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Posted: 4/30/2011 8:46:26 PM EDT
[Last Edit: 4/30/2011 8:50:00 PM EDT by brucers99]
My BoB medical kit has grown to unreasonable proportions and weight.  I could use some help identifying where I can cut.
Here are the current contents:








 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 





 

 






 
2


 

 
Trauma Pads - 5" x 9"


 

 
6


 

 
Lidocaine and Aloe Cleansing Wipes


 

 
2


 

 
Benzoin Tincture Ampules


 

 
1


 

 
Stretch Gauze Bandage - 3"


 

 
1


 

 
Povidone-Iodine 10% Solution


 

 
1


 

 
Petroleum Gauze


 

 
1


 

 
CoFlex LF2, 3"


 

 
1


 

 
Suture Strip Plus, Wound Closure
 Strips



 

 
1


 

 
PriMed Compressed Gauze Bandage


 

 
1


 

 
Suture Materials - 3/0 Nylon


 

 
1


 

 
Suture Materials - 5/0 Nylon


 

 
1


 

 
Scalpel, #10


 

 
1


 

 
Mitigator Sting & Bite
 Treatment



 

 
1


 

 
2nd Skin Dressing


 

 
1


 

 
Hemostat, Kelly Forceps Straight -
 Sterile



 

 
2


 

 
Benzoin Swabs


 

 
4


 

 
Antiseptic Towelettes


 

 
10


 

 
Cotton Tipped Applicators


 

 
4


 

 
Povidone-Iodine Prep Pads


 

 
2


 

 
Gauze Pads - 4" x 4"


 

 
6


 

 
Personal Antimicrobial Wipes


 

 
1


 

 
Tick Tweezers


 

 
4


 

 
Bandaids


 

 
4


 

 
Finger Bandaids


 

 
1


 

 
Syringe and Needle (Details?)


 

 
1


 

 
Aloe Vera Gel, 0.75 oz.


 

 
4


 

 
Triple Antibiotic Ointment


 

 
4


 

 
Hydrocortisone Cream 1%


 

 
10


 

 
Aspirin, 325 mg Tablet


 

 
10


 

 
Acetaminophen, 325 mg Tablet


 

 
10


 

 
Ibuprofen, 200 mg Tablet


 

 
10


 

 
Diphenhydramine, 25 mg Capsule


 

 
10


 

 
Diamode, 2 mg Tablet


 

 
10


 

 
Diotame Tablet


 

 
10


 

 
Alamag Tablet


 

 
1


 

 
Glucose, 25 mg Tube


 

 
3


 

 
Cera Lyte 70, 50 g Packet, Lemon


 

 
1


 

 
Combat Shears


 

 
1


 

 
SOF Tactical Tourniquet


 

 
1


 

 
4” Olaes Modular Bandage


 

 
1


 

 
6” Olaes Modular Bandage


 

 
1


 

 
Blast Bandage


 

 
1


 

 
Zpack Gauze


 

 
1


 

 
Petrolatum Gauze


 

 
1


 

 
Nasopharyngeal Airway


 

 
1


 

 
Lubricant for Nasopharyngeal Airway


 

 
1


 

 
2” Tape


 

 
3


 

 
Nitrile Gloves (Pair)


 

 
1


 

 
14ga Needle


 

 
1


 

 
Asherman Chest Seal


 

 
1


 

 
Celox D (3 17g Soluble Bags)


 

 
1


 

 
Waterjel Burn Dressing


 




Link Posted: 4/30/2011 9:28:00 PM EDT
what is your training level? the first 2 items i see that can go is the naso airway and lube for it. without a BVM they are useless. another item is the chest seal. you have petroleum gauze, that and tape and you can make your own chest seal. hell you can use a small piece of saran wrap and tape and make a chest seal.
Link Posted: 4/30/2011 10:12:36 PM EDT
start http://www.ar15.com/forums/topic.html?b=10&f=18&t=644558 here are supplement with what you need. ive read through all of this and it seems solid to me. of course you may want to bulk up the quantity a little bit because this is a minimum kit but you should be able to figure it out.
Link Posted: 4/30/2011 10:12:57 PM EDT
A lot of the creams, towlettes and ointments and what not could probably get traded for 100% betadine.   That could be cut with water to various strengths as needed.  





It seems to me with 1st aid and emergency medical stuff, everything is either too much or never enough regardless what you do.  
But then again, my first aid kit consists of a 10$ "boo boo" store bought kit (all the band aids and stuff for scrapes and bumps), a big triangle bandage, an Israeli bandage, and a few odds and ends I grabbed out of my IFAK before turning it in in the military  (Tourniquet, quick clot and such).
Link Posted: 5/1/2011 4:03:29 PM EDT
Lots and Lots can be done with 4x4's and tape.  
All of your meds look ok at a glance, except for dosages.  Think about how long you plan on bugging out, then look at dosages.  10 Ibuprofen?  That's 2 and a half max doses, or just under 10 hours of coverage.  Also, no need for that and Acetaminophen.  Ibu does all that Tylenol does and is an anti inflammatory.
Remember, BoB is mainly for a few days, so accordingly, a few days worth of dressings could be a SHIT load, especially with a serious wound.  We use the large packs of 4x4's at work for just one dressing change on a surgical wound that shouldn't be actively bleeding much.  If SHTF and you have a big laceration it's gonna bleed.  
Suture as a last resort, or you will sew contaminants into the wound.  Duct tape should work to close a wound, though so should those steri-strip type things you have, it's just the Duct tape has 4 Billion uses.  
Use the 2 packs of 4x4's(which is far more practical anyway) and grab a lot of them.
Whoever said Betadine replaces a lot is right on.  Good old 10% betadine is great.  It doesn't sting, so no need for lido pads nor alcohol pads.  Also, I believe 10 drops in a Liter of water will purify it, and add a Vitamin C tab and it takes the taste away.  However, remember to wait 30-45 mins as the Vit c also cancels out the purification properties of the iodine along with the taste.
Coflex is a good idea too.
The Sting and bite treatment is just a boo-boo level thing.  Look at the main ingredient.  Ammonia.  I'd imagine you could Pee on a mosquito bite and it'd be the same thing more or less, and Sterile to boot with no added weight.
Q-tips are ok, if a little bulky.  More suited for a stay put kit, but if it fits...
Syringe and needle?  no need.  The back woods are not the place to play with these.  If you need details, you shouldn't have them.  Hell, I'm a nurse and I don't include them.
Grab one big tube of triple antibiotic.  It's basically Vaseline (aka fire starter) and really doesn't take up much weight for the utility and many more doses.
Scalpels weigh nothing and are hella useful.. If you get some, get a box and throw 6 or 8 in a kit.  then some more in your survival kit.  And a couple more in your wallet.  
The hemostats are good, if only to replace the tick tweezers and to grab that screw that fell into the console of the bug out truck.
The 4” Olaes Modular Bandage looks cool, I'll have to look more at that for me.
The 14g needle the ascherman and the Celox should be in a seperate bag, right?  Do you know where to put the 14g or how long to make the NPA?  Not to be a dick, but it's a training thing.  NPA too short it's doing nothing, too long, it's not as effective as it could be.  Needle to low, you puncture the lung, too High you could hit the subclavian artery.  
As for the Celox, I have recently decided to grab a Quickclot gauze dressing.  Watch the Training video on youtube.  Not sure how it compares to Celox, but the Quickclot gauze is heat free.
You could also use a SAM splint.  Combined with your compressed gauze or the coban that'd be a great addition.


These are my $.02.  I work  as a surgery nurse so I see wound closure and wound dressing every day. I have thought a lot about how to take wound dressing to it's most basic in order to buy just a few things and be able to stack them deep.  I have my educational limitations and as I have yet to attend a tactical trauma course, I leave that to the professionals, though I would recommend most folks to leave the chest decompression and NPA management to the professionals or get training.  I have no Idea your level of training, so I am just trying to help you.  I for one have attended a trauma course where we learned where how and when to decompress, and I would be shitting my pants as I slid that Needle in.

Hope that helps...

jim
Link Posted: 5/1/2011 5:10:38 PM EDT
One thing our Corpsman did was "Field strip" packaging on a lot of the stuff they carried.  My Doc said it was because whatever caused the trauma in the first place was going to be a lot less sterile than the stuff in his Truama bag, and it made it faster to deploy when needed, since he wouldn't have to contend with trying to find tiny edges of wrappers to peel open.    Made sense to me at the time, since I could have very likly been the guy bleeding out he was trying to save.  
YMMV of course.  
Link Posted: 5/1/2011 5:54:46 PM EDT
[Last Edit: 5/1/2011 5:55:23 PM EDT by gasdoc09]
Originally Posted By mylt1:
what is your training level?

Most important question, it determines what you're capable of doing with the stuff.

2nd most important question is to decide on a weight budget, it determines how much stuff you can carry.  The med bag I carried when attached to the Marines was a 50+ pound blackhawk stomp2 with a pair of side bags full of stuff, but I didn't walk anywhere with it, my gun/ammo weight was just a pistol and a couple extra mags, and I had a bunch of heavily armed friends along ready to kill anybody who needed killing.  I had corpsmen who wanted to carry 40 pound med bags stuffed with endotracheal tubes and traction splints and other crazy stuff.  Usually after a couple days toting that crap around they didn't need my help thinning it out.

At present I have 3 packed med bags.  I still have my greenside-era overstuffed med bag packed and ready to go someplace ... in a vehicle.  The med bag I have ready to carry on foot is a barebones minimum, really not a lot more in it than what they put in ifaks these days.  I also have a somewhat larger bag that goes with me to the range because I figure the odds of me or someone near me getting shot are highest at the range when someone's girlfriend goes along for the first time ...

Originally Posted By mylt1:the first 2 items i see that can go is the naso airway and lube for it. without a BVM they are useless.

I don't really agree with this.  Most of the time, apnea in an unconscious person is due to obstruction, not absent respiratory drive.  I sometimes put NP airways in patients under varying levels of anesthesia without bagging them.  An open airway frees your hands that don't have to head-tilt/chin-lift any more.

The truth is that a trauma patient that has no respiratory drive (ie, needs mechanical ventilation) is probably going to die no matter what you do, especially if a higher level of care isn't nearby.  But obstructed airways can kill people who have otherwise survivable injuries.

Originally Posted By mylt1:another item is the chest seal. you have petroleum gauze, that and tape and you can make your own chest seal. hell you can use a small piece of saran wrap and tape and make a chest seal.

Agreed.  Tape, lots of tape, is super important because those chest seals have a bad habit of not sticking to people covered with blood.
Link Posted: 5/2/2011 4:07:49 PM EDT
My training level is decent due to having a friend who is an EMT show me how to work most things in theory.  I will admit I have had no real world or even dummy practice.  I included some of the items with the expectation that my ER doc and/or EMT friend will be close at hand.
Link Posted: 5/2/2011 5:32:30 PM EDT
Originally Posted By gasdoc09:
Originally Posted By mylt1:
what is your training level?

Most important question, it determines what you're capable of doing with the stuff.

Originally Posted By mylt1:the first 2 items i see that can go is the naso airway and lube for it. without a BVM they are useless.

I don't really agree with this.  Most of the time, apnea in an unconscious person is due to obstruction, not absent respiratory drive.  I sometimes put NP airways in patients under varying levels of anesthesia without bagging them.  An open airway frees your hands that don't have to head-tilt/chin-lift any more.

The truth is that a trauma patient that has no respiratory drive (ie, needs mechanical ventilation) is probably going to die no matter what you do, especially if a higher level of care isn't nearby.  But obstructed airways can kill people who have otherwise survivable injuries.


He doesn't do anesthesia does he? Nothing wrong with a NP airway and/or an oral airway for that matter.  Not much to add to what you've said on this cause I agree 100%. I too carry a stripped down kit not larger much than and IFAK. I've never seen the need for much more in civ use. My .mil experience is different, but I was part of a CSH (Combat Support Hospital) for that.
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