I took a training with a Medic who I worked a few bad calls with. He rode a Medi-Vac bird, good guy. We were going over RSI for ground transport and he was quick to reiterate that you must make sure you need to do this...There is absolutely no way to secure the airway without knocking this patient down. As good as he was and like I said he was good, he said he always kept the cric kit right there by the tubes, the Etomidate and the Sux, to remind him if you Fu-k this up you might need this.@pmclaine - well said.
There is a reason IFAKs have an NPA and not a combi tube or an iGel airway (easy adjuncts) and not a cric kit.
The field of folks who are really solid and qualified for a field cric is not dissimilar to Div 1 NCAA quarterbacks. Its a pretty small group.
Have seen more than a few botched by "those trained and qualified".
I have seen them done. more than a couple. Trained on them (on dummies and pig trachs) and know how.
I dont carry a cric kit.
Not trying to be a jerk and too much stuff in a bag creates chaos when people are really sick.
Look at the .mil IFAK refill kits. thats key IMO, worth even less than you paid for it!!
So,long time pre-Scout lurker, reloading forum, vintage rifle,and px(buyer) troll. Former 3531 Marine, EAS’d in 1997. Been a Journeyman Lineman since ‘08 and have a lot of hurt man rescue and enclosed space training, in my work environment scenario’s. First aid, CPR,Aed, burn treatment at scene, etc. Pretty much has been milk toast in my opinion. “We’ll provide you with enough immediate aid stuff till EMS arrives” type training, is what it is. Wanting to advance myself past that.My question, and haven’t seen it here, unless I’ve missed it, what are you guys that have been down range, or first responders, using for compound fracture splints with and without arterial bleeding? As in what worked for you, and what hasn’t? And how about the Boo Boo’s? I’ve super glued a cut on myself to continue a task, painful, but doable, and being 47 now and younger then, healed nicely.What brand of cold packs work the best, the longest,and what to stay away from? Been doing a lot of Helocopter work out west recently and tried to do a comms check on a Inmarsat and couldn’t get comms to work and got me thinking about what to start looking at for splints, cold packs, snake bite, and dehydration. I’m talking 30 mi hump to nearest blacktop
road shit to get to EMS, because overland travel for a bus is too rough, can’t get comms with airship to come get to us and we can help scenario, all for power to cell tower...,.
So, my request for stuff that has worked for you guys and gals.
-No shit cold packs that work more than 5 minutes
-Snakebite kits, as well as the truth and myths about them, and what to do if i don’t have one. Side effects etc, if i use one on a crew member
-Splints
-TQ’s, self and assisted applied, think thread was started in ‘17, what are you guys training with and using in’22
-Hydration, we hold 2.4KV-16KV in rubber gloves and sleeves almost daily, (call it holding the devil), and have a hard time staying hydrated. So we’ve tried all the Pedialyte (sp?) type shit, liquid iv’s included. Anything else we can try, that maybe you don’t see online that is as good as a saline Iv bag when you need it for the consumer that isn’t main stream?
-Ankle wraps, wrist wraps in
-Iodine, we still using this for wound sterilization or not? Cream Corps was all about Iodine and ibuprofen back when I was in.
-What to use on a crew member if bird goes down, splashes fuel on the deck and a guy on the ground and gets JP8 fuel burns
-Tampons, are they sterile enough for wound packing and blood control? Flame away, just thinking outside, yes, the box. Was thinking their pretty light to carry and stuff.
Appreciate any comments and recommendations, been trolling a long time here and I think it’s one of the best topic’s and threads.
road shit to get to EMS, because overland travel for a bus is too rough, can’t get comms with airship to come get to us and we can help scenario, all for power to cell tower...,.
So, my request for stuff that has worked for you guys and gals.
-No shit cold packs that work more than 5 minutes
-Snakebite kits, as well as the truth and myths about them, and what to do if i don’t have one. Side effects etc, if i use one on a crew member
-Splints
-TQ’s, self and assisted applied, think thread was started in ‘17, what are you guys training with and using in’22
-Hydration, we hold 2.4KV-16KV in rubber gloves and sleeves almost daily, (call it holding the devil), and have a hard time staying hydrated. So we’ve tried all the Pedialyte (sp?) type shit, liquid iv’s included. Anything else we can try, that maybe you don’t see online that is as good as a saline Iv bag when you need it for the consumer that isn’t main stream?
-Ankle wraps, wrist wraps in
-Iodine, we still using this for wound sterilization or not? Cream Corps was all about Iodine and ibuprofen back when I was in.
-What to use on a crew member if bird goes down, splashes fuel on the deck and a guy on the ground and gets JP8 fuel burns
-Tampons, are they sterile enough for wound packing and blood control? Flame away, just thinking outside, yes, the box. Was thinking their pretty light to carry and stuff.
Appreciate any comments and recommendations, been trolling a long time here and I think it’s one of the best topic’s and threads.
A lot of good questions. I'm retired now so I'm not UTD on helicopter protocols and comm's but just before I left only the IC could call for a bird. The cost was getting out of sight and hospitals were reporting that some patients could have been ground transported. I've been on scenes when we had 2 birds on the ground and one on station and I know all of them we needed. As far as a company contracting with a flight system to protect their workers in remote areas that would be a good idea and as long as both entities agree on cost and payment Great. In that case employing a TCCC trained Paramedic on scene would be a no brainer. As far as equipment I have always dealt with these guy's https://tacmedsolutions.com/. Their stuff is top shelf and state of the art. They have training available, some of it free. I started with them when I was working on Active Shooter Response. The County I work for now has I think a response protocol that is World Class. They are I think reasonable " not cheap" but when you want stuff that has been tested and used in the field and works they have it.
I'll jump on the splint question since we just finished teaching a training session on them -
SAM splints will cover a multitude of issues, both in the wilderness and in/near civilization. If you can find training, get some, but even their web site offers some good information, and there are tons of youtubes as well. I carry one every time I'm in the field, and have a couple in my vehicle as well.
For long bone splinting, the HARE splint is the gold standard IMHO. However, it's not something you'd likely backpack with, and it takes some focused training to deploy effectively (I still have to stop and think every time we take one out). I've never used one in the wild, but one of the guys on my team has, and it's the shit. You can jury rig a hiking pole and a couple of bandannas/cravats into a long bone splint in an emergency, and those are things you'll likely have in the wild.
*As far as tampons, that's an old urban legend, and a seriously incorrect use of one. Tampons absorb blood, they don't clot it, and you always want to clot a severe bleed. A tampon will worsen the situation. Get some QuikClot and training on it. Also, learn to use a Tourniquet appropriately. I carry both a CAT and a SOFTT-W. The CAT is more popular, but I like the clasp on the SOFTT-W for use on leg bleeds where you have to navigate around drop leg gear and filled BDU pockets on .mil and .leo
SAM splints will cover a multitude of issues, both in the wilderness and in/near civilization. If you can find training, get some, but even their web site offers some good information, and there are tons of youtubes as well. I carry one every time I'm in the field, and have a couple in my vehicle as well.
For long bone splinting, the HARE splint is the gold standard IMHO. However, it's not something you'd likely backpack with, and it takes some focused training to deploy effectively (I still have to stop and think every time we take one out). I've never used one in the wild, but one of the guys on my team has, and it's the shit. You can jury rig a hiking pole and a couple of bandannas/cravats into a long bone splint in an emergency, and those are things you'll likely have in the wild.
*As far as tampons, that's an old urban legend, and a seriously incorrect use of one. Tampons absorb blood, they don't clot it, and you always want to clot a severe bleed. A tampon will worsen the situation. Get some QuikClot and training on it. Also, learn to use a Tourniquet appropriately. I carry both a CAT and a SOFTT-W. The CAT is more popular, but I like the clasp on the SOFTT-W for use on leg bleeds where you have to navigate around drop leg gear and filled BDU pockets on .mil and .leo
+1 on the tampons. There are many dressings available at reasonable cost that actually do the job. When I was a Tac Medic with the County I carried OLAES, H&H compressed gauze and APAX. I even had a hemostatic bandage but never really expected to use it. Anything short of a TQ can be handled by a properly administered packing and bandage. I used the OLAES on my regular shifts with EMS and FD and that bandage is remarkable
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Appreciate the replies. As far as the tampons, figured it was urban legend, but thought I’d ask.
Snake bite kits are a joke too….
Rapid trip for Crofab (anti-venom) is key.
Last guy I gave it to it was 12k a bottle and he got 12!
Woulda died otherwise though.
Other advice looks good.
TCCC is awesome for more remote/long response time areas.
Rapid trip for Crofab (anti-venom) is key.
Last guy I gave it to it was 12k a bottle and he got 12!
Woulda died otherwise though.
Other advice looks good.
TCCC is awesome for more remote/long response time areas.
Your sat phone didn't work at all or just when you were in restrictive terrain? A hump to the top of a terrain feature with some elevation probably beats a 30 mile hump to the road. (I was going to mention something like SPOT https://www.findmespot.com/en-us/products-services/spot-gen4 but I reread your post and saw you have a sat phone already)
https://prolongedfieldcare.org/ has lots of lists, resources, and techniques for austere medicine. Knowledge weighs nothing. Plenty of reading and podcasts etc.
https://prolongedfieldcare.org/ has lots of lists, resources, and techniques for austere medicine. Knowledge weighs nothing. Plenty of reading and podcasts etc.
Dose anyone have a copy of the most up to date US Army Hemostatic Study?
Now a question - I took a WFR training way back in the day, and even WAY WAY before that a basic military first aid course (lots of wound info).
I want to get another course mostly around remote first aid, but with shooting in mind as well. What suggestions do you have for local courses (im in Colorado) and what pros/cons are there for them?
I want to get another course mostly around remote first aid, but with shooting in mind as well. What suggestions do you have for local courses (im in Colorado) and what pros/cons are there for them?
Can you expound on why?
If someone is bleeding, what other color fluids do you plan to encounter?
Lotta people “pimping wares” in this arena.
Caution as there are A LOT of inflated resumes.
Look up licenses and a couple calls and they are 15% what they say.
Would be happy to do a little class for you, as Im big on spreading safety in my community.
My cost is pretty high though.
(Free)
Lotta people “pimping wares” in this arena.
Caution as there are A LOT of inflated resumes.
Look up licenses and a couple calls and they are 15% what they say.
Would be happy to do a little class for you, as Im big on spreading safety in my community.
My cost is pretty high though.
(Free)
dont you dare tease me with a good time... Fred and I are in!!
maybe could have it at my next NRL match... a stop the bleed
It was suggested to me that black gloves mask the color of the fluid your dealing with, and while I would consider any fluids to be problematic and to keep them away from my skin, it just seemed to be a good practice to be able to visibly see some indication of the color of the fluid on my gloves.
Since I don't know of a great reason to avoid blue or other color gloves, it seems like a smart precaution?
I would love to take you up on the course! How long would it run? Its been a long time since my last WFR training and I really don't remember a lot of it.Lotta people “pimping wares” in this arena.
Caution as there are A LOT of inflated resumes.
Look up licenses and a couple calls and they are 15% what they say.
Would be happy to do a little class for you, as Im big on spreading safety in my community.
My cost is pretty high though.
(Free)
About a year ago I witnessed a motorcyclist get T-boned in Boulder coming off of Mapleton and while I was able to assist until EMR got there, I realized I really needed to get refreshed on my training.
Like others (perhaps) I also spend a lot of time in the backcountry with and without friends so being able to tide people over until we can get help is a great idea.
With all due respect, follow your heart, but I have been a surgeon for 40 years now. 10 years civilian trauma in major metropolitan hospitals and 5 years military deployed to southwest asia. There is no clinical or practical reason to be concerned, disheartened or be enlightened by the color any personal protection equipment (PPE) , gloves or otherwise. Just sayin'.
Lotta people “pimping wares” in this arena.
Caution as there are A LOT of inflated resumes.
Look up licenses and a couple calls and they are 15% what they say.
First Iraqi combatant being serviced by me after all my military brethren were safely attended.
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Good answer on glove color.
I been doing this a couple weeks, about 1/2 as long as you.
And make way less money than a trauma surgeon.
But I do cool stuff and work with great folks.
Our new TMD starts in a couple weeks, AF guy, leaving BAMC to come to us.
Sounds like a top notch guy.
I been doing this a couple weeks, about 1/2 as long as you.
And make way less money than a trauma surgeon.
But I do cool stuff and work with great folks.
Our new TMD starts in a couple weeks, AF guy, leaving BAMC to come to us.
Sounds like a top notch guy.
Someone had ordered a shit ton of black "tactical" nitrile gloves. Once I showed them you can't tell what color any fluid is on them in low light they all ended up in a dumpster.
Keep it simple. Practice with what you have and know your shit.
Period
Doc
Keep it simple. Practice with what you have and know your shit.
Period
Doc
Ok there is a lot to read here so I’m gonna be that guy. What do I need in a IFAK for self aid. I mean as in alone. Tq, Israeli dressing, z folded quick clot, shears? Specifically to go into a Haley strategic multi mission hanger. Not gonna be needle d’ing myself I would guess. Extra qauze, tape?
No reason you couldn't needle D yourself; depends on your evac plan, might help lol. That seems like a reasonable ifak load.
I have the ATS SOF bleeder pouch . It is slightly smaller than the Haley but I have 2ea TQ, 2 quik clot, an Israeli, NPA, poor man's cric kit, needle, iodine swipes, gloves, space blanket and probably a couple other things (I didn't unpack completely). G17 for scale.
Not trying to sell the ATS. Figured it was a little smaller, stuffed full, might help you visualize.
Your choice of items indicates skills.
Do you actually know how to cric someone?
No trach hook.
No 11 blade
Also, if you dont know 100% what is in your iFAK from memory, its time to study more.
There is ZERO need for iodine or anything like it in an IFAK.
And get a 50’ compact roll of duct tape in there. 2 if you can.
Will see more use than all other items combined.
And thanks for the input!
So why not at least a complete field kit for it?
Odd to show your kit, claim skills very few have, but not have the needed equipment in it….
If you have the skills, surely you can sign your own Medical Device Authorization form or easily get it signed by a supervising MD and get the complete kit with needed supplies.
My $0.02 and worth what you paid.
(The 11 blade is under the betadine swab)
Never used a trach hook in my training long ago, hence the "kung-fu grip" comment. I'll admit not the best technique/I'm not arguing.
I keep one of these in a pouch on the back of my PC, with more medical kit.
There is a wealth of knowledge in this thread. I respect your experience powdahound and will probably rearrange a few things.
Never used a trach hook in my training long ago, hence the "kung-fu grip" comment. I'll admit not the best technique/I'm not arguing.
I keep one of these in a pouch on the back of my PC, with more medical kit.
There is a wealth of knowledge in this thread. I respect your experience powdahound and will probably rearrange a few things.
I had a training with a Great flight medic. I ran a few with him in the Northern part of the County. We were talking RSI. Now flight protocols are different but he said whenever he was going to knock someone down he would always put a crick kit on the seat along side. This was to remind him that if he fuc-ed this up that was the next step. I was able to control a sh-ton of airways without a tube or a crick. Just saying
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I originally typed way too much in reply to these posts. In my 40 plus years as a medic (military, urban/suburban/rural, flight and tactical), I have learned that most of the stuff people wish to sell you is junk. Currently I only carry CAT and wide SOF-T TQs and prefer 6 inch kerlex to "combat gauze" It has been found equal for wound packing. 3 minutes of direct pressure then coverage with a pressure dressing is needed. I like the Olaes dressings, but use what you have. I have performed advanced airway management on many, many patients. Nasal airway are nice for drunks, but are not the life saving devices some put forward. RSI was mentioned, though it is not really appropriate on the X, nor is intubation.
this is not the place to discuss the relative poor merits of etomidate and sux, or any other meds for induction. chest decompression is rarely needed, but 3.5 inch 10-14 ga needles are preferred. If the patient truly has tensioned, it will likely require more than one. My surgical airway "kit" usually has one #10 scalpel and one 5.5 cuffed ETT with stylet and 10cc syringe. Anything more will fall off the chest/seat/rock and get lost. cloth tape can secure it. Packaged kits with shiley tracheostomy tubes are OK for pygmies and Hmong tribesman, but are too short for cric use, as the sternocleidomastoid and platysma muscles plus SQ tissues will limit the insertion depth.
Stay safe and train with those material you have. Most treatments are simple and adaptable.
I can get almost all military aid gear at a local surplus, PM me if need be. Not many surgical kits, etc., but lots of CLS shit. It's in sealed packages, but can't guarantee the sterility, it's surplus. I look for the best though. Needles and other new sterile shit can be had from medical supply stores online; some of it is very expensive. This is how I'd buy it.
Has anyone used the Varusteleka Särmä TST Rip-Off IFAK Pouch?: https://www.varusteleka.com/en/product/sarma-tst-rip-off-ifak-pouch-w-mount/56570
I like horizontal pouches in the middle of my back - accessible, yet out of the way. But the BFG pouch doesn't hold much, relies on elastic, and the release mechanism can be iffy. The T-Rex Arms pouch is about the right size, but the zippered opening gap is exposed to the weather.
The Varusteleka looks like a well-thought-through, but simple option. Like much of their stuff, I guess. Anyone have any experience with it?
I like horizontal pouches in the middle of my back - accessible, yet out of the way. But the BFG pouch doesn't hold much, relies on elastic, and the release mechanism can be iffy. The T-Rex Arms pouch is about the right size, but the zippered opening gap is exposed to the weather.
The Varusteleka looks like a well-thought-through, but simple option. Like much of their stuff, I guess. Anyone have any experience with it?
Looks big but I should be the last to comment as I am a violator of the term “compact and only what’s necessary” in my kits.
That’s probably better than the HSGI I’m using or the repurposed NVG pouch on my other belt.
Looks OOS? Similar to the ATS pouch I pictured in post 121?
ATS pouches are awesome.
Have more than one.
Have not had any of their stuff that I didnt really like.
Have more than one.
Have not had any of their stuff that I didnt really like.
Looks like an interesting alternative to the Varusteleka option. Shame it doesn't have Velcro section for a med kit patch. Guess I could man up and learn to sew!
Saw this as a "new post" .
Looks like a pretty comprehensive one stop shop.....
www.snipershide.com
Looks like a pretty comprehensive one stop shop.....
Accessories - Tacticon IFAK V3 Extensive (Individual First Aid Kit)
Tacticon IFAK V3 Extensive (Individual First Aid Kit) Black and Multicam I have two of these for sale which are brand new. Asking 89.99. I take credit/debit cards or venmo or paypal. Anyone can save a life with this Individual First Aid Kit. Civilians, Outdoors Enthusiasts, Teachers, First...
www.snipershide.com 
Good to know and the experience is valued as I have none.
I was trying to get a look at the products to see where/what manufacturer.
I buy components from Chinook and build my own.
This looked pretty comprehensive for the beginner, too comprehensive with the nasal airway.
I guess my post is to buy with caution.
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