Medical/First Aid Kit pouches/bags

[Nephrology]

Don't get me wrong I was just curious about your choice. I don't even have NPA's or anything for airway. Just bleeding in my kit which is really
just hemostatic compress , TQ, an Israeli bandage because they are the freaking bomb and some tape. I have zero interest in trying to manage someone's airway and feel that's way above my pay grade now, hell even then. I was really just wondering if LMA was easier in general than the ET or if you felt there was more benefit to it over the ET for you specifically. Thanks for taking the time to humor me. It's really interesting to hear about your experiences, thoughts on this stuff along with your responsibilities and how they differ by locale.


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Well given that this kit is for my personal vehicle, an LMA is basically about as invasive as I am willing to go and even then I am pretty unlikely to need it. LMAs have been shown to be used with great effect in MI in other countries but I will be too busy thumping on their chest to use it. If I am lucky I'll get someone to help me bag. Definitely woudn't even think of intubating someone in the field without RSI drugs on board and ACLS level support. EMS can handle that.

Speaking of which, you can do a lot of good work with a BVM if you know how to use it and have the right sized mask. Honestly I'd rather have a good BVM than the LMA.

[schüler]

Chinook sells some of their bags separately, not too expensive.
http://www.chinookmed.com/category/c...s/cases/1.html

[Doug MacRay]

I've owned a number of portable med kits. Ironically, the best one I've found for a compact kit is an old laptop bag I got at a thrift store for $5 that I cut the internal straps from to allow it to splay open flat. I have a full sized Iron Duck kit with everything up to first-line drugs and chest tubes + Heimlich valves. But seeing as it's probably $20k+ worth of supplies, it stays locked in the home except for road trips or range days, when it goes in the trunk. For my smaller kit that stays in my trunk I have:

Small pouch

PPE (N95 mask, nitrile gloves)
CAT Tourniquet
Quikclot Z-folds
Decompression kit (Clorhexidine scrub pad, 14g IV catheters, 3-way stopcock valves, Durapore tape)
Gauze (rolled and loose)
Coban roll
Trauma shears & gauze shears
10cc saline flushes
Hemostat & tweezers
Bulk sterile military gauze dressing (for open abdominal wounds/eviscerations)
NPA + Surgilube
Sharpie

Large pouch:
Hyfins chest seals
Bolin chest seals
Asherman chest seal
4x5.5in. Opsites (for chest seal)
6x8in. Tegaderm (for chest seal)
Various IV's (14-24g + plugs + lines + tape + tourniquets + alcohol swabs)
1l Saline
0.5l Ringer's lactate
SAM splint + wrap
Various Naloxone kits (0.4mg/ml MDV + 2mg/ml pre loaded syringes + IM syringes + tourniquet + alcohol swabs)
Stethoscope

Outside pouch:

Heat blanket
MRE heaters
Chemlights (white, high intensity)
Cravats

I live in a very murdery, heroin infested place, hence the abundance of chest seals and Narcan. I could bring back 6 heavy-duty OD's @ 2mg's naloxone each and treat ~20 individual thoracic wounds with just what is in the smaller kit. With my full kit I can do much more, including crich's, chest tubes, cardiac arrests and intubations (though no RSI drugs anymore ). But I would be heartbroken to have it stolen from my trunk, so it stays at home except for certain occasions.

[Hambo]

I could bring back 6 heavy-duty OD's @ 2mg's naloxone each

Get a lot of ODs at the range? Also, doesn't fentanyl require multiple does of Narcan most of the time?

[Doug MacRay]

Get a lot of ODs at the range? Also, doesn't fentanyl require multiple does of Narcan most of the time?

Lol, no, not at the range, thankfully. I take the full kit to the range because it's rural and accidents do happen. But I've heard a number of cases of people in my neighborhood shooting up while driving and wrecking out when they blackout. I've also found used insulin syringes in my alley and in front of my house (so either a diabetic found it necessary to inject their insulin at the bus stop or people get high there, the latter being much more likely). Fentanyl is pretty fast in & out of the body, but then again so is naloxone. My only job is to keep them breathing until the medics get there, so no more than 15 minutes, even in the worst case. If the "patient" wants to opt out of transport and treatment, that's between them and the ambo medics.

I've had enough addicts wake up following a full 2mg dose of Narcan and either fight me or vomit on me that I minimize the dose I give if possible. If they're breathing at too slow a rate but not blue/grey/pale, then I'll give them 0.4-0.8mg IM until they come around and breathe deeply (IV if I see a good vein, which is rare). If they've already stopped breathing and/or they've been anoxic for a while I just hit them with 2mg IM right away. If I don't see any rebound within ~90 seconds they get a repeat dose with a few rescue breaths. I'll put a full bottle of Narcan in someone if necessary, but I've found that the "Narcan-resistant opioids" to be largely overblown by the media. Outside of carfentanyl or a really hot batch it's rare to need more than 2mg. Repeat doses might be needed at the ~45 minute mark, but that's the ambo/hospital's problem.

[Nephrology]

I've owned a number of portable med kits. Ironically, the best one I've found for a compact kit is an old laptop bag I got at a thrift store for $5 that I cut the internal straps from to allow it to splay open flat. I have a full sized Iron Duck kit with everything up to first-line drugs and chest tubes + Heimlich valves. But seeing as it's probably $20k+ worth of supplies, it stays locked in the home except for road trips or range days, when it goes in the trunk. For my smaller kit that stays in my trunk I have:

Small pouch

PPE (N95 mask, nitrile gloves)
CAT Tourniquet
Quikclot Z-folds
Decompression kit (Clorhexidine scrub pad, 14g IV catheters, 3-way stopcock valves, Durapore tape)
Gauze (rolled and loose)
Coban roll
Trauma shears & gauze shears
10cc saline flushes
Hemostat & tweezers
Bulk sterile military gauze dressing (for open abdominal wounds/eviscerations)
NPA + Surgilube
Sharpie

Large pouch:
Hyfins chest seals
Bolin chest seals
Asherman chest seal
4x5.5in. Opsites (for chest seal)
6x8in. Tegaderm (for chest seal)
Various IV's (14-24g + plugs + lines + tape + tourniquets + alcohol swabs)
1l Saline
0.5l Ringer's lactate
SAM splint + wrap
Various Naloxone kits (0.4mg/ml MDV + 2mg/ml pre loaded syringes + IM syringes + tourniquet + alcohol swabs)
Stethoscope

Outside pouch:

Heat blanket
MRE heaters
Chemlights (white, high intensity)
Cravats

I live in a very murdery, heroin infested place, hence the abundance of chest seals and Narcan. I could bring back 6 heavy-duty OD's @ 2mg's naloxone each and treat ~20 individual thoracic wounds with just what is in the smaller kit. With my full kit I can do much more, including crich's, chest tubes, cardiac arrests and intubations (though no RSI drugs anymore ). But I would be heartbroken to have it stolen from my trunk, so it stays at home except for certain occasions.

Thanks for sharing that! I will definitely borrow from it heavily.

Interesting re: Narcan. I wonder if that's something I can get my hands on. It will probably be the last addition to my kit as heroin is not a huge problem where I live (yet) and there are other items I'd rather buy first.

One thing I am thinking of getting is an Epipen. My preceptor said he'd be happy to write me for one as he considers them indispensible for first responders.

A few questions for you :

1. What is your reasoning behind the decompression kit?
2. Same for the IV bags/start kits - what is your reasoning there? Do you anticipate a long EMS response time or is there something you want the fluid resuscitation for acutely?
3. Any suggestions for my list? To add or remove.

I have a few bottles of lido/epi that ended up in my possession so I was halfway tempted to throw in needles/flushes/sterile saline/drivers/pickups and some 3-0 silk but decided that whoever needs suturing can wait til they get to a real doctor first...

[Doug MacRay]

Thanks for sharing that! I will definitely borrow from it heavily.

Interesting re: Narcan. I wonder if that's something I can get my hands on. It will probably be the last addition to my kit as heroin is not a huge problem where I live (yet) and there are other items I'd rather buy first.

One thing I am thinking of getting is an Epipen. My preceptor said he'd be happy to write me for one as he considers them indispensible for first responders.

A few questions for you :

1. What is your reasoning behind the decompression kit?
2. Same for the IV bags/start kits - what is your reasoning there? Do you anticipate a long EMS response time or is there something you want the fluid resuscitation for acutely?
3. Any suggestions for my list? To add or remove.

I have a few bottles of lido/epi that ended up in my possession so I was halfway tempted to throw in needles/flushes/sterile saline/drivers/pickups and some 3-0 silk but decided that whoever needs suturing can wait til they get to a real doctor first...

If you have someone willing to write you a script for Epi, then they should have no problem writing you one for Narcan. It's a remarkably safe drug, there's almost no downside to administering it. Where I live, literally anyone can buy it via a "standing prescription" at nearly any pharmacy (though it's only the nasal formulation, which I don't really want). I have both the weaker 0.4mg/ml MDV's and 2mg/ml pre-filled syringes, but I wish I could find stronger MDV's, for resistant cases. But I would just buy whatever's cheapest for you honestly. Either would work, and I have no problem giving a 3ml+ bilateral vastus lateralis IM injection if all I have is the weaker stuff and it's a serious OD.

For epi, I've found it's much cheaper to buy 1:1000 epi ampules and a few IM needles than an epi-pen (like $3 vs $250). I'm assuming based on what I've seen you post in the past that you're either an MD or PA equivalent, so you know how to give an IM injection. Ask for either a 1:1000 MDV or a few ampules and a few filter needles, it's remarkably cheap. Epi-pens are way overpriced and hurt like hell from what I understand.

1. I commute ~30 mins from an urban area and work in a fairly remote place, plus I have the habit of seeing a relatively large number of MVA's along the way. A decompression kit is very light and doesn't take up much room, though I'd be very unlikely to use it on anyone with a pulse unless I was expecting a delayed response for some reason (i.e. weather, mass-casualty, etc.). More likely than not, it would go into a person with no pulse ("they're not dead until they're warm, decompressed and dead" was an old EMS mantra).

2. Again, I'd be more likely to simply start an IV and hook up a bag while keeping it TKO just in case of a rapid decompensation. Having worked on a ambulance when I was younger, it's much harder to do a large-bore IV in the back of a moving ambulance than on the ground. When people start to become seriously hypovolemic, IV's become much more difficult due to flatter veins, lower circulatory volume, etc. If I'm an accident first-responder, a large-bore distal IV is one of the most useful thing's I could do before EMS arrival, even if I don't push any fluids.

3. I really like your pack. It should mostly be based on your skills/comforts/AO, but it seems pretty comprehensive for common "oh shit" trauma situations. After looking at your list I'll probably add some ASA/nitro to my kit (because it's small and light and could come in serious handy). I'll also add a penlight and CPR mask to my own kit. Honestly, most of the stuff in my main, much larger kit wouldn't be useful in a common situation, it's more for SHTF, civil-breakdown situations (chest tubes, suture kits, antibiotics, etc.). I'm not ever going to use that stuff on the side of the road, only at home when 911 isn't picking up the phone. This smaller kit is only for the stuff I figure I'm most likely to see while driving or at work.

[Coyotesfan97]

https://www.amazon.com/Voodoo-Tactic...niversal+medic

Im using this bag for my dog's first aid kit. It was recommended by a paramedic I work with. I'm not sure how big or small you're looking for.

[Nephrology]

If you have someone willing to write you a script for Epi, then they should have no problem writing you one for Narcan. It's a remarkably safe drug, there's almost no downside to administering it. Where I live, literally anyone can buy it via a "standing prescription" at nearly any pharmacy (though it's only the nasal formulation, which I don't really want). I have both the weaker 0.4mg/ml MDV's and 2mg/ml pre-filled syringes, but I wish I could find stronger MDV's, for resistant cases. But I would just buy whatever's cheapest for you honestly. Either would work, and I have no problem giving a 3ml+ bilateral vastus lateralis IM injection if all I have is the weaker stuff and it's a serious OD.

For epi, I've found it's much cheaper to buy 1:1000 epi ampules and a few IM needles than an epi-pen (like $3 vs $250). I'm assuming based on what I've seen you post in the past that you're either an MD or PA equivalent, so you know how to give an IM injection. Ask for either a 1:1000 MDV or a few ampules and a few filter needles, it's remarkably cheap. Epi-pens are way overpriced and hurt like hell from what I understand.

1. I commute ~30 mins from an urban area and work in a fairly remote place, plus I have the habit of seeing a relatively large number of MVA's along the way. A decompression kit is very light and doesn't take up much room, though I'd be very unlikely to use it on anyone with a pulse unless I was expecting a delayed response for some reason (i.e. weather, mass-casualty, etc.). More likely than not, it would go into a person with no pulse ("they're not dead until they're warm, decompressed and dead" was an old EMS mantra).

2. Again, I'd be more likely to simply start an IV and hook up a bag while keeping it TKO just in case of a rapid decompensation. Having worked on a ambulance when I was younger, it's much harder to do a large-bore IV in the back of a moving ambulance than on the ground. When people start to become seriously hypovolemic, IV's become much more difficult due to flatter veins, lower circulatory volume, etc. If I'm an accident first-responder, a large-bore distal IV is one of the most useful thing's I could do before EMS arrival, even if I don't push any fluids.

3. I really like your pack. It should mostly be based on your skills/comforts/AO, but it seems pretty comprehensive for common "oh shit" trauma situations. After looking at your list I'll probably add some ASA/nitro to my kit (because it's small and light and could come in serious handy). I'll also add a penlight and CPR mask to my own kit. Honestly, most of the stuff in my main, much larger kit wouldn't be useful in a common situation, it's more for SHTF, civil-breakdown situations (chest tubes, suture kits, antibiotics, etc.). I'm not ever going to use that stuff on the side of the road, only at home when 911 isn't picking up the phone. This smaller kit is only for the stuff I figure I'm most likely to see while driving or at work.

thanks for the info! I am an MD-PhD student 3 years and have been doing my preceptorship in the ED of a major county hospital/ACS Lvl 1 trauma center so I am very comfortable doing minor procedural stuff solo. IM injections are no problem. Most low-invasion interventions I am comfortable with. The LMA is about the limit of my comfort zone and honestly I will probably table it for now until I get more time with one as they aren't that commonly used in the ED (much more likely to go right to ET intubation).

Good call on the narcan and epi ampules. Ill ask about it. Definitely want to save money as medical supplies get pricey fast How do you store your pre-filled syringes to keep the plunger from getting knocked around?

I'll probably pass on the epipen for now as if I find someone down and pulseless I will probably give them chest compressions til EMS arrives, but good to know why you have it. I do however like your argument for the IV start kits and saline. I think I might try chunking out my kit into a boo boo kit/trauma kit/BVM case/IV start kits. If they are subdivided and I can get a bag or Pelican case to store them all in that might give me flexibility on my trunk space and also help me more readily locate the items I want.

https://www.amazon.com/Voodoo-Tactic...niversal+medic

Im using this bag for my dog's first aid kit. It was recommended by a paramedic I work with. I'm not sure how big or small you're looking for.

I wish that bag was cheaper in non-tactical colors or had female velcro I could stick a hi-viz PVC red cross onto. I like my lifesaving gear to be super bright so I am not scrounging for it in the back of my truck.

[Coyotesfan97]

It's crazy the red is $10 more and double the shipping