Trauma Kit Recommendations

Civilian or off-duty Bleeding Control Kit/Trauma Kit

After the Department of Homeland Security launched the Stop the Bleed Campaign in October, 2015, the number of kits devoted to the treating significant trauma has exploded. These kits are often known as IFAK (individual First Aid Kit) or Bleeding Control Kits. These kits are geared towards injuries usually seen on the battlefield, such as gunshot wounds, or explosions, and are different than traditional first aid kits, which often consist of band-aids or some small gauze. The following are a few things to consider when purchasing such a kit/or kits:

Get some training.
The equipment in the kit is only as good as the training of the user. For civilians, the
Stop-the-Bleed course is a good start.
Professional rescuers (EMTs, paramedics) should consider a TCCC or TECC course. Above all, make sure the scene is safe for the rescuer before initiating medical care.

Do some research.
Medicine is always evolving, as research is conducted and new items come onto the market. The recommendations in this document may become outdated as new research and new treatments becomes available. Remember, just a few years ago, almost all EMT textbooks recommended against tourniquet placement, whereas it is now the standard of care.

Only obtain equipment appropriate and legal to your level of traini
ng.

Some kits contain items such as decompression needles, airway adjuncts, IV equipment, and suturing supplies that should only be used by medical personnel under the supervision of a physician.


Commercial Kits

Each kit has strengths and weakness. I do not recommend any one specific kit over another. For more on what a kit should contain, see the later portions of this document. Websites that sell commercial kits include:

Bleeding Control.org
North American Rescue

Rescue Essentials
The EMS Store


Kit Contents
A good trauma kit should contain some version of the items listed below:

Essentials:


Medical Gloves: Are essential to protecting the user from blood and bodily fluids. Latex should be avoided, as many people are allergic to latex. These are available from
Amazon or any drugstore. Consider carrying 2 pairs, in case one pair rips, becomes contaminated, or if there are multiple rescuers.

Regular Gauze: Is used to provide direct pressure over surface extremity and head wounds, or pack deep junctional wound
s. Rolled
, or vacuum packed gauze is preferred over gauze pads, because they can be used for wound packing. Rolled gauze can be found at most drug stores, but vacuum-packed gauze is mostly found online.

Hemostatic Gauze: May be used in place of regular gauze. This is gauze that is impregnated with agents that promote blood clotting, and is thought to stop bleeding faster. Again, rolled, or z-folded gauze is preferred over gauze pads because they can be used for wound packing. Several types are on the market including:
Quickclot, Celox, and Chitogauze.

Compression bandage: Some method of stretch bandage is needed to hold gauze in place. Options include
Coban (ace wrap), the Israeli Bandage, or Emergency Trauma Dressing.

Tourniquet: Are used to stop severe extremity bleeding. Commercial tourniquets approved by the Committee on Tactical Combat Casualty Care (TCCC) are recommended because they have undergone rigorous testing. Such models include the
CAT, SOF-T and SOF - T wide.

Trauma Shears/Scissors: Are used to remove clothing and cut bandages to size. Cheaper, easily replaceable shears may be desired over expensive models.  They come in
5.5 inch
and 7.5 inch models.

Optional:

Vented Chest seals: Are used to seal torso wounds to prevent air from being sucked back into the chest cavity. Vented chest seals allow air to escape and should help prevent a tension pneumothorax from occurring as a result of chest seal placement. Common types include the
Bolin, and the Hyfin Vent.

Triangular Bandages: Are cheap, multi- use
items, that with proper training can be used to pack wounds, create arm slings, or when coupled with a windlass, create additional improvised tourniquets.

Mylar Blanket: After external bleeding is controlled, hypothermia should be prevented, because it decreases the body’s ability to clot. Mylar blankets are cheap, disposable, and can be found
online.

Medical Tape: Has many uses, such as taping dressings, securing tourniquet handles. Tape can be purchased at drugstores, or
online.

Permanent Marker:
S
uch as a
sharpie,  can be used to write on skin, paper, tape, tourniquet flaps, etc.

Light:
LED penlights or small flashlights. may be useful in when working at night.

CPR Faceshield:
While CPR is futile in trauma, it is good always have a CPR pocket mask or face mask
available for any medical cardiac arrests that are encountered.

Things to Avoid:

Off Brand/Counterfeit Tourniquets: There are many tourniquets on the market that are not TCCC approved. Tourniquets such as the MAT, are often made with cheap plastic parts that may fail in an emergency. Also, some tourniquets are made to look like genuine CAT tourniquets, but are actually cheap knock-offs that do not meet the same quality standards.

Non-Vented Chest Seals/Occlusive Dressings:
Non-medical personnel, and even inexperienced EMTs, should avoid non-vented chest seals or traditional occlusive dressings. Studies have shown that by placing an unvented dressing, one risks turning an open pneumothorax into a tension pneumothorax, which is significantly worse. Also, there is little evidence that taping an occlusive dressing on 3 sides (as has been traditionally taught) will provide an effective vent. Those providers who lack the training or experience to recognize a tension pneumothorax should only utilize vented chest seals to reduce the chances of a tension pneumothorax occurring from chest seal placement. Understand, though, that a tension pneumothorax could still occur from the primary injury.

Powdered Hemostatic Agents:
Some powdered hemostatic agents have been known to create exothermic reactions and burn patients. They also can blow away when working outside in the wind. For this reason, impregnated gauze is preferred.

Airway adjuncts: Placement of nasal and oral airways are medical procedures, and should only be performed by trained, on-duty, medical personnel who are legally authorized by a physician.

Decompression Needles: Needle decompression is a medical procedure, and should only be performed by trained, on-duty, medical personnel who are legally authorized by a physician.

IV therapy: Is a medical procedure, and should only be performed by trained, on-duty, medical personnel who are legally authorized by a physician.

Suturing: Is a medical procedure, and should only be performed by trained, on-duty, medical personnel who are legally authorized by a physician.

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