My first introduction to the importance of carrying a Tactical First-Aid Kit came when I met Fred Perrin in Paris. He was so well equipped he could support an army field unit. His doctrine was, if you teach the knife you must also teach first-aid, and that has been my conviction since then as well. From that time onward, I have always invited medical personnel to my seminars to teach self-triage and first-aid. Although this article was written primarily for police agencies, I also feel this is an important article for the reality-defense community.�
Tactical First-Aid Kits�
By Fabrice Czarnecki, M.D., M.A., M.P.H.*�
Police officers should carry a medical kit specifically designed for penetrating trauma injuries such as gunshot and stab wounds. Such a kit can be assembled at a fairly low cost, while meeting your requirements better than most commercial kits.�
Individual medical kit:�
While it’s a good idea for all officers to carry this small kit at all times, they should definitely carry the individual kit during high risk activities like warrant service, protective details and firearms training (in case of accidental injuries). Contents should include:�
2 pairs of gloves�
1 or 2 tourniquets�
1 or 2 trauma dressings�
1 or 2 rolls of gauze�
Gloves should be made of nitrile (first choice) or latex (second choice). Nitrile gloves are usually blue, purple or green colored. They are more resistant to puncture and chemicals, and do not cause the allergic reactions that many people have to latex.�
Tourniquets are safe and effective in trained hands, especially if left on an extremity for less than one hour. Tourniquets alone could save 6o % of all the preventable deaths from combat trauma, according to Capt. Frank K. Butler, MC, of the Naval Special Warfare Command. My preferred tourniquet is the triangular bandage (usually 37 x 37 x 52 inches). It is inexpensive, lightweight, and easy to deploy. First choice for the tourniquet is the US military (Bandage, Muslin, Compressed, Camouflaged, 37 x 37 x 52 inches, NSN 6510-00-201-1755), or any high quality brand named triangular bandage.�
*Note: Realfighting is a distributor of the Q-Tourniquet. This tourniquet can be applied with one hand, and incorporates a seamless 2″ band secured with a built in ratchet. There is no pinch point to damage tissue and nerves.�
The key is the ability to apply pressure to the wound, rather than just covering it and absorbing the blood. First choice for the trauma dressing is the military field dressing (Dressing, First Aid, Field, Camouflaged, NSN 6510-00-159-4883, 4 x 6 1/4 x 7 1/4 inches), but it is difficult to obtain if you do not have connections with the military. Second choice is the Cederroth Bloodstopper (sold in most public safety catalogs).�
Rolls of Gauze�
The gauze should be sterile “disorganized” conforming bandage type, like Kerlix bandage rolls (4 inch wide preferred).�
Car or Team Medical Kit�
A larger medical kit should be kept in cars. It could be pre-positioned at the door during warrant service.�
Suggested contents include: Two (or more) individual medical kits, wrapped separately and used only for penetrating trauma; Laerdal pocket mask; Co-Ban cohesive bandage (sticks only to itself); SAM splint; Xeroform dressing or other non-adherent dressings; Bandage strips, tape wound closure; 4 x 4 gauze pads; Tape; Elastic wraps; Safety pins; Space blankets; EMT shears; Cold compresses; Medications: acetaminophen, ibuprofen, triple antibiotic ointment, aspirin; Artificial tears (saline); Antiseptic solution; Alcohol gel; An automated external defibrillator (AED) is recommended to trained officers, if available.�
*Dr. Czarnecki, an emergency physician, is the Director of Medical and Legal research with the Gables Group, Inc., and the Director of Training of the Center for Homeland Security Studies, a non profit corporation conducting training in counter terrorism and intelligence for domestic law enforcement. He served as a trainer and a consultant for several law enforcement agencies and the U.S. Marine Corps.
The Importance of a Personal Casualty Care Kit�
By Paul S. Shubinsky, RN, CEN
The reality in today’s world is that we can’t just dial 9-1-1, and expect that someone will come and save us. We must be responsible for our own wellbeing. When we engage in combat either due to occupation, or by chance, we are at risk of being injured. During the fight these injuries should not distract us from our primary goal of winning; however, they may require immediate self treatment afterward to prevent death. While being healthy and in good shape will increase your chance of survival, it is no guarantee. Shawn Taylor of the Washington Redskins, died from blood loss after receiving a single gunshot wound to the leg, during a robbery of his home.
Penetrating trauma (Ex. Gunshot and stab wounds) can quickly become deadly. Blood loss from an extremity is the number one preventable cause of death in combat at 60%; the second is tension pneumothorax at 33%. Death from severe blood loss can occur very rapidly. The average response time for an ambulance in the city of New York is approximately six and a half minutes.
Penetrating trauma to the chest wall can cause a sucking chest wound. This type of wound interferes with the normal process of respiration and can lead to a tension pneumothorax, which can quickly become fatal. Normally when we breathe in, the pressure in our chest lowers and air enters through our nose or mouth. When we breathe out this process is reversed. In the case of a sucking chest wound, air enters and exits through the hole in the chest wall.
A personal casualty care kit is a first aid kit that contains the items to treat the above injuries. It is small enough to be kept with us at all times, thus allowing us to render care to ourselves or loved ones, immediately after the fight. When traveling to areas where immediate medical care is not available, other basic first aid items should be added to the kit. Some pain medications (acetaminophen or ibuprofen) to treat mild to moderate pain, an antihistamine (diphenhydramine) is helpful for treating allergic reactions, and a topical antibiotic ointment (bacitracin or triple antibiotic ointment) to help prevent infection in minor cuts and burns.
A personal casualty care kit should contain a few pairs of nitril or latex gloves, sterile dressings, pressure dressings, occlusive dressings, hemostatic dressings, tourniquets, sterile saline eye wash, medical tape, and a pocket face mask. This is a device that acts as a barrier when performing CPR. Some of these items can be improvised from common items in an emergency. Any clean cloth can be used in place of a sterile dressing to help control bleeding. An occlusive dressing can be improvised using anything that is flexible and non-porous, and some tape. For example you could tape part of the bag from your potato chips over the wound. In addition to washing dirt and caustic substances out of your eyes, the eye wash could also be used to cool burns, and irrigate wounds. Tourniquets can be made from a loop of cloth or belt, and a stick.
While we invest in training in combat arts, we should also invest in first aid training. This will increase our chances of surviving violent encounters. A basic first aid, certified first responder (CFR), or emergency medical technician (EMT) class is highly recommended. These classes will teach you how to care for common emergencies such as bleeding, fractures, and burns. Bleeding is controlled through the use of direct pressure, elevation of the injured area, pressure points, hemostatic dressings, or tourniquets. Sucking chest wounds can be treated through the use of occlusive dressings. These are dressings that prevent the passage of air through the wound. The emergent treatment of these injuries can be easily accomplished using a few items that we can have with us at all times.�
Disclaimer: This article is intended for informational purposes only. It is not intended as a formal training. The author accepts no responsibility for the use or misuse ofthis information. The practice of medicine is something that should only be undertaken by trained professionals.
About the author: Paul S. Shubinsky is a Certified Emergency Nurse. He has worked in the field of Emergency Medical Services in New York City for the past 17 years. He spent several years working as an EMT, and has worked as a registered nurse in Level One Trauma Centers for the past 15 years. He is also involved in martial arts, close protection, and defensive tactics training.
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