Update AAR added here.

The incident happened in northern Minnesota in a very remote area with zero cell service.  I was loading up my kayak into my truck at a lake when I could hear some atv’s crusing on the road. I could hear a couple of them at once, then I heard a loud crash about 200 meters from me.  It was clear that two of the vehicles hit each other. I quickly jumped into my truck and drove to the site.  Two Polaris ranger crews hit each other head on going around a corner.  When I arrived about two minutes after the collision, people were laying everywhere. One ranger had 4 passenger another had 5. A third utv was also there with 4 people.  The people from the third ranger were just yelling for help like anyone was going to hear them.  

I immediately grabbed my first aid bag and ran to a guy with a compound fracture of his tibia and he was bleeding from his skull. He was unconscious also.  First I treated his injury to his skull which turned out to be a large gash on his forehead. Than I moved on to his leg. While I was doing this I was giving orders to the people in the third ranger.  People freeze up and have difficulty follow direction when something traumatic has happened. Everyone was drunk or had been drinking in all the vehicles so that didn’t help anything. Finally one lady got her self together and went around to see who needed my attention next.

I wrapped the first guys coumpound fracture up with gauze pads over the wound then wrapped it. I grabbed a branch and used that as a splint.

Next person I helped had a forearm compound fracture. Treated this just like the first guys leg at first.  Her arm would not stop bleeding I had to apply a tourniquet. People were confused when I wrote the time on her upper arm above the tourniquet. I had to explain that the doctors at the ER would want to know how long it was on her.

Moved onto the next person. He was one of the drivers and as he was thrown from the ranger his thigh must of caught on something metal and sharp. He had a huge gash about 12 inches long and it was deep. My first Israeli bandage got used here along with some gauze. He had small cuts all over his body as most of the people but I didn’t treat these.

After treating the first 3 people out of 9 I was out of gauze and rolls of gauze. The amount of bleeding from these 3 people was unreal.  

All while I was treating the first 3 people I got the people from third ranger to all finally help and got them to calm down.  Once I was done with the first 3 people I had them taken away by the driver of the third ranger.  We had no cell service and I had zero idea how long it would take to get help. So I made the call to self transport these people at least back to a place where help could be called from.

The remaining 6 people all had cuts and two had broken arms. Only one of them had a serious cut and it was on her bicep. I used my remaining Israeli bandage and tape on her. Everyone else had to use the bandaids I had on the small cuts and their own clothes on the bigger stuff.  Two of the people appeared to have serious back injuries so we just kept them immobile.

Of all 13 people none had any training.  Some simply couldn’t handle the situation and were zombies.

The situation was much more complex and involved than what I’ve written out but I’m not the best at writing things.

I’ve had lots of first aid/emt training. When I was in the service I helped treat worse injuries than what happened in this accident. The difference was the people. Soldiers that I was with always knew what to do and how to help. These civilians didn’t and what was worse was they couldn’t handle it mentally.

It was an hour before the first emt arrived. I doubt the 3 worst off people would of made it that long with out help.

So what I learned. Take charge immediately when it’s clear no one else has. Be prepared to repeat commands several times.  Label the items in your first aid bag. Some people don’t even know what a roll of gauze is. Don’t waste your limited supplies. On the first guy I definitely used to much stuff on him.

After reading everyone’s posts I put together a new bag one for each vehicle.  Each bag is a 40l duffle bag. I made compartments in them and everything is labeled. One day I’ll take pictures and a list of everything I added.

Last thing I added was a garmin inreach. Now I can request help from anywhere. I probably should of had one already for when I’m gone on my long solo trips.

…………….
Two weeks ago I had to deal with a significant atv accident that involved several people. This happened in a very rural area with zero cell service so there was no calling for help immediately and we had to treat the injuries ourselves.  I had my first aid bag with luckily because no one else had anything. Two of the guys would of bled out before helped arrived if I wasn’t prepared.  I thought I had an extensive first aid bag with enough supplies to handle any situation I might encounter.  Well this accident proved my thinking very wrong because I ran out.

So my question is what bags and supplies do you guys keep on hand in your vehicles?  

The items I ran out of. Gauze pads and rolls, surgical tape, gloves, trauma dressings, cold packs.

Items that I didn’t have and wish I had.  Emt shears and an arm splint.  The emt shears could of saved a lot of time removing the clothing I had to cut away.

I’ve had to deal with a lot of injuries when I was in the army but this is the first significant incident that involved several people in the civilian world.  I found that almost no one has a clue what to do during a major accident and that most people are a hindrance when they try to help.  So please go out and take some first aid classes.

Looking forward to the replies because I need to build a bigger, better bag and I don’t want to leave anything out.

Good job,  now I know I'm even more lacking

I have found some great kits with quality components and decent prices here:
https://bearindependent.myshopify.com/collections/first-aid-kits

All of the kits components are listed for each one to help you figure out what you should have.
I am in no way affiliated.

There are pretty good videos of setting up your overland kits on youtube. I use the trauma kit, base camp kit, boo boo kit trifecta of organization. Rescue essentials and chinook medical are by far the better places to buy supplies. They have the contents of their premade kits listed on site to give you a cheat sheet of what you might want to start with if building ala carte.

I have an M5 medic pack under the back seat in the truck. I'm EMT-B trained and have enough for 4-6 casualties (within my skill level, of course).

Most people put too much elaborate stuff in their first aid kits because they think they are going to do the job of a surgeon.  You aren't....unless you are a surgeon.  If you get a truly traumatic injury, you are going to die if you don't get to an ER.  A first aid kit will help prolong life but if the injury is that bad, you need an ER with a competent surgeon.  Even then, a competent surgeon can't always save someone's life...that's just the way it is.  

That said, the essentials still apply.  Restore breathing, stop the bleeding, protect the wound, treat for shock, get to emergency medical care.  Relatively minor wounds can be treated with a first aid kit and solve the problem but major injuries need treatment and then medevac.

My ATV and vehicle medical kits include normal bandaids, gauze pads, tape, OTC meds, and antibiotic ointment.  I also add some Israeli pressure dressings (one of the best first aid items you can have IMO...useful for so many things), a tourniquet, and medical shears.   Each of my ATVs and the RZR have their own first aid kits.

Yep, all plans go to hell once the stress hits and you can see how ill prepared most people are.  I really stuffed my kits full of extra dressings along with clotting agents.  Found it easier and cheaper to buy most of this stuff in bulk from med supply companies.  A lot of the off the shelf kits are pretty limited and need to be buffed up to account for typical situations.   I'm not looking to do surgery; just keep someone stabilized until I can get them to professional help.

How large a bag are you thinking?

I'm no medic, do have first aid and CLS from Army prior to 2000...

I have put together some kits I feel are good.

I have an excel file, witch covers : IFAK/ Small Group Aid/ Larger Group Aid/ Add on for two previous and storage... Then some other stuffs... Been working on it for years now. I have bags filled, and then some storage supply. I need to get back to working on it again. Been a bit...

If I had a way to email to you.. Maybe it could help.

MyMedic has a really nice one but expensive.   Blackhawk makes the S.T.O.M.P. bag that is really big and packs a lot of equipment.

Tbh, I don't carry a FAK on my ATV probably should.  A small bag, maybe smaller than the "fanny pack" that goes on the MOLLE assault pack, is all I'd carry.

4x4 and kling are your friend.  ACE wraps too.  Gloves.  Maybe a TQ if inclined.  One could argue for hemostatic gauze.  

Don't go too nuts, they're either going to bleed out or they're not.  You can't do much for really big trauma alone.  Like, a traction splint and pelvic binder are nice, but bulky. Same with IV fluids.  If you want to do CPR, have fun with that.  Splints can be made from damn near anything.

Right now the bag carry in my vehicles which I also had at this accident is about 12 liter in size.

I had to treat 9 people. Two Polaris crew rangers hit each other head on at about 40 mph. All of them we’re ejected from the vehicles. Two people had compound fractures.  Now I know the odds of me ever having to deal with a situation this bad again is most likely never.  But there is always a chance.

So I was just asking what size bags do you guys carry and how much stuff.  I’m thinking about carrying a much larger bag like a duffel bag and tripling everything I had in my original bag and adding a few items like arm splints and definitely a trauma shear.  Cutting clothes off with a knife sucks.

Israeli bandages are worth their weight in gold, learned that in the army and they proved it again this time.  But two wasn’t enough, so I’ll be adding more.

I’ve went to sites that you guys linked and looked at some of the bags you can buy already filled.  I think I’ll buy my own bag and fill it myself. Most likely will be cheaper.

I’ll say this once again if you read this and don’t have the basic knowledge of first aid please get some training and please carry a small kit in your vehicles.

Did you have blankets?  

Compound fractures?  As in, bone through skin?  If so, I hope you controlled bleeding then splinted as is.  As I said, splints are usually easy to make in the field.

Would love to hear your AAR, how you triaged, what you were thinking.

I would be interested in an AAR as well.

I am not a trained medic, but have some training.  I use an M-3 medical bag, something like NSN 6546-00-912-9870.  

I like the bag.  It functions well to make everything available quickly.

I have it stuffed full, including EMT shears, 2 small and 1 large Israeli bandages, hemostatic gauze, extra gauze rolls, three rolls of tape, hemostat, lots of 4x4 gauze pads, 5x9 gauze pad, 4 pairs of gloves, sharpie, Ceralyte, iris scissors, large triangle bandage, sharpie marker, CAT tourniquet, and a bunch of other useful things.





One of my observations about tools in general these days:  
Don't buy the cheapest tool on the market.   It will be a piece of crap from China that looks like a tool, but doesn't actually function.    There seem to be a bunch of EMT shears on the market that look like they will break as soon as you try to use it.    Buy good quality EMT shears.   They will actually work when you need them.

I actually have two of these bags, and the contents of the second one is basically a clone of the first one.    The primary bag has a few more nice-to-haves.

I keep anywhere from 3-5 NAR SIRK Refill kits in my truck. 2 of those are always in trauma kits on a seatback organizer and the other are still vac packed from NAR and just shoved in door pockets. Only had to use one when I came up on a motorcycle accident one day. Guy lived but had some nasty calf and ankle wounds from wearing shitty shoes and shorts.



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@SigsandCider

Is that 3 bottles of bleach?

It is. Was stocking up for water treatment preps.

Nah, just super Covid prepared

OP, I use a little bag from the fishing section of Walmart. It's pared down over the years.  I threw in a pair of trauma shears, since I'd used them at the range and never put them back


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Short of driving a fully stocked ambulance as your daily driver, I doubt that anyone here has enough med supplies on hand in their vehicle for a 9 patent mass cas incident.

Stock enough for your family.

If the people you play with are good friends, by them their own kits.  Use their supplies on them.  

You can't save everyone, especially in a MCI.

So tagged.

I just have beefed up FAK, but I have all the supplies, just stored at home.  I have a larger Tactical Tailor med bag that I need to get updated.  Specifically for what you just mentioned: gauze pads/rolls, tape, gloves, trauma dressings, CATs, etc.  That stuff doesn't really expire and relatively stable for our changing temps.  I hadn't thought of cold packs and I do have a couple of SAM splints I could add as well.

I have some dated training and was a certified CLS, but it never hurts to get refresher training for those that don't do it as a day job.  Again, I'm not out to save the world and a mass-casualty event is beyond most non-EMT types, but I don't have an issue being prepared for accidents at family or "friend" events...they are less likely to sue you for trying to assist

Good topic and reminder...

ROCK6

I went to Cabelas, bought one of their $12 tackle bags, stuffed it with tourniquets, Israeli bandages and Epi-pens.  Also added big bandaids for minor cuts and a bottle of aspirin for heart attacks along with an asthma inhaler for my nephew.

Pair of dykes for cutting embedded fishhooks.

Also some Bactine and meat tenderizer for such things as jellyfish stings.  I  leave it in the truck or the boat mostly.

I keep the following items in a Iron Duck Pack Case Plus, which is about 20" x 12" x 8".  It is nice having the organization of a purpose built EMS bag, but I only use it since it was gifted to me.  Any of the previous mentioned bags would work well for a fraction of the cost.  This is the bag that stays in my house, but I put it in the truck for all camping trips, extended road trips, and shoots in the desert.  Most of the common boo-boo items are in a small first aid kits that lives in the truck, Band aids, Neosporin, OTC medicine for various ailments, etc.  

PPE – Patient / Injury Access
(8)Pair Nitrile Gloves
(2)N95 Fold-able Face Masks
(1)Clear Goggles
(2)Trauma Sheers
(1) Headlamp with Lithium Batteries
(3) Glow Sticks

Airway
(1)CPR Mask
(1)Nasal Suction Bulb
(2)NPA (28 French)
(1)OPA Kit, Assorted Sizes

Bleeding / Burn / Trauma
(2)SOF-T Tourniquets
(25)4” x 4” Bandage
(2)4” x 4” Sponge
(8)5” x 9” Abdominal Pad
(2)8” x 10” Abdominal Pad
(2)12” x 30” Trauma Dressing
(4)2” x 4 yds Roll Gauze
(5)3” x 4 yds Roll Gauze
(5)4” x 4 yds Roll Gauze
(2)6” x 4 yds Roll Gauze
(2)1” Tape
(2)2” Tape
(1)3” Tape
(1)60” x 96” Burn Sheet
(1)8” x 8” Burn Dressing
(1)4oz Bottle Burn Gel
(3)0.9% 250 ml Saline Bottle
(3)Sam Splints
(6)Triangle Bandages
(3)Instant Ice Packs
(1)Locking Forceps
(2)Skin Staplers
(1)Bag of assorted Band Aids

Clean Up / Other
(20)Anti Microbial Wipes
(2)Bio hazard Bags (Red Bags)
(1)Vomit Bag

This is great information, I am currently putting together a large medical bag to take along places. All my vehicles have small bags already.

Ironically, I've pulled out 2 fish hooks in my last 2 shifts.  Shoving the hook through is surprisingly tough.

Might I suggest buying some lidocaine patches, available OTC.  Leave them on for about an hour, then push the hook thru and remove.  It *might* help decrease the pain.  Also, some neosporin because they're usually dirty.

I keep one in the door of my truck that contains

CAT TQx1
Combat gauze x2
Rolled gauze x1
NPA x1 +lube
Needle Dx1
Space blanket x1
Non-vented chest seals x2

And I have one in my EDC backpack that contains duplicates of everything above plus

SAM splint x1
Compression bandage x1 (OELAES or whatever the acronym is)
ACE self adhesive wrap
Waterproof tape

I’ve been trained on how to use all of it in a training class, and I review the material regularly but I don’t have any certifications. My thoughts on carrying some of the stuff like NPA/Needle-D is that I’m sometimes in rural SE Asia where a trauma center is hours away. If I have to take the risk between a loved one dying with certainty or having a chance to save them, I know which option I’d prefer.

Be very wary of pre-made kits. The my medic fills a lot of theirs with bandaids and such. They actually use the smaller ems quikclot roll.

The one from bear independent, while very nice it’s overpriced if you spec it out.

I actually started my own small business supplying local atv dealers/riders with quality kit. I feel people shouldn’t  have to order everything online and I’m at the epicenter of a huge atv community.

This isn’t a sales pitch but more of a reference. You can find these items at chinook medical, H&H website, North America rescue. I also used to order off of medical gear outfitters. Best I can tell you is learn what you need and the individual cost of each item. Too many “kits” include stuff you don’t need. Below is my core kit for the atv community. You can always, and I suggest you do, add to your kit/kits to give more flexibility/capability. Be very careful not to add too much all in the same place, separation of levels of kit is key. Last thing you want to do is be digging through a lot of stuff to find what you need in a hurry.

I sell my kits as follows:

1- Cat tourniquet gen 7
1- Quikclot combat gauze
1- Hyfin vented chest seals- twin pack
1- Nar compression bandage
1- H&H compressed gauze
1- Trauma shears
1- Nar survival blanket
1- Burntec burn dressing 4x4

Includes the Booboo kit

-Assorted Finger Bandages
-Steri Strips
-2 Small Burn Cream Packs
-2 Small Triple Antibiotic Ointment
-2 Small Bacitracin Creams  
-2 Small Hydrocortisone Cream
-4 Alcohol Wipes
-4 Sting/bite Wipes
-4 Povidone- Iodine wipes
-1 Tylenol
-1 Ibuprofen
-1 Asprin
-1 Diphen(Benedryl)

I sell all of mine either stripped down to the guts or in a condor rip away pouch. For atv user I option them a weather proof case to keep the pouch/contents clean and dry.

If you are making this for multiple injured people you might consider multiple essentials. You can add 2 additional Swat T tourniquets for the price of 1 Cat tourniquet. More compression bandages, another set of chest seals and compressed gauze will easily turn a core kit into a multi person/injury kit.

Lastly, get training if you haven’t already. The training will help you realize what you need and what you don’t. Our local county area have free stop the bleed classes periodically. They don’t advertise it but offer it to anyone. You may find somewhere close that offers the same.

Feel free to PM me for anymore help

Depends how far you want to take it and who you’re treating. If it’s for you or your family you would more than likely do some more invasive things. But for trauma being the concerning things you always want to take care of abc’s. Splints are nice and can help a lot with comfort levels but usually if the trauma is that bad the bone will have to be manually reset. But a cpr mask or bvm is great and can be collapsed to fit in a bag. Npas or opas to keep the airway intact. Needle decompression. Some sort of chest seal to prevent a sucking chest wound or you can make shift a lot of things for a chest seal. Saran Wrap is great for abdominal cuts with internals being out to keep everything moist and sterile as best as possible(have ran into this with atv accidents) your typical bandages, gauze, cling, tourniquets, Israeli bandages due to them having the wound packing built into the bandage. Gloves of course. If you can keep it sterile as possible given the situation it gives a better outcome due to a lot of people surviving the trauma incident but passing later due to infection. But that’s just some basic things. I’ve worked as a medic for quite some while working busy beach units and now working in rural areas where there can be a longer transport to the hospital. But I wouldn’t go needle decompressing some random person on a hike just due to the world these days and you may save a persons life but then they’ll sue you over some dumb stuff months down the road.

Bags I'm using for kits I put together myself.

IFAK on belt

Combat Trauma Bag V3 - small group

Molle II medic Bag - Larger group

NAR WALK (warrior aid litter kit) with litter - doubles as add on for larger group bag and truck bag.

When I started putting together my kits and in trying to figure out how I wanted to do it. I found I was pretty much in line with this guy.

he has what I feel is a good list of areas to cover. I have tried to base all my aid bags with coverage as he lists.

AAR in the OP now.  Been busy sorry about just getting to it now. Lots of knowledge shared so far by everyone thank you.

Very good AAR. You were a hero that day. Those people owe you in many ways….likely some of their lives.

Most people freeze up under stress unless they have had training and experience. Good job pointing out the need to repeat yourself for those who can’t comprehend what you are saying.

Out of curiosity, have you heard how they ended up?

Fantastic job! The world has far too few people like you.

The guy with a compound fracture of his tibia got a bad infection and from what I understand is back in the hospital. The lady who I put a tourniquet on kept her arm. Only one person after the incident reached out and said thank you. Only reason I know how everyone is doing is because the police charged both drivers with a dui and the police have called a few times asking questions about my statement I made on the day of the accident.

Good work.

That said, I dont think it is reasonable worry about how to pack enough stuff to treat 13 people when you are on a solo trip.
Take a pair of trauma shears and take some of their clothing to make bandages.
Do the best with what you have.

Good call on the inReach.  I love mine.

Excellent work. Very good points. You did the best you could with what you had. If you hadn’t, it would have been a very different day for those folks.

Amazon had OD Green STOMP packs for $70 which is a bargain.  Do not buy the knockoff version of that pack.

In 18 years of EMS, I've never worked in or seen an ambulance capable of handling 9 patients. Much like the OP's situation...decisions will have to be made as what must be treated, and what can wait.

Agreed.  Biggest I rolled up on was a 6 car pile up, fortunately all walking wounded.

A classmate of mine in EMT class had a bus MVA/MCI as his first call on his ride along

I got one of these a few months ago. Fairly complete and concise. They accepted an offer of $45 and I believe $40 if you buy 2. Not sure if it still works.

I keep this one with me all the time.  Goes in the car and when I go to church, in a small pack I keep with me.

Thank you for posting this and also for being a good neighbor and taking action to helps others.

Your post kicked my ass in gear.

I had purchased some med kits before but never took formal training.

So I took a “civilian” TECC course.

Based on that knowledge of how to perform some of the triage and care I have been putting together new kits and modifying existing kits.

Not doing it to take care of others, but focusing on ability to take care of close family.  If others happen to benefit then so be it.

Priority planning for kits is following MARCHE acronym with the following anticipated scenarios.

Car accident
Hiking/walking trauma
Bicycle trauma
Heat stress
Penetrative trauma
Industrial trauma (job)

For 99% of time formal medical response is less than 20 minutes away, so figure stabilizing for that is priority 1.  For trips to more remote areas I’ll need to assess on an individual basis and rework kit(s) as needed.

Your near-thankless intervention made the difference on that day and is to be commended.

Glad to see that people got a little motivated by this thread.  With the upcoming healthcare shortages we will need to have more supplies on hand than ever.

Great AAR.  It's easy to get caught up and over spend time and resources in that situation,  don't beat yourself up too much.

Re:bandages.  You can throw something clean/sterile (like a 4x4), then cover with cloth (like a t shirt) for the bandage. That might stretch your supplies.   I'm a fan of 4x4s, you always use more than you think.  ACE wraps and some gauze make a good pressure bandage.  I use those and Israeli bandages, similar reason.

Good job on the improvised splints.  Watch out for accidentally making a tourniquet if you use duct tape or something.

We put together our own "bag" with help from my Doc and trauma nurse we know. It's about 10 pounds and it goes everywhere with us. From sucking chest wounds to sunburn we're covered.

I probably would not have investigated the sound. Some people owe you a big thanks.

Good job.

Fwiw, if you're bandaging big cuts then it could possibly need a tq and probably some gauze to pack inside the wound.

For those that carry quick clot, look into chitogauze. Quick clot isn't effective if someone is taking nsaids. Try not to pack motrin in the same pack as quick clot.

Quick clot works well otherwise.

I'm not 100% sure how many of each I have in my car bag but I get TQ, chitogauze, ETD bandages, chest seals, extra wound packing gauze, decompression needles, NP tubes Everytime I see a sale at NAR.

My car bag

Rubber gloves, stethoscope, bp cuff, a couple sharpies and the above equipment.

Benadryl, Tylenol, Motrin, and aspirin.

Probably a few things I forgot too.