The Oxford Dictionary defines the “Golden Hour” as: The first hour after the occurrence of a traumatic injury, considered the most critical for successful emergency treatment. In many cases, you may be within an hour’s ride to an emergency room. But, what if you’re not? Or, what if you can’t get there? Or, what if the ER is overwhelmed, due to a natural disaster for instance? In some cases, especially in those of an arterial bleed for instance, the wound must be treated immediately, otherwise the injured may die from loss of blood. This can happen in just minutes. Imagine an accident on the highway, or a wound inflicted by an assailant. Or, imagine having the opportunity to save a loved one, but not having the right medical gear or knowledge on how to do it?
Accidents do happen. Why not carry a small but specialized kit that could end up making all of the difference? You can accomplish this for around $20 for a pocket-sized kit, or $100-200 for a full-blown trauma kit.
Over the years, I’ve learned there are 3 components to bettering the chances of survival from a severe injury:
A: Having the right GEAR.
B: Having the right TRAINING
C: Having the right MINDSET, to include keeping your cool, determination and applying encouraging ‘psychological first aid’ to the patient.
The good news is that quality gear and training are now widely available, and very affordable. Though, it’s always best to have a qualified paramedic or medical professional handle it, they won’t always be there. So, with a minimal investment, you can dramatically increase the chances of survival with some items we’ll cover here and some important know-how.
Further, our fight in the Global War on Terrorism (GWOT) has led to numerous changes and new developments in both the techniques and the equipment needed for effective wound treatment, especially for severe bleeding. In particular, recent innovations in blood clotting and staunching of severe bleeding have materialized in the form of some easy to use products that have saved limbs and lives. There are some very specialized emergency wound care items that have to be in your possession for the most critical and specific of injuries. Some of these can be improvised, such as a tourniquet, but some cannot. Others have been invented in recent years, then proven on the battlefields of Iraq and Afghanistan and on the streets by our EMTs, which have done wonders in helping to save lives. Now it’s all available by mail order.
So, a properly outfitted wound trauma kit of some kind should always be in your car, at the range, on a hunt, or ready for higher threat travel or disaster situations. This article focuses on having a smaller trauma kit, or set of kits, that focus on severe bleeding, to include gunshot wounds.
Medical Training & Knowledge:
Don’t just buy the kit and not know how to use the contents. There is a source of free videos listed here that can show you how some of it used. However, there’s more to it. The cross-training that we received from our Army Special Forces medics, who have to pass over a year of medical training, was simply outstanding. They would costume up role-players with special kits that looked like they came from a Hollywood movie set. These simulated the injuries quite colorfully, to include squirting fake blood and more. We got into some pretty advanced stuff to handle the worst of situations in far off lands. But, not everyone can get to Fort Bragg and join the Special Forces. Later on, I went through some excellent commercial training and then to a very high end, week-long medical course taught by former special operations medics. This taught us what gear to carry and what to do. The point here, is that the training is both a necessary component of your medical readiness as well as an excellent confidence builder. It reduces the need for panic as you’ll know what do to and how to do it, should the need arise. There are three types of medical training that you should consider having:
- Emergency Wound Treatment Course (sometimes these are called “Tactical Treatment of Gunshot Wounds” or TTGSW)
- Wilderness First Aid certification (usually 2 days)
- CPR/AED certification (usually 1 day, from an American Red Cross certified instructor)
Sometimes CPR/AED are included within the program of instruction of other courses. Further, I’d recommend having with you a current pocket-sized manual. Sometimes these are available in the course. It helps to review these. (I do it while on the plane sometimes)
So, if searching for a course, make sure that the instructors are very current and know their way around the newer gear and methods. The best case scenario is a course that includes teaching techniques & strategies and uses medical items in a program that is endorsed by with what is called TCCC – Tactical Combat Casualty Care. Such courses are now widely available both through many of the top firearms schools as well as from individual instructors and outlets. TCCC is the standard endorsed by the American College of Surgeons and the National Association of EMTs (NAEMT). This is very important, as much has changed over the years on how to manage severe bleeding and other injuries. There’s been a real revolution in emergency wound care. So, if you went through an advanced first aid class years ago, or were a medic in the Army in the 80s, be warned, as much has changed. But, most all of the combat medics and care providers in our Armed Forces who served in the war zones in the past few years have this up to date training. And all of our ground troops now carry, usually in their uniform sleeve pocket, a one-handed tourniquet as well as some type of medical kit on their person (usually it’s the one called the IFAK).
Additionally, if you are going to be in the backcountry, or for certain injuries where you may not be able to get evacuated in time, it is highly recommended to attend the 16-20 hour Wilderness First Aid. These are certification courses from the Wilderness Medical Institute (WMI) of the National Outdoor Leadership School (NOLS). These are usually conducted on weekends and include important topics such as patient assessment, treatment of fractures and breaks, recognizing and treating shock, dealing with spinal injuries, hot & cold injuries, lighting strikes, anaphylaxis and more.
Emergency Medical Kits:
This is the core of your medical readiness. I won’t address standard first aid kits here, just trauma kits applicable to severe bleeding and a few other life-threatening injuries. I recommend a two-kit ensemble, based on size and what you will be doing.
- Compact or Pocket-Sized Kit – these cost between $19 and $45 each and contain the essentials for treating a gunshot wound or other severe bleeding episode. This could be one of the pre-fab kits, such as the Trauma Pak with Quik Clot, available from Brownells. It’s truly pocket sized, has 11 essential types of items, and very affordable at $19.99 (but has no tourniquet). The ARK Casualty Throw Kit, available from Tactical Medical Solutions (which includes a tourniquet) is just under $30. Or, assemble a custom one from components. What I have been doing for a few years is carrying either of two very low profile custom trauma/first aid kits (shown in the photographs) which do not look very ‘military.’ I have been through security both at airports all over the world as well as in and out of government buildings and events with no problems whatsoever. I carry two of my medical certification cards just in case they ask any questions. One of these kits goes in my laptop case, with me while hiking, or as a quick insert to my go-bag. Just remember to have your compact kit either on your person or very close by as an extra insurance policy.
- Trauma Kit – purchase either a ready-made kit, or one that you assemble with the proper components. This will cost you between $90 and $300, depending upon which items and if you decide to include more than one of certain items. Let’s put this another way: consider what you pay in annual premiums for your life insurance policy. Having one of these kits is a bargain considering the possible consequences of not having one in a severe trauma situation. It could make all of the difference. There are a few on the market that have most all that is needed. The first example is the type of kit that I have gotten my most current training on, carried in the field, and is one of those designed for when you are on the go, on the range, or far from help. I later deployed with this exact type of kit, and it’s really the right stuff – The Echo Sigma Trauma Kit. The makers of this kit really did their homework. Another great option is one that combines standard first aid items with needed, specialized severe bleeding and wound treatment items – The Bighorn Sportsman Series First Aid Kit. This has a removable insert with the severe bleeding items. The makers of both of these kits really did their homework, and they contain the items recommended in the training mentioned.
Trauma Kit Contents – What to look for
The bare minimum should involve treatment of severe bleeding. These items should be in the kit, so look for them:
- One-Hand / tactical tourniquet (note: this requires training on proper use. The SOFTT from Tactical Medical Solutions or the Combat Application Tourniquet® "CAT" are two of the best)
- Hemostatic (clotting) agents (note: these are often contained within a wound dressing)
- Wound dressings (note: these are highly absorbent, high density bandages, which often contain a wrapping mechanism which also provides some pressure, and can be used to actually plug large wound holes, such as from gunshots) One of the best on the market is the OLAES® Modular Dressing. It’s worth having extras of these.
What to Add to Your Trauma Kit:
What I have done is to pack a lot of redundant items of the most important components in the extra space in these packages, as well as some basic first aid items. But, as you may find in professional training for emergency medical care, there are some items worth adding, to include:
- Additional tourniquets – for multiple wounds. Or, have cravats and some type of unbreakable stick for use as the windlass that you turn to tighten it.
- Additional dressings – either the OLAES®, Israeli Battle Dressing, or similar. These are especially needed in cases of a single in-and-out gunshot wound or multiple gunshot wounds.
- Abdominal dressings – these are a much larger, and flatter highly absorbent dressing.
- Additional bandages – kerlix or gauze can always be useful.
- Occlusive Dressings and seals - Either 1 or 2 heavy duty clear trash bags or thick plastic - for certain types of sucking chest wounds, burns, and other uses. Or, acquire the purpose built dressings, which are the called the Russell Chest Seal, the Fox Chest Seal and the Asherman Chest Seal. All are available for $11 to $23 each.
- Duct Tape – cut into at least ten each 7 to 15 inch long strips with pull tabs, and tapped to the inside or outside of the kit. It’s needed to secure the plastic and for other purposes.
- Permanent Marker – for marking bandages, blood types, and more
- Keychain flashlight - which can be held in your mouth
- Bandage shears – available in most stores, for cutting away clothing. Secure this to your kit with a piece of thin shock cord or para-cord so that you don’t leave them.
- Splints - there are a variety of these available, which have aluminum that can be custom formed to immobilize certain injuries.
- Burn Gel and/or petroleum gauze
- Nitrile Gloves
- NPA airway with lubricant (requires training)
- Additional items for chest decompression and other trauma, which all require professional training.
Here is a great tip - one of the most difficult to treat and painful medical situations is a dental emergency. Many of the needed items are impossible to improvise, so having a ready-made kit for this can prevent or forestall a lot of pain and misery. For a surprisingly low cost, you can get the compact Dental Medic™ kit from Brownells.
My overall recommendation is to have your medical / trauma kit on your person, such as in a pocket or in a pouch, so that you can self-treat, even if separated from your pack. I carry a kit in my laptop case and car. Not only have these items been proven to save lives, but having a proper kit, and the knowledge of how to use it, can give you the piece of mind and assurance that you need.
Once you have your kit(s), then the important things to do are to (1) periodically open up the kit and go through the contents, looking for breaks in the sterile seals, and to re-familiarize with them, and (2) get out your course manual, go online, and watch some videos for review. If you can get to a refresher course, do it, or at least keep in touch with the school that you went to, in the event that updates or changes have occurred.
This is life and death stuff that we are talking about here. These kits only weigh a few ounces. Hopefully it won’t happen to you or those around you, but if it does, you’ll then find that ‘an ounce of prevention was worth a pound of cure.’
Where to get it – Sources for Emergency Medical Kits and Information:
Brownells: http://www.brownells.com/emergency-survival-gear/index.htm. They carry the Echo-Sigma and Adventure Medical Kits brand products recommended in this article.
Some of the best medical gear, videos & downloads on how to use it, and a blog are provided by a company owned & operated by former Army Special Forces Medics, Tactical Medical Solutions www.tacmedsolutions.com
Wilderness First Aid http://www.nols.edu/wmi/courses/wildfirstaid.shtml
American Red Cross courses: http://www.redcross.org/lp/take-a-class. This link takes you to a page which leads to all of their training and course locator. It’s where you can get your CPR/AED certification, but they offer 15 types of courses that are worth a look.About the author:
John Peterson an instructor & consultant who is a combat veteran of the Global War on Terrorism which included service as a U.S. Army Special Forces soldier.