Monday, February 4, 2013

Lesson Three: Basic Kit

(Note: This was originally written circa 2005, with regard to a basic minimum kit for all purposes. I'll be updating it with a list of TC3 considerations/additions in the near future. For anything from under your carseat to next to your workshop bench, this is still the go-to kit I would recommend.)

Lesson Three: Have a good basic first aid kit

The first rule of a gunfight is “Bring a gun.” George S. Patton used to say that “A good plan NOW is better than a perfect plan later.”

In exactly the same measure, the first rule of being a prepared human is: Bring a first aid kit. And a good first aid kit NOW is better than a perfect one somewhere ELSE.

Example of reader-submitted First Aid Kit:

“My Travelling first aid kit is pretty basic.
Various sized Bandaids
4X4 Gauze pads
adhesive tape
Hydrogen peroxide- A debrider, not a disinfectant. I use it to clean wounds.
Neosporin/Bacitracin- Antibiotic cream for wounds after being cleaned by soap and water or Hydrogen peroxide…
2 ace bandages- 1 narrow, one wide. Good for slight sprains.
Ibuprofen tablets- My favorite pain reliever after Demerol…
Imodium (Liquid) A good plugger upper when Montezuma gets his revenge.

This covers most of the emergencies that you can self remedy. It all fits in a small plastic container that can be put in a backpack, carry-on luggage or even a tackle box...If these items can’t help, you probably should head for an Emergency Room."

The exemplar travelling kit just listed is a pretty good start. Personal preference, but I’d dump the peroxide, trade it for a bottle of Bactine—see Lesson One—and add four small things:
  • a pair of latex/non-latex exam gloves
  • a small pair of SHARP bandage scissors
  • a couple of ABD large wound dressings
  • and instead of eye drops, a 99-cent 4 oz. bottle of generic brand sterile non-preserved saline for contact lenses.
It’s sealed until you pierce the cap, it’s an instant sterile water wound cleaner; you can get some darn good pressure squirting it into wounds to blast the gunk out of a cut, scrape, puncture, etc. when you’re far away from running water. And that stuff is made to use for contact lenses, so it happens to be great for getting stuff out of your EYES. With those minor changes, the kit would be pretty decent.

What would make that kit, or virtually ANY kit you may favor, MILES ahead of ANY OTHER KIT IN THE WORLD, would be actually having it whenever you need it.

My day job (actually, my night job) is in one of the busiest ERs in the country. We see 300-500 patients a day, 24/7/365. And the reality is, there, or at the trauma center I used to work at—busiest on the planet!—almost 95% of EVERYTHING I needed for any patient I took care of in 15 years would fit inside the lunch pail I carried in 4th grade. (For those who’re wondering, the other 5% would be the prescription drugs by the ton, plus defibrillators, chest trays, CAT scanners, etc. A bit large for the personal kit, not including doctors. And for those wondering about the lunch pail, it was The Man From U.N.C.L.E. And you’re really weird for wondering!)

The example kit would be that small, or smaller. But you gotta bring a first aid kit to the accident. Without it, you’re not doing First Aid, you’re doing Last Aid, i.e. holding someone’s hand as they potentially expire. And we’re better people than that.

Another War Story: A friend of mine, one of my earliest medical instructors, was a well-known Disaster Magnet. Chad could be on a hike across Death Valley miles from anyone, and you could bet money he’d come upon a newly crash-landed 747 with 400 fresh patients. Probably before the FAA even knew it had gone down. And what made it funny rather than tragic was that he always carried his kit.
He was driving on the I-405 in the middle of L.A. one Saturday afternoon (way back in the pre-cell phone era), when he came upon two car loads of large families that had collided and crashed. It couldn’t have happened 5 seconds before he pulled up. With 14 patients, from 3 years old to 80. The paramedics/fire engine company arrived in 12 minutes. Which had given Chad an 11+ minute head start, which didn’t even work him into a good sweat. He had found, assessed, and recorded names and vital signs (yes, he even carried pediatric blood pressure cuffs) on every patient, written the info down, done the ABCs, hastily bandaged the wounds, sorted them by priority, and was waiting for the fire captain with a full report when the first engine and ambulance pulled up.
He proceeded to give his full report to the fire captain, whose men tagged along, and when he finished, Chad asked, “So, you guys got all that?”
The fire captain looked at him and replied “Yeah. But who ARE you?!”
Chad said, “Oh, just a first aid instructor.” And got in his car, got back on the road, and made it to that night’s first aid lecture, where he shared the story.
(He was subsequently invited by one of the fire department’s asst. chiefs to regularly assist in teaching their paramedics about accident scene management.)

A first aid kit can save a picnic, a day, or a life. Perhaps of YOUR loved one. But it can’t do any of those things if it’s sitting in the pack in the back closet of the bedroom 20 miles away.

So come up with a bare minimum, as suggested above or slightly different, pack it in whatever suits your fancy and will protect it and make it easy to find, and make sure it, or an expanded, enlarged, upgraded version of it—but NEVER less than that minimum—goes with you, on you, or close enough to get quickly, everywhere you go.

Remember, in a world where s#^t happens, the person with the roll of toilet paper is King.

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