Trauma kit/logger's first aid kit

[Engineer]

Pardon me if this has been discussed before but I am not having a lot of luck finding an answer in a search.

I want to put together a first aid kit for working out in the woods.  Basically a trauma kit or large wound kit, like you might get if you hit your leg with an axe or cut yourself with a chainsaw kickback.  I hope to never have to use it, but it might mean the difference between life and death.  I see "logger's first aid kits" being sold by the places like Bailey's or Ben Meadows, but they have limitations - either nothing is listed and you have to go by a poor photo; it's for 15-20 people and I need it for a maximum of two people; or the items included are enough to deal with a bug bite or a thorn scratch and not much else.  A tube of bactine and a Minion Band-Aid ain't gonna do much good in the woods. 

I have spoken to a couple of former Army field medics, who have to deal with gunshot wounds obviously.  They mention blood clotting agents, cotton t-shirts, large bandages, and various chemicals or meds that protect against infection.  I don't have any specifics.

Would anybody care to chime in about what they think should be in a woodsman's trauma kit?  I am going to compile a list and put one together, and hopefully post the results here so that others can put their own together.  My son will have to do a version of this for his BSA First Aid merit badge, but I don't feel like waiting any more - got wood to cut and no time to waste.

[Magicman]

A blood clotting kit should be in every first aid kit.  I also carry one when hunting.

[sawguy21]

This is the contents of a Canadian Red Cross level 1 kit.
4 Sterile Abdominal Dressings (8" x 10")
12 Sterile Gauze Pads (4" x 4")
8 Pairs Latex-Free Gloves
12 Cotton Tip Applicators (6")
6 Triangular Bandages with Pins
4 Sterile Pressure Dressings (4" x 6")
1 Scissors (stainless steel, 5½")
1 Splinter Forceps (4½")
1 Pocket Mask
100 Hand Cleansing Towelettes
100 Assorted Adhesive Bandages
2 Adhesive Tape Rolls (1")
24 Antiseptic Wipes (Benzalkonium Chloride/BZK)
2 Elastic Bandage Roll (3")
1 Accident Record Book (10 pages)
1 Pencil
40 Non-sterile Gauze (3" x 3")
4 Conforming Gauze (3")
2 Wooden Splints (9")
1 Wooden Splint (12")
1 First Aid Pocket Guide
It comes in a soft bag, weighs about 6 lb and easily fits under the truck seat. That reminds me, I need to check mine. The antiseptic wipes have an expiry date.

[Stuart Caruk]

I carry enough pressure dressings to stop a massive bleed, and a sealed pack of tampons. They work great for stopping blood flow from serious puncture wounds. Cut up they stop serious nose bleeds as well.

Last year when I worked in my shop with a tunnel catheter sticking out of my chest, I always had these close by. If I managed to rip the sucker out, it fed straight into my jugular and down into my heart. Ripping it out inadvertently, I figured might make a mess...

[Magicman]

Something similar to this:  WoundSeal Powder or this:  Clotting Kit

[Gary_C]

Here is one that meets the OSHA requirements. Logger First Aid Kit

The one thing I see as missing in sawguy21's kit is a blanket of some kind to prevent shock. They have those reflective foil blankets that are compact and foldable.

Also in our first aid training, the EMT doing the training says to keep a box of women's menstrual pads in the kit as they are good for stopping blood flow. That and pressure are your best friend. I would not advise using any wound seal powder or clotting agent on any wound that will require further treatment. Pressure and an absorbent pad are the best remedy.

[Magicman]

I would not advise using any wound seal powder or clotting agent on any wound that will require further treatment.

I'm all ears.  Whatever I need to know, I'm ready to learn.   :P

[Gary_C]

Here in MN and through the MN Logger Education Program (MLEP) we are required to take first aid training every other year with CPR the other years. The EMT lady that gives the training does NOT recommend putting anything on a wound except clean water, alcohol pads and/or sterile dressings. Burns get nothing because even gauze pads will stick and be very painful when they have to be scraped off later.

The basic rules that I know are to clean the wound with clean water or antiseptic pads. apply sterile dressing, and apply pressure till it stops bleeding. If something is still in the wound, leave it because it may be plugging the blood flow and apply pads and pressure around the foreign object. If the blood flow is pulsating, then more pressure and perhaps a tourniquet should be used. If you use a tourniquet, don't loosen it when the flow stops. Leave that for the EMT's to deal with.

When we had livestock, our vet would not even use blood stop when dehorning and castrating when the blood was spurting all over the place. If anything he would pinch off the vessel or burn it with a hot iron. He said the blood stop was worthless and a potential contaminant.

I've had countless blood draws and even when on blood thinners they just apply pressure and a tight gauze wrap and tell you to take it off after about 20 minutes. On a cardiac catherization when they make an incision in a vein in your groin, they just apply a dressing and a weight when they are done and make you lie still for two hours.

[Texas Ranger]

We taught that blood clotting agents were for extreme use, remote, help not on the way, survival situation.  I never saw the need working in the woods.

[Magicman]

OK, but I have not been told anything that I did not already know.  I too worked in an industry that required advanced first aid, CPR, both conscious and unconscious pole extraction, manhole and trench extraction which included poisonous gas.  I know that the only time that a tourniquet is to be used is to sacrifice a limb to save a life.  I am also a many gallon blood donor and I grew up on a farm where dehorning and castrations were normal activities.  I was also so unfortunate as to witness a co-worker killed that was standing less than 10' away.

The purpose of a clotting agent is not for normal first aid, but for an extreme circumstance which I hope never happens.  I have no hesitation or reservation about having a kit in my truck and also a packet in my hunting backpack.

[Gary_C]

The purpose of a clotting agent is not for normal first aid, but for an extreme circumstance which I hope never happens.  I have no hesitation or reservation about having a kit in my truck and also a packet in my hunting backpack.

That's certainly OK, but for me in those extreme circumstances the chances of clotting agents doing any good are close to zero. If I were to add anything to a first aid kit other than what's recommended, the first thing would be some Forceps, Hemostats

[Stephen Alford]

 Over the years I have found a  mirror has been great to have for the odd time you get debris in your eye.

[RPowers]

I am a full-time firefighter/EMT. Have some clotting agent impregnated gauze for packing non-tourniquet accessible deep wounds such as abdominal or thoracic, and have some CAT tourniquets for all extremity bleeds. If direct pressure won't stop it then tourniquet and leave it on with application time noted. A good conforming splint such as a SAM splint with some gauze rolls is great also for displaced breaks.

[Bruno of NH]

I worked for a Dartmouth College professor that made a special bandage for large wounds very large he told me .
Him and the college sold the idea to the military for a large amount of money.
He told me it help the wounded person to have a chance to make it to the trauma unit.
This man was very smart

[codemunk3y]

I'll provide my background so that the following has context. I am currently a police officer full time and a member of the Australian Army as a reservist. I have completed a number of first aid courses through work, volunteer fire brigade and have done a Combat First Aid course through army which included insertion of IV's, giving morphine and dealing with trauma.

I have two first aid kits, a trauma kit and a boo boo kit.

The trauma kit has a CAT Tourniquet, compression bandage and 3 shell dressings. It covers the immediate incident such as losing control of the saw and hitting something not protected by safety gear, as well as snake bite. It will help me until I seek medical attention from external sources. I am planning on adding an IV kit to it at some point, but have not done so yet. This kit lives on my person at all times. I have a very small chest rig similar to what you would see in the army that contains all of that. The reasoning behind that is that if I'm changing gear such as taking jackets on and off, chaps on and off, then I always have it on me as opposed to in a pocket or on a belt.

The boo boo kits sits in the car and contains everything else. Band aids, antiseptic, splinter removers and everything else. It's bulky but it covers every other situation.

The other thing to consider is how you go about seeking medical assistance. I work alone in an area of limited to no phone reception. I carry a EPIRB/PLB on me that I can use to get help if my phone doesn't work. I know that if I need to get help then it's at least 60mins by helicopter and 2 hours by road. I make sure I carry a small amount of food to keep me going while I wait and a section of panel marker if I need to attract attention to air assets.

I hope to never use any of it but I know it's there when I do and more importantly know how to use it. First aid courses give you a good idea what you need to do and what you need to carry.

[Wedgebanger]

I am a full-time firefighter/EMT. Have some clotting agent impregnated gauze for packing non-tourniquet accessible deep wounds such as abdominal or thoracic, and have some CAT tourniquets for all extremity bleeds. If direct pressure won't stop it then tourniquet and leave it on with application time noted. A good conforming splint such as a SAM splint with some gauze rolls is great also for displaced breaks.

Coming from another ff/emt I agree completely and add in a couple chest seals (prefer HALO myself) and keep a survival kit handy in case of extended time out.

[Old Greenhorn]

I'd like to jump in here, but before I do, let me try to understand what you are looking for. Are you looking for a personal kit to be carried by a person daily, or a crew kit that will live in the skidder, truck, or at the landing? There is a big difference between the two and the decisions and choices you make.

[lxskllr]

Visited this thread after having purchase paralysis debating over a trauma kit. Didn't help much tbh, but what I ended up getting was an Israeli bandage, and a RATS tourniquet. I'm gonna put them in an m16 magazine pouch, then add some stuff I consider useful to fill it up. That'll easily fit on my saddle or chaps, and it's a nicer case that just about any end user case.

Seems like the kits have junk I'll never use that only serves to inflate the price, and not enough, or none at all, things I'd find useful.

[Old Greenhorn]

Visited this thread after having purchase paralysis debating over a trauma kit. Didn't help much tbh, but what I ended up getting was an Israeli bandage, and a RATS tourniquet. I'm gonna put them in an m16 magazine pouch, then add some stuff I consider useful to fill it up. That'll easily fit on my saddle or chaps, and it's a nicer case that just about any end user case.

Seems like the kits have junk I'll never use that only serves to inflate the price, and not enough, or none at all, things I'd find useful.

a Couple of 4x4's, some Stop Clot, and some roller gauze should finish it off. Put everything in a zip log bag with the air squeezed out before you put it in the pouch. This will keep it in good shape for years. Mine is very similar, about 4x6 pouch, hangs on my felling belt. Everything in it is clean as a whistle. These take a lot of abuse, rain, snow, mud. Dirt and moisture work their way in.

[doc henderson]

the stop the clot gauze works well and as stated it is for large deep wounds.  do not use a maxipad if a finger with gauze will work.  You can watch the stop the bleed videos if you like.  you want the most psi over the area or proximal to it to stop arterial bleeding.  If you get a kit to keep stuff clean, you can keep adding stuff as you figure out you need it.  we throw out hemostats as they are all disposable now. I carry quick clot and a tourniquet in my car everywhere.

[Old Greenhorn]

Since I have been 'out of the game' I have lost my sources. Gotta look for some of those hemostats. I may have some in an OB kit if I still have one laying around, but I thought they just had cord claps, not the same thing exactly  . Never did get around to buying a CAT, I should do that, usually have stuff handy that will do the job. Is Stop Clot OTC now Doc? Last time I messed with it, it was new, and had a short shelf life with a big price tag. Our state had not yet approved it for field use and I forgot about it for a while. I always have a 'big kit' not too far away, but keep small ones with the right stuff handy.
 I am going to have to cultivate a source soon. Too may kits to keep up with. Each with it's own target purpose. My favorite is the StatPacks thigh bag I use for festivals now. Just basic initial stuff, a b/p cuff and steth, pulse ox, a few 4x4's, wipes, gloves, hemostats, roller gauze, tape, notepad, pen, glasses, bandage & trauma shears, antibiotic packets, and various band-aids. I give out lots of band-aids. Its a nice little pack, easy to carry. It is ALWAYS in my truck the rest of the year.

[doc henderson]

I think so.  I get samples.  fire carries it, and ems is about to start.  email the co and ask for a sample.  We used to save up hemostats and would have 5 gallon buckets of med tools.  I might try to save up a batch for who needs um.  I carry quick clot.  I thinks it uses some parts of crab/seafood to stimulate slotting.

[WV Sawmiller]

@doc henderson ,

   May be a silly question but won't be my first or likely my last, but if the quick clot product you mention is made from shellfish is it likely to cause a serious allergic reaction to people allergic to seafood/iodine like my daughter? Or is it one of those cases where you don't care because you can always give epi later, if needed, and treat the allergy/reaction while not stopping the blood loss would be more serious or fatal?

[doc henderson]

I think it is a processed protein, and I do not think that is a concern but let me double check.  A tourniquet is also a good thing to keep handy, or have to know how to make one in a pinch.  The R & D department (US military)  has found that most limb salvage is based on the wound, not from the tourniquet.  So only use if needed, but the leg won't do much good if you bleed to death.  if I put a tourniquet on my uninjured leg for an hour, it would hurt but my leg should be fine.  do not try this at home.  so if needed, do not hesitate to apply a tourniquet and seek medical help.  again more info at "stop the bleed"  including some active shooter stuff.

[doc henderson]

They refer to it as a mineral Kaolin.  Little to no risk of allergy.  I agree that the risk is so low that it should be used and ongoing treatment rendered as needed.  I assume and will verify that the Iodine is absent, and the risk may be to other things in the product.  

[doc henderson]

there is a lot of stuff out there.  you can get quick clot on amazon or Walmart online. an ace wrap or dedicated compression bandage.  there is a medication called TXA we are beginning to use for massive bleeding in the usa.  It has been used a long time in Europe and the pills are sold over the counter for heavy periods.  on the highway, working with heavy equipment and chainsaws, this is definitely something to consider.  keep in your car, backpack, workplace.

[Old Greenhorn]

I have been following t'quit usage and studies for over 20 years. Read them ALL (Boston Med was my favorite) and  still wonder why it took the AHA so long to endorse them given the evidence. Anyway, I should get a proper one. If you ever find yourself with excess samples of stop clot, I know an EMT that would like to have a few in his pouch. ;D ;D Mine long expired. When I get back, I will see if I can snag some directly, no time now. Who are the main producers now? I did have some samples from Moore medical when I handled the EMS account with them, but since I don't spend money with them now, I doubt they would help me out.
 WV that was a great question, I never thought of that! I assume we would all do what has to be done in the moment, but it's great when you know what to expect next and can be ready for it. Truthfully I have never had one that got to the point of using a stop clot like product, but I would be a fool if I were not thinking about it. I have had them either controllable with conventional methods or way past any clotting agents being of use (CTD). I have not yet seen it all, because nobody has. Right Doc? Looking forward to hearing if Doc gets a definative answer. I suspect his initial thoughts will hold true and it's not an issue. But it is still a great question I would want to know.

[doc henderson]

just so you know, (prob. already do)  most pharma items have a shelf life that is arbitrary.  so 3 years after the exp. it is still prob. fine.  It does matter to store properly and not damage the package.  the quick clot is dry and a mineral so it should be fine.  at least do not throw it out until you get some new.  there are a few drugs like tetracycline that can become toxic when old, most will loose a little efficacy, but most are fine even past the exp. for a while.  I get samples at training stuff, but if I get some extra, I know what to do.  can get some instruments as well,  @Old Greenhorn 

[doc henderson]

here is what is in my bleeding pocket of my back pack.



 

In another pocket is a heavy froggs rain gear, safety glasses and gloves.

[Old Greenhorn]

Philmont rules, right DOc? 'Be able to find all critical items in your pack in pitch darkness. That's the way I always packed too. Upper rght was always emergency med stuff, rear was weather emergencies, upper left was water. 
 Thanks. Headed out in the morning, just came in from doing a rush slab for our camp (long story) and I got pictures, but no time to make a post. On the road early in the AM, back in a week. Thanks.

[ManjiSann]

This has been an excellent read and reminds me I need to get started on some trauma kits for various activities I do.

I'd imagine it's obvious to those medically trained but what an average person such as myself use forceps for in the field? 

Thanks,

Brandon 

[Old Greenhorn]

Not sure where you saw forceps, unless you are referring to Doc's photo. Those are hemostats, they are clamps that lock in position. Likely he uses them for pinching off bleeders, or retracters. He could tell you more, and likely will ;D. That type of work is not within my protocols and I don't carry those in my bare bones kit, especially for logging type stuff. However I do carry them in my quick jump kit in the truck along with bandage and trauma scissors for car accidents, etc. They have many uses even if just for holding a tube in pace to keep it from pulling out of the patient. I don't have the training to use them to pinch off a bleeder and would be afraid of damaging the tissue. (But I do have some umbilical cord clamps and have not tried them out yet. ;D) Now in my back country kit I carry a lot of stuff you might consider over the top, but the further you are from a road (help) the more the 'rules' get flexible and you start to focus on triage, damage control, stabilization, and infection. Far enough from the road, and the only question is "Did he live?" and if the answer is 'yes', it doesn't matter much how that happened. ;D :D
 Knowledge is power.

[doc henderson]

that is specifically my "stop the bleed" kit.  the videos on line show you how to use a tourniquet.  Kelly clamps are used most commonly by nurses to get a "screw on nut" loose on IV tubing.  Docs may use them to explore a wound or remove foreign material.  there are all kinds of instruments all with names and subtle differences.  mosquito forceps are tiny, alligator ones have a straight portion with hinged opening at the tip.  Normal folks do not need them but like all tools, you can find uses for them.  In our suture kits we get a needle driver, Kelly clamp, forceps, and scissors.  due to insurance companies requirements, most EDs use a disposable kit and everything used or not gets thrown away.  I offer them to some Dads if I think they can use them.  We used to throw them in a 5 gallon bucket and send them overseas.  the quality of the disposable are not quite as good.  the old days, we got them from Pakistan and reused/sterilized them.  they work well to use on electronic fishing ect.  you can not ever have too many tools.  I think everyone should have knowledge on how to stop serious bleeding and do basic cpr.  not only for your family, but in case of disaster or accidents far from help.  @Old Greenhorn @ManjiSann.  the stop the bleeding programs started in response to mass shootings so people in a building can respond before help arrives.  we are teaching boy scouts, teachers and students.

[Ron Scott]

I used them quite often doing sutures on wounds when I was a combat corpsman with the Marine Corps during my Korean War days. I still have a set of the scissors and forceps which were indestructible and still carry them in my personal first aid kit. We could cut through barbed wire with the scissors. 

[doc henderson]

trauma shears are great.  get them on line for a few bucks.  I will try to save some instruments and bring to the next big FF event.  maybe Jake's, for the people that want them.  otherwise disposed of.  Kelly type clamps were the classic fly tying instrument, as well as used by a few for consumption of weeds that are still not legal in the state of Ks.  Although i hear it is now legal to go topless in the state!  Off 'top' ic a little, but it was legal on the lake up at lake George NY when I used to sail there.  In four years only passed close enough to another sail boat to get an eye full.  the woman in the other boat seemed quite proud of her self.  My girlfriend at the time, not so much.  now what were we talking about?  

[JJ]

Doc,
I like to duck hunt by jump shooting from canoe in slow moving small streams.
your comment brought back a memory of one of those trips.   was floating under a roadway bridge, and on other side were 2 naked girls (maybe 18-20) sun bathing on the bridge embankment.
All I could think of doing was a little wave while I drifted by in camo and with dog, they seemed quite surprised but both waved back.

What was the subject?

       JJ

[doc henderson]

it is the little things in life... or maybe the bigger ones too.  all in fun! .  i do not expect many Kansas women will casually start running around naked anytime soon.  most states just do not see the point in fighting lawsuits by activists.  or swimsuits for that matter.   8)
Kansas is fairly conservative.  concealed carry was a thing that required a permit, but open carry with a gun in a holster has always been legal here.  a few cities have ordinances.  i think being hung for stealing a horse or cattle is still on the books!!  i have personally never seen it done.   ;)

[doc henderson]

what you need in the kit is dependent a little on your knowledge.  i think all responsible adults should be trained in basic cpr, and cardio version, and know how to stop bleeding including a tourniquet.  the more you know the more you need and can use.  

[Old Greenhorn]

Maybe this explains why I have 3 kits in my trucks back seat? :D When on a 'job' I would throw my keys to somebody and have to explain which stuff to grab "The big red bag behind the passenger seat that looks like a suitcase, and the green round bag behind the drivers seat on the floor, also the medium sized black bag with the shoulder strap, not the other one." I should really downsize a bit. ;D This still happens at work from time to time, I send somebody out to my truck in the parking lot for gear when a co-worker goes down because the stuff I need is not on the 'approved corporate first aid list'. Very frustrating at times. (OK, ALWAYS).