Home Forums Hunting & Shooting AR and Tactical Rifles Blow out kit

So me and my buddy were talking today, he's ex military and everything they did, there was always someone there to plug a wound as well as the needed items to do so.

Now when we're out shooting, we really have nothing more than a basic first aid kit if even that. I'm not expecting to do brain surgery nor am I expecting to be shot but let's face it, things do happen.

So if I were to put together a first aid kit geared towards a gunshot, what would you suggest? This needs to be something small enough to keep on a belt or in a pocket and simple to use.

If you already have a small first aid kid then simply throw a few tampons in it to plug holes and a roll or 2 of 3m vet wrap. Vet wrap is a much cheaper name for Coban, a self adhesive bandage/wrap. Hell if one wraps it with increasing pressure it can even be made to act as a tourniquet.

Check out the kits from Dark Angel Medical, and listen to Mike Seeklander's podcast interview with the founder of Dark Angel. Lots of solid info on what kind of trauma kit to select, and how to use it if you need it.


http://darkangelmedical.com

http://americanwarriorshow.libsyn.com/dark-angel-medical-life-saving-kits-techniques-and-mindset

I'm going to go against the grain of what a lot of people probably will have to say. But this is a topic that's worth it. I've got a lot more experience with this stuff than a lot of people, and less experience than a lot more people. But I have actually treated a GSW, so I've got that going for me. After doing it live and training in it extensively, here are the conclusions I've come to.

You can get shot or punctured in three places....Extremities, your trunk and the tweener spots like armpits and groin. They'll need to be treated differently.

Extremities
Tourniquets are the answer. I carry two. The last two times we've had to apply them we've used two. Especially on the upper leg, one might not work. I like SofT but they're bulkier than a CAT and I use CATs where space is a concern. Get a tourniquet you can apply to yourself with one hand. For that reason I don't like the rubber band type models. If you've got kids around a lot the rubber band models can be very good as they'll compress smaller limbs. Get an extra and learn to use it. They'll wear out from practice, so have a designated tourniquet for that.

This might make people mad, but ignore anyone who says that they're gonna use a belt as a tourniquet. 1-It won't work effectively on a real bleed. 2-It's gonna be waaaay too slow to get into action and will nearly always necessitate "cutting a stick" or some other such nonsense. If you need a tourniquet you need it right now, not after you go cut a stick.

Tourniquets are cheap, relative to what they offer. Just buy one and try to hide your eye rolls at guys who swear they'll figure it out when the time comes.

Trunk
You can't tourniquet your trunk and you can't stuff enough gauze into it to stop the bleeding, and you don't want to stuff your trunk full of gauze anyway. You can cover the wound to keep air out of the chest cavity. Do that. A chest seal takes up hardly any room at all. This is one thing that can be improvised, but only if something to be improvised is handy. Your chest is airtight right now, just keep it that way.

Tweeners
Armpits and groins can't be tourniqueted, at least with conventional stuff. But you can pack the wound to help stop the bleeding. Vacuum sealed gauze weighs nothing and takes up nearly no space at all. Grab the end of it and start packing it as far into the wound as you can and keep stuffing it in there until nothing else will fit. Then compress it as tight as you can.

Tampons only work for crevices appropriate to their size. They're not suitable for a LOT of wounds. Especially when you consider how cheap and easy it is to use vacuum sealed gauze that's actually made for the purpose of packing wounds and isn't any more expensive or complicated. On a gunshot wound it's rarely as simple as just plugging a hole.

Every professional I've asked has said that the QuikClot impregnated stuff isn't substantially more effective. EVERY single one has just said to bring a lot of gauze and pack it deep and tight.

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A tourniquet, gauze (vacuum sealed) and chest seal can be easily kept on a belt.

If we're in the field I have a legitimate kit with us and everyone in the family knows how to apply a tourniquet.

Bluedreaux nailed it.

Pretty much what our EMS says is what Blue says. I work with them often on fire and ems calls.

They carry impregnated guaze but my feeling is that is a liability issue and nothing more...

One can typically gauge someone's knowledge and experience directly on their opinion of tampons as emergency medical devices.

I carry several blowout kits. One in my pickup, one in each hunting pack, one in my go bag, and a larger one in my patrol car. Each of them, at their core, contains a tourniquet, an Israeli bandage, a Quick Clot sponge, and a chest seal.

Remember that it is quite possible that a torso wound will have both an entrance wound and an exit wound, therefore two seals may be necessary. I like the Halo chest seals because they come in a pack of two and the adhesive sticks really well even when bloody. The down side to the Halo is that you may need to "burp" it as it doesn't have a valve. A good trauma class will teach you about that and it is simple and easy to do.

I second the recommendation of the SOFTT (wide) over the CAT. It is a bit longer and more likely to fit over a large thigh, uses metal instead of plastic for the windlass mechanism, and so far, I haven't seen any Chinese knock-offs, unlike the CAT. The problem with the knock-off CAT's is that the plastic windlasses often break when applied, leaving you in world of hurt.

Caleb Causey of Lonestar Medics turned me on to the OLAES pressure bandage because of its flexibility in design, but the Israeli bandage is a lot easier to find and more compact. Regardless, the gauze portion is the most important feature of any pressure bandage. You can't carry enough gauze so if you have extra room in your kit, add more gauze.

You might consider adding a pair of extra large nitrile gloves to your blow out kit. You might be willing to plug a leak with your bare hands, but with the blood pathogens out there, many people will not. Many people have latex allergies, thus the suggestion for nitrile gloves, and I would also recommend gloves in a light color such as tan or white so blood stands out on them when searching for a wound. The extra large size is handy because those gloves can be a royal pain to get on quickly, especially if your hands are wet or bloody (you may have minor injuries yourself.)

I would also recommend adding a some sort of light source-- a Cyalume light stick can be useful when working in the dark and does not require regular battery replacement.

And finally, a pair of trauma shears or safety hook knife to quickly cut away clothing doesn't take up a lot of room but can be extremely useful as well. There are other items you can add such as chest darts and NPA's, but they require much more training before using.

All very good points, and most of which are ones that I have addressed in my kits...but not all. Thank you.

That being said, my kits are built and carried primarily for self treatment. Any use on others is wholly secondary.

Thanks guys, this is what I was wanting to know. There are a lot of threads out there but most of them turn into a mobile medical center with trained staff. This will be for gun shots only and only to keep someone from bleeding out before help arrives.

I have a CAT on order and quick clot gauze pad and will build from there. More gauze and a chest seal next as well as tape.

tag

Care to elaborate on how all of your LEO experience makes you qualified to critique someone's medical advice? I have over 20 years of career EMS and many as a SWAT medic which tells me otherwise. But I have a college degree, a license to practice this stuff and actually make my living providing emergency care. The OP asked a basic question so I gave a basic and cheap to procure answer that is very effective!

I have treated an absolute ass load of GSW's and unless their is arterial involvement they don't bleed for shcitt. If their is Only moderate bleeding you typically just need a packing device and pressure bandage I.e Coban or Israeli dressing. In the case of significant arterial involvement, pneumothorax, hemopneumothorax, suspected abdominal organ (main concern is liver and spleen) injury or head injury concerns with the shooting then your probably going to need a lot more then a single blow out kit to save a life.

The fact is the OP asked about a kit for the range which to me means fire/EMS is minutes away. In that scenario a bleed kit with material to pack wounds, Israeli splint or Coban for pressure and a triangular bandage to immobilize and a possibly simple CAT or Sofft tourniquet is likely enough. He didn't ask about a kit for hunting miles from the road or about a blow out kit like we both carry for entering austere environments such as active shooter events where EMS won't enter until the scene is secured. Im quite sure that the blow out kits that you, Blue and myself and others here carry are all very similar in their contents but as we are using them in possibly austere environments and we have training to use that equipment.

For small extremity wounds from handguns a tampon packed into the wound and covered with a pressure bandage with significant force to tamponade the bleeding is typically more then sufficient. Larger caliber holes can indeed take a lot of packing but in a extreme case, people are usually always wearing a shirt at the range, hell I always have clean terry towels in a ziplock in my range bag so packing material can be improvised as anyone in need of that level of packing has bigger concerns then a possible infection risk.

Outside of a freak accident I have a hard time imagining a Hunter or Causal shooter having to deal with sucking chest wounds . Abdominal and extremity injuries will probably be 95% of what they will see. Therefore most guys aren't going to go out and purchase adequate quantities of legit bandaging supplies that we both have access to. This is even more so when they realize a lot of this stuff has expiration dates so it needs to be monitored and replaced.

Chest seals are damn good items to have for sure and I have both Hyfin (vented) and Halo (both vented and invented) in my first aid kit. But again let's be honest quality chest seals aren't cheap and don't accomplish a single thing that can't be done with a chunk of plastic wrappet or cellophane and taping to the chest leaving one small corner untaped to act as a valve. in a austere situation I will take the speed of a real chest seal, but again that doesn't mean the same thing can't be done cheaper with materials already on hand.

Fullauto01 mentioned trauma shears and I keep a pair in each of my first aid kit but typically only use them for cutting bandages. For exposing injuries or quick cutting of seat belts, clothes, web nylon etc the Benchmade Rescue Hook is without peer. Cheap at under $30 and has countless uses.

My own blow out kit the gist is 2 Hyfin vented seals, 3x compressed guaze, 3 occlusive dressings, a roll of Vet Wrap (Coban), 3 sizes of NPA's, a Softt tourniquet, an Israeli bandage, a roll of medical tape and a Benchmade rescue hook. All of this goes into about a 6"x8"x3" Nylon pouch. All of these items definitely have their places in medical care but all require some understanding of the device and the how/when to use it or they are at best ineffective and at worst more harmful to the patient

A quick note about clotting powders, gauze and sponges, a lot of this shcitt is nasty!!! Much of it has an exothermic reaction when it hits blood which causes burns, and it has to be surgically removed. In a true life or death situation with arterial bleeding it can be a lifesaver but it isn't the end all be all.

It's quite possible that I misread the OP's wants/needs but it took it as he wanted a basic first aid kit with a few simple ad one for gsw. If we are discussing commercial blowout kits (as most of these medical supplies are sold in bulk) there are many good ones on the market but all could use some tweaking. I recommend the one from Itak Medical with atleast some extra Coban, petroleum gauze and compressed gauze added.

Halo chest seals come either vented or nonvented now.

For now, a basic kit is all I could use. I have not had any training to use or even know what you guys are talking about. All I know is I want something for our range that is 15 minutes away from a hospital but no cell service. I have had CPR and AED training, know enough that pressure stops bleeding, that's about it.

I've gotten some good info and it's evident that a first responder or even a first aid course would be a good idea. I appreciate all the advice guys, I really do.

So I take it that the clotting sponge I bought should be used only if nothing else is available?

TWR, The type of bleeding will dictate whether or not the sponge will be a good thing. A constant oozing of bright red blood is typically a venous type wound and shouldn't need clotting agents, just packing and pressure. If the wound is spurting dark red blood it is an arterial bleed and in that case yes go for the quikclot sponge and then add a tourniquet as that is a life threatening wound that needs addressed Immediately.

Also unless the bandaging attempt is entirely ineffective you never take it off, just add more bandaging and pressure or tourniquet. The reason for this is that even though the bandaging attempt isn't perfect, you can potentially remove a clot that is starting to form in the wound and your back to square 1.

Also I would like to ad that tourniquets are life saving devices that should only be used in major arterial bleeds. They of course stem bleeding from major wounds, but they also restrict/stop blood flow to the rest of the extremity so there use must be with caution.

In your situation do what you feel the wound needs to control bleeding and get your ass headed towards the closest emergency room and cell coverage.

Thank you

Even better if you can get pressure on the bleed while SOMEONE else moves that way to the ER... And even though I"m EMS< remember, it takes time to call EMS, for them to get the page, to activate, and get moving, you MIGHT be at the ER by the time they would arrive on scene... but if you are going to be at location for any amount of time, then always call 911 to initiate, even if you decide to boogie later.. please let 911 know you are on the move though...

RE tourniquets and cutting off flow to extremities, while I'm far from a paramedic we hear more and more that there is nothing wrong with a tourniquet used for an amount of time, that limb damage takes a couple of hours of application to be probable... again just EMS information I hear floating around lately... they use to be so scared of them here, we were not allowed to use them. Or even carry them... but 34 years ago when I took my first EMT course, you could carry and use them...

We NEVER take off what we put on, I've never been in a situation that we've been told to take off, its always put on and add bandaging as noted above also. Thats not natural for most folks FWIW.

Clean tshirt....duct tape and super glue.

You're retarded.

For civilian scenarios (outside of extreme backcountry stuff) you won't have a tourniquet on long enough to cause damage.