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Tom Perroni
January 20th, 2010, 01:13 AM
MD Shooters,

I have gotten a ton of e-mails from students who say ...I saw you were wearing a Blow Out Kit on your plate carrier in class what's in it?


1. (3) pair of BLACK Gloves (Non Latex)
2. Nasal Airway 7.0 with lube
3. 2 large safety pins
4. (2) 14 ga or larger 3” needles
5. (5) 4x4 pads
6. Cinch Tight “H” bandage/ Israeli Bandage
7. priMed gauze roll 4”
8. 3 inch tape
9. Quick Clot Powder
10 Quick Clot ACS sponge
11. Ashmear Chest Seal
12 CAT tourniquet
13. EMT Shears (Small)
14. Black Permanent Marker
15 Forceps/clamps


What’s in your Kit?

mikec
January 20th, 2010, 01:43 AM
Tom, looking at your list it seems that items 2, 9, 10, 11 and 12 shouldn't be used without proper training. Do you offer that training or refer people to a particular "medic" trainer? From what I remember from my Red Cross first aid class, use of those items wasn't covered.

Somewhat reminds me of a first aid kit sold by a scuba shop. The kit included a staple gun, meant to close wounds. In the RIGHT hands, a great tool, but in the hands of an untrained novice, I could see an infection running unchecked.

glock_forty5
January 20th, 2010, 03:09 AM
Tom, looking at your list it seems that items 2, 9, 10, 11 and 12 shouldn't be used without proper training. Do you offer that training or refer people to a particular "medic" trainer?
FYI - Tom is a Medic and he does offer medic training. He did say Blow Out kit as in the treatment of a GSW not a 1st aid kit. You are right about needing the proper training to effectively use that kit.

Les Gawlik
January 20th, 2010, 08:21 AM
Okay, I'll bite. Why the "black" gloves? I can understand non-latex, because of allergies/sensitivities and possible adhesions, but non-latex nitrile gloves come in lots of colors. I assume it's not just a fashion statement...

drking2
January 20th, 2010, 09:29 AM
I carry about the same, keep 2 abd pads in mine also

Todd v.
January 20th, 2010, 09:48 AM
Okay, I'll bite. Why the "black" gloves? I can understand non-latex, because of allergies/sensitivities and possible adhesions, but non-latex nitrile gloves come in lots of colors. I assume it's not just a fashion statement...

Might be that, if in combat and trying to lay low you wouldn't want to be wearing white gloves....

Les Gawlik
January 20th, 2010, 10:40 AM
You mean like that older woman who was wearing white gloves to hang laundry and was shot by a deer hunter who mistook her for a whitetail?

mikec
January 20th, 2010, 10:43 AM
FYI - Tom is a Medic and he does offer medic training. He did say Blow Out kit as in the treatment of a GSW not a 1st aid kit. You are right about needing the proper training to effectively use that kit.

That is what I wanted to hear.

I assume Red Cross basic first aid first, then what classes?

Archangel
January 20th, 2010, 10:43 AM
My BOK contains:

3 pair gloves
Olaes Modular bandage
2 x PriMed gauze
2" roll of tape
SWAT-T Tourniquet
4 x 25g Quick Clot ACS+ sponges
Asherman Chest Seal.
NPA
several 4x4's
several alcohol prep wipes
Black Sharpie
Shears

I need to add a 14ga cath or two.

Tconfo
January 20th, 2010, 10:58 AM
Make sure the 14G are at least 2" long. I'm assuming your using them to decompress the chest cavity. Also, A couple of 18/16 1" gauge angiocaths with 1000cc bag/admin set of ringers may help. At least that's what I have in mine.

Tconfo
January 20th, 2010, 11:00 AM
14G 3" long. Sorry for the typo

Tom Perroni
January 20th, 2010, 11:24 AM
14G 3" long. Sorry for the typo



4. (2) 14 ga or larger 3” needles

Tom

Tom Perroni
January 20th, 2010, 11:30 AM
Make sure the 14G are at least 2" long. I'm assuming your using them to decompress the chest cavity. Also, A couple of 18/16 1" gauge angiocaths with 1000cc bag/admin set of ringers may help. At least that's what I have in mine.

GTG! But this is a GUN SHOT WOUND BLOW OUT KIT NOT A Trauma BAG!

Tom

boule
January 20th, 2010, 11:31 AM
11. Ashmear Chest Seal

I would argue about that! If you have an open chest trauma, the lung is already collapsed and you do not need an airtight seal. If you suspect either a pneu- or hematothorax, stick a needle or a chest tube in there and close it off with one of the commercial seals - I would always worry about either needle or tube placement with the ashmear seal closing off any access to the wound area.

9. Quick Clot Powder
10 Quick Clot ACS sponge
Depending on location and environment you are in, these are debatable. If you are way out and have someone slowly leaking out - great choice. If you have serious arterial bleeding it does not help that much and trying to find all the small arteries under the clotting when you finally get him into surgery is a pain in the posterior. Given a relatively speedy evac, I would rather give the guy enough volume to last and try to conservatively (pressure) stop the bleeding.

Asking the question: are you guys assembling the kits for a trip to Afghanistan or to the range?

Tom Perroni
January 20th, 2010, 11:34 AM
That is what I wanted to hear.

I assume Red Cross basic first aid first, then what classes?


CCJA Teaches:

American Red Cross

First Aid / CPR / AED

EMT-B, EMT-I, EMT-P for the State of Virginia and National Registry (Check Out our Upcoming Medic (EMT-B) course) below:

http://www.mdshooters.com/showthread.php?t=26971

As well as:

CONTOMS
TCCC
TCCC Under Fire
SWAT Medic

Tom

Do No Harm....Do Know Harm

Tom Perroni
January 20th, 2010, 12:13 PM
I would argue about that! If you have an open chest trauma, the lung is already collapsed and you do not need an airtight seal. If you suspect either a pneu- or hematothorax, stick a needle or a chest tube in there and close it off with one of the commercial seals - I would always worry about either needle or tube placement with the ashmear seal closing off any access to the wound area.

Thanks for the input! While I have used an ashmear chest seal they do not adhere well on there own. Tape (Duct Tape) works to keep them in place with lots of blood they do not stick. Remember you may have (2) wounds entry and exit.
Depending on location and environment you are in, these are debatable. If you are way out and have someone slowly leaking out - great choice. If you have serious arterial bleeding it does not help that much and trying to find all the small arteries under the clotting when you finally get him into surgery is a pain in the posterior. Given a relatively speedy evac, I would rather give the guy enough volume to last and try to conservatively (pressure) stop the bleeding.

While I see your point...I do not agree 100% Quick clot is a last resort for massive blood loss after elevation, direct pressure, pressure points, tourniquets are nor working and we are still bleeding out. If I am not mistake it only takes a few moments to bleed out ....What is the response time of EMS? Gun shot wounds are much different than any other type of Trauma.

Asking the question: are you guys assembling the kits for a trip to
Afghanistan or to the range?


The kit I use was intended for a Non permissive environment (Iraq / Astan) However I do keep it on the range due to the proximity of the nearest hospital

boule
January 20th, 2010, 02:49 PM
Quick clot is a last resort for massive blood loss after elevation, direct pressure, pressure points, tourniquets are nor working and we are still bleeding out.

Surely it is a last resort but if you can not slow the bleeding first, it will not work. If major vessels are injured, the blood pressure will still be able to sweep the agent or the clot away - so you either have to reduce bleeding through conventional means before it works or wait until the blood pressure drops on its own ;) If we are talking about blood loss that will kill you in minutes, chances are that you start applying pressure and the agent at the same time anyway just to be safe. If something like the pulmonary artery is bleeding and you cannot put pressure on it, sprinkling magic powder will not help. You can convince me that the sponge or compresses coated with these clotting agents may have a use but putting the powder into a major bleeding without any other means of reducing blood flow is imho not a viable option.

it only takes a few moments to bleed out ....What is the response time of EMS?
Usually those few moments plus something. Fortunately they arrive in time if someone slows down the bleeding and then make jokes of how you mess up their ambulance with that patient.

While I have used an ashmear chest seal they do not adhere well on there own. Tape (Duct Tape) works to keep them in place with lots of blood they do not stick. Remember you may have (2) wounds entry and exit.
Yup, in wilderness medicine and in the shop - if you want it to hold, duct-tape it. Nonetheless, if you already have 2 holes in the chest cavity of a patient, he is bound to have lost lung function on this side and you have little worries of either a pneu or haematothorax there as the side is really well-ventilated to the outside. Therefore no ashmear on the injured side..... and when a small injury on the "healthy" side is causing a pneu, you have to stick a needle or a tube in, anyway.
The way I see the seal is just for the rare case of a penetrating injury that is forming a self-sealing valve, allowing air to be entrapped in the thorax.


After all, while this kit may be ok, if you only carry it in a backpack somewhere, I do prefer a real trauma kit. It just pays of to be able to correctly ventilate (et-tube, if necessary) and give volume.

Tom Perroni
January 20th, 2010, 03:41 PM
Okay, I'll bite. Why the "black" gloves? I can understand non-latex, because of allergies/sensitivities and possible adhesions, but non-latex nitrile gloves come in lots of colors. I assume it's not just a fashion statement...

Les,

Becuse they are TACTA-COOL!

Real Reason:

The black nitrile gloves are exam grade powder-free, 510K approved and can be used in medical applications. The black exam gloves with their textured finish offer chemical resistance and a great grip. These disposable exam gloves are popular due to their great strength and ability not to show blood, dirt or other contaminants.

Tom

Streetgang
January 20th, 2010, 03:50 PM
Tom,
A great kit. I agree with you on the Quick Clot and Asherman Valves. A little trivia on that. The valve was invented by a SEAL operator...Mr. Asherman, I'm sure is set for life.

Luxor
January 20th, 2010, 04:50 PM
My blowout kit ( gunshot ) kit.

Two Tk-4s tourniquet

Two H-bandages

Two packs primed gauze

One npa/lube

One small role of duct tape

Two pairs of gloves

Yeah the needle too!

Shears

Two rolls of Kerlex

Sharpie

Safety pins, ect... I keep a duplicate of this in my range bag as well.

smokey0118
January 25th, 2010, 06:54 PM
here's a question that's probably pretty dumb but i'm interested in the responses from knowledgeable folks. if you get shot and you've got a bloody hole in you, would shoving a tampon in the thing be a valid way of stopping bleeding(assuming it's not spurting cause of an artery or something)? i figure they're sterile, bullet-hole shaped and expand to fill a wound cavity. didn't know if anyone considered just dropping a few of their wife's 'pons in the range blow-out kit...if it's a horrible idea because of clotting complications or something...or if it would work in a pinch, but there's better stuff out there.

boule
January 25th, 2010, 07:03 PM
Well, there are a few books (novels) that actually talk about that. Frankly said - the question is where you got shot. The tampon will expand and put some pressure on the wound. If you have been shot somewhere in the muscle, it sounds like a good idea (alabit these things are not sterile) although you WILL have fun getting a tampon out of a wound (they stick). Anything dealing with chest, rather keep away from!

edit: Oh yeah, forgot to say - provided you do not have anything else to use!

drking2
January 25th, 2010, 07:09 PM
Issue is you don't want to shove anything into the wound. I've used pads for building up dressings, but we don't put anything into the wound. The point is to build up the dressing to cause pressure to stop the bleeding. If I am alone and all I had was a gunshot wound and atampon...besides wondering where it came from...who knows

StrikeFace
January 28th, 2010, 07:01 PM
I'm a complete noob as far as medical training and a product of US Army "buddy aid" emergency medical treatment instruction from the last decade so this has been a very informative look into the blowout kit / IFAK.

Since a lot of this stuff is above my head (I know bandages and tourniquets and IVs but that's it), I'll ask my question about the placement philosophy of the kit on Joe's gear. Back when I was wearing Velcro rank, I used to have my guys keep a tourniquet and Israeli bandage on their belt and then a duplicate set plus whatever else they could scrounge up (Quick-Clot and whatever whizbang followed) on their body armor. Is this common or do we have guys just lumping their stuff into one pouch on their second line gear these days? I've seen guys rubberband tourniquets and Israeli bandages to their MOLLEs, keep them in various pouches, have multiple items spread across different areas of their body, etc. I never agreed with the nonsense idea of keeping bandages/tourniquets in ACU calf pockets (too vulnerable to damage / loss, defeats purpose of using Joe A's patches on wounded Joe A), though it was common overseas. I've also seen "Oh S***" kits hanging off the back of Humvee seats... basically a blowout kit laid out on a cloth panel with a cover flap, items secured with breakaway ties or rubberbands. It's not designed as a replacement to a CLS bag, but in the same spirit, I suppose.

Tom Perroni
January 28th, 2010, 09:08 PM
StrikeFace,

Good to see you on here bro! For those that don't know it SF has been to the wonderful vacation destinations of Iraq & Astan.

Here are my placement guidelines:

First bear in mind that as a medic if you were down I would be using your kit to patch you up!

As for placement: I had my team put their Blow Out Kit in the middle of their chest. In that way if you were hit, And I could not get to you Ricky Tic you could administer self aid. Why the center of the chest on you Plates? It is so that you could get to your kit with both or either hand without any impediments.

I also had my team by ratchet straps from WALMART (The Tactical Super Store) because they are great & cheap Tourniquets. placement was right above or below blow out kit! Held together with (2) ruber bands and woven into mole or molly gear.




I'm a complete noob as far as medical training and a product of US Army "buddy aid" emergency medical treatment instruction from the last decade so this has been a very informative look into the blowout kit / IFAK.

Since a lot of this stuff is above my head (I know bandages and tourniquets and IVs but that's it), I'll ask my question about the placement philosophy of the kit on Joe's gear. Back when I was wearing Velcro rank, I used to have my guys keep a tourniquet and Israeli bandage on their belt and then a duplicate set plus whatever else they could scrounge up (Quick-Clot and whatever whizbang followed) on their body armor. Is this common or do we have guys just lumping their stuff into one pouch on their second line gear these days? I've seen guys rubberband tourniquets and Israeli bandages to their MOLLEs, keep them in various pouches, have multiple items spread across different areas of their body, etc. I never agreed with the nonsense idea of keeping bandages/tourniquets in ACU calf pockets (too vulnerable to damage / loss, defeats purpose of using Joe A's patches on wounded Joe A), though it was common overseas. I've also seen "Oh S***" kits hanging off the back of Humvee seats... basically a blowout kit laid out on a cloth panel with a cover flap, items secured with breakaway ties or rubberbands. It's not designed as a replacement to a CLS bag, but in the same spirit, I suppose.