What's In My First Aid Kit And Why

As a Corpsman, my job in the military was to put band-aids on Marines and hold them when they felt sad. I received a decent amount of medical training during that time and also had a small bit of hands-on experience (mostly treating wounded Iraqi children and inept terrorists). I was not a SARC and did not go through the 18D pipeline. Before joining the Navy, I worked in an emergency room as a physician’s scribe. These experiences have shaped my outlook on emergency medicine and the equipment I carry for first aid purposes.

Recently, I have noticed more people talking about what first aid kit or trauma kit they carry or own, which is a good thing. However, having a band-aid is only part of the equation when it comes to treating a cut. Unlike being in a gunfight, for which not bringing a gun is a cardinal sin, first aid can often be improvised with available materials while help is summoned. Some of the most serious injuries I have ever dealt with were treated with inadequate supplies. Realize that as a first responder, the best thing you can do is to get your patient to a higher level of care as soon as possible.

Vitriolic Tangent About Training

While it is popular in the gun world to “get training” (and I definitely think you should attend the ones I teach!), it does not seem as popular to get training in other areas – driving, first aid, etc. Think about it – how much time do you spend driving each day versus how much time you spend in a gunfight each day? How many people are killed by drunk drivers each year versus armed criminals or terrorists? Why would you bias all of your training towards firearms instead of spreading out your expendable income to include a high performance driving course? Similarly, why go to more than one firearm training course before you know basic first aid? Excuses for not attending Bondurant include the fact that it’s really expensive, but basic CPR and first aid courses are generally available through the Red Cross for affordable prices.

If you haven’t kept current with first aid in a while, a refresher might not be a bad idea. For example, CPR, which was once called “rescue breathing,” has now changed into “continuous chest compressions.” A few years – or maybe a decade – ago, there was a pretty wide separation between military and civilian medical training. Lessons learned in Iraq and Afghanistan seem to have trickled down to those in fire departments and EMS, although I can’t say that everything is now being taught the same way on both sides. However, whether you go through a Red Cross class or a Combat Aidsman course, I think you’ll be well ahead of someone who hasn’t bothered to get any first aid training. For that matter, a 12-year-old Boy Scout with his neckerchief and a stick will be light years ahead of someone with a fancy trauma kit and no idea how to use it.

Okay, back to the topic at hand.

Stuff I Generally Keep In My Car

I have a lot of medbags thanks to my time in the military – mostly Unit Ones and a big London Bridge bag. However, one of the most useful first aid kits I own was purchased after I got out: an Adventure Medical Kits Guide 1. It was discounted heavily on Steep and Cheap, so I didn’t pay $270 for it. However, I’ve gotten plenty of use out of it and try to keep it replenished. I’ll cover individual items later, but a good kit like this will cover most of your needs. Even a $20 kit at Walmart or Target has the basics.

I originally posted this photo on Instagram. You should follow me on Instagram @vuurwapenblog, or else.

Although the Guide 1 has some items for treating trauma injuries, I also carry a kit of my own assembly. This generally consists of tourniquets, pressure dressings, chest seals, 14 gauge IV catheters, SAM splints, ACE bandages, abdominal bandages, and Water-Jel. Putting together something like this from scratch with the basics (mostly just tourniquets/pressure dressings) shouldn’t be too expensive. I like using brightly colored bags or keeping the kit in a larger, easily recognizable bag so that I can tell someone to run to my car and grab “the big red bag” or something like that, rather than tell them to grab the khaki pouch in the trunk full of khaki, coyote, tan, and brown items.

I use the CAT tourniquet because I have seen it work well, but I would not be too particular about the type as long as I could apply it to myself or others without too much difficulty. Some people say that the CAT windlass breaks easily, but I haven’t seen that – it’s something to consider, but as long as you know how to apply it properly, you will be fine. I was issued Cinch-Tight pressure dressings and have not seen a need to look for anything else.

Chest seals – I was taught to improvise them (using an ID card taped at three corners over the wound, allowing air to escape but sealing fairly well against the entrance of air) as well as use the Ascherman, although the HALO is supposedly better; I have not had occasion to use the HALO, but much like the CAT, the Ascherman works well if you know its failure points.

The IV catheter is for relieving tension pneumothorax. I was trained how to use it, although it’s up to you as to whether or not you carry one. If you take my advice and seek out training, this won’t be an issue.

The SAM splints and ACE bandages are for joint immobilization; this can be improvised if the patient needs to stay in place, but if you need to move to a pickup point, having good supplies for joint immobilization might be invaluable.

Finally, the Water-Jel is for treatment of burns.

I also like having an axe or large hammer in my car, and a knife in my pocket. These items can help free someone if they are trapped. Oh, and I bring nitrile gloves, too. I also have a prepaid cell phone with up to date service with a different provider than my normal smartphone just in case said normal smartphone is dead or doesn’t get service when I need help.

Stuff I Carry With Me In A Pack

It’s okay to put a big bag of stuff in the trunk of my car, but do I carry all that stuff with me on a day hike? No. I’ll generally bring a small kit with band-aids of various sizes, Neosporin, alcohol pads, ammonia poppers (to wake up dead people), gloves, ACE bandages, Kerlex, some 4×4 gauze pads, NSAIDs (generic Naproxen most of the time) as well as an Epi-Pen (I don’t have allergies, but other people do). You’ll notice that I don’t bring the majority of trauma kit items, and that’s because they’re far less likely to be needed. You don’t want to be the guy standing there saying “Sorry about the scraped knee, but I can only help people who have been shot in the chest or leg.”

Final Thought

Understand the human body, the mechanisms of injury which it is likely to encounter, how the body responds to these injuries, and how you can help the body in this fight until help arrives. Have appropriate tools if possible, but focus on understanding first.

27 comments

  • Kit is missing a couple of band-aids ! Thanks!!!

  • Thanks! I really have been meaning to go to a class. I am going to talk about this in our group.

  • my first aid kit list nothing but band-aids, neosporin, alcohol wipes, and a shit-ton of gauze because I like to pretend to be a mummy for Halloween costume emergencies

  • also I’ve been meaning to look into driving and 1st aid classes for a while

  • Thanks for the info, I took a WFR course WAY too long ago but the principles they taught dovetail nicely with your philosophy. It’s nice to know what works in terms of carry gear, because this course was before 12 years of war and the new kit. I’ll need to pick up those items you mentioned, and then take another good comprehensive course!

  • Great post as always Andrew, but I’m interested in what first aid gear you carried with you while traveling; in Lebanon for example? While far from hostile, some might view environments like the Beka Valley, and certainly some places in Syria as more dangerous. As someone who is currently taking a brief respite from traveling and working in the region, I see this as a good time to put together a travel kit.

    • A small first aid kit in a plastic waterproof case; the whole thing is about the size of a pack of cigarettes. I also carried a keffiyeh. Tourniquets and pressure dressings attracted too much attention at customs in Tunisia. Strangely enough the Syrians never searched my bag, but the Lebanese did.

      • My CAT tourniquet almost got me in trouble in Cairo, so I’m scaling down for my next kit. Thanks for your input.

  • You make some great points. I’ve been mulling this over myself. I do a lot of hiking. Next question should be, what are common hiking injuries: sprains, thorns, stings, scrapes.

    So yeah, being prepared for IED injuries is not sensible under those circumstances.

    And of course the obvious: know how to use everything in your kit.

  • Great article! Something potentially noteworthy is that, currently, they teach to seal all four sides of a dressing on a sucking chest wound. I’m not sure when they changed this, but I’m been told all four sides since 2010. My source of training is the Combat Life Saver course taught in the US Army. I took the course in 2010 in BCT and again last February/March.

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  • Would you ever consider teaching a first aid/emergency medicine course in addition to your firearms courses? Or would you prefer to recommend a course from another source?

    I’ve been through basic CPR and (double bold underline) BASIC (/double bold underline) first aid courses, but nothing that goes over the use of pressure dressings, chest seals, or IV catheters.

  • Asherman Chest seals… While they are the standard for the Sucking chest wound, for the most part, work marginally on large wounds (in my experience). Might I recommend expired defib. pads. The sick like crazy-awesome-goodness… even through diaphoresis! My Trauma kit has at least 1 shemaugh as well.

  • Another thing to bear in mind is what the common causes of death are in the United States. Do you know how to recognize the symptoms of a heart attack or stroke? As a civilian you are umpteen times more likely to encounter someone having a stroke than someone who has been shot in the chest.

    Recognizing the symptoms can save someone’s life.

  • Ancient Woodsman

    Excellent post. Concurrent with my LE job, I was a suburban and then rural EMT for 20+ years before I took my first WFR course with SOLO. That was an eye-opener and very much worth the expense. Here in NH, SOLO offers many such courses, and the SIG academy is now offering a ‘first aid for range officers’ class, which is next on my list.

    At the start of every range session we have a first-aid briefing as part of our standard “read the playlist the same way every time” agency policy – which I helped to develop. As the lead instructor I also have a show & tell with all of the first aid supplies – some Dark Angel pre-made blowout & range-officer FA kits, as well as the gunshot trauma kits from Galls and my own old but updated EMT go-bag. All the goodies fit nicely & orderly in a day-glo-blue bag. Just in case I’m the one who is injured, I put a ‘script’ on top of the first-aid kit, held in place with the radio microphone on the front seat of my truck. The radio is set & tested on the local dispatch frequency prior to the day’s events. All anyone has to do is pick up & key the mic and read the script and Lord willing & the creek don’t rise we’ll get an ALS ambulance on site PDQ. I have several pre-made scripts depending upon what facility we are using.

    I may be an ‘armed professional’ but even after almost 3 decades am far from being a professional shooter. I really enjoy your site here and while I don’t comment much please be sure that many like me get a lot out of what you do. Good no-BS, objective & provable – and current – information that is relevant to any number of otherwise quiet but competent folks.

  • My kit is very simple, but in the Netherlands there’s not that can kill you.
    -A 1m long roll of gauze, about 10cm wide.
    -scissors
    -tweezers
    -alcohol wipes
    -leukoplast (tape made out of brown cloth, leukoplast is the brand name)
    -iodine ointment
    -Some self adhesive stuff I don’t remember the name of.

    I have to buy new bandaids…

  • Thoughts on Quikclot ?

    • I still have burns from the original stuff. I think it works very well when used properly and that the newer variants are easier to use. I do not think that it is absolutely necessary to have.

      • Thanks. Not your average situation but my mom is older, on blood thinners, quite active and “accident prone” so I got some for her to carry around just in case.

  • Great article, Andrew! I really enjoyed reading it. I definitely recommend the small axe or hammer as well, as you suggested in the article. Sometimes the car windows are very hard to break in case of an emergency so it’s better to have something with you.

  • As a paramedic I would say: here’s the problem with things like chest decompression…it’s really hard to validate carrying a 14 ga iv to decompress your own chest…it’s really for doing it on someone else. Using specific gear in many states can suddenly exempt you from good samaritan laws. It’s not like you used some bandages the guy had to stop bleeding, or used your own bandages that you bought for yourself to suddenly stop someone else’s bleeding, you bought a 14 ga needle for the purpose of decompressing someone else’s chest. If you are uneducated as to how to do this procedure, you may actually escape legal repercussion, but while you may watch videos on how to do something like this, you may not be aware of other things (like placement of intercostal arteries) that a professional would know, and while you may not feel the legal repercussions, you may certainly harm the person just as much as you helped them. As far as a trained professional using gear while not operating under the specific duties set forth by a medical director, they may quickly save a person’s life, but them be guilty of practicing medicine without a license. Additionally, they will now be liable for any extra harm caused to the patient during the treatment.

    I would only recommend carrying something like a 14 ga iv for decompression if:
    a) You have sufficient training. You hold current, sufficient state certification/licensure. You have a medical director for your range. Your medical director approves it as a response protocol.
    b) You have sufficient training. You are going so far down range that law doesn’t really apply. No one will see a courtroom.
    c) You have sufficient training. You are so far from medical response that laws-be-damned. You are willing to suffer any consequences for your actions.

    A few years ago, when I first started teaching full-time, another instructor at a conference suggested that all firearms instructors take an EMT class (at the time EMT was EMT-B). I thought that was silly, but, eventually, my boss paid for me to do so, and I was very grateful, and yes, that other instructor was really beyond right. Eventually, I took Paramedic (EMT-P), and am very grateful for the opportunity and knowledge…

    …I would suggest taking medical training of any sort, as much as you have the ability to take. Then, when you build your kit, build it really simply. Focus on having things that are for your own emergency. This way, all gear you have can be legally justified as to why it was there and why you used it. Then, after you have medical “training”, take more. Never stop learning.

  • Good discussions -
    I will have to check out the Adventure Medical Kits- I’ve carried a jump bag in the back of my SUV for years, have used it many times and am mostly good about replacing used-up stuff, but it got completely trashed due to a leaked-out chemical cold pack and I have been too lazy to replace it yet –

    My most-used item has definitely been gloves.

    I’m a physician – started out life as an ED doc but it’s been many years since that career phase. I now do occupational medicine, but I still stop at “fresh” MVCs as old habits are hard to break.

    Just a thought — don’t forget about airway stuff. Airway and breathing issues are much more common than penetrating injuries to the chest [in a civilian setting].

    BTW – I have never used a tourniquet yet, as usually many hands will show up quickly to use direct pressure — as in “Here – PUSH DOWN ON THIS or RIGHT HERE” –

    Good Samaritan laws in most states will protect the responder who acts in a reasonable fashion during a bona fide medical emergency; so I’m not too worried about liability – but one should always act within the scope of one’s knowledge.

    Great blog – keep it up!

    Oh – BTW, I did take a Bondurant course!

    Cheers,
    “Rutger”

  • Where I live a basic first aid education with exam is mandatory to get a driving license. Though gun laws are draconian, so there’s that. :(

  • Good food for thought. I’m previous Army and have 24 years in the Fire Service with 19 of that as a Paramedic. It’s amazing to me how many people are out there without the slightest clue of how to help themselves or someone else in the case of a medical emergency. EVERYONE should be prepared. It’s not that the sky is going to fall so much as it is that Murphy lurks around every corner. Sooooo, if there are any of you avid subscribers out there living in Oregon that would like to learn First Aid skills, IV, IO, Suturing, Advanced Airway Management etc., just let me know (I won’t certify you in anything as it would be illegal to do so and I hold pieces of paper stating you’re a this or that in very low regard).

    Stay Safe
    Justin

  • If you ever do any Medical Training, I’d be interested in hosting a class here in Mesa. We’re looking to host medical classes from different people bi-monthly (we have a classroom area and training aids). Our first class is next Saturday…

  • Ordered some SAM cx seals for our dept. Fiddled with them a bit and they seem better than both the Asherman and Bolin…guess we’ll see.

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