A Paramedic's First Aid Kit

[4x4Lamm]

A few people have asked me for advice on what to carry as far as medical kits for off-road, camping and general use. You have to build your kit to your own specific needs but I think mine does a pretty good job of covering all the bases. Obviously you should have appropriate food/water and clothing for the trip so those are not included.

I have been doing fire and EMS since I was in high school and have worked/work in wilderness, rural and urban settings. Aside from being a paramedic I have ACLS, ITLS, PALS and BLS certs. I also used to teach first aid and survival courses too if any of that matters to you.

Here is my kit,

Airway Kit:
2 Magil forceps, 1 small, 1 large
1 pocket mask (high quality)
1 CPR mask, (low quality)
1 bulb syringe
1 manual suction device with catheter
1 Asherman chest seal
1 oral airway set
1 nasal airway set
Surgical lube packets
3 16 GA. IV catheters
1 pair sterile gloves

Tools:
Misc. sterile surgical blades
Misc. splinter removal needles
1 disposable body staple kit with remover (Adventure Medical)
1 Wound closure kit (Adventure Medical)
1 pair trauma sheers
1 pair bandage scissors
1 hemostat clamp
Misc. safety pins and small needles
1 BP cuff
1stethascope with spare parts kit
1 LED penlight
Misc. pens, sharpie marker
1 Paper pad
1 “Vital Stats” notebook
1 pediatric trauma/meds guide
1 magnifying glass
Misc. q-tips
1 small mirror
1 window punch
2 pair tweezers
1 N95 mask
1 thermometer with extra covers
1 space blanket
1 emergency poncho
Misc. tongue depressors

Medications/Ointments:
1 hydrogen peroxide gel
1 activated charcoal
2 instant glucose tubes
1 Vaseline lip balm
1 bottle Motrin
1 bottle Imodium
1 bottle ipecac syrup
1 bottle sterile eye wash
1 tube of Rolaids
1 Primatene mist inhaler
3 packets of oral hydration salts (Adventure Medical)
Misc. packets multi symptom cold medicine
Misc. packets nasal decongestant
Misc. packets aspirin
Misc. packets electrolyte tablets
Misc. antiseptic, alcohol, iodine wipes
Misc. packets orajel
Misc. packets loratadine tablets
Misc. Pepto Bismol tablets
Misc. packets cortisone cream
Misc. packets Technu ivy cleanser
Misc. Benadryl, tablets and strips
Misc. ammonia inhalants
Misc. packets burn gel
Misc. amps of sting relief
1 packet of cough suppressant strips (dextro)
Misc. packets Goody’s pain relief drink mix
Misc. packets antibiotic ointment/Neosporin
1 packet Stay Alert caffeine gum

Bandaging/Trauma:
1 large packet of Quick Clot
2 triangular bandages
1 tourniquet
2 finger splints, 1 small, 1 large
1 “Extractor” snake/insect bite kit
2 rolls of tape, ½” and 1” (waterproof)
Handful of 4x4s
1 ACE bandage
1 roll of 2” Kling
1 SAM splint
Handful of 2x2s
Dozen large Band-Aids
1 small baggie of Misc. small Band-Aids
1 2” roll gauze
1 4” roll gauze
Misc. Moleskin
Misc. occlusive dressings
2 small packets of Quick Clot
1 multi trauma dressing
Half dozen 3x5 ABD pads (can use sterile napkins too)
1 sterile burn sheet
Misc. rubber/latex gloves

http://img136.imageshack.us/img136/2186/img0902gi8.jpg (http://imageshack.us)

Here are the two Pelican Cases everything is in.

http://img163.imageshack.us/img163/811/img0890vn1.jpg (http://imageshack.us)

The small case hold supplies for airway and breathing management.

http://img138.imageshack.us/img138/6474/img0889va2.jpg (http://imageshack.us)

This is the airway case opened and the equipment stored in it.

http://img163.imageshack.us/img163/3431/img0892kk3.jpg (http://imageshack.us)

This is the main EMS case.

http://img171.imageshack.us/img171/1416/img0895vo1.jpg (http://imageshack.us)

Here is what you see when you open it up.

Except for the burn sheet and multi trauma dressings it is 100% contained in 2 Pelican cases. The airway kit is in a 1200 series box and the rest rides in a 1500 EMS series case.

IMPORTANT NOTE: Some things can do more harm than good if you do not know what you are doing. Unless you are trained as EMS or military (combat lifesaver) please don't do a needle decompression on me or something like that :) If you are unsure of what something on the list is or what it's for chances are you don't need to be carrying it but that does not mean you can't save a life with other items. Also, training is more important than anything on this list, the best return you can get on your time and money is a good first aid and CPR or even EMT-B class. EMT-B is only a few hundred bucks and about 120 hours of class in most areas, a real bargin if you ask me.

Enjoy and feel free to ask questions.
4x4Lamm

[purity]

not only would i not know how to use half of that stuff or know what it is used for, but i wouldnt be able to even identify any of it if placed in front of me either. its amazing how little us non medical types know. thanks though.

[4x4Lamm]

not only would i not know how to use most of that stuff or know what it is used for, but i wouldnt be able to even identify any of it if placed in front of me. its amazing how little us non medical types know. thanks though.

It's all good. When it comes to any serious 4x4 mods/repair I'm all thumbs. I know a lot about electrical, recovery and that is about it. We all have our own skill sets :welder:

4x4Lamm

[purity]

for sure, it would be great to have a guy like you (fully prepaired medic) on the trails or just around in general at all times just for piece of mind lol! hopefully your post will inspire others. i want to beef my first aid kit up and this should help by including things i didnt think of that I DO know how to use. :D

[mdinana]

Geez... nice kit. Either you've got one hell of an extended scope of practice in OH, or you're pushing the boundaries of your cert's. Mainly I'm looking at the stapler, Loratadine, and a few of the OTC meds (ie, Motrin) when I say that. Funny thing is, they all are OTC!

Anyway, it's still a nice kit. You carry a laryngoscope with the macgills?

I've been in EMS since '96 as a -B, but finally graduated to physician level practice. My FAK is def. aimed at trauma level, without most of the meds you carry. I mean, Tylenol and ASA are about all I carry full time in the car. Might supplement with Tums and Loperamide when I'm out for a camping trip, but don't get too much in the way of charcoal and some of your stuff. Eventually plan on an airway kit, a few bags of NS, and maybe a medic-level med bag, but that's way off. And only on car-camp trips, not backpacking.

Though it probably wouldn't happen, it would be pretty cool to meet some day and swap BS over a few beers. I'm sure you've got a story behind all that you're carrying.

[WallyP226]

I suppose the rules change a little between states, but I would think that if someone is trained to use the equipment, the Good Samaritan laws would apply in an emergency situation in the field.

Its one thing when one has every tool available in a hospital, another when in the field and there is the potential delay in treatment secondary to the remoteness of the area. As medical people, during an emergency of the ABCs, time is of the essence.

Thats why the standards of care are a different between the field and the hospital.

IMO thats a pretty cool and thorough emergency medical kit.


Wally

[mdinana]

I suppose the rules change a little between states, but I would think that if someone is trained to use the equipment, the Good Samaritan laws would apply in an emergency situation in the field.

Wally

As a general rule, Good Sam laws do NOT apply to trained personnel. The though being that they're "trained" and thus not necessarily acting in good faith, but rather based on standards of training. Now, that person doesn't technically have to stop and render aid, unless actually identified as a trained provider (ie, big Star of Life on their window, "rescue squad" on their license, etc).

Having said that, I know some states are re-working the laws to better cover medically trained folks.

[Pikeman]

I am an Army CLS and carry my CLS bag with me whenever I camp or wheel. However living in the litigeous area of So Cal I am afraid of using my IV's or needles on anyone not closely associated or known to me. I have started about 75-80 IV's in field environment. So it is not due to lack of experience it is fear of legal. I would not hesitate to take care of any other wounds or needs and I carry 4-5 SAMS splints with me. ***Which reminds me I need to check dates on all my supplies***

[WallyP226]

I think what MD is talking about is having the equipment and the training and then performing interventions in the field. Then the standards of care would apply.

Ie trained and certified in starting IVs, ACLS, PALS, ATLS, intubations, central lines, etc etc etc..... Performing said skills in the field.

The standard of care wouldn't apply however if one didn't have the equipment regardless of the training or care would be delayed because of the inability of EMS to respond to the location for whatever reason.

For instance, several years ago, I was rock climbing. Some college kids wanted their picture taken at the edge of the cliff. As luck would have it, one kid stepped backwards off the cliff. He was in bad shape, with head injuries, broken femur, dislocate shoulder, couldn't get a life flight chopper in, the closest road was 2-3 miles away in a rural area. So between a nurse, an EMT (at that time) a paramedic. We made make shift C-collar, took peripheral pulses, made a stretcher out of our climbing ropes and two sapplings and transported him out of the woods to EMS.

The other part of this is having the experience but not having the certifications to do more than one is doing, then there would be liability. Don't do more than your scope of practice otherwise one is opening themselves up for liability issues.

It would be nice if tort laws were changed to help get care to people sooner in life or death situations, so that liability wasn't as much of a concern as trying to help prolong another person's life.


Wally

[Kaistie]

"The other part of this is having the experience but not having the certifications to do more than one is doing, then there would be liability. Don't do more than your scope of practice otherwise one is opening themselves up for liability issues."

Otherwise known as Gross Neglegence. It was put very simply to me during my EMT training years ago; cutting a persons throat (or performing a trache) to establish an airway cause you watched it on an episode of ER would be considered gross neglegence. The Good Sam law does not protect you in this situation.

[trifenix]

so if someone cant breathe and you have to stab their throat with a pen cuz you saw it on ER... you can get in trouble? shoot last thing i want is to be sued. I heard the good samaritan law isnt bullet proof so i guess if someone is dying just hope the next person to come along helps them because its not worth the liability.

"yea he is bleeding out pretty bad...how far out are you?"
"about 30 minutes"
"yea....i dont think he has that much time."
"well why dont you just do the procedure?"
"i can't not certified yet, one more month and I don't want to get fired."
"........"
so the rescuer on site can either:
A. help the injured and risk a lawsuit and lose cert and job= no money for bills/family
B. Hope he survives for 30 minutes but knows he probably won't and have to live the rest of his life knowing he could have saved him but at least he keeps his job and does not get sued.

i dont understand.

this also reminds me of the article where 2 friends were in a car accident and the car caught on fire. friend 1 had spine damage and friend 2 could walk. friend 2 decided to move friend 1 because she was afraid the car would explode. friend 1 sustained further spine damage and cannot walk as a result of friend 2 moving her. car did not explode. friend 1 is now suing friend 2. Good friends / good samaritan law FTL.


p.s. that first aid kit is wayy awesome but complicated for the untrained. I can't wait to watch the new show Trauma!

[NightRyder]

im training to be a medic

kit looks great man

[mdinana]

"........"
so the rescuer on site can either:
A. help the injured and risk a lawsuit and lose cert and job= no money for bills/family
B. Hope he survives for 30 minutes but knows he probably won't and have to live the rest of his life knowing he could have saved him but at least he keeps his job and does not get sued.

i dont understand.



what's not to understand? you can sue for pretty much anything, and a decent lawyer would win that case. Remember, you're not sued for OUTCOME, you're sued for ACTIONS.

It's total horse pucky, but welcome to America.

[AGGIEFIREMAN]

As a Texas Certified Critical Care Paramedic and NREMT-Paramedic, some of that stuff is overkill for you non-EMS providers. Most people don't know what that stuff is, much less know how to use it or when to use it.

Keep in mine this is Texas only, but the Good Samaritan Laws are aimed at protecting volunteer first responders and lay people who stop and render aide. They do protect trained medical providers so long as that person does not have a duty to act.....i.e. that person is not on duty or being paid to be a medical provider. In addition to that, to be protected under those laws as a paramedic, that medic can only provide his BLS skill set....basically act as an EMT-Basic. If medic provides ALS skills while not operating under his Medical Director/protocols.....he is setting hisself up for one hell of a law suit.

OP---While I understand that someone has sought your advise on putting a med kit together, but I could see some confusion being created. You are a highly trained provider that knows when/how to use this eqiupment. I think some might think, if a Paramedic carrys this stuff it must be a good kit to have.

One example, I can think of real quick is the Primatine Mist. Primatine Mist is used to treat shortness of breath, from bronchial constriction. Say a lay person was to give someone Primatine Mist b/c their Asthma was excerbated, and that patient had an allergy to Peanuts......Primatine Mist uses an aerosol propellant based on peanut oil......see the complictions!!!!! Non-EMS people don't know to obtain a Med HX, including allergies prior to med adminstration.

These are only my thoughts,

Gari S.

Firefighter/CCNREMT-Paramedic

[marnes2986]

hey i have an offtopic question for those working in the paramedic/med field of that sort........are there any options for RN's in the field. im a second year RN student....im curious on more options for me instead of ICU and ER. I know there are Helicopter Nurses for trauma etc.. anymore 'unique' nursing occupations like that?

[mdinana]

Yeah, in CA if you look up the EMS regs, an RN can challenge the EMT-P test and get licensed. there might be some minor hoops to jump, but you can skip the entire 1000 hr class.

You can also do "CCT's" - Critical Care Transports. Don't let the name fool you, they're inter-hospital tranfers, of usually not-critical patients. You play IV pump and EKG watcher.

Finally, I think, and don't quite me, that Mercy Air uses nurses.

[toymota]

Sooooo

Just because a similar thought came up - what do you think about normal civilians having suture kits? For liability reasons, I'd only use it on myself (and have). I carry the skin glue, sutures, bandages, heat/cold wraps, burn gel, scissors, CPR barrier, Saline, eye wash, Arterial bleed cutoff strap (Basically a funny looking zip tie to be used as a tourniquet) and the rest of the normal crap like blanket, antibiotic cream, Potassium permaginate(sp?), tums, etc.. I guess I would rely on vehicle parts and nature for such things as splints and braces.

If you EMS types don't mind - give a list of useful items for the average joe. Maybe also list some stuff for someone that is maybe smarter than the average bear as far as medicine goes (you know - maybe worked volunteer fire, was in military or the like) - but not certified in any way.

[4x4Lamm]

I think it's important to understand the intended idea and application of your medical kit. One kit is not necessarily the end all be all med kit. The fact that I am a paramedic does not change the type of first aid I would do for friends, family and loved ones at home, on an outdoor excursion or the like.

MOST of the items in my kit are not for LIFESAVING, I can't recall the last patient I brought back with 400 mg of Motrin but it's really nice at the end of a long day of snowboarding when your legs are sore as all get out. The thing to remember is that as a municipal or military medic your efforts will be for lifesaving most of the time. When you are the "first aid" guy in your group your objectives may be a bit different.

Aside from the things you should not be without and other "basics" the stuff in my kit is selected from my experience in Boy Scouts and later working at the "health officer" at a very large scout ranch.

Long story short, I would not likely provide care in any mannor for anyone who I was not close enough with to be sure it could not lead to litagation. Even if the state pulls my card I can keep my job but if I get sued in civil court for a few million, well that would be an issue. Having said that I rarely find myself in a situation where I would be "forced" to do so, Ohio is not exactly like the western states. Hell, there are 4 helicopter EMS agencies that are within 15 minutes of my house.

4x4Lamm

[Logan]

My "kit" used to look like the above.....now it is condensed to a much smaller scale!! Ahhh the memories!!

[blakeape]

I am a Paramedic working at a fire dept in Montana. When not on shift, I am only allowed to work at the paramedic level in the county I live in. Anywhere else and I can only legally work at an EMT basic level. For me that is fine. Though there are times that we really make a difference with all the fancy tools in our bags more often good basic life support skill such as opening an airway or controlling bleeding are what truly makes the difference. When I first got my my paramedic license I built myself an amazing first aid kit with intubation tools, iv supplies, a nember of meds, etc. Though I still have it I rarely if ever use it. I now carry a much smaller kit with basic bleeding control equipment, some splinting devices, band-aids, a tube of oral glucose (i have a diabetic friend), some benedryl, ibuprofen and aspirin, a tube of neosporin and bsi equipment. I would recommend that anyone who enjoys the outdoors take a wilderness ems class such as those offered by Aerie Med in Missoula MT. A little bit of knowledge can go a long way when it matters. Good luck all.

[marnes2986]

Yeah, in CA if you look up the EMS regs, an RN can challenge the EMT-P test and get licensed. there might be some minor hoops to jump, but you can skip the entire 1000 hr class.

You can also do "CCT's" - Critical Care Transports. Don't let the name fool you, they're inter-hospital tranfers, of usually not-critical patients. You play IV pump and EKG watcher.

Finally, I think, and don't quite me, that Mercy Air uses nurses.

thanks for the info.....bummer, i thought there would be more options for nurses outside the hospital...i enjoy all the technical stuff nursing offers i just hoped there was something where i could work outside and didnt have to deal with dickhead dr's lol

[my2coma]

One thing I would add to any 1st aid kit is a flask of whiskey :D

J/K

[totalloser]

I'd be tempted to "bend" the rules and get an epi pen in there. I'd rather bend the rules than let someone die because of a damn bug.

C-spine hardware might be worth considering, too. IE TC situations off road aren't that uncommon.

But I think the #1 (NUMBER ONE!!!) Thing I'd carry is my issue radio. 5 watts of "help guys!" Plus you can interface with an air ambulance.

[Scuba]

I'd be tempted to "bend" the rules and get an epi pen in there. I'd rather bend the rules than let someone die because of a damn bug.



I need to get a couple of those for my first aid kit

[MisfitToy]

Wow been awhile sense I've invintoried my kit but I got the basics CPR masks gauze alot of bandages feild dressings shears iodine Airways splints basic stuff. I'm a marine combat life saver but my certs don't meen shit in the civilian world. I usta carry an iv in my bag but Ive heard to many horror storries about people just trying to help getting hosed. Don't get me wrong ill stop and help someone but as far as more than basic life saving only close freinds and family. Kinda shitty you can be the only reason that shmuck in the court room across the isle is alive right now

[4x4Lamm]

FYI a sam splint makes a pretty decent C-collar as well.

[ksp04031]

You guys watch too many movies. Swap your fancy "Rescue Ranger" kits for some decent means of communication. 80% of medical emergency victims are stabilized with basic life support, such as CPR and the ABC's. The other 20% need surgery. Someone with a First Responder cert is going to help a hell of a lot more because they're taught to know their limitations, know their local laws and are stressed the importance of timely transport. If you really want to help on the trails, go to your local community college and take a First Responder class.

[rustyshakelford]

under whose medical direction are you working under if you perform anything other than bls skills on the trails or out on your own? seems to me that you would be opening yourself up to alot of legal risk

brett

[wingysataday]

depending on what state your in they have laws like the good samaritan act that allows you legal coverage without the risk of being sued if you only perform what you have been trained in or is allowed by your license in that state.
EPI pen would be a great thing to have.

[4x4Lamm]

You guys watch too many movies. Swap your fancy "Rescue Ranger" kits for some decent means of communication. 80% of medical emergency victims are stabilized with basic life support, such as CPR and the ABC's. The other 20% need surgery. Someone with a First Responder cert is going to help a hell of a lot more because they're taught to know their limitations, know their local laws and are stressed the importance of timely transport. If you really want to help on the trails, go to your local community college and take a First Responder class.


Whom is this directed to? :confused:

[yamaharider1585]

most of those things dont require a whole lot of brain power to use. Yeah some of those things are a bit out of range of a non trained person but non of those things are going to hurt to have. I guess its easier for me to say since ive been an emt for two years but still a lot of it is common sense.

[Jmv2025]

haha well if I see some guy running with his first aid bag like its the end of the world to anything other than a full arrest (and even then a real professional probably wouldnt run unless its a kid)....ima try hard to not start laughin cause those people almost always hurt more than help, its like AGGIEFIREMAN was saying with the primatine mist, alot of people have good intentions but let themselves get too worked up and cant just size up the scene very well and just breath. Hey I was a Ricky Rescue once (4 years ago) as with all of us, but the person you want is the one who doesnt go around announcing he is an EMT. I know when I need to help and am always willing. I would recommend a cpr class for starters.

[ksp04031]

I guess its easier for me to say since ive been an emt for two years

I'm just gonna pretend that was a joke :lmao: