On Call w/ Chris Episode 02: Trauma vs First Aid

[RainGoat]

@El Solis, I was wondering if you could address your recommendations between two tourniquets in your recommended kit:

COMBAT APPLICATION TOURNIQUET (C-A-T Gen7)(CAT TQ) &

SOF TACTICAL TOURNIQUET WIDE (SOFT-TW TQ)?

I heard your recommendation for CAT TQ Gen 7 over the RATs secondary to patient tolerance of the tourniquet due to it's wider width. I did a bit of a literature search and can't really find anything recommending the SOFT-TW TQ over the CAT TQ Gen 7. Is there any reason to get anything besides the CAT TQ? I did read that it had problems with pediatric applications but that was true of the SOFT-TW TQ as well.

Thanks for your time!

 

[Ubiety]

Thank you for this series! @Heidi the BSN approves whole heartedly! Really good stuff! Thank you!

 

[copperblack]

There is something about trauma that makes me scared huhuhu. Meanwhile I only have the free first aid Genuine Mopar First Aid Kit (Part No: 82215912).

 

[Pete E]

Very interesting video, but I don't think the trauma kit concept goes far enough...

Rather than a kit to deal with just breathing and bleeding issues, I think it should also contain items to deal with other of the more common life threatening or serious, potentially life changing injuries. An emergency/trauma kit if you will..

For instance, I would include one or possible two Sam splints to allow speedy immobilisation of things like a broken femur or neck injury. Another injury worth considering kit for would be serious burns...In a remote area, they may not be considered immediately life threatening, but add in the possiblity of shock and infection, and I think they need to be considered.

Finally, there is nothing related to HAAD, ( Heart attack, Anaphylactic shock, Asthma, Diabetic hypoglycemia)...This may be from a legal/liability perspective, or it may be that the items required ( aspirin, epipens, inhaler, glucose pouches) are carried in the Basecamp kit, but where legal, I would prefer them in my emergency/trauma bag.

 

[MunsterGeo Overland]

Very interesting video, but I don't think the trauma kit concept goes far enough...

Rather than a kit to deal with just breathing and bleeding issues, I think it should also contain items to deal with other of the more common life threatening or serious, potentially life changing injuries. An emergency/trauma kit if you will..

For instance, I would include one or possible two Sam splints to allow speedy immobilisation of things like a broken femur or neck injury.

With the utmost respect in the world, I'd be looking at a traction split, such a a Kendrick, for a broken femur and not primarily a SAM splint.

In the first instance ABC's are always the most important unless there is massive haemorrhage.

It's possible to carry a Kendrick or similar in a trauma kit but remember that traction can be applied in numerous ways and a traction split manufactured on-scene if necessary or even held while something suitable is being sorted. However I'd generally not consider a SAM splint for primary management of a broken femur.

If a person or organisation can afford to include a Kendrick or similar then absolutely pack it in but the cost of these devices is not cheap.

 

[Pete E]

With the utmost respect in the world, I'd be looking at a traction split, such a a Kendrick, for a broken femur and not primarily a SAM splint.

In the first instance ABC's are always the most important unless there is massive haemorrhage.

It's possible to carry a Kendrick or similar in a trauma kit but remember that traction can be applied in numerous ways and a traction split manufactured on-scene if necessary or even held while something suitable is being sorted. However I'd generally not consider a SAM splint for primary management of a broken femur.

If a person or organisation can afford to include a Kendrick or similar then absolutely pack it in but the cost of these devices is not cheap.

Not going to argue there isn't a better way, but using a Kendrick wa,s and still is, way above my pay grade and training, and I am the first to admit that.

I received basic medical training as a Combat Medical Technician Class 3 as an Army Reservist in the late 80's and the training and equipment we were issued was pretty basic compared today, the watershed/quantum leap forward being the war in Afghanistan.

That said, two of us did immobilise a broken femur with a SAM and if I remember correctly, wooden fence post, and also managed to keep shock and hypothermia at bay until the weather cleared a bit and a civilian mountain rescue team arrived a few hours later...Given our very basic training and the limited kit we had, i think we did as much as was practical and the person lived, which I suppose is the acid test of success....

 

[MunsterGeo Overland]

Not going to argue there isn't a better way, but using a Kendrick wa,s and still is, way above my pay grade and training, and I am the first to admit that.

I received basic medical training as a Combat Medical Technician Class 3 as an Army Reservist in the late 80's and the training and equipment we were issued was pretty basic compared today, the watershed/quantum leap forward being the war in Afghanistan.

That said, two of us did immobilise a broken femur with a SAM and if I remember correctly, wooden fence post, and also managed to keep shock and hypothermia at bay until the weather cleared a bit and a civilian mountain rescue team arrived a few hours later...Given our very basic training and the limited kit we had, i think we did as much as was practical and the person lived, which I suppose is the acid test of success....

Congratulations, genuinely :) great job.

There's always more ways than one to get a job done.

For me the trauma kit is exactly that. A trauma kit.

Outside of a First Response vehicle it's impossible to carry the gear to deal with every possibility but having the gear to deal with the ABC's is within reach of everybody.

It's up to the individual to add equipment as appropriate.

 

[El Solis]

Happy to help! Glad you liked it. Please let me know if there are any specific topics you want to hear about.

 

[Deleted member 59857]

This made me rethink my entire first aid setup. It's interesting how the best things are the most simple, and simplicity is the domain of experts and experience.
I now have a small trauma kit at the ready- disciplined to use it for nothing else, and there just for that. My first aid kit (much larger w/ all the plasters and such) is stowed.

I have gone through them, and can actually use everything in both. I didn't go overboard. I feel confident in the tools I have, and may expand it if needed.
For me, I kept everything visible. I did not stack and jam pack so I can't see everything. I'm not a medical expert. In the heat of the moment, I want to be able to unzip and spread open the trauma kit and easily see what I have to work with. That helps me, as I won't remember what I packed in there 3 or 6 months ago.

Also, for any specific medical needs of those travelling, I still seperate the immediate 'trauma' meds from things that can be 'first aid'. For example, epi-pen for severe allergic reactions is in trauma bag. Aspirin is not.

I now look at that trauma bag as the fire extinguisher in the glass case. When you gotta get someone help fast. Otherwise, it must not be touched.
I doubled up on things like med scissors so it doesn't get used and forgotten to be put back. One in first aid, one in trauma.

I wish everyone had to go through this, even as a mental exercise, so that if the need arises there is no additional stress added by fumbling around and what not.
It's given me a lot of confidence for the first aid side of things.
I'm not going to be curing cancer out there, but i'll be covered for the most common issues - hopefully minor and hopefully will never have to use the trauma bag.

Thanks for sharing this information, and the thought process behind it all. Very valuable!

 

[mikeD1Esel]

This made me rethink my entire first aid setup. It's interesting how the best things are the most simple, and simplicity is the domain of experts and experience.
I now have a small trauma kit at the ready- disciplined to use it for nothing else, and there just for that. My first aid kit (much larger w/ all the plasters and such) is stowed.

I have gone through them, and can actually use everything in both. I didn't go overboard. I feel confident in the tools I have, and may expand it if needed.
For me, I kept everything visible. I did not stack and jam pack so I can't see everything. I'm not a medical expert. In the heat of the moment, I want to be able to unzip and spread open the trauma kit and easily see what I have to work with. That helps me, as I won't remember what I packed in there 3 or 6 months ago.

Also, for any specific medical needs of those travelling, I still seperate the immediate 'trauma' meds from things that can be 'first aid'. For example, epi-pen for severe allergic reactions is in trauma bag. Aspirin is not.

I now look at that trauma bag as the fire extinguisher in the glass case. When you gotta get someone help fast. Otherwise, it must not be touched.
I doubled up on things like med scissors so it doesn't get used and forgotten to be put back. One in first aid, one in trauma.

I wish everyone had to go through this, even as a mental exercise, so that if the need arises there is no additional stress added by fumbling around and what not.
It's given me a lot of confidence for the first aid side of things.
I'm not going to be curing cancer out there, but i'll be covered for the most common issues - hopefully minor and hopefully will never have to use the trauma bag.

Thanks for sharing this information, and the thought process behind it all. Very valuable!

I would add to keeping everything visible, there are a LOT of different setups that are just velcroed on. You can basically just grab a panel out with what you need (ABC wise).

My current medic does this and it works great in the field. I’m in a heavy weapons company currently (all HMMWVs) and getting in/out of a vehicle with a small kit containing everything you need is key to immediate life sustaining support.

Generally wheeling/overlanding in a group makes it very convenient to having people aid you i.e. grabbing your more robust aid bag.

I know I’m a newbie on the forums but no stranger to trauma and bad situations. Hopefully I can learn as much as possible here!

 

[Jacksonpak]

These videos are so great. Clear and useful information

[/QUOTE]

 

[shansonpac]

Its second episode time! This time, Chris is talking Trauma vs First aid, and some of the mindset and med kit implications.

Dr. Chris is great. Excellent, practical videos. One caveat. What a trauma surgeon needs, and what an untrained lay person needs, are two entirely different things. Training is critical to avoid doing additional harm in a seriously injured trauma patient. If you don't know how to use advanced airways, don't put them in your kit. If you don't know how to protect the spine, don't try to move the patient.

If you do encounter a critical medical emergency or trauma in the wild, ABCs are first, but rapid evacuation to definitive medical and surgical care is priority.

 

[shansonpac]

Another injury worth considering kit for would be serious burns...In a remote area, they may not be considered immediately life threatening, but add in the possiblity of shock and infection, and I think they need to be considered.

Finally, there is nothing related to HAAD, ( Heart attack, Anaphylactic shock, Asthma, Diabetic hypoglycemia)...This may be from a legal/liability perspective, or it may be that the items required ( aspirin, epipens, inhaler, glucose pouches) are carried in the Basecamp kit, but where legal, I would prefer them in my emergency/trauma bag.

I worked for ten years as a surgical PA staffing a burn ICU. Large serious burns present serious hemodynamic and thermoregulatory challenges that would be impossible to deal with in the wild, even if you are trained and experienced in this area. Serious burns can be small, and are best dealt with with a clean, dry dressing, and immediate evacuation to a burn center.

Also, you can carry epinephrine, ASA, glucose etc., but knowing when to use them (and when not to use them) is critical to doing no harm.

I would recommend that in groups, knowing at least some of the medical history of participants would be helpful in trip planning (i.e., people with a history of anaphylaxis making sure they bring their epipens).