are right guys standards of care and treatments change that's why you need to redo your CPR yearly and first aid bi-annually (min). CPR/choking methods have changed a lot since I did my initial cert. 15+yrs ago.
Personally I use good old Bayer ASA [caff. free according to the labels I've read.] 86mg dose is generally sold as "childrens aspirin" for anyone who wants to know.
Some thing no one mentioned as a quick fix for minor cuts is "super Glue" athletes use it all the time. but make sure the wound is clean first like mudd said sepsis is bad.

VSU_4runnin · 09-29-2009, 07:31 PM

another simple trail aneseptic is deodorant, pack that into a cut then use super glue, its crude but it works. And if you can care for it is codorizing. its quite painful, but if you can keep it clean and covered it works.

muddpigg · 09-29-2009, 11:03 PM

VSU: I heard it was vagisil, and midol will stop the pain.

Guys I'm going to cut it short tonight want to research some trailer stuff and the ambien will kick in soon

4x4Lamm · 10-01-2009, 12:08 PM

Muddpigg no hard feelings but either I'm not sending clearly or you are not receiving clearly on some things it seems.

I'm not certain I'm going to "save" anybody with a wound stapler. The kit does contain equipment and fluid to irrigate and clean a wound. I picked it up for a few bucks at Cabelas of all places figuring if I ever felt the need to close a wound with more than steristrips the stapler was at least sterile. Lots of people use a standard sewing kit or even fishing tackle. I had the chance to staple a few lacs during my clinical time and it was dang easy. I'm not planning to cut myself one day, staple it up and call it a day if that is what you are thinking. I would of course seek difinitive care ASAP.

As for charcoal, it's a lot easier to carry and affordable compared to an NG tube. Plus the fact that I am not trained or permitted to use an NG tube. All the things I have been taught about activated charcoal is that it will reduce the ammont of poison absorbed by 50%-60%. Better than 100% and people vomit all the time with or without drinking it, you still have to manage an airway at all times so I don't see that concern as valid. As far as I know the poison control center still instructs people to eat "burnt toast" for some things and for providers to administer charcoal if avalible.

Ipicac is also useful in some cases. Example, a camping trip I was one once. The camp staff delivered pre-packed dinners for a meal one night. Although nothing tasted rotten something was funky with that meal, maybe the milk got too warm? Anyways after several minutes of wanting to vomit but not being able to myself and a few of my buds drank down a shot of it and threw up soon after, felt 100 times better. A finger in the back of the throat does not work for everyone (myself included).

H202 works well enough for me. I have used it myself for years on simple cuts and scrapes. I'm willing to bet millions of others have too. Clorohexidine gluconate is not the standard anywhere around here because nobody I know has even herd of it.

In my opinion any outdoor adventurer worth thier salt will take and use if needed an anti-diarrheal. Lot's of simple things in the outdoors can cause the squirts, even Taco Bell on occasion. You are viewing the situation from more of a MDs viewpoint than someone who could be struck gravely ill by dehydration in a matter of hours. If you eat too much chili and get the hot poops and don't want to take anything for it that's your choice but not mine.

I'm aware ASA is a frontline drug for possible MI, anyone who has seen a Bayer commercial knows that. That's part of the reason I do infact carry some. It's on the list between nasal decongestant and electrolyte tablets.

I do not carry IV fluids. Not sure where you are getting that from? I carry 3 IV caths for the purpose of a tension pnemo if needed. No op-sites, no fluids, no tubes etc.

One thing that continues to astound with emergency services is how different people in different areas do the job. Under my orders only a Paramedic can intubate even though basics are trained. One county to the south basics intubate fairly often. One county to the north paramedics sedate people with succs and where I work they barely want you to use valium. Some areas stress an OPA and a BVM, others ET anyone that can take it, some stress the LMA etc. I'm sure these differences in education, operations and "standards" would be even more shocking to me in another region of the country or a different application such as military medical or medics working on an oil rig for example. Those differences often seem to lead to squabbles such as this but it's no big deal. This is America, you can have your own opinion and there is clearly "more than one way to skin a cat" in the field of emergency medicine.

Muddpig I (and for that matter the fourm) may benefit from you sharing your general medical kit setup. Clearly you are educated and passionate about the subject. Fink, I'm at work today but I will get you those other pics as soon as I can. Maybe we need a "show off your med-kit" picture thread?

4x4Lamm

**4x4Fink** · 10-01-2009, 02:10 PM

Quote:

Originally Posted by 4x4Lamm

Muddpigg no hard feelings but either I'm not sending clearly or you are not receiving clearly on some things it seems.

I'm not certain I'm going to "save" anybody with a wound stapler. The kit does contain equipment and fluid to irrigate and clean a wound. I picked it up for a few bucks at Cabelas of all places figuring if I ever felt the need to close a wound with more than steristrips the stapler was at least sterile. Lots of people use a standard sewing kit or even fishing tackle. I had the chance to staple a few lacs during my clinical time and it was dang easy. I'm not planning to cut myself one day, staple it up and call it a day if that is what you are thinking. I would of course seek difinitive care ASAP.

As for charcoal, it's a lot easier to carry and affordable compared to an NG tube. Plus the fact that I am not trained or permitted to use an NG tube. All the things I have been taught about activated charcoal is that it will reduce the ammont of poison absorbed by 50%-60%. Better than 100% and people vomit all the time with or without drinking it, you still have to manage an airway at all times so I don't see that concern as valid. As far as I know the poison control center still instructs people to eat "burnt toast" for some things and for providers to administer charcoal if avalible.

Ipicac is also useful in some cases. Example, a camping trip I was one once. The camp staff delivered pre-packed dinners for a meal one night. Although nothing tasted rotten something was funky with that meal, maybe the milk got too warm? Anyways after several minutes of wanting to vomit but not being able to myself and a few of my buds drank down a shot of it and threw up soon after, felt 100 times better. A finger in the back of the throat does not work for everyone (myself included).

H202 works well enough for me. I have used it myself for years on simple cuts and scrapes. I'm willing to bet millions of others have too. Clorohexidine gluconate is not the standard anywhere around here because nobody I know has even herd of it.

In my opinion any outdoor adventurer worth thier salt will take and use if needed an anti-diarrheal. Lot's of simple things in the outdoors can cause the squirts, even Taco Bell on occasion. You are viewing the situation from more of a MDs viewpoint than someone who could be struck gravely ill by dehydration in a matter of hours. If you eat too much chili and get the hot poops and don't want to take anything for it that's your choice but not mine.

I'm aware ASA is a frontline drug for possible MI, anyone who has seen a Bayer commercial knows that. That's part of the reason I do infact carry some. It's on the list between nasal decongestant and electrolyte tablets.

I do not carry IV fluids. Not sure where you are getting that from? I carry 3 IV caths for the purpose of a tension pnemo if needed. No op-sites, no fluids, no tubes etc.

One thing that continues to astound with emergency services is how different people in different areas do the job. Under my orders only a Paramedic can intubate even though basics are trained. One county to the south basics intubate fairly often. One county to the north paramedics sedate people with succs and where I work they barely want you to use valium. Some areas stress an OPA and a BVM, others ET anyone that can take it, some stress the LMA etc. I'm sure these differences in education, operations and "standards" would be even more shocking to me in another region of the country or a different application such as military medical or medics working on an oil rig for example. Those differences often seem to lead to squabbles such as this but it's no big deal. This is America, you can have your own opinion and there is clearly "more than one way to skin a cat" in the field of emergency medicine.

Muddpig I (and for that matter the fourm) may benefit from you sharing your general medical kit setup. Clearly you are educated and passionate about the subject. Fink, I'm at work today but I will get you those other pics as soon as I can. Maybe we need a "show off your med-kit" picture thread?

4x4Lamm

Very well said post, Lamm.

Muddpigg, it seems to me that you may have a military background?
If so then that would completely explain your opinions and experiences with the techniques and medications we've talked about.

The military has pioneered a vast majority of modern medicinal practices and techniques and are the reason that a lot of us street personnel use them today.

Lamm, whenever you get a chance on the pics will be fine.
I got the rest of the stuff from BuyEMP.com today so I'll sort through that and see what I can figure out.

Also, where do you get the individual packets of medications?
I got the Aspirin and Antacid from BuyEMP made by First Aid Only but I can't find decently priced multi-symptom cold medicine, ibuprofen or electrolytes anywhere.
I found some but they are very expensive and come in massive bulk packs.

Fink

muddpigg · 10-01-2009, 04:08 PM

I really need to put a kit back together. As I have been deployed and am having may ankle reconstructed monday d/t injury monday.

You guys are right I am military, the nicest thing about it is great efforts have been put into place to keep my skills fresh.

Chlorhexidine gluconate (I misspelled in earlier post) http://en.wikipedia.org/wiki/Chlorhexidine I scanned this and it is accrurate to my knowledge

As for H2O2 I've worked in the Army's burn center in BAMC well actually its the ISR as it is a hospital within a hospital and this was had long fallen out of favor. Chlorhexidine is used as a scrub to clean with copiuos amounts of fluids. This is what I've used in the ER and feild applications. Yes I've used it many many times myself but it distroys exposed tissue cells and prolongs the healing. But it will still heal.

As far as vomitting being natural and people survive it all the time. But I've worked on more than one person who has aspirated vomitous. Let me tell you gastric juices tear up lung tissue. I have done the ipicac challenge and won the pool, and no aspiration issues for me. But in a sick person protecting an airway is/can be an issue. http://www.poison.org/prepared/ipecac.aspHere is an explanation for you.

https://online.epocrates.com/u/10318...tions+Cautions look at the statement of infectious diarrhea. This is because it can cause major issues and yes major issues can become lifethreating. Here this is a good read. http://emedicine.medscape.com/article/169640-overview

As for wound closure in an outdoors setting. I'd still recommend no. Just because a piece of equipment is packaged still does not mean it will be sterile after it is open till use. Yes, I am fimiliar with working in a sterile field and maintaining one, it can be a challenge in a hospital setting and impossible in a feild setting. I will say again that if not able to bet a person to the hospital I will bandage so I can monitor the wound not close it. Personally I think sometimes in the medical feild we get caught up in fancy toys and ignore the basics. Remember KISS keep it simple stupid

I noticed your IV's for a pnuemo. Why a short 16ga? I carry a 14ga at 3.25" length. In an obese person or someone with a well developed chest shorter caths may not be suffecient. I also want as big a bore as possible. Hell a decompression can be done with an 18ga but the potential to clog or clot increases. Yes the simple answer is throw another on in but with a seriously injured pt I want things as simple as possible as thing will already be complicated. I want my interventions to last as long as possible.

Yes, I am very passionate about my job. To me the worst possible thing is for someone else to pay for my mistake. It has happened and will happen again but I will not facilitate it. I know that the military has pioneered much in the medical field this is one reason I am military and not civilian, I can tell a big difference. I don't mean that to be insulting, but it is my observation.

I also realize that an aide kit packed for family as compared to one for work may/can address different needs and concerns. Yes I do realize what I am allowed to do varies as to where I am, what role I am in, who needs help, and what the situation is.

I encourage in any and all levels of first responder, emt, paramedic, combat lifesaver, medic, nurse, pa, DR to continue to learn. Most hospitals have grand round find them and attend, they even give out CEU's for attending some. Swnakhealth has online classes that are very well prepared. But continue to learn then bring it back and teach it to your crew. Have them do the same. Your care will improve, your service will improve, your patients will improve. So it becomes a win win situation.

Gotta go, helping with homework and my full attention is needed.

**4x4Fink** · 10-01-2009, 04:16 PM

Quote:

Originally Posted by muddpigg

I really need to put a kit back together. As I have been deployed and am having may ankle reconstructed monday d/t injury monday.

You guys are right I am military, the nicest thing about it is great efforts have been put into place to keep my skills fresh.

Chlorhexidine gluconate (I misspelled in earlier post) http://en.wikipedia.org/wiki/Chlorhexidine I scanned this and it is accrurate to my knowledge

As for H2O2 I've worked in the Army's burn center in BAMC well actually its the ISR as it is a hospital within a hospital and this was had long fallen out of favor. Chlorhexidine is used as a scrub to clean with copiuos amounts of fluids. This is what I've used in the ER and feild applications. Yes I've used it many many times myself but it distroys exposed tissue cells and prolongs the healing. But it will still heal.

As far as vomitting being natural and people survive it all the time. But I've worked on more than one person who has aspirated vomitous. Let me tell you gastric juices tear up lung tissue. I have done the ipicac challenge and won the pool, and no aspiration issues for me. But in a sick person protecting an airway is/can be an issue. http://www.poison.org/prepared/ipecac.aspHere is an explanation for you.

https://online.epocrates.com/u/10318...tions+Cautions look at the statement of infectious diarrhea. This is because it can cause major issues and yes major issues can become lifethreating. Here this is a good read. http://emedicine.medscape.com/article/169640-overview

As for wound closure in an outdoors setting. I'd still recommend no. Just because a piece of equipment is packaged still does not mean it will be sterile after it is open till use. Yes, I am fimiliar with working in a sterile field and maintaining one, it can be a challenge in a hospital setting and impossible in a feild setting. I will say again that if not able to bet a person to the hospital I will bandage so I can monitor the wound not close it. Personally I think sometimes in the medical feild we get caught up in fancy toys and ignore the basics. Remember KISS keep it simple stupid

I noticed your IV's for a pnuemo. Why a short 16ga? I carry a 14ga at 3.25" length. In an obese person or someone with a well developed chest shorter caths may not be suffecient. I also want as big a bore as possible. Hell a decompression can be done with an 18ga but the potential to clog or clot increases. Yes the simple answer is throw another on in but with a seriously injured pt I want things as simple as possible as thing will already be complicated. I want my interventions to last as long as possible.

Yes, I am very passionate about my job. To me the worst possible thing is for someone else to pay for my mistake. It has happened and will happen again but I will not facilitate it. I know that the military has pioneered much in the medical field this is one reason I am military and not civilian, I can tell a big difference. I don't mean that to be insulting, but it is my observation.

I also realize that an aide kit packed for family as compared to one for work may/can address different needs and concerns. Yes I do realize what I am allowed to do varies as to where I am, what role I am in, who needs help, and what the situation is.

I encourage in any and all levels of first responder, emt, paramedic, combat lifesaver, medic, nurse, pa, DR to continue to learn. Most hospitals have grand round find them and attend, they even give out CEU's for attending some. Swnakhealth has online classes that are very well prepared. But continue to learn then bring it back and teach it to your crew. Have them do the same. Your care will improve, your service will improve, your patients will improve. So it becomes a win win situation.

Gotta go, helping with homework and my full attention is needed.

I agree with all that has been said and I look forward to reading those links.

Continuing/furthering your education is absolutely key - I plan on getting as many CEU's as I can and taking as many additional courses as I can.

Mudd, if you ever decide to put a kit together be sure to post up what all you carry - should be interesting to see and to get some ideas from.

Fink

muddpigg · 10-01-2009, 10:57 PM

Part of my stuff is Iraq and part in the back of the closet. But sure I'll post pics may give me something to do as I get cut on Monday and the recovery is between 3-6 months. But if they have to graft in ligaments it'll be 3 months of LLE immoblization. Goodtimes.

**aviator** · 10-02-2009, 10:26 AM

Thanks for the links mudd I'm going to look into some of those myself as for "grand rounds" I may have to check with some local teaching hosp. see if it's possible for a first responder/semi-lay person to attend. lol

just look at the 6mos as paternity leave with full pay.
How'd the homework go? learn anything?

4x4Lamm · 10-02-2009, 06:41 PM

Fink, as requested,

Muddpig, goodluck and get well soon!

4x4Lamm

Junkers88 · 10-02-2009, 09:27 PM

Good God! I am (as a prior service ARMY Combat Life Saver {CLS}) so far out of my league after reading this thread. Crap I carry my old CLS bag when I wheel but that isn't much more than 119 assorted bandages/wraps/splints/tape and a stock of morphine shots (don't ask) along with a box of standard medication. Damn I need to rethink my responsibilities to the folks around me when I go wheeling.

Thanks guys, I need to restock, rethink, re-equip and rearm.

**aviator** · 10-02-2009, 10:15 PM

Watch those morphine shots junkman as I recall that stuff does come with an expiry date.

I just had a thought something that has'nt been covered in these kits...
you might want to consider carrying a stock of diaper rash ointment. Not just if you have little kids it also works well on "saddle sores" from long days wheeling (particularly on hot vinyl seats) and is also highly useful for those who are suffering from "redness" after excessive TP usage related to certain "intestinal malfunctions".
It's also good for topical treatment of other chaffing (waist band, shoe etc) as well. And being for little kids it is gentle and has usually has a pleasant fragrance (or non at all) rather then the harsher creams sold for "adult" usage.

Of course if you choose to merely supply the product or apply it for the patient will depend on how well you know and or like them... personally my rule in the latter case is only if they are very young or she is very cute and very single.

muddpigg · 10-02-2009, 11:35 PM

Junker: In my opinion the bandages, splints, and tape are invaluable. Really makes up most of what I carry. The two biggest killers on the battle field are blood loss and pnuemothorax. You always have to keep in mind what you role is. As a first responder what is expected of you and how far is out of bounds. If you go outside of your scope of practice you stand to face legal actions, its your desicion as to what you can live with. In the civilian world I'm an EMT-B IV's aren't in my scope. Military is a whole different ball of wax and deployments are even more so different as to what intervention I can perform.

Aviator: yeah, I did learn from the homework.

If you come across a heart attack quality CPR. Is where its at, defib is golden but I don't carry a defib nor know anyone that does outside of the job. Remember the basics, and a hospital is where these people need to be.

What can we do for a stroke, a TBI, an ABD bleed. All we can do for these people is apply diesel/gas after the basics are performed, they too need the hospital.

What I hope comes out of this discussion is that no kit will compensate for the basics. C-spine and ABC's. The only reason I put c-spine first is it affect how you deal with airway. The basics are most critical.

None of us wheel so far out that we need to perform "field surgery" we are all with in access to some sort of assistance. Though be prepared for a couple hours.

If you wheel in a group and are going to act as a medic then do as we do, find out what conditions people in the group have, allergies, scheduled meds. This will allow you to tailor your kit to the intended audience. What if some one has bad allergic reaction an epipen is going to buy you 20-30 minutes how far out will you be, one or two epipens ain't going to cut it. I tailor my kit to my family and friends I'm with we're all rather young and healthy so trauma is my concern.

Thats what being a medic/EMS is about solving problems, the more we prepare and prethink and plan and train the better the outcome will be when/if something happens. As a medic I am accustom to doing more with less but know that time is of the essense so plan accordingly.

**4x4Fink** · 10-03-2009, 01:32 AM

Quote:

Originally Posted by muddpigg

Junker: In my opinion the bandages, splints, and tape are invaluable. Really makes up most of what I carry. The two biggest killers on the battle field are blood loss and pnuemothorax. You always have to keep in mind what you role is. As a first responder what is expected of you and how far is out of bounds. If you go outside of your scope of practice you stand to face legal actions, its your desicion as to what you can live with. In the civilian world I'm an EMT-B IV's aren't in my scope. Military is a whole different ball of wax and deployments are even more so different as to what intervention I can perform.

Aviator: yeah, I did learn from the homework.

If you come across a heart attack quality CPR. Is where its at, defib is golden but I don't carry a defib nor know anyone that does outside of the job. Remember the basics, and a hospital is where these people need to be.

What can we do for a stroke, a TBI, an ABD bleed. All we can do for these people is apply diesel/gas after the basics are performed, they too need the hospital.

What I hope comes out of this discussion is that no kit will compensate for the basics. C-spine and ABC's. The only reason I put c-spine first is it affect how you deal with airway. The basics are most critical.

None of us wheel so far out that we need to perform "field surgery" we are all with in access to some sort of assistance. Though be prepared for a couple hours.

If you wheel in a group and are going to act as a medic then do as we do, find out what conditions people in the group have, allergies, scheduled meds. This will allow you to tailor your kit to the intended audience. What if some one has bad allergic reaction an epipen is going to buy you 20-30 minutes how far out will you be, one or two epipens ain't going to cut it. I tailor my kit to my family and friends I'm with we're all rather young and healthy so trauma is my concern.

Thats what being a medic/EMS is about solving problems, the more we prepare and prethink and plan and train the better the outcome will be when/if something happens. As a medic I am accustom to doing more with less but know that time is of the essense so plan accordingly.

Hey Lamm,

Where do you get the individual packets of the medications? I can't find any decently priced ones.
I just went to Wal-Mart and got a few of the small bottles of the basic meds - Advil, Excedrine Migraine, Pepto, Benadryl, Baby Aspirin.
Also picked up a crap ton of Band-Aids too - found some good deals on some wound closure strips and fingertip/knuckle ones also.

Still need to get some moleskin bandages though, nobody seems to carry them around here.

Fink

muddpigg · 10-03-2009, 08:29 AM

http://www.1staidsupplies.com/store.php?crn=77 will help fink

http://www.semedicalsupply.com/pulse_oximeters.htm these little tricks are awesome. There is alot that the SPO2 will tell you and invaluible unless CO poisoning is suspected, that prices is awesome. But they're others out there I just pulled the first hit on my search.

A good thermometer is need to, especialy before antipyretics are given.

4x4Lamm · 10-03-2009, 02:00 PM

Fink myself and a few friends split the cost of the meds. As I remember the boxes of about 100 packets or so ran about $10-$15. We split the cost and meds 3 ways.

Lamm

**4x4Fink** · 10-03-2009, 05:36 PM

Quote:

Originally Posted by 4x4Lamm

Fink myself and a few friends split the cost of the meds. As I remember the boxes of about 100 packets or so ran about $10-$15. We split the cost and meds 3 ways.

Lamm

That's a good idea.
Those are the boxes I found too.

Thanks for the links muddpigg, I'll check those out.

Fink

09-29-2009, 05:31 PM	#27 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Whoa boys serious technical discussions going on here, way way above the level of the average reader here... you probably lost most of them at charcoal and staples... let alone Chlorohexidine Gluconate lol... You are right guys standards of care and treatments change that's why you need to redo your CPR yearly and first aid bi-annually (min). CPR/choking methods have changed a lot since I did my initial cert. 15+yrs ago. Personally I use good old Bayer ASA [caff. free according to the labels I've read.] 86mg dose is generally sold as "childrens aspirin" for anyone who wants to know. Some thing no one mentioned as a quick fix for minor cuts is "super Glue" athletes use it all the time. but make sure the wound is clean first like mudd said sepsis is bad. __________________ 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; 09-29-2009 at 05:32 PM.

09-29-2009, 07:31 PM	#28 (permalink)
VSU_4runnin Registered User Join Date: Oct 2008 Location: South Georgia Posts: 657	another simple trail aneseptic is deodorant, pack that into a cut then use super glue, its crude but it works. And if you can care for it is codorizing. its quite painful, but if you can keep it clean and covered it works. __________________ 1998 Toyota 4Runner: 33" BFG A/T T/A: KO 2.5" Lift CB Radio Brush Guard Yakima roof rack manikin head (Viola), and more to come! Clicky For Picky Buildup GATTORA KJ4HVQ Skywarn Ga 208 ΦΣK DAMN PROUD!

09-29-2009, 11:03 PM	#29 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	VSU: I heard it was vagisil, and midol will stop the pain. Guys I'm going to cut it short tonight want to research some trailer stuff and the ambien will kick in soon __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

10-01-2009, 12:08 PM	#30 (permalink)
4x4Lamm Registered User Join Date: Nov 2003 Location: Canton, Ohio Posts: 2,573	Muddpigg no hard feelings but either I'm not sending clearly or you are not receiving clearly on some things it seems. I'm not certain I'm going to "save" anybody with a wound stapler. The kit does contain equipment and fluid to irrigate and clean a wound. I picked it up for a few bucks at Cabelas of all places figuring if I ever felt the need to close a wound with more than steristrips the stapler was at least sterile. Lots of people use a standard sewing kit or even fishing tackle. I had the chance to staple a few lacs during my clinical time and it was dang easy. I'm not planning to cut myself one day, staple it up and call it a day if that is what you are thinking. I would of course seek difinitive care ASAP. As for charcoal, it's a lot easier to carry and affordable compared to an NG tube. Plus the fact that I am not trained or permitted to use an NG tube. All the things I have been taught about activated charcoal is that it will reduce the ammont of poison absorbed by 50%-60%. Better than 100% and people vomit all the time with or without drinking it, you still have to manage an airway at all times so I don't see that concern as valid. As far as I know the poison control center still instructs people to eat "burnt toast" for some things and for providers to administer charcoal if avalible. Ipicac is also useful in some cases. Example, a camping trip I was one once. The camp staff delivered pre-packed dinners for a meal one night. Although nothing tasted rotten something was funky with that meal, maybe the milk got too warm? Anyways after several minutes of wanting to vomit but not being able to myself and a few of my buds drank down a shot of it and threw up soon after, felt 100 times better. A finger in the back of the throat does not work for everyone (myself included). H202 works well enough for me. I have used it myself for years on simple cuts and scrapes. I'm willing to bet millions of others have too. Clorohexidine gluconate is not the standard anywhere around here because nobody I know has even herd of it. In my opinion any outdoor adventurer worth thier salt will take and use if needed an anti-diarrheal. Lot's of simple things in the outdoors can cause the squirts, even Taco Bell on occasion. You are viewing the situation from more of a MDs viewpoint than someone who could be struck gravely ill by dehydration in a matter of hours. If you eat too much chili and get the hot poops and don't want to take anything for it that's your choice but not mine. I'm aware ASA is a frontline drug for possible MI, anyone who has seen a Bayer commercial knows that. That's part of the reason I do infact carry some. It's on the list between nasal decongestant and electrolyte tablets. I do not carry IV fluids. Not sure where you are getting that from? I carry 3 IV caths for the purpose of a tension pnemo if needed. No op-sites, no fluids, no tubes etc. One thing that continues to astound with emergency services is how different people in different areas do the job. Under my orders only a Paramedic can intubate even though basics are trained. One county to the south basics intubate fairly often. One county to the north paramedics sedate people with succs and where I work they barely want you to use valium. Some areas stress an OPA and a BVM, others ET anyone that can take it, some stress the LMA etc. I'm sure these differences in education, operations and "standards" would be even more shocking to me in another region of the country or a different application such as military medical or medics working on an oil rig for example. Those differences often seem to lead to squabbles such as this but it's no big deal. This is America, you can have your own opinion and there is clearly "more than one way to skin a cat" in the field of emergency medicine. Muddpig I (and for that matter the fourm) may benefit from you sharing your general medical kit setup. Clearly you are educated and passionate about the subject. Fink, I'm at work today but I will get you those other pics as soon as I can. Maybe we need a "show off your med-kit" picture thread? 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; 10-01-2009 at 12:09 PM.

10-01-2009, 04:08 PM	#32 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	I really need to put a kit back together. As I have been deployed and am having may ankle reconstructed monday d/t injury monday. You guys are right I am military, the nicest thing about it is great efforts have been put into place to keep my skills fresh. Chlorhexidine gluconate (I misspelled in earlier post) http://en.wikipedia.org/wiki/Chlorhexidine I scanned this and it is accrurate to my knowledge As for H2O2 I've worked in the Army's burn center in BAMC well actually its the ISR as it is a hospital within a hospital and this was had long fallen out of favor. Chlorhexidine is used as a scrub to clean with copiuos amounts of fluids. This is what I've used in the ER and feild applications. Yes I've used it many many times myself but it distroys exposed tissue cells and prolongs the healing. But it will still heal. As far as vomitting being natural and people survive it all the time. But I've worked on more than one person who has aspirated vomitous. Let me tell you gastric juices tear up lung tissue. I have done the ipicac challenge and won the pool, and no aspiration issues for me. But in a sick person protecting an airway is/can be an issue. http://www.poison.org/prepared/ipecac.aspHere is an explanation for you. https://online.epocrates.com/u/10318...tions+Cautions look at the statement of infectious diarrhea. This is because it can cause major issues and yes major issues can become lifethreating. Here this is a good read. http://emedicine.medscape.com/article/169640-overview As for wound closure in an outdoors setting. I'd still recommend no. Just because a piece of equipment is packaged still does not mean it will be sterile after it is open till use. Yes, I am fimiliar with working in a sterile field and maintaining one, it can be a challenge in a hospital setting and impossible in a feild setting. I will say again that if not able to bet a person to the hospital I will bandage so I can monitor the wound not close it. Personally I think sometimes in the medical feild we get caught up in fancy toys and ignore the basics. Remember KISS keep it simple stupid I noticed your IV's for a pnuemo. Why a short 16ga? I carry a 14ga at 3.25" length. In an obese person or someone with a well developed chest shorter caths may not be suffecient. I also want as big a bore as possible. Hell a decompression can be done with an 18ga but the potential to clog or clot increases. Yes the simple answer is throw another on in but with a seriously injured pt I want things as simple as possible as thing will already be complicated. I want my interventions to last as long as possible. Yes, I am very passionate about my job. To me the worst possible thing is for someone else to pay for my mistake. It has happened and will happen again but I will not facilitate it. I know that the military has pioneered much in the medical field this is one reason I am military and not civilian, I can tell a big difference. I don't mean that to be insulting, but it is my observation. I also realize that an aide kit packed for family as compared to one for work may/can address different needs and concerns. Yes I do realize what I am allowed to do varies as to where I am, what role I am in, who needs help, and what the situation is. I encourage in any and all levels of first responder, emt, paramedic, combat lifesaver, medic, nurse, pa, DR to continue to learn. Most hospitals have grand round find them and attend, they even give out CEU's for attending some. Swnakhealth has online classes that are very well prepared. But continue to learn then bring it back and teach it to your crew. Have them do the same. Your care will improve, your service will improve, your patients will improve. So it becomes a win win situation. Gotta go, helping with homework and my full attention is needed. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

10-01-2009, 10:57 PM	#34 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	Part of my stuff is Iraq and part in the back of the closet. But sure I'll post pics may give me something to do as I get cut on Monday and the recovery is between 3-6 months. But if they have to graft in ligaments it'll be 3 months of LLE immoblization. Goodtimes. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

10-02-2009, 10:26 AM	#35 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Thanks for the links mudd I'm going to look into some of those myself as for "grand rounds" I may have to check with some local teaching hosp. see if it's possible for a first responder/semi-lay person to attend. lol just look at the 6mos as paternity leave with full pay. How'd the homework go? learn 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.

10-02-2009, 06:41 PM	#36 (permalink)
4x4Lamm Registered User Join Date: Nov 2003 Location: Canton, Ohio Posts: 2,573	Fink, as requested, Muddpig, goodluck and get well soon! 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!

10-02-2009, 09:27 PM	#37 (permalink)
Junkers88 Registered User Join Date: Mar 2008 Location: Albuquerque NM Posts: 2,776	Good God! I am (as a prior service ARMY Combat Life Saver {CLS}) so far out of my league after reading this thread. Crap I carry my old CLS bag when I wheel but that isn't much more than 119 assorted bandages/wraps/splints/tape and a stock of morphine shots (don't ask) along with a box of standard medication. Damn I need to rethink my responsibilities to the folks around me when I go wheeling. Thanks guys, I need to restock, rethink, re-equip and rearm. __________________ RB4R Life Member. 1989 SR5 4runner. Tread Wright 31/10.50/15's. 4.56 thirds, an Aussie in the @$$, Budbuilt plate, Marlin Crawler front, modified MC rear, Supra MAF conversion, ZUK coils in the rear and 4crawler BJ's in the front, LCE header.

10-02-2009, 10:15 PM	#38 (permalink)
aviator Super Moderator Staff Join Date: Mar 2003 Location: COTKU,Ontario,Canada Posts: 7,467	Watch those morphine shots junkman as I recall that stuff does come with an expiry date. I just had a thought something that has'nt been covered in these kits... you might want to consider carrying a stock of diaper rash ointment. Not just if you have little kids it also works well on "saddle sores" from long days wheeling (particularly on hot vinyl seats) and is also highly useful for those who are suffering from "redness" after excessive TP usage related to certain "intestinal malfunctions". It's also good for topical treatment of other chaffing (waist band, shoe etc) as well. And being for little kids it is gentle and has usually has a pleasant fragrance (or non at all) rather then the harsher creams sold for "adult" usage. Of course if you choose to merely supply the product or apply it for the patient will depend on how well you know and or like them... personally my rule in the latter case is only if they are very young or she is very cute and very single. __________________ 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.

10-02-2009, 11:35 PM	#39 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	Junker: In my opinion the bandages, splints, and tape are invaluable. Really makes up most of what I carry. The two biggest killers on the battle field are blood loss and pnuemothorax. You always have to keep in mind what you role is. As a first responder what is expected of you and how far is out of bounds. If you go outside of your scope of practice you stand to face legal actions, its your desicion as to what you can live with. In the civilian world I'm an EMT-B IV's aren't in my scope. Military is a whole different ball of wax and deployments are even more so different as to what intervention I can perform. Aviator: yeah, I did learn from the homework. If you come across a heart attack quality CPR. Is where its at, defib is golden but I don't carry a defib nor know anyone that does outside of the job. Remember the basics, and a hospital is where these people need to be. What can we do for a stroke, a TBI, an ABD bleed. All we can do for these people is apply diesel/gas after the basics are performed, they too need the hospital. What I hope comes out of this discussion is that no kit will compensate for the basics. C-spine and ABC's. The only reason I put c-spine first is it affect how you deal with airway. The basics are most critical. None of us wheel so far out that we need to perform "field surgery" we are all with in access to some sort of assistance. Though be prepared for a couple hours. If you wheel in a group and are going to act as a medic then do as we do, find out what conditions people in the group have, allergies, scheduled meds. This will allow you to tailor your kit to the intended audience. What if some one has bad allergic reaction an epipen is going to buy you 20-30 minutes how far out will you be, one or two epipens ain't going to cut it. I tailor my kit to my family and friends I'm with we're all rather young and healthy so trauma is my concern. Thats what being a medic/EMS is about solving problems, the more we prepare and prethink and plan and train the better the outcome will be when/if something happens. As a medic I am accustom to doing more with less but know that time is of the essense so plan accordingly. __________________ http://www.youtube.com/watch?v=rqtr_RvR3sY Balljoints for sale. Open to trades and offers. http://www.yotatech.com/f11/ball-joi.../#post51278784

10-03-2009, 08:29 AM	#41 (permalink)
muddpigg Registered User Join Date: Mar 2007 Location: injured and stateside :( Posts: 1,388	http://www.1staidsupplies.com/store.php?crn=77 will help fink http://www.semedicalsupply.com/pulse_oximeters.htm these little tricks are awesome. There is alot that the SPO2 will tell you and invaluible unless CO poisoning is suspected, that prices is awesome. But they're others out there I just pulled the first hit on my search. A good thermometer is need to, especialy before antipyretics are 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

10-03-2009, 02:00 PM	#42 (permalink)
4x4Lamm Registered User Join Date: Nov 2003 Location: Canton, Ohio Posts: 2,573	Fink myself and a few friends split the cost of the meds. As I remember the boxes of about 100 packets or so ran about $10-$15. We split the cost and meds 3 ways. Lamm __________________ -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!

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