My experiment with single-casualty trauma kits

| July 20, 2016 | 1 Comments

In February of this year, we hosted Rob Schoening of LHGK and his “Bullets, Blades, and Bandages” trauma class (our review). Rob led a great class and had a bunch of interesting things to say.

One of the things I found thought provoking was breaking up a larger trauma kit into smaller ones. Each smaller “bleeder” kit could be used to treat a single casualty. Rob serves as his local SWAT team medic, and carries an aid bag full of these little guys. If necessary, Rob could hand a pouch off to another first responder, either to tend to themselves or someone else.

The kit I carry in my EDC bag is meant to treat more than one injury and/or more than one casualty, so I found this idea intriguing.

The Kits

Each bleeder kit contained:DSC06302

  • A tourniquet (2 had the Slick-T from Cav Arms, 1 had a RATS)
  • 1 8″x10″ ab pad
  • 1 roll of gauze, 4″x4 yards
  • 2 pair nitrile gloves
  • 2 4×4″ surgical sponges
  • 48″ of 3M VetWrap
  • Emergency blanket

The Experiment

I broke my EDC kit into pieces a few weeks ago, and carried my bag around. I also did some other stuff, like sprinting up hill, moving off the X, etc to see how it would hold up.

My EDC bag, the Adidas Rydell sling bag, has a large flap-covered pocket with a clip closure. This is where I kept my single kit. Due to the other tools in the bag (office stuff and Other Stuff), I wanted to keep the trauma kit(s) in the same flap pocket.

After this short experiment, I am going to go back to a singular kit in my EDC bag, but transition the smaller kits to my car bag. In retrospect, this is in closer alignment to Rob’s usage: a dedicated bag full of smaller bleeder kits.

Here are my reasons.

Every kit doesn’t need every tool

DSC06301

I carry a few tools that are either critical (scissors) or extremely situational (tension pneumothorax decompression needle). I carry a few markers for triage, and some illumination devices so higher care providers can find casualties if I have to leave wounded behind.

It doesn’t make sense to carry a copy of each of these in each bleeder bag, because they aren’t universally important enough to warrant them. However, I still wanted these things, and wound up bundling them into their own bag.

I carried less (mostly)

DSC06300

I added an extra tourniquet and two ab pads when I broke my kit up, but I lost the following:

  • Olaes bandage
  • HALO chest seal
  • 3 rolls 4″x4 yard gauze
  • 1 pair gloves (no big deal, but still)
  • Battery powered indicator lights (bike lights, with strobe functions)
  • A larger, more versatile roll of VetRap

I thought about building another bag with these items in it, but I ran out of room in my flappy pouch. I wound up putting the scissors in a separate part of the bag. When I assembled these above items for this post, I had to grab another pair of scissors because I’d already forgotten about the one stored separately from the rest of my trauma kits.

Stability

I found that the four kits moved around too much inside the flap pocket of the Rydell bag. After sprinting up and down a hill, one of the kits had wiggled lose and was about 1/3rd of the way out of the pocket.

A few days later, a different kit partially slid out.

Yes, my original kit was big and obnoxious, but it also stayed put in my bag.

Your bag will probably be different from mine, so this may not be a concern. It was for me.

Trauma care mothership

DSC06307

I transitioned my three bleeder kits to my larger bag carried in my car. I expect to use this kit in the event of a car accident. A less likely scenario may be during or after a protest.

The least likely scenario would be after an active shooter / terrorist incident that I am involved in or respond to while driving my car.

No matter what, Rob Schoening’s “Trauma Care Mothership” idea will live on in that car kit.

About the Author:

Short Barrel Shepherd Short Barrel Shepherd is a regular guy and works to make Web sites and mobile apps easier for people to use. He spends his free time attending fight-focused firearm, knife, and combatives training, motorcycling, writing, and playing games. His daily carry is a Glock 19 pistol and an AR15 .300 Blackout pistol in a backpack.
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1 Comment on "My experiment with single-casualty trauma kits"

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  1. CR Williams says:

    From the Journal of Trauma and Acute Care Surgery, abstract of the article:

    “BACKGROUND: The incidence and severity of civilian public mass shootings (CPMS) continue to rise. Initiatives predicated on lessons learned from military woundings have placed strong emphasis on hemorrhage control, especially via use of tourniquets, as means to improve survival. We hypothesize that both the overall wounding pattern and the specific fatal wounds in CPMS events are different from those in military combat fatalities and thus may require a new management strategy.

    METHODS: A retrospective study of autopsy reports for all victims involved in 12 CPMS events was performed. Civilian public mass shootings was defined using the FBI and the Congressional Research Service definition. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author.

    RESULTS: A total 139 fatalities consisting of 371 wounds from 12 CPMS events were reviewed. All wounds were due to gunshots. Victims had an average of 2.7 gunshots. Relative to military reports, the case fatality rate was significantly higher, and incidence of potentially survivable injuries was significantly lower. Overall, 58% of victims had gunshots to the head and chest, and only 20% had extremity wounds. The probable site of fatal wounding was the head or chest in 77% of cases. Only 7% of victims had potentially survivable wounds. The most common site of potentially survivable injury was the chest (89%). No head injury was potentially survivable. There were no deaths due to exsanguination from an extremity.

    CONCLUSION: The overall and fatal wounding patterns following CPMS are different from those resulting from combat operations. Given that no deaths were due to extremity hemorrhage, a treatment strategy that goes beyond use of tourniquets is needed to rescue the few victims with potentially survivable injuries.

    LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV; therapeutic/care management study, level V.”

    This indicates a need to re-think the mix, maybe.

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