One thing often tragically neglected by people who think they are prepared is the ability to respond to a serious causality incident, where a trauma kit and some knowledge of how to use it can save lives– even your own.
If the terrible events of the past several days have proven anything is that you can expect the unexpected to rear its horrible head when and where you least anticipate. In a world of domestic and international terrorism, if you live, work or play near a large city you can quickly find yourself in the middle of a nightmare where overtaxed first responders may not be available or are stretched too thin to control the situation until additional resources appear. On the opposite side of the coin, in a rural or suburban area where a small-scale accident or incident pops off, you could find yourself isolated with the nearest support vital minutes or even hours away. It’s these moments, where conventional civilian emergency medicine protocols fail, that is the most dangerous.
Thus, the need to be ready for trauma.
First off, while there is no law about who can apply first aid or emergency care– there is not a reg that says you must watch someone die while waiting for emergency personnel– it is a priority to be initially competent that what you are doing is not causing more harm. With this notion, reach out and gather skills that are portable and, by and large, nonperishable for a few years at a time.
Basic to advanced CPR and first aid courses are offered nationally by organizations such as the American Heart Association and American Red Cross for a nominal fee while local fire departments, emergency management agencies, and police departments often hold free training courses and citizen’s academies in the interest of preparing the community for disasters. Another stepping stone is FEMA-organized Community Emergency Response Team (CERT) courses which over the course of several afternoon or evening sessions provide free training. While geared to emergency management, these courses do have a medical module that teaches basic first aid including diagnosing and treating airway obstruction, bleeding and shock by using simple triage and rapid treatment techniques.
Moving from the simple to the more advanced, the next level would be specialized tactical medical or field medic training for civilians. Alternatively, you can help your community by working with your area volunteer fire-rescue department and seek out medical training opportunities through them. Training as an EMT, AEMT, or Paramedic with a National Registry certification is invaluable.
Once you are trained, think about what you carry with you.
In the military or in a deep woods survival or extended hiking situation, large IFAKs (Individual First-Aid Kits) are common as is detailed training for self-aid and buddy care with regular updates. However, while efficient, they are still too large for most civilian every day carry use unless your typical pocket dump includes MOLLE gear and a plate carrier. On the flipside, a $9 band-aid and boo-boo kit from the local pharmacy is not going to do much good in a trauma situation, especially if dealing with rapid blood loss such as a gunshot wound.
Good contents are a CPR face shield (also keep in mind that many health care professionals teach chest compression-only or hands-only CPR especially where strangers are concerned), an Ever Ready or Israeli-style bandage, nitrile gloves (be sure to verify your size before you start carrying these as you don’t want to find out they don’t fit for the first time when you need them the most), gauze, and some sort clotting sponge such as QuikClot. Keep in mind that these are often sold in kits which can help bring down the price.
These kits do not have to be bulky and there are several options for carrying including ankle pouches and any number of “tactical coin pouches” to accommodate your needs. For many, a repurposed Altoids tin works.
While the face shield and gloves are self-explanatory, the other items will help to quickly control bleeding at the scene to stabilize an injured person before seeking more advanced care. Speaking of which…
Since the mass casualty incidents on Sept. 11th and at the Boston Marathon Bombing, small, portable tourniquet systems have become very widespread. Those events saw first responders using belts, hoses, shoelaces and other improvised objects coupled with ersatz windlasses such as pens and pencils to save lives. Now, excellent lightweight and purpose-build systems made by vendors such as C-A-T, R.A.T.S, RE Factor, SOFTT-W and SWAT-T, are on the market for about the price of a quick lunch. These rapid application devices are made specifically to be carried. Contrast this with a more elaborate tourniquet stored in a vehicle or cache somewhere that may take precious minutes to reach–whereas a small kit can slip in a back pocket or ride along in a laptop or sling bag.
If you are freaked out by the prospect of applying a tourniquet, check out this video from the Mayo Clinic about ready access to a field device and the basics of its use, but do not let it be your only training.
As a bare minimum, most instructors recommend carrying at least a set of gloves and a tourniquet as part of a trauma kit, with gauze, clotting sponges and the rest of the items mentioned above as a welcome bonus. As a pro-tip, avoid getting too bulky as you will be less likely to carry the kit if you do. Remember to stay on top of your supplies as items such as gloves will dry rot, break down, and tear over time.
From a legal standpoint, if an individual is conscious always ask before you attempt treatment. Make sure help is on the way as you do, and never try to bite off more than what you can handle and are competent to perform. Items such as needle decompression kits, vent chest seals, and airway tubes, if you are not trained in their use, are best left to those who are.
Above all, be safe out there.