BLS/Trauma Kit Advice

[will]

Hopefully the right part of the forum to post this.

I've got a few smaller kits around, a minor personal Trauma kit I carry daily (Kerlix, Vaseline gauze, Abdominal pads, 4x4's, 3x3's, hemostatic gauze, an Israeli Emergency bandage, Military Sam Splint, and perhaps a few other knick nacks... all fits in a small bag on the side of my daily carried pack, also BP Cuff, Stethoscope, thermometer on the other side)

Most are your typical boo boo kits (first aid with band aids) or in the case of my daily carry pack enough to take care of a fairly major wound for a short duration (I hope, everyone that's experienced has told me it's a good setup)

Anyways, I have a friend bringing me a larger pack (Stat Packs Perfusion) to check out this weekend and if I like it, will buy it from him (likely at dealer cost). This pack will be my primary vehicle carried pack to remain in my car at all times, and will also be at close proximity when involved in backwoods, and other activities where injuries will likely be more sever than usual... also for any other emergencies I might encounter in daily life.

My current training thus far permits me the use of O2, Bag Valve mask, manual ventilator, CPR, First Aid, and AED (perhaps more other things mixed in there, I know the steps of taking BP but need more practice with actually doing it.) Eventually it will gain equipment as I gain experience/knowledge (EMT-B and Intermediate Training)

I think I know the basics of what bandages to include, I've made up a list based off of 3 of Galls most popular pre-made kits on what's included and will utilize them for what to put into my kit.

My question is what above the standard band-aids/gauze, etc, would one suggest? O2 is likely out at least for a while, due to it's higher cost, as well as an AED (just not practical, however useful)

Thus far I'm thinking basic BP (probably an digital/semi-auto, or full auto for this pack, my other is full manual so not to worry about batteries), stethoscope, thermometer (likely digital for this pack as well), and likely an Ambu-Bag (I feel they are worth having, even if most situations might make their use difficult for a single rescuer)

O2 and Bag Valve Mask are probably good ideas, since I am a certified Diver, O2 is a divers emergency must have. Typically I do dive with folks who have O2 on site, however not sure any have the bag valve, which would deliver the highest O2 concentration aside from the manual ventilator (which seems higher risk for damage to me, even with it's over pressure relief)

I live and work in areas where EMS response times can be as low as a couple minutes (presumably, since I live next door), to upwards of 20-30minutes in Rural Volunteer only areas, to likely an hour or more in remote diving/camping locations.

So, this kit needs to be able to support the lay rescuer (with perhaps a bit more knowledge than the average First Aid/CPR trained person) for the typical emergencies one might encounter, and the possible more major traumas/emergencies... and also allow for the future use by an EMT-B/EMT-I as well as any RN's/Nurses/MD's etc. who may be in the same location but not prepared at all or very well.

Thanks all.

 

[medic258]

Will,

I guess my first question is why are you buying this kit. If you work or volunteer for an agency that does 1st responder shouldn't you get the supplies through them? I am sorry if I do not fully understand. Where I live and work most EMS is full-time. However, I would take a look at what you think you will use often. I do not have a kit of my own but if I did I would include necessities only. If you try to have everything you might as well purchase an ambulance as well. Sure a few bandaging supplies are definitely worth it. I wouldn't get too crazy. 4x4's and 5x9's would probably do. Maybe a trauma dressing. A couple rolls of Kling. I would stay away from the automated BP cuffs that you can get at a drug store. The cost and reliability seem to be too much. You can not go wrong with a good old fashioned BP cuff and stethoscope. I would always manually check the BP before trusting those machines anyway. The one thing I would definitely have is sterile water for flushing eyes and wounds. I probably leave out the thermometer as well but in my region we do not use them. I hope this helps.

--Bryan

 

[will]

Thanks Medic.

Let's see if I can answer. I guess reason for having it, I can come up with more reasons to have one than not to... Only reason I can think of not to, is perhaps why spend the money, and EMS is quick to respond.

Reasons to have it: Natural Disaster, Major Emergency/catastrophe (acts of terror, etc), Major Vehicular accident in rural area, Wilderness Emergency (do a considerable amount of backwoods camping, often near vehicles, but over 1hr from EMS services), and I assist with Firearms training (though we've not had an injury above minor cuts it could happen, EMS is approx 30mins out from the
facility)

I'm not currently EMS (volunteer or otherwise, plan on attending EMT-B classes in the Winter.) So I don't get anything from anyone in that regard.

I currently carry the Thermometer as it was recommended for the Wilderness stuff (I think more for identifying Infection)

I'll have to see if I can find some sterile water, I looked for solutions such as plain saline before, but didn't realize it was an Rx, seems most irrigation solutions are... any suggestions on locating something non-Rx?

I just don't like not being prepared, I'd rather have someone look at me strange thinking I'm over prepared, than have something happen and be wishing I had something. I drove Long-Haul Truck for a couple years, and saw enough accidents and such, to make me wish I had a fairly well equipped trauma kit... In the scheme of things it's a small amount of time/energy/money to spend for a LOT of peace of mind. I've seen enough things on TV/Life of people not prepared at all or well enough to make me not want to be that person.

 

[medic258]

I hope I did not offend you by asking the why question as it was not my intention. I just was not sure if you would be using this kit as part of a dispatched response. As far as the sterile water thing... it does require a prescription and I have no idea as an over the counter substitute. Good luck with your kit. I hope you never need to use it...especially at the range!

 

[will]

No offense taken Medic, I'm with you, I'd be happy to buy this up, and never need anything (small bandage for a cut aside, or a 4x4 for a scrape). It's possible the kit could be later used as a dispatched response, as I may join the volunteer side of our FD once getting my EMT-B and not sure if they do dispatch volunteers or just allow them to respond if nearby (I've known guys in the past who were volunteers and were assigned either radios or receivers), in which case, if they provided a kit, I'd utilize it as needed, and either store mine, or just resupply my kit as needed with their supplies.

Yeah, we HOPE to never have an accident at the range, knock on wood, we take every precaution we can, unfortunately sometimes stuff does happen... The Sheriff's Office has had 1 or 2 Accidental shootings (upon holstering) despite their best efforts, all it takes is one person not paying attention and an instructor paying attention to something else and BAM! But then we did have an instructor cut his finger open with a knife like a goof ball, but he's done it enough to know how to deal with it (he's cut himself many times)

As for sterile water, maybe my MD will give me an Rx, he's pretty cool guy and knows all about my upcoming EMT training and the other activities I'm involved with, and might write me up a single Rx for one small bottle or something.

 

[medic258]

Yeah, we HOPE to never have an accident at the range, knock on wood, we take every precaution we can, unfortunately sometimes stuff does happen...

You can't cure stupid

 

[firecoins]

I carry a box of non latex gloves, a couple of 4x4s, 5x9s, cling, tape, cpr mask, my stethescope, a normal bp cuff, glucose, a flashlight, a flourescent EMS vest for ID, pens and a notepad. I have only come across MVAs and some diabetic problems. Often i need just gloves, a flashlight and the vest for personal safety of being seen.

 

[will]

You can't cure stupid

No, but you can kick them off the property

Thanks guys... I guess I should have said my car normally has 2 (came across a spare recently) ANSI II vests, at least one flashlight (normally have about 3 more on my person), about 10-12 30min flares, 10 Turbo Flares (LED Flare Alternative) and already have about 2-3 blankets

Also I was at the Walmart (I hate that place) picking up the latest release of House MD (Love that show, Season 3) and came across some Wound Wash in a can, said contained .9% Sodium chloride, and was Saline, in the normal OTC section, think that is worth getting since is non-Rx or something else? I seem to recall my Wilderness book suggesting provo-iodine or something similar diluted in clean water as a wound rinse alternative. This is the same stuff here... http://www.brucemedical.com/wounwassalst.html

 

[medic258]

Very true :lol:

 

[Flight-LP]

As for sterile water, maybe my MD will give me an Rx, he's pretty cool guy and knows all about my upcoming EMT training and the other activities I'm involved with, and might write me up a single Rx for one small bottle or something.

Hey Will, after reading this thread and remembering the conversation from the previous one, I still think there is an aspect you are not grasping. You have to have physician medical direction. That means a continuous authorization by an MD to practice as an EMT. The "Rx" will not cut it. That prescription is for your use, not to be used on others. You also must have a physician authorization to administer oxygen regardless of what training you have. Perhaps you Dr. friend would be willing to put his license on the line and work as your medical director, but before buying anything and offering any level of care beyond that of a private citizen, I would secure this very important detail. You can and eventually will run into issues down the line...................

 

[rgnoon]

Hey Will, after reading this thread and remembering the conversation from the previous one, I still think there is an aspect you are not grasping. You have to have physician medical direction. That means a continuous authorization by an MD to practice as an EMT. The "Rx" will not cut it. That prescription is for your use, not to be used on others. You also must have a physician authorization to administer oxygen regardless of what training you have. Perhaps you Dr. friend would be willing to put his license on the line and work as your medical director, but before buying anything and offering any level of care beyond that of a private citizen, I would secure this very important detail. You can and eventually will run into issues down the line...................

My intent on the other thread was to point this out. I apologize if I wasn't clear, but Flight-LP is right on the money. Just having an emt card doesn't allow you to provide all of the care you are trained for. Here in NJ we have standing orders at the basic level for things where most other states require on-line med. direction. I don't know what your situation is in Oregon, but you will still need to be operating under some form of med. direction to render care other than that which a private citizen would know. Depending on local protocols, you very well may need Med. Direction to obtain O2 as it is also an Rx. I only re-iterate this as it seems my last post didn't express what I was trying to say, and that is my fault.

BTW, way to go on the PPE!, I can almost see you from here. Seriously though, if you see yourself stopping for MVAs (when under med. dir), the vest and a few flairs are a good call.

 

[medic258]

I must have missed all of this stuff before I replied but these guys could not be more correct. I guess I just am naive to the way the rest of the country works.

 

[will]

Well as far as O2 is concerned, I have already been able to obtain O2, without an Rx. The rules changed on O2 back in I think 1992 or sometime after, PER federal regs, it is an Rx, to be administered as Prescribed by an MD, except in emergencies by someone trained in it's use. I have that current training and was able to obtain O2 under that (the O2 is for use at my Dad's company) In an emergency anyone trained in the admistration of O2 for emergencies may do so.

That is non-professional Medical training, it's is lay rescuer training, and is allowed under Federal Law (I've checked into it considerably, and was confirmed by the gas supplier when I went to get a fill without Rx)

I totally got what you guys were saying in the previous post, I am only asking for advice on what is worth having given my current level of training... If there was anything beyond the basics of 4x4's 5x9's standard gauze, etc... that was recomended.

One suggestion was the sterile water, which as I stated I actually found .9% Sodium Choloride wound rinse in the over the counter section, and wondered if that was worth having.

I understand the Med. Directive, etc.. and have no intention of doing anything I would/could get in trouble for.

Given my current level of Normal Citizen training (non-professional) I have been trained in the use of BLS (CPR/First Aid) as well as AED, O2, Manual ventilator (with O2), and Bag-Valve Mask with/out O2. I can legally obtian and use O2 in an Emergency (i.e. respritory distress/near drowning/decomression sickness/CPR/diving emergencies/etc)

 

[rgnoon]

Will, I apologize for repeating myself like that. I was just afraid that I hadn't made my point effectively (I do that sometimes). We really are just trying to help. It sounds like you've got a pretty good idea of what you want in a jump kit.

One good thing to keep in mind, and its been pointed out on this forum in the past, is that many items that are regularly carried in trauma kits and BLS bags have expiration dates (i.e. occlusive dressings). If it were found that a pt were treated expired supplies, there lies potential for accusations of negligence. This is just something that we have to keep an eye on in our personal gear.

 

[firecoins]

One good thing to keep in mind, and its been pointed out on this forum in the past, is that many items that are regularly carried in trauma kits and BLS bags have expiration dates (i.e. occlusive dressings). If it were found that a pt were treated expired supplies, there lies potential for accusations of negligence. This is just something that we have to keep an eye on in our personal gear.

I doubt that if you stop someone's bleeding with an "expired" bandage, you will get sued. If your equipment works, your fine. If it doesn't work and serious harm is caused, there is a case reguadless of the expiration date.

 

[rgnoon]

I doubt that if you stop someone's bleeding with an "expired" bandage, you will get sued. If your equipment works, your fine. If it doesn't work and serious harm is caused, there is a case reguadless of the expiration date.

You're definatley right about that brian.
The main concern is just that allot of it has expiration dates for a reason. For example, we had some occlusive dressings that were WAY past their expiration date. The vaseline managed to "clump", for lack of a better word, and leave dry spots. I don't have to tell you brian that this part of the country especially can be so incredibly over-litigious, it can't hurt to have a healthy concern about this trend. We obviously can't let it get in the way of exceptional patient care, but I think it is something that we need to be aware of.

I've hijacked this thread, sorry Will. I'm done.

 

[VentMedic]

There have been a lot of different interpretations for the "emergency O2" OTC use. The exemptions have been for airlines, schools, athletic clubs, LEOs, dive boats and various practitioners' offices including Chiropractors. Using their exemption approval to obtain O2 for purposes outside of their premises/purposes may not necessarily be part of the exemption. My health club has "public access" O2 tanks and most of the employees have had the National Safety Council training. However, these employees can not take the O2 off the premises with the chance of seeing a cardiac arrest on the way home if they are not acting on behalf of the healthclub.

http://www.lifecorporation.com/fda-gif.html

http://www.lifecorporation.com/cder.html

Fresh Air "2000" - A look at FDA's Medical Gas Requirements
(excerpted summary)
Fresh Air "2000" provides FDA's interpretation of how the minimum current good manufacturing practice (CGMPs) regulations apply to the manufacturing, filling, transfilling cascading, etc. of medical gases compressed and cryogenic. Please note this presentation is not all-inclusive.

(Edit. Note The following paragraph on page 13 provides the exemption for emergency oxygen from prescription RX requirements . Please read the "--- or for emergency use,..." phrase. It is not easy to interpret but the FDA does confirm therein that Emergency Oxygen remains Non-Prescription.
However, if a firm sells Oxygen U.S.P. to emergency medical services, i.e.' fire departments, rescue squads, ambulance companies, etc. or for emergency use, then the label is required to contain the statement: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only."

(Edit. Note The following paragraph does appear on page 1 of 32, and it causes much confusion in the Emergency Oxygen industry, because you have to read page 13 to find the exemption.
Medical gases are prescription drugs that must be dispensed by prescription only. Each firm has a responsibility to determine if its consignee, not the patient is authorized to purchase the drug gas, and if required, is registered with FDA, and properly licensed with the state, where required prior to selling them medical gas.

http://www.lifecorporation.com/cder.html
another Quote:

(Edit. Note The following further clarifies the present policy above, in an often quoted FDA policy letter.
In a letter dated 19 September, 1996 to the Compressed Gas Association from the FDA administration regarding the use and labeling of emergency oxygen, the FDA states: "FDA recognizes that there are medical emergencies in which there is not sufficient time to seek the assistance of a physician or hospital before the administration of medical oxygen may be necessary. In such emergencies, it is desirable that properly trained personnel ... be prepared and equipped to administer oxygen to persons in immediate need of oxygen. In these situations, the FDA believes that medical oxygen should be available. This has been the agency's position for more than 40 years."

As far as everything else in a trauma kit, I think every household should have one especially if you live in a disaster prone area or have kids. The EMS supply magazines give many good examples of a fully stocked trauma/BLS bags. You could use one of them as a model. The earthquake and hurricane survival sites also offer examples of trauma bags.

 

[will]

No worries, good point about the date... I got some stuff recently from a Nurse Family member, who pointed out the expiration date on much of this stuff is kinda silly (gauze for example) and much other items are still good for some time after that date (the items they gave me were close to date, but are used to send to 3rd world countries as they are still good but the hospital can no longer use them due to the date issue)

Some items, such as hemostatic gauze, occlusives, meds (antibiotics, etc) are well worth chucking after thier date... We recently bought new hydrogen peroxide as the bottle we had, had no visible date, and we thought was probably 10 years old at least... it still appeared to work, and upon purchase of a new bottle, wasn't appearing to work any better...

Based on my limited knowledge I don't think I'd see much issue with gauze/bandages past thier date.. I'm guessing they are still likely sterile... plus it's been proven from good samaritan laws, etc.. that the use of a dirty shirt is better than nothing at all, given it's all you have available.

Anyways, no problem on the repeating.. I'm sure I am a little (how to say) overly ambitious anyways about what can/can't be done. In this instance I was just looking for advice on gear that could be used by anyone, but also have friends/family who are RN's etc... who have told me what they carry and suggest I might want to have, which is inline with my current thoughts.

My personal belief has been for many years that there is a serious lack of pre-ems (ie professional) care in the US... we are all used to there being rapid response times, which isn't always the case, given some remote areas (much of Oregon has areas of greater than 30min response times, ie. mountains, wilderness, etc) but there is a signifigant lack of "layperson" care IMHO... CPR/First Aid Classes teach CPR (important) and then touch on basically sticking a bandaid on anything bleeding... beyond that, nada... It seems to me simple things such as how to help someone administer thier own EPI Pen, more hands on with bandaging, shock, and likely things where EMS maybe delayed by more than 10minutes should be taught somewhere... perhaps an Advanced Layperson First Aid, or ??? There seems to be a huge gap (IMO) between CPR/First Aid and First Responder (difficult to find a course around here) or EMT-B

 

[will]

There have been a lot of different interpretations for the "emergency O2" OTC use....

VentMedic, that's the reason I got the O2 filled I did... Both as training specifically to provide O2 in an Emergency, and as a CPR Instructor able to train others in much more basic use than what I've been trained to do.

The Gas filler filled a bottle owned by a company I work with for me, and other than one former Combat Medic who is now an RN I don't know of anyone at the company trained in it's use. O2 is just too expensive to have anyways... I wouldn't mind having it in my Kit, but not about to shell out the $300 or so to get a cylinder, regulator, etc...

Sorry to create all the arguing/hardships... guess I'm good at starting topics on controversial subjects It's my curse... Guess I'm always a bit too gung-ho for my own good

 

[VentMedic]

will, you have some good ideas and a lot of ambition. Get back to me in about 20 years with that same ambition and I'll put you up for Sainthood.

Again, EMS supply magazines, websites have many, many examples for trauma bags at every level and need. You could design one for yourself using them as a model. My home hurricane survival kit is probably better stocked than any trauma bag I had working Rescue.

Good Luck!