Personal First Aid Kit

[XTROOPER]

I carry a fairly extensive First Aid Kit in the Kubota RTV 1100 I use to haul firewood. I have been thinking lately of carrying a small personal first aid kit on my belt. I am often far from the rig and assume many chain saw injuries would tend to be very serious. I am thinking something like Quick Clot and a tourniquet. Many tactical law enforcement officers are carrying small trauma kids on them to respond quickly to trauma like gunshot or knife wounds. What do you guys think? I know carrying extra weight on you is a pain, but I am a novice at this stuff and know of many pros over the years that have been seriously injured and worse. Any thoughts would be appreciated, good bunch of folks on this site with a great deal of knowledge.

Thanks.

XTROOPER

 

[avalancher]

Forget the tourniquet, that is a no no. What you want to stop bleeding in a large wound is a large bandage and direct pressure. A tourniquet is used when nothing else will stop the bleeding as it often destroys more than it helps.

For chainsaw injuries that are bad, get yourself some womens maxi pads along with a few rolls of tape. Pull the tape end up and stick it back on itself just on the end so that in the case of an severe injury you can get ahold of the tape with one hand when you have the jitters.

Even in the case of an arm being severed off, you can generally stem the flow of blood with direct pressure right on the stump. I was working in a cabinet shop years ago when a guy ran his hand right through the table saw, and took it right off right at the wrist. I slapped half a dozen sheets of newspapers over the stump, held direct pressure to it, and we threw him in the back seat of a nearby pick up and raced to the ER.I had the guys retrieve his hand from underneath the table saw, and told em to wrap it up in two shirts and keep it on ice until they got to the ER with it. Believe it or not, they were able to reattach his hand, and two years later he returned back to work.Sure, the hand did not work as well as it used to, but it was better than walking around like Capt. Hook.

If you are going to carry a personal trauma bag, limit it to severe trauma stuff like maxi pads, tape and a whistle (to get the attention of anyone working nearby you). Anything else can wait until you get back to the truck for minor injuries that require band aids etc. When working alone I carry such a rig taped to the oil jug for my saw as it is rarely more than a few steps away from me.Havent had to use it yet, but its nice knowing its there.

 

[mikey517]

Avalancher beat me to it.

Best thing to carry are the maxi pads and tape / gauze. Carried kotex pads in my briefcase in the late 70's when I was in uniform and used them regularly at accident scenes, etc until the first aid rigs arrived. Those pads are sterile and will do the trick when packed into an open, gaping wound. The PD started ordering the individual commercial packs and putting them in every kit in every radio car.

Last year at my retirement job in a middle school, a custodial worker caught the tip of his finger in a pully. Took the finger right off at the first knulcke, and left it hanging by a whisper of skin. I grabbed a pad from the health office, put the tip back in place (sort of), and wrapped it in a pad & gauze, and kept his arm above his heart. We transported him to the nearest ER for treatment.

He still has, and can use that finger tip!

 

[VTWoodchuck]

First, my background so you know I'm not full of it. 12 years active duty as an infantryman. 8 regular Army, 4 full time national guard which I'm still doing. 3 combat tours, most recent was 2010 to a-stan.
When I first joined the tourniquet was a last resort. Now things have changed. We all carry at least one CAT tourniquet Combat Tourniquet on us at all times in a easy to reach location. Reasoning is that you will be with a surgeon before major damage occurs. They stop bleeding and you can put on yourself with practice. If your are out cutting alone it will may keep you from bleeding out which is worse than losing a limb.
Quick clot is a no go in the Army these days. There is a potential that it could enter your bloodstream and really screw you up. I've seen it put on an Iraqi who was in a car we shot up and he lost part of his arm. He did NOT enjoy having it poured on his stump! I hear it hurts like hell.
Wear your chaps and pay attention to what you're doing. I always treat guns, women and chainsaws like they're trying to kill me at all times.:msp_thumbup:

 

[kevin j]

My background is basic training in wilderness medicine (canoeing) and some industrial safety, so I am just a novice.
However, a climber friend of mine recommended a tourniquet made from a thin bike innertube, with plastic Fastex buckles tied on each end. His logic, and makes sense from some other types of injuries I have seen, is that in a serious chain injury, especially to the groin arteries, there may not be two hands to work with, and everything is messy and slippery so working with tape may not be possible and time may be critical before passing out. The rubber tourniquet can be wound a few turns around an upper thigh and buckles snapped together quickly. all one handed and stays in place if the injured one passes out.
One trainer said stop the bleeding. It that means a dirty rag, you may have a bad infection in a day or two. If the blood keeps running, infection is sort of irrelevant. Same story on the tourniquet. Stop the bleeding, get the heart going again, and the rest is details.
So I have a small pocket on chaps belt, with the rubber strap, a maxipad, and aspirin (heart). The whistle is a good idea. Have them in my outdoor gear, never thought about sawing.
I don't cut alone, have someone with a cell phone handy, and hope this is all excess baggage.

 

[kingsixx]

I'm going to second VTWoodchucks post and I have a similar background to him. Tourniquets like the one he mentioned are very user friendly, designed to be applied by the victim in the event that there is no one there to aid him/her. Recent studies are showing that the use of tourniquets have been instrumental in stopping the loss of blood volume in a way that has decreased the mortality rate of severe traumatic injuries significantly.

Quik Clot makes a product called "Combat Gauze" basically its a 3 or 4 yard roll of gauze that is impregnated with a homeostatic agent designed to stop the bleeding fast. This gauze is designed where you can wrap it around an injury (externally) or you can actually "stuff" it into a penetrating wound and use it internally. Pretty amazing stuff.

If you're not squeamish, check out this video. Its testing done on live pigs that demonstrate the effectiveness of this product. It might be kinda graphic for some so please, if found to be offensive I apologize in advance but I think that the information is very important and people should know how to use their kit.

[video=youtube;C3TUKKx0cus]http://www.youtube.com/watch?v=C3TUKKx0cus[/video]

These two items are always present in my kits both portable and the larger ones. One thing that people forget is that they need to know what's in their kit and how to use it. You can have the best gear in the world but if you have no idear how to use it, what good is it? Seek training and practice on your own.

 

[Dalmatian90]

Forget the tourniquet, that is a no no. What you want to stop bleeding in a large wound is a large bandage and direct pressure. A tourniquet is used when nothing else will stop the bleeding as it often destroys more than it helps.

That's no longer the current training.

Now it's don't #### around with blood loss if you're within two hours of a hospital. If a basic bandage and direct pressure doesn't immediately fix the issue, tourniquet the limb.

If isolated in the wilderness w/o communication to a hospital, release it every hour and re-evaluate.

If isolated but able to communicate to a hospital, then it's time to talk to the doc to manage the tourniquet cycles.

You still need pressure bandages since not all wounds (torso, groin, face) can be tourniqueted.

And for those treating someone isolated from timely EMS, you might use the tourniquet to initially control the bleeding while you clean up the wound area (slippery blood on skin, etc.) and bandage it tightly before releasing it and seeing how the bandage is doing.

 

[stihly dan]

First, my background so you know I'm not full of it. 12 years active duty as an infantryman. 8 regular Army, 4 full time national guard which I'm still doing. 3 combat tours, most recent was 2010 to a-stan.
When I first joined the tourniquet was a last resort. Now things have changed. We all carry at least one CAT tourniquet Combat Tourniquet on us at all times in a easy to reach location. Reasoning is that you will be with a surgeon before major damage occurs. They stop bleeding and you can put on yourself with practice. If your are out cutting alone it will may keep you from bleeding out which is worse than losing a limb.
Quick clot is a no go in the Army these days. There is a potential that it could enter your bloodstream and really screw you up. I've seen it put on an Iraqi who was in a car we shot up and he lost part of his arm. He did NOT enjoy having it poured on his stump! I hear it hurts like hell.
Wear your chaps and pay attention to what you're doing. I always treat guns, women and chainsaws like they're trying to kill me at all times.:msp_thumbup:

How doe's one treat a woman, like she is going to kill him.

 

[VTWoodchuck]

How doe's one treat a woman, like she is going to kill him.

You must not be married

 

[Hddnis]

You must not be married

Or drive on public roads.




Mr. HE

 

[Hddnis]

I've been know to climb with a small one in a pocket.




Mr. HE

 

[stihly dan]

You must not be married

Oh I am.... But if I treated her like she was going to kill me, she would be pushing up daisies. Not that she's not trying to kill me, I just don't treat her that way. How's the song go? (killing me slowly)

 

[blackdogon57]

Make sure you have a cell phone that works. Assuming you have service, and many rural areas now do, you can get help to you pretty quick. With gps technology they will find you even if you pass out once the call is made.

 

[C7W]

From a flight paramedic

Hey XTROOPER,
Also to throw my credentials as well. Army Flight Paramedic for 15+ years with two combat tours to Afghanistan as well as firefighter/paramedic for about 10+ years. Not great with chainsaws and wood yet, but I do know some stuff about emergency trauma care. I have to support everyone on here in regards to early and immediate use of a tourniquet. Tourniquets are back in fashion. Used to be taught that they cause lots of damage. Now studies are showing that tourniquets are saving lives without causing any damage (in many cases the tourniquets can stay on for 8+ hours without any long term damage caused by the tourniquet.) Packing a wound with Maxipads or flaked out rolls of Kerlix gauze with direct pressure on top of the packing is also extremely effective in stopping bleeding... I speak from multiple personal experiences on this. But, if you think it's at all serious, put the tourniquet on and don't screw around at all. The medics can loosen it later or take it off later if necessary (usually it isn't that big of a deal). Stopping bleeding effectively and early is really the key. The quick Clot is now controversial as mentioned before... the concern is causing pulmonary embolisms or other blood clots where you don't want them. We carried a thing called Combat gauze which was impregnated with Celox which was somewhat different than quick clot but helped in the clotting cascade... I don't know if this is still considered safe or not but I have some that I intend to use if needed while cutting.


So, what to carry:
First things first: Wear your chaps and other appropriate PPE. Prevent the injury in the first place.


1. *Tourniquet* if you want is a good thing to have. (C-A-T - Combat Application Tourniquet)

2.**Rolls of roller gauze or H and H gauze** (PriMed Compressed Gauze Bandage | www.chinookmed.com)

3. Celox type gauze (Massive Hemorrhage)

I hope this helps. If you have any questions, let me know, but the tourniquet and wound packing can stop almost any bleeding in almost any situation. If no gauze is available, then almost any sort of soft absorbant fabric can work for wound packing... especially like a T shirt. Infections can usually be treated with antibiotics later and the chain that caused the wound is likely to need to be treated with antibiotics anyway.

*Try to get a tourniquet that will last a long time under harsh conditions, because it is likely to sit in your bag for awhile (hopefully forever) and degrade with time. Plastic tends to break after being exposed to heat when you need it most. The CAT tourniquet is good, but you need to check it periodically and replace it periodically. The SOF tourniquet might last longer, but I always used the CAT, but we used them frequently.

** The H and H gauze is compressed and takes up very little space... I would get a couple of these in case you are worried about a major wound with arterial involvement.

 

[avalancher]

I guess emergency medical training protocol has changed a good bit since I received my EMT training 15 years ago, back then tourniquets were a no no, and if i remember right we didnt even carry them in our severe trauma bags, they were forbidden. The thought back then was direct pressure only, if it meant piling on gauze and sitting on the wounded guy to keep the pressure on. Thanks for giving me a heads up, looks like I have some brushing up to do!

 

[VTWoodchuck]

Oh I am.... But if I treated her like she was going to kill me, she would be pushing up daisies. Not that she's not trying to kill me, I just don't treat her that way. How's the song go? (killing me slowly)

Dude, you have the best screen name! Thats a great band.

 

[XTROOPER]

Thanks

C7W, that was just what I needed to know. I was hoping a pararescue or combat medic would contribute here. Thank you very much for you contribution.

XTROOPER

 

[C7W]

Glad to help. Anymore questions on that sort of stuff I would love to help. Emergency medicine in the field is something I love and am always trying to improve or learn more about.:msp_smile:

 

[C7W]

Tourniquets and War

I guess emergency medical training protocol has changed a good bit since I received my EMT training 15 years ago, back then tourniquets were a no no, and if i remember right we didnt even carry them in our severe trauma bags, they were forbidden. The thought back then was direct pressure only, if it meant piling on gauze and sitting on the wounded guy to keep the pressure on. Thanks for giving me a heads up, looks like I have some brushing up to do!

Yeah, that's exactly how it was when I started too. Using tourniquets has been a difficult change to institute, but here's where it came from- Early in Afghanistan and Iraq there were three things that were killing somewhere in the neighborhood of 90+% of US soldiers. 1. Compressible hemmhorage (something a tourniquet would work on. 2. Tension pneumothorax (something that a single needle could at least temporarily release. 3. Airway issues that could be addressed with a nasopharyngeal airway. The other 10- % were immediately fatal injuries such as gunshot to head or other totally nonsurvivable injuries. So those three things were the driving force in creating the IFAK (Improved First Aid Kit)... the kit included a Tourniquet, a large needle for chest decompression, and a nasopharyngeal airway (NPA). The IFAK is small, light and carried by ALL on the battle field and all were trained on how to use a tourniquet, needle decompression, and NPAs... Addressing those three basic things helped to foster about 90%+ survival rate for troops wounded in battle during recent years.

Funny, thing: I got a chance to talk to a Vietnam Medic (who was a Medal of Honor Recipient) and a person in the group asked him about what sorts of things he carried in Vietnam. He said: 1. A good pair of Scissors for cutting off clothes. 2. Gauze or something to bandage wounds, 3. A good tourniquet. It seems like some techniques just wind up getting cycled back to because they work... I think tourniquets got used in WWII and further back as well. The longer I do emergency medicine, the more I respect the basics!

In any case, there were a lot of people who didn't get tourniquets early on in the wars and as a result died. This data was captured, studied, and acted upon in recent years with great success.

This is the closest to what I carried on me in flight (I had a lot of other stuff too, but this plus Morphine autoinjectors was pretty close to what I always had strapped to my leg with almost the exact same little pouch):

S.T.O.R.M. Operator IFAK

Hope this helps. One other thing is to actually youtube actual use of tourniquets to see how to actually do it. It seems simple, but medics screw it up all the time. I can't tell you how many of those things I had to re do or tighten or add a second one to. Training on this stuff is totally necessary to get it right... it's not as intuitive as it seems. :msp_biggrin: