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  • #13703
    Profile photo of cajun
    cajun
    Medic
    member2

    Let me start by saying that I’ve been in the medical field for 21 years.  My specialty is in the OR.  What I carry will not be appropriate for everyone to carry.  If you do not know how to use something, don’t pack it.  You may do more damage (kill) to someone that help them.  Here is my list:

    1. EMT sheers
    2. Small surgical tools with suturing equipment (scalpel, #15 blades x4 (these things dull fast), hemostats, oschners, 3 different kinds of pickups, Mayo scissors, Metzenbaum scissors, needle holders)
    3. different size suture absorbable and non absorbable (vicryl, nylon, plain gut, silk, and prolene)
    4. Mastisol, steri strips (1/2 inch and 1/4 inch)
    5. Nasal airways (24fr, 28fr, 32fr)
    6. Oral airways (80mm, 90mm, 100mm)
    7. tongue depressors x 5
    8. single sterile 4x4s (x10)
    9. abd pads (x4)
    10. coban and ace wraps
    11. 3cc, 5cc, 10cc syringes (3 each)
    12. hypodermic needles: 25g, 22g, 18g (3 each)
    13. Iv Catheters (22g and 20g 5 each) (bigger is better but pop a 22g in if that is all you can get) and tourniquet for IV’s
    14. silk tape 3″ (1 roll)
    15. transpore tape 1″ (2 rolls)
    16. conform gauze (2″ and 3″)
    17. Kerlex 4″
    18. IV tubing (primary and secondary)
    19. 500ml Lactated Ringers IV solution (4 bags)
    20. 1″ and 3″ bandaids
    21. alcohol prep pads
    22. Iodine swab sticks x12 and duraprep (iodine based prep sticks) x2
    23. small bottle of hydrogen peroxide
    24. disposable cautery (battery operated)
    25. tegaderm
    26. tourniquet
    27. dermabond x4
    28. Tylenol
    29. Aspirin
    30. Benadryl
    31. Lidocaine 1%
    32. Bupivicaine 0.25% and 0.5%
    33. Toradol 30mg/ml
    34. zofran 2mg/ml 2ml
    35. kenalog 40mg/ml
    36. epinephrine carpijets
    37. ancef
    38. clindamycin
    39. levaquin
    40. flagyl
    41. saline flush
    42. imodium

     

    I forgot to put 2 rolls of 4″ fiberglass cast material.

    edited to add gloves.  non sterile nitrile gloves and sterile biogel gloves.  Several pair of each.

     

    I know this sounds like a lot to carry.  It does pack pretty well.  The only real weight is the IV fluids and the cast material.  It’s not that heavy.  I may be forgetting a few minor things, but this is the bulk of what I have in my BOB and I also have this set up in each vehicle and in my house.  If you have any questions about anything, please feel free to ask.

    #13708
    Profile photo of Novus Ordo
    Novus Ordo
    Hunter
    rprepper

    Holy smokes – I think maybe only Selco will know what all that stuff is!  Regardless, always good to get a list to go by.  I’d rather have something and possibly learn to use it later or give it to someone of your skills that comes along than not have it at all.  Shows how much I still have to learn on the medical side.

    Much appreciated – K

    Arms discourage and keep the invader and plunderer in awe, and preserve order in the world as well as property... mischief would ensue were the law-abiding deprived of the use of them.
    - Thomas Paine

    #13727
    Selco
    Selco
    Survivalist
    member6

    Thanks Cajun, I like your kit, especially some items like disposable cautery.

    #13753
    Jay
    Jay
    Survivalist
    member3

    Cajun, awesome kit. What would you consider a more basic loadout for the mere mortal without much specific knowledge? Are there some essentials that you think the standard kits you can buy already packed are missing?

    I will learn a lot more about first aid this year. Can’t wait for that! :)

    Alea iacta est ("The die has been cast")

    #13754
    Profile photo of cajun
    cajun
    Medic
    member2

    Thanks Novus.  My wife always says I overdo it.  LOL.  I’d rather have it and not need it than need it and not have it.

     

    Selco,

    The cautery works great.  We use them in the ER and I really like these.  They come individually packed sterile.

     

    I always think of something else to pack and add to my list.  This list will cover most situations.  What it won’t cover, the person probably won’t survive anyways.

    #13756
    Profile photo of cajun
    cajun
    Medic
    member2

    Jay,  Most of your basic first aid kits only treat cuts and scratches (not wounds).  I would get a basic kit and add pressure dressings (abd pads, kerlix, coban, ace wraps, silk tape), sure clot (good for in the pinch) and some airways.  Oral and nasal airways are easy to use (nasal are easier, no measuring).  Make sure you have some KY jelly if you use nasal airways.  I forgot to list that.

    Sutures and surgical tools are useless if you don’t know how to use them properly.  You could keep a pair of hemostats to clamp off a vessel if there is bleeding.

    IV fluids are a must if you know how to start an IV.  Meds are great if you know how to use them.  You can get a drug book and read about the meds and learn what they are for and the correct dosages.  Some of these meds can be very dangerous if not administered properly.

    Another good reference to have is a PDR (physician desk reference).  Use it to study on the common illnesses and situations you may face in a SHTF situation.  Diarrhea, vomiting, bacterial infections, fungal infections.  These tell you signs, symptoms, treatments.  A very valuable reference tool.

    I would never recommend someone to do something they are not trained for, but in a SHTF situation, you may be all that’s there.

    Check with your local fire departments and Ambulance services.  They offer classes all the time.  Take CPR and ACLS classes.  You will learn a lot.  Take trauma classes if you can find one.  Check with local hospitals and see what classes they offer.  All the guns and food in the world wont matter if you can’t treat common infections.

    Stay current on your tetanus vaccine and immunizations.

    Sorry for rambling, just jotting things down as they pop in my head.  Please feel free to ask any questions.  I am more than happy to answer anything I can or point you in the right direction if I can’t.

    #13777
    Jay
    Jay
    Survivalist
    member3

    Great advice cajun thanks a lot!

    It’s not easy to find real classes where I live in South East Asia but I’m pretty sure I can help out in a hospital near the border where I live that has quite a couple of refugees. I guess this will also help me to get hands on experience with common diseases of poor people.

    Alea iacta est ("The die has been cast")

    #15250
    Profile photo of Broadside
    Broadside
    Survivalist
    member3

     

    Anything worth doing is worth overdoing!

    You could do just about anything anyone could accomplish outside of a standing medical facility out of your med kit.  Awesome job!  Anything I could add is fluff or just being picky.

    That said, a skin stapler is handier than sutures and doesn’t take a great deal of dexterity to use, in case you’re cold, hungry, or tired.  It’s especially good for scalp lacs.  A needle appropriate for chest decompression would be nice too (although the outcome would still be a crap shoot), and I would add oral hydration gels and a small water filter like a Lifestraw or equivalent to maybe save from having to use an IV (especially where sanitation is an issue and you don’t want to introduce an infection route, or, if one just can’t be placed).  One thing I would definitely want in the pack is a dedicated headlamp, chem-lights, or something.  I know a light source is supposed to be on your person, but we all know Murphy’s law.  Someone is bound to get effed up in the middle of the night.  It will probably be me .  ;)

    All that said, I am still very impressed with your setup.  Great job!

    #15266
    Selco
    Selco
    Survivalist
    member6

    The cautery works great. We use them in the ER and I really like these. They come individually packed sterile.

    I used them one or two times those small “pen style” but here it is way to expensive and kinda hard to find. In some ER s here only sometimes it can be found, but not battery operated, more like huge “Russian” style machines :)

    Other then oral and nasal airway, what are the your suggestions for “advanced” airway?

    I pack laryngoscope and ET tubes, combitube too, BVM etc. Still looking for laryngeal masks (yes, again, here airway management stops at ET tubes, everything above is like “man, that s cool where did you find that? :)

    As a colleague I am interesting to hear your opinion on that, simply because there s opinions that it is “too much” in real SHTF, and no means for continuing care for that kind of patient.

    I agree very much with taking classes, and I strongly suggest PHTLS classes too. Not sure for requirements who can take that classes (there) but I guess everyone can order a book:

    Prehospital Trauma Life Support

    Appreciate your contributing here.

    #15396
    Profile photo of cajun
    cajun
    Medic
    member2

    Selco,

    I don’t keep any “advanced airways” in my kit. I may add a #3 and #4 LMA but still undecided. It is my opinion that if you need advanced airways in SHTF situation, you will not have a good chance of survival. More than likely you will be wasting valuable resources on someone that has no chance of real survival. Maybe I’m wrong in thinking that way, but I can’t help but think that they would be useless in that type of situation.

    A LMA could give you more options without carrying more bulk (laryngoscope, different blades…etc). you would still need an O2 source and ambu bag to properly ventilate.

    Again, in SHTF situation, I just think that it is a battle in futility if it comes down to advanced airways. I am the only one in my group that has any medical experience. If you have 2-3 experienced people in your group and have enough supplies to operate a “mini hospital”, my opinion is that would warrant that type of equipment. I know we all want to do everything we can for those we love, but sometimes that is not the right course to take in a bad situation.

    #15403
    Selco
    Selco
    Survivalist
    member6

    Thanks for answering Cajun, I am trying to establish something like, “hospital” (definitely not hospital, but that word will do) at my BOL.
    Will see how all that work, simply some stuff here is impossible to get. Agree with opinion about losing the resources when there is no chance (and precious time), all that goes under the battle triage.

    Still, I am trying to cover as much as I can, other members of the group for now have basic medical training (first aid, or BLS at best)

    #15416
    Profile photo of Broadside
    Broadside
    Survivalist
    member3

    Cajun and Selco, pardon me for butting in here but you guys really have me thinking on this one. I’m an ED nurse, and even now while the lights are on and the sheeple are fed and happy there are times when we have to send people out from my hospital and transfer them to a higher level of care. We get traumas on occasion. They usually get transferred to the city once stablized. We get CVA’s all the time. If it’s ischemic we handle it in house, but for subdural bleeds and whatnot we send them to the big hospitals with neurosurgeons and more resources. Same for kids since we don’t have a pediatric floor. Do you think that higher levels of care will exist at all in SHTF, or am I just wishful thinking?

    I completely agree with you Cajun that some cases are going to be lost causes. We get those patients now that we all know aren’t going to be saved because of down-time, history, mechanism of injury etc., but we work the code anyway. But what do you think about keeping a couple ET tubes, ambu-bags etc. around for the instances when maybe all the person may need is a little time, or a trip to somewhere that still has a higher level of care functioning? Granted, I know that anyplace with the lights still on in a crisis is going to be overwhelmed with problems of their own, but what do you guys think anyway? It would undoubtedly be case to case decision making.

    #16002
    Profile photo of Koldsteel
    Koldsteel
    Medic
    member1

    I also carry vaseline gauze or a commercial chest seal. Takes up little room. A chest injury that would require this might be a lost cause but will go all out to save a family member. Also, Lactated Ringers is very hard to come by without a prescription ( as are many meds on the list). Normal Saline can be purchased on-line without an RX. LMA’s are great but are bulky. A laryngoscope w 2 blades, batteries, tubes, etc are just as bad. Learning how to use the nasal trumpets and a compact ambu bag would be great.

    Training, training, training….

    Thanks

    Those who sacrifice liberty for security deserve neither liberty nor security.

    #16003
    Selco
    Selco
    Survivalist
    member6

    Broadside, depends from level of SHTF and seriousness. I have seen patients died (babies too) simply because electricity is gone and no generator, or no oxygen.So who knows.

    I like to cover as much as I can from my field, so I have ET tubes, O2, BVM s, and similar equipment, it is simply stuff from my field of knowledge, so I have it.

    I am perfectly aware that there is no too much sense to ventilate dead guy in the middle of nowhere, in the middle of SHTF, but we do not know what kind of scenario we will face.

    Maybe we gonna have some means of transporting the family member to the place where there is still higher level of care. Nobody knows.

    I just have things that I am trained and skilled to use, we ll see.

    #16031
    Profile photo of cajun
    cajun
    Medic
    member2

    I look at it this way. My bug out location is kind of the middle of nowhere. We will be 30 miles from any facility that could handle a true trauma. I have minimal chance of interacting with many outsiders when SHTF. Only family. I am the only person in my family with any medical training. I have tried to hoard as much supplies as I can. I am more worried about infections, dehydration, diarrhea, heat exhaustion….etc.

    Bugging out will be the biggie. facilities are currently being built where I can store a great amount of things. As of now, I have to keep everything with me. I have some stuff closer by, but the bulk isn’t at this point.

    Maybe once I can safely store stuff at our location, I may change my mind.

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