Gunshot Wound First Aid Kits for Survivalists

Gunshot Wound First Aid Kits for Survivalists

By Cache Valley Survivalist 

It is extremely naive to think that if society falls apart, your small band of survivors will rack up action movie kill ratios as they stand against the onslaught of angry mobs and criminal gangs without ever being touched by a bullet themselves. OK, so maybe that's an exaggeration, (I sure hope so) but if you are all firearms and no first aid, you are not being realistic in your preparations. An IFAK is critical equipment for Survivalists and preppers. Even if you don't own or use firearms, they still pose a great threat to you. (Even more so if you don't carry them and train with them.)

 

The IFAK - IFAK stands for either Improved First Aid Kit or Individual First Aid Kit depending which branch of the service you are from. SOP (standard operating procedure) for most survival groups is that everyone carries an IFAK and everyone carries the same minimum first aid supplies in their IFAKs and everyone learns how to use them. An IFAK is for trauma and/or gunshot wounds, and that's it. You can (and should) carry additional first aid supplies and medicine but it goes in a separate kit called a snivel kit. SOP regarding IFAKs varies from group to group. Some groups identify IFAKs with a red tab, patch or require everyone to carry them at the same position other their load bearing equipment so they can be quickly and easily found, even after a fight (when you may experience tunnel vision, tunnel hearing and may have difficulty thinking straight of using fine motor skill because so much adrenaline is coursing through your body).

Why do I need an IFAK when I already have a first aid kit? +Aid rendered immediatelyfollowing a GSW (gunshot wound) or other trauma can give the patient a fighting chance. Clearly, this is not a good time to have to dig your +aid kit out of your pack, but more importantly, it's much more difficult to put blood back into the patient than to prevent its loss in the first place. But the implementation of IFAKs into your group SOP is not just about having easily accessed first aid supplies on hand, it also involves training all group members in the use of GSW-specific first aid supplies and establish SOP for their use. If you sustain a GSW, you should be treated using the supplies out of your IFAK first, because if your buddy treats you using supplies out of his, then you are transported to an aid station with your IFAK still on your load bearing equipment, your squad is down two IFAKs instead of one. If your buddy is later wounded, he will need someone else's IFAK and there might not be anyone else around. If your group has a medic, the medic will likewise use the supplies from the wounded group member's IFAK before using up the supplies in his aid bag, but the medic carries extra supplies and supplies which require more advanced training that other group members may not have.

What should an IFAK contain?  Normally, an IFAK is supposed to provide immediate post-trauma care to stabilize the patient for transport to a trauma center. In a post-TEOTWAWKI world, first aid, trauma care, intensive-care and transportation will likely be very different than what your group members are accustomed to. The implementation of IFAK SOP in your group may mean the difference between the use of a hemostatic dressing on your wound or cauterizing it with a hot poker an hour later. Treating a GSW is probably not the best occasion to try out that new homeopathic remedy that you read about on the internet. In choosing the standardized supply list for your group's IFAKs, keep in mind that: 

1.    The most common, preventable causes of death due to GSWs nowadays are: hemorrhage, shock, compromised airway and tension pneumothorax, so your group standard equipment for IFAKs should include basic +aid supplies to treat these injuries. (This paper is about IFAKs for survivalists and preppers so if you want to learn about GSW first aid or how to use your IFAK, that will be the subject of another paper, but I strongly suggest that you do so. Even if you have training, you could likely benefit from additional training.)

2.    The most common, preventable causes of death due to GSWs post-TEOTWAWKI will likely differ from those that ER's and Military ER's commonly see today. e.g. Fewer people will be wearing body armor, so wounds to the torso will be more common, as will their severity. Also, more GSW casualties will die from infection and complications so these factors should be considered as you select the contents of your group standard IFAK.

3.    Post-TEOTWAWKI casualty care will almost certainly lack resources available today, so the contents of your IFAK and medical supplies that you have on hand when TEOTWAWKI occurs very well may be all you have to treat the patient. 

4.    The larger and heavier your group standard IFAK is, the more likely it is that a given member will leave his behind.

This much more likely to justify leaving it behind.I have different sizes of kits to keep on hand in different places. If the kit is for post-TEOTWAWKI, you will likely choose it's contents a little differently since wouldn't be a "golden hour."

Basic IFAK Contents

§  Nitrile Gloves (1-2 pair) - For the person helping to treat you.

§  Trauma Dressing (1-2) - Multi-purpose compression bandage, they normally come in 4", 6" & stump/abdominal sizes. A 4" or 6" compression trauma dressing will suffice. They have many many uses for first aid and in a survival situation. "Israeli" bandages in particular have a multitude of uses.

§  Compressed Gauze (1-2) - Z-fold or Roller Gauze - Vacuum packed into a small cube or square shape so they take up less space

§  Small 1.5"-2" Roll of Duct Tape or Multi-purpose Medical Tape - Can be used in conjunction with gauze to create various types of bandages if have scissors. Duct tape also has many other first aid and survival uses.

§  Sterile Gauze 4x4's (2-4) - To clean blood and debris away from wound so tape/adhesives will stick well

§  Petrolatum Gauze 4" x 16"- Sterile, non-adherent bandage that causes minimal trauma to a wound when removed. Can be used in conjunction with tape and the pressure dressing to create a chest seal for a sucking chest wound in order to prevent air from getting sucked in through the wound and possibly creating a tension pneumothorax (build up of air between the lung and chest wall or the pleural space). Without intervention, a tension pneumothorax can worsen with every breath, eventually resulting in a collapsed lung or lungs and inability to carry out respiration. Situations have occurred where trained GSW victims were able to see and reach the wound, making it possible for them to use a credit card and tape to create a basic chest seal and even crude flutter valves by only taping down 3 sides of the card.

§  Hemostatic Agent - Comes in granule, impregnated gauze and impregnated sponge forms. Some older varieties caused an exothermic reaction upon contact with blood, but when a patient would surely have succombed to blood loss, minor burns where not a grave concern. Newer products help stop bleeding without generating excessive heat when used in conjunction with direct pressure. The downside of sponges is that they are single use and come in fixed sizes. Agents in granular form enable the use of just the amount of agent needed and are especially useful in areas of the body where it may difficult to secure a sponge in place and in wounds of certain shapes. The worst downside of agents in granular form is that they can be blown by wind, rotor wash, etc and can be blown into people's eyes where they cause injury. Because of the downsides of the other forms of hemostatic agents, impregnated z-fold gauze seems to be being adopted as the new standard, but the other forms still have their places in trauma kits. Like most medical products, hemostatic agent com imprinted with expiry dates, but I would recommend that you research this on your own since almost all expiry dates are overly conservative in order to avoid liability and encourage early replacement which generates more revenue for the manufacturer.

§  Plastic Bag - Some IFAKs are vacuum packed into bags or stored in Zip-lock bags. If so, the bag the kit is stored packed in can be used in conjunction with duct tape to make an improvised weather-resistant cover for a wound, a chest seal or even a flutter valve if you have a cutting tool. A flutter valve allows exhaled air to leave the pleural space, but prevents additional air from entering it, worsening tension pneumothorax.

§  Tourniquet & Mini-Sharpie Marker - Useful to slow life-threatening blood loss in extremities. Be sure to learn how to properly apply a tourniquet before using one, mark the time with a marker. Never use a tourniquet to stop bleeding in a head wound. ;)

§  Chest Seal (1 or 2) - For entry and sometimes exit wounds to chest causing sucking chest wounds. Many designs are available with and without flutter valves.

Advanced IFAK Contents

§  Nasopharyngeal Airway with Lubricating Jelly - Sometimes called an NPA or nasal trumpet. Less likely to trigger gag reflex than than an oropharyngeal airway or listening to Obama blame others for his failures. Less invasive than intubation and fits in an IFAK. Learn how to use them properly before someone needs one. Pay special attention to when not to use them since NPAs shouldn't be used on patients with certain injuries to the skull, face and head. Maintains airway in unconscious patients and patients where swelling may block the airway. (Don't practice on your younger sibling.)

§  Chest Dart - Angiocath for needle decompression of pleural space. Not supposed to be dispensed without a prescription since you could kill someone if you really screwed up so research heavily before using. That said, learning to use them properly is not exactly rocket science and they aren't that hard to find. Used to decompress the chest in a patient with symptoms of tension pneumothorax.

IFAK Contents to Consider

§  Benzalkonium Chloride Antiseptic Wipe (2) or a tiny bottle of 2% Iodine Tincture - Can be used in combination with gloves and sterile gauze to clean blood and debris from the skin surrounding the wound (but not the inside of the wound) to help prevent infection. 2% iodine tincture can also be used to treat drinking water.

§  Triangle Bandage (2) - For immobilization and splinting of injured or broken limbs, holding bandages in place and many other uses.

§  Cohesive Wrap, 2" - Stretchy tape that adheres to itself, but not the skin, provides light compression and support and is very useful in bandaging. Included in USAF survival kit medical modules. Packs best when removed from the roll and rolled in a flat shape.

§  Tincture of Iodine, 2% - Very small bottle of topical disinfectant that can also be diluted with sterile water and used for irrigation or used to purify water. For external use only. Do not use inside penetrating wounds.

§  Medication - Medications are sometimes useful in treating GSWs but consult a physician/research this on your own. 

§  Bacitracin Antibiotic Ointment - Prevent infection.

§  Water-Jel Burn Dressing 4" x 16" - USMC uses this in place of petrolatum dressing.

Most survivalist will want to create various GSW kits or IFAKs. Some need to be smaller or they would get left behind, other can be a little bit bigger, but size is very important for gear that you may be carrying constantly. Good places to keep them are: 

§  In your home defense waist pouch or shoulder pouch

§  In your vehicles

§  In your range bag

§  In a MOLLE pouch on your fighting load carrier, tactical assault panel, plate carrier, etc

§  In your pocket or on your belt when you go hunting

§  In a jacket, coat pocket, or briefcase if you carry concealed

So there you have it. I hope that you never have to use one. I've needed and not had one, as I'm sure other folks in this group have, and I hope that nobody else has to go through that.
-Cache