Saturday, February 15, 2014

SHTF Medical Kit

So, Baby Brother, while generally ignoring my advice on any number of things, mostly out of simple orneriness, occasionally does recognize that I have some wee amount of expertise in the medical arts. It's nice to know that the degree and twenty years of experience weren't a total waste.

Which got him, in a roundabout way, noticing a decided lack of medical preparations for longer-term care. (Longer than, say, the farcical Official Suggestions from TPTB that 72 hours' worth of anything will see you through until Help arrives. As if...)

As for training, let's note that he was a diligent student of basic First Aid For Soldiers when it was taught him. In his case, that would be several presidents ago.

I asked him his absolute max budget, and he said that $1K was the top end. In other words, not the Mayo Clinic, but pretty much anything reasonable. (You should know that my professional kit for use in the entertainment industry on location comes in at around $2K, give or take. YMMV) He'd come upon a Pelican 1600 case, and wants to fill it.

So, my suggestions to him, sourced and costed, and notes after:

1. The divider set and lid liner for your Pelican 1600 case            
2. Quickclot ACS Gauze  Pads                                             
(3) x $29.99@
3. Quickclot Combat Gauze Rolls                                         
(2) x $42.89@
4. Asherman Chest Seal                                                        
(2) x $10.75@
5. Combat Application Tourniquet                                          
(4) x $29.99@
6. NP Airways 1 ea 28Fr/30Fr/32Fr/34Fr                                
(4) x $3.74@
7. Surgilube packets for using NP Airways, 25 3g packets            
8. SAM splints                                                                         
(2) x $12.00@
9. Israeli Emergency Bandage 4"                                          
(4) x $6.29@
10. Israeli Emergency Bandage 6"                                         
(4) x $6.56@
11. Primed Compressed Gauze Bandage                             
(6) x $2.44@
12. Israeli Emergency Abdominal Bandage                             
(2) x $12.12@
13. Muslin triangular Bandage                                                   
(6) x $0.47@
14. BZK Antiseptic towellettes (100/bx)                                         
15. Povidone-iodine prep pads (100/bx)                                     
(same source as above)
16. Bottles of Bactine and Betadine Solution (3-6 oz.)             
- $10@
Wal-Mart. CVS, Target, etc.
17. Burn kit                                                                                 
18. Water jel burn gel                                                         
(12) x $0.53@
19. Triple antibiotic ointment (generic Neosporin, 25 0.9g packets)
3 x $4.30@
20. Military casualty space blanket                                         
2 x $19.67
21. Band Aids Assorted (100)                                                     
      Band Aids 1"x3" (100)                                                           
      Band Aids Extra Large (10)                                               
2 x $5.49@
      Knuckle Bandages (40)                                                           
      Butterfly Bandages (100)                                                         
22. Self-adhering 3" bandage wrap (24)                                     
23. 1" First Aid tape       silk     (12s)       
                                        plastic (12s)         
24. Gauze sponges         4"x4"   (200)                                       
                                         2"x2"   (200)                                        
25. Gloves, nitrile                                    
- $15
Wal-Mart, CVS, Target, etc.
 Around $850, out the door.
You can trim back some of the spendier high-speed tactical stuff to save a few bucks, but it's your ass (or someone near and dear to you), and I don't think you want to run out of supplies before you fix all the holes.
Drop the money on the divider. It's the reason the EMS Pelican is another $150. It gives you small clear pockets for the small stuff, and 18+ pockets in the bottom for the big stuff.
I set this up so you could handle the most likely emergency problems (cuts, punctures, burns, sprains & fractures), including the TCCC {look it up!} supplies most likely to save your or someone else's life if someone catches a cowboy load at the range, as well as GSWs after the Zombie Apocalypse. Dual utility.
The plain gauze, tape and band-aids are for the far more frequent little stuff, to prevent turning it into bigger problems.
I didn't source (but you should add) two things:
* A good AAA LED headlamp, because you'll really appreciate light and both hands free when it's dark. My personal favorite ( I have 3 of them) is the Petzl Tactika Plus Headlamp. I get mine at REI for about $46 or so.
Runs on 3 AAA, has a red lens that flips on or off, and has 4 light settings - econo, medium, bright, and flashing.
* The other thing is a good disposable CPR face shield, so you don't swap cooties in CPR. I'd get one in case you need to do CPR on family members, or them on you, but otherwise, I can't see you doing rescue breathing on anyone not on the cover of the Sports illustrated Swimsuit issue, so I left it out.
Until such time as you re-acquaint yourself with First Aid, bear in mind that it's still mostly what you learned in boot camp in the prehistoric era: Stop the bleeding, start the breathing, protect the wound, and treat for shock.
Direct Pressure, Pressure dressing, elevate the limb, tourniquet (don't be shy - unlike in the 1980s, they now know tourniquets like the CAT applied early is a lifesaver for bleeding extremities).
For minor holes, pressure with the 2x2s or 4x4s, then clean with the BZK/Bactine (same thing, except Bactine has low-dose lidocaine to make it sting less!), clean any penetrating trauma with Betadine and sterile non-preserved saline, then sterile dressing and clean bandage. pressure and pressure dressings, including Israeli bandage, or plain old ACE wraps, and if necessary, a tourniquet as well.
Airway is simple once 911 isn't an option: either a nasal trumpet, lubed outside with the Surgilube, up one or both snotstrils will open it, or they're going to die.
If you want to learn about TCCC needle decompression, and cricothyrotomy airways, we can talk. There are actual military/medical training vids on YouTube right now.
But outside of civilization, you aren't going to save anyone with CPR after 30 minutes, unless they were immersed in frigid water. If they stop breathing for other reasons, and you can't get them breathing again after half an hour, and help isn't on its way, that's probably a hint to go through their pockets for loose change, and collect one of their dogtags.
And in any victim unable to move around afterwards, whip on those space blankets, either for shade, or for warmth.
I also left out things like C-collars and anything diagnostic, until such time as you learn how to use it.
If you get a wild hair up your ass, find out who's doing basic EMT training at the local CC out there, and consider doing the class.
Training is the only thing you can't pull out of a kit, and some things, you just have to learn.
If you want, I can teach you how to measure blood pressure in about 20 minutes, but you need a stethoscope (A $20 Sprague works fine) and an adult cuff (manual, with a squeezy bulb, not one of those pieces of electro-garbage.) Let me know, anytime you want. One of the $60 fingertip pulse oximeters gets you pulse and O2%. Add a good thermometer, and you've now mastered the same triage vitals done in every ER from coast to coast.
A couple of good tweezers for splinters (a flat set, and a pointy set) are always a good idea, and you can grab those at any decent drugstore. Several small sewing needles work great for working out splinters and shallow stuff imbedded at the surface of the skin. An X-acto knife if you're feeling daring. Note that the large burn kit has a pair of good EMT shears in it, to use anytime you need to cut clothes open or off, so no need to buy a separate one.
Resist the urge to get a "kit, instrument, surgical". They're overpriced, under-useful, and you could get better instruments just by visiting a gun show.
And unless you know what you're doing, you don't need the toys to go poking around in holes, or start yanking things out until you know what they're into. Anything deeper than your range of sight needs to be left in a hole until someone with better training decides whether it can come out or not, verstehen sie?
When you get the box, and the goodies, not everything on that list can or should fit inside it. And adhesives don't like hot cars. So put some of the items inside, and replenish as you use them, or annually check them and replace the crusty ones.
DO put the kit in your truck, because if you need it at a shoot, or on the highway, it won't do you any good at home on top of the gun safe, right?
I hope you have stashed/are stashing a cushion of any family Rx meds by any means possible, including "oops, I lost my meds and need a whole month's replacement!" provided you're footing the bill, or any other legal way possible. Cycle through the overstock first in/first out, so you eventually always have 3-6 months of fresh stuff in reserve. Imagine a major earthquake, and no pharmacy for a month or three. Let alone anything more dire.
Note also I didn't include any meds except topical wound stuff.
I'm a big fan of getting the unit dose packages of whatever you already use, like Tylenol, Motrin/Advil, Tums, Pepto, and anything else. OTCs don't magically go bad after three years, so don't throw them out, just don't give them to anyone not related to you by blood. Except for certain antibiotics, most pills remain useable for 10-30 years if stored properly (cool, dark, dry).
Don't forget sunscreen, chapstick, and bug juice.
Any questions, fire away.
Nothing earth-shattering there, but if I'm giving give away free first aid kit advice, I'm at least going to get a blog post out of it.
You could spend a lot more and still do a lot worse.
Make use of this as you will, but the usual caveats apply:
I'm not a doctor, I'm sure as hell not your doctor, read and follow all label directions, use of any or all of this equipment or advice without adequate training or basic common sense means you're a dangerous idiot, and completely on your own in a court of law, where I will laugh at you and ridicule you at length, may contain peanuts, or chemicals known to the State of Califrutopia to cause birth defects, cancer, or an overwhelming desire to attend Justin Beiber concerts.
Now you've been warned.
Go put a first aid kit together, and not the $4 one from the auto club in your glove box put there in 1994.


RandyGC said...

Working events like parades and festival (radio support) I found having some kid band aids with cartoon characters are a hit when a little one has a minor boo boo not requiring EMT support.

Good write up, I need to fill some holes in my kit.

Aesop said...

Been doing that myself since about 1990, for the same uses.
They're in my movie kit.

(There's nothing funnier than putting a Disney princess bandaid on a Teamster where he can't see it - like his forehead - and then waiting for one of his fellow Teamsters to tell him about it. Or not.)

BB's youngest started college this year, so that's not an issue currently.

Frankly, I'm happy he finally noticed that just guns and ammo weren't going to get it done if things go all sideways.

Maybe it's The Walking Dead Effect, maybe he's just a slow learner, but it's progress.

My next mission is trying to get him to stock his pantry like he does his arms locker.

Small steps.

Jason said...

Great info, thank you!

Aesop said...

Hope you can make good use of it.

Retired Spook said...

A Sprague is okay, but for those of us who spent our formative years on a two-way rifle range, (or are simply getting old, or both), a Littman is Da Bomb, and doesn't cost all that much more.

Doing BPs in an industrial setting, I've found that if I pump the cuff up to 200, THEN apply the stethoscope as the needle is creeping down, I get a better reading than if I tried to listen through the inflation sequence.


Stu said...

Your website is one of the reasons I took my EMR class and will take my EMT class this fall. Knowledge is power. Just yesterday I had to call EMS for my dad, on the same day my mother had gall bladder surgery. It truly can happen anytime, anywhere. Be prepared and be ready.