NUTN! DUDE! WHERE ARE YOUR TOURNIQUETS!??! I'm a line medic in an airborne infantry battalion and I have to say man, there is a gaping hole in the capabilities of this kit to treat arterial extremity injuries & other gunshot wounds. Tampons WILL NOT cut it for a severed artery; whenever running and gunning, you NEED some form of tourniquet capability, and you need it readily accessible. preferably 6-8. You also want some form of chest seal capability.
Nutn, two notes with Tegaderm that I was taught in my NOLS First aid course: 1. You can use suture strips underneath the tegaderm for lacerations 2. It does not stick well to skin with a lot of hair.
Regarding tegaderm, the entire under surface is adhesive. The border is primarily used to keep it from sticking to itself when applying. It can be used as described in the video atop scrapes etc. But if applying to a laceration, you can place it over folded gauze (above a nonadhesive dressing like adaptec) to achieve compression. This is commonly done in the inpatient postoperative setting.
I got the Blackhawk medic roll based on your review. I loaded up my first aid stuff and threw it in the Jeep. Not two days later a guy at work laid his arm open and all we had in the first aid cabinet was 2 x 2 gauze pads... not sufficient for this cut. The Blackhawk really makes it easy to find what your looking for in a hurry (and labeling is a plus as well). Anyway, thanks for all the good info and honest review.
Nutnfancy - I've not very experienced with first aid but I have patched myself and others up on a few occasions as I grew up doing barn work and working with dangerous machines and large animals. Making a first aid kit is very expensive but a way I found that help immensely with the cost issue is to buy vet supplies from equine or other large animal shops. You can usually find the same stuff for a fraction of the price. Just something you might want to check out.
Something that I believe we should all have, that I bet Nutn has no incorperated into his kits is some Quickclot. It is proven itself to be one of the best life saving tech to come along in years. I feel it is the most important part of my first aid kit.
Good kit! As an EMT, I would also recommend a couple of hemostatics (QuickClot, Celox etc.) Gauze is key, several rolls. you can improvise any dressing you need and pack wounds. A big multi-trauma dressing is good to have, you can always cut it down. A CPR mask and CAT tourniquet are essential, if I could only have two things it would be those. Good old-fashioned triangle bandages are still great. You can make a sling, secure a dressing, whatever. They're compact and about $1/apiece.
I believe the Adaptac bandage is a actually an occlusive bandage for sealing an injury to the chest cavity. They use Petroleum Jelly to seal the wound and the old school thought was they should not be completely sealed to the body on all sides so they were not normally coated with an adhesive. You attach the bandage on three sides so that during exhalation some air could escape and thus help to inflate or maintain inflation of the lung.
After watching this vid I went to the store looking Maxi pads. I was comparing few different options(looking for the most absorbent) and was holding all of them in my hands. Then I noticed I was getting weird looks from few ladies shopping in the same aisle. I got embarrassed and ended up putting everything back and walked out of the store quick as I could. lol Thanks for the great videos
+Sitting Duck (SittinDuck) So true. This morning, for the first time ever, I was actually shopping for those things at WM. Had no idea what to look for, but bought some anyway. I actually opened one up, at home, just to see what the damned things looked like. And I'm 65 years old!
i love your vids and as a result have purchashed a medic roll for myself. had a situation recently that showed how ill-prepared i was and how i needed more supplies. thanks
In reference to the Tegaderm adhesive dressing, I've used it MANY times for certain wounds I've had (I'm a paraplegic and have had dozens of pressure sores), and a really good example of when Tegaderm is used is when you have a skin graft the surgeons will place a sheet of Tegaderm onto the DONOR sight and leave that same piece in place for two or three weeks, allowing it to heal without scabbing up REALLY badly, which would make the donor sight take way longer to heal, months instead of weeks.
Being a navy corpsman I would recommend tourniquet especially the cat tourniquet. I would also replace your blood sponges for israeli bandages or H bandages. They also sell combat gauze as well. and for a little pointers you don't want to worry able stuff that soaks up blood supplies that would stop it like the ones I mentioned
Tegaderm also a replacement for using tape silk or paper for holding IV catheters in place as opposed to using field goal technique or other learned techniques for securing catheters. Of course as Nutnfancy mentioned that a vaseline dressing is good for "dressing" a bandage, especially for sucking chest wounds.
3 most common combat causes of death Extremety bleed, tension pnumo thorax, airway obstruction. you will see a lot of those same injury in a traumatic situation PLUS abdominal and head injury, so having a squared away kit and training to use it can save lives, seconds do count. thanks Nutn for making these vids
First of all Very good and comprehensive video. Second To my understanding (correct me if I'm wrong) Tegaderm is only used on non bleeding wounds. What i mean by that is a wound that you stopped the bleeding on and is not a deep cut or hole. more like on scuffs and mat burn (used in lack of better word i know). I'm not saying it wont work, but it will firstly not stay on as long and secondly for deep cuts its better to use the standard options. Tegaderm is more used like second skin. Greets.
A lot of times, you can use your smaller gauze pads and put the tegaderm over it. It is often used in the hospital over IV ports so we can check the IV site to make sure that the integrity of the IV site is still good. Also if you have a large enough tegaderm, use the oil emersed gauze for a chest/lung wound to keep the pressures from going further berserk, like this person said, a sucking chest wound is one, so the person could breathe using pressures, until medics arrive.
Several months ago I had an infection develop on my forearm that needed to be lanced. Being in an awkward spot, a plain Band-Aid wouldn't work. The Tegaderm bandages are awesome. However, be advised that when placed on top of hair, it isn't too comfortable to remove.
I had a chronic wound on my leg for two years. The wound care specialist gave me some Tegaderm patches to use (at one phase of the healing) for when I showered to keep it dry. FYI: it was very difficult to get it watertight/germtight with the hair on my legs and I did have some failures if I didn't have a smooth shaven area on my leg. If you've got some extra adhesive to aid sealing then bring it. Bring a razor too (if you're carry knife isn't "shaving sharp" as Nutn likes)!
That CamoForm tape you have, I used the quick-release straps on the outside of the bag and ran those through the same tape and then buckled it up and it makes a great fit
One way of water proofing everything in it could be to just put the whole bag into a Ziploc storage bag and squeeze/suck all the air out. It looks kinda dumb but it keeps everything fairly well water-proofed. And it adds hardly any weight. I've done it with my laptop. When I'm driving my truck in the rain and there are so many people in there that I can't drive with it in the cab, I throw it in a bag I have and lay it in the bed. Works great. Don't know about underwater though.
I get my bags from the local thrift shops for two or three bucks a piece. Every once in while you'll come across an actual medic's bag (or a part of one like a paramedic fanny pack etc.) lots of hiking and school/college backpacks too. It makes it so much easier to afford the stuff that goes in them when the bag system is only a few dollars. BTW, I find that the insulated nylon "lunch" bags work great for helping to keep first aid items dry. Couple bucks for those at thrift. Thanks for vid!
The large bandage around 19:49 is a Kerlix bandage. It's ore commonly used to pack a wound, the kind of severe bleeding wound where just covering it isn't sufficient to stem blood flow because there could be a cavity inside the wound. The Kerlix is unraveled and stuffed inside the opening, its' as if you're bandaging the wound on the inside.
Another thing you can use for bleeding are feminine pads - sure, not macho, but they are built to absorb blood. In a remote area, sterile isn't as important and let's face it, the cost is greatly less than sterile pads. They are bulkier, but for direct pressure to wounds, they work VERY well. I really like these practical kits (I'm a nurse and a retired Navy Corpsman). Another, rather pricey way of stopping bleeding is Quik Clot, which is made from ground shrimp carapaces.
Absolutely. You can even get a CPR shield that stows in a tiny pouch on your keychain. There's really no excuse not to have one within reach, if you're trained. It sounds cold, but I'm not sure I would risk rescue breathing on a stranger without any PPE. What if that victim has drug-resistant TB or some other nasty bug? You want to help, but you have to think about your own safety too. First day of EMT class: 1) Your safety. 2) Your crew's safety. 3) Patient's safety. It's cold, but logical.
You can use small gauze pads under a Tegaderm. They're most often used in hospitals to secure IV's to skin. They do not stay adherent very well in flexion areas (i.e. fingers, knees, etc.). Benzoin may help but not a lot.
From personal experience I highly recommend BSI or body substance isolation (ie: gloves, mask, apron) protection as Nutnfancy recommends always consider yourself and your patient's survivability as the primary focus as in any scene size up! Also in the heat of the situation "from personal experience," I realize gloves can be a foregone BSI technique." At least at the end or in between please use some sort of sterilzation technique.
@MayuraSakai, we use Tegaderm to cover large and deep wounds after they are packed with Seasorb or the like. But yes, you want to get the bleeding under control before applying. It works in the way you are describing as well for abrasions, etc.
EXCELLENT Vid Nutn! I can personally vouch for the effectiveness of the combination of oil emulsion/Adaptec bandages with kerlix gauze rolls. A few years back both of my legs were severely burned (2nd and 3rd degree mixed) - my left leg circumfrentially and my right leg partially. The combination of the aforementioned wound coverings probably helped me keep my legs! Sure they're expensive, but a worthy investment indeed. Thanks again Nutn!
Hey Nutnfancy, they make tegaderm with pads in them, and I think it would be nice to have a pad inside because after you stop bleeding and clean the wound, the wound will continue to Ooze body fluid. So I just wanted to let you know if you didn't already.
Sorry, chimed in before the end! Good job, Nutn... There are definitely lots of options in first aid. Learn to look around you for stuff. Heck, a clean T-shirt is better than nothing!
I actually use a foodsaver machine to seal all the stuff in the kit. They actually have small bags that can be ripped open now after the contents are sealed.
in the horse world you're aways having horses getting into trouble and you're aways dressing wounds. The bandage warp that we use a lot is called VET warp, that might be a good item to include... just a thought
the self adherent ace banadage (stuff) is sold as a product called Corban or Coflex - honestly I prefer it over actual adhesive tape for holding dressings in place. If flexes with the body and, if wrapped correctly, will hold the dressing right were you want it. I also use the "paper" micro-pore (not plastic dura-pore ) to secure the dressing from shifting, but then wrap with corban. that's just me, my skin is sensitive to the glue used on most medical tape. I've found it works well.
I busted out laughing when you brought out the maxi-pads. They really do work for blood stopping, and it's certainly better then a dirty old rag or a sweaty shirt/jacket.
tegaderm and polymem is perfect for that kind of thing because it essentially replaces the lost layers of skin and soothes the raw surface of the injury.
As a medic, I strongly recommend you get a tourniquet. If you come across a serious hemorrhage, most first aid kits are rendered useless without a TQ. Personally, I carry and recommend SOF Tactical Tourniquets..
Tegaderm is also great for severe burns, I had a wicked chemical burn under my left armpit from when I was shot in Iraq. It wasn't from the bullet, but from the Quikclot chemical powder that was applied to my entry wound to stop the bleeding (which saved my life, btw I love Quikclot and would be dead had it not been for that miracle powder, plus it burned and hurt like hell which kept me awake). The nurses only had to change that dressing over my burn just once a week. Tegaderm is good stuff!
Tegaderm works wonders for cuts, and gashes. I work at a hospital, and if I have a cut on my hands or something like a hangnail, i cover it with the tegaderm. it's a great way to protect yourself from infections.
Tegaderm is quite nice. However (at least here in Sweden) the whole thing is adhesive, not just the edges. Also, if the cut/wound is deep, I'd sugest something to absorb the blood. And as we're talking new materials, perhaps Sorbion. A bit expensive perhaps, but very absorbant. Plus, it encapsulate the blood etc. into the pad. Very nice, from personal experience.
I've started buying almost all Kendall from my local pharmacy. 7.5x8 Abd pad for $.45 a pop. Cheap, sold individually, and made in the usa. Its basically a bigger surgipad. My only criticism of Kendall is their packing is a bit big, but it can be folded or compressed.
Correction on Tegaderm: The whole surface of the sheet is adhesive. What you were calling the adhesive is a removable strip of backing that runs around the edge to make it easier to manipulate it during application without it sticking to your fingers or getting all wrinkled or sticking to itself. Benzoin (Friar's Balsam) is not necessary (or recommended) with them as long as the skin is clean and dry, it does however work very well with Steri-strips which have less adhesive power.
Tegaderm sounds similar to chitosan. I'm not sure if it's the same thing but it is also shellfish-based. When in BCT the medic running my CLS class stressed that chitosan dressings were superior to things such as quickclot. His philosophy was that quickclot causes more harm then good (as it causes tissue damage in order to seal the wound). As far as I know, chitosan has a membran that reacts with your blood to create a seal over the wound. If one doesn't stop the bleeding, you can use up to 3.
An easy 'all waterproof' bag would be to simply get a contractor garbage bag (bought at any hardware store such as Home depot) and when you suddenly come on heavy rain pack the bag in one of those. In any camping situation I always make sure to have plenty of large, durable garbage bags. They're worth their weight in gold imo.
Tegaderm may prevent infection, but it will not promote wound healing. When you remove the tegaderm to change the dressing, you will most likely take much of your skin with you as it is a very sticky bandage.
Nutnfancy, I love your work and keep the videos comming. However I think it would be good for you to include a couple packets of Quickclot in your pack. They are well worth the ability to stem arterial bleeds
Nutnfancy is probably the greatest philosopher on RUclips and all his videos are excellent sources of the best info available....however I could not hold laughing 0:30 - 0:38
Nutn, I know you pretty much have a gun with you where ever you go, so I was waiting and waiting to make sure you had a contingency for a sucking chest wound!! But of course you had thought of everything haha!! Nice work with your kits, I am a search and rescue tech for my state as well as a flight medic, and I have to say I am impressed... great work!! Im digging that black hawk bag... and you make me want to post a vid of my kit!! Have a great weekend!
There are also two newer types of tegaderm called Tegaderm plus pad. One kind has an absorbent gauze in the middle and the other has a non stick absorbent gauze in the middle. The size is about an inch square.
Thanks for the videos man! I like to keep my first aid kit on a thigh rig on my WEB gear. It has some pretty advanced (for me) components but it's deffinitley a level 1. Now I'm really considering making a level 2. Here goes another paycheck!
you could add some aluminum emergency sheets, the are prety cheap (about two dollars each) and they are made as emergency sheets that can conseve the body temperature over 6º celsius than the envioremental temperature, they are also very compact (they can fit in your pocket). they are very useful in case of hipotermia.
Having watched these videos SEVERAL times, I totally agree with your philosphy. One question though. Could you please do a video about a Tactical First Aid Kit, but not like for a group, more like an IFAK, to carry on your person for yourself. Thanks a lot! -Nax
tegaderm and polymem is better for use on large abrasions. That is probably a very common type of damage/injury people encounter from hiking. A person carrying a heavy pack, climbing up or down a steep hill, they step on a twig, it rolls, they fall and fall hard, potentially averting another more serious injury like rolling down the slope and breaking a bone or spraining a wrist by breaking against the ground with elbows, knees, or buttocks. Dirty, silty, gritty, scree will buff your skin off.
i start kind of hating the soundtrack but by the third video it kind on grows on you XD. shaking it old school style!. Great videos, there is always new to be learn. Thanks
Also, Benzoin Tincture is a bit redundant for Tegaderm. The white portion you mentioned as being the only adhesive portion is incorrect. The white portion is actually on the non-adhesive side. It works as a border of sorts so you can clearly see where the edges are(it can be removed as well). The WHOLE underside of Tegaderm is adhesive, from edge to edge and it is extremely sticky. At Ft. SH, we'd actually shave the inside of our arm so the tegaderm wouldn't rip the hair out when DCing IVs
Hi nutn great vid as always I was just thinking that you might want to consider "quickclot" packs as a good addition to your level 2 first aid kits. It's easy to use and can quickly stop a really bad wound from bleeding you out. It's a bit heavy but is well worth it in my opinion. I assisted in a car accident where a passenger was thrown from a vehicle and piece of the side of her face was sliced off by the window. The quickclot that I had saved her life, works well when you don't have time.
You can also discard the packaging altogether, if you need to. Sterility is not the primary concern for first responders--we're worried about immediate life threats and minimizing suffering, that's really it. Infection is not going to present for a couple of days, the hospital can deal with that. Stop the bleeding with whatever you have--a clean dressing (rather than sterile) is just fine. NEVER withhold immediate care over concerns about sterility!
In my level 2.5 first aid kit, I keep my blood stoppers in an old fashioned video cassette box that I sealed with duck tape and then keep that in a aloksak bag.
Yes you can but a training is needed to use some items and medication that you would find in a trauma kit, you can do more bad than good if you try to help but you dont know what you are doing. Basic first aid is more about learning what not to do than what to do.
Level 1 would be the a small kit that you can take anywhere. Level 2 a bigger kit for use at home or that you can carry when you know you may need it. Level 3 would be a "trauma kit" like the ones use by paramedics, you will need to be a certified EMT to use most of the item in that kit.
I would not leave tegaderm on for an extended period of time because it will leave you suseptable to anerobic infections. Putting it on for long enough to hike back out of the woods would be great though.
@hibob841 As an EMT-B, soon to be W-EMT, myself, I wholeheartedly agree. Several Triangular Bandages are essential in the Backcountry, particularly when travelling in a group. Falls are bound to occur, particularly when transversing boulders, cliffs, muddy terrain, etc. and fixing a Sling and Swath is essential to treating broken limbs, particularly when you may need to hike in excess of 20 miles back to civilization for extended care. Ballsy or not, no one wants to do that without a sling!
Direct pressure>pressure with elevation>pressure elevation and pressure points>tourniquet as a last resort. Ask tactical about the latter two he can show you better than I can explain
@wolfinside I think he mentions Quickclot and some of the TIA/Stroke ,etc, risks associated with it. But I agree it should be in your bag and if you use it and someone is transported to a medical facility that it should be mentioned to the attending staff there. You may also wish to mention to someone ELSE you use it on that if they have been diagnosed with any coronary disease, have had a previous stroke, or are taking blood thinners that they should seek medical attention immediately.
Forgot to mention that tegaderm is not adhesive only on the sides. The whole surface area of the product is adhesive, it seems tho that it doesn't stick on wounds. There is also another type of tegaderm called Tegaderm +Pad which has an absorbent gause in the middle and another one that has a non stick gauze in the middle.
I think as a contingency you might want to carry some quickclot. In my personal kit I carry quickclot silver and battle bandages, the quickclot silver has an antibacterial agent along with the clotter....good kit though similar to my jump bag as an EMT
Nutn, as far as the hydrogen peroxide, I've been told by many medical experts that it works great as an initial antiseptic. Continual use is not recommended. It's a great, super cheap way to clean a wound.
@OliviaSST I have known NAR for several months, and I couldn't agree more with you. They have clent videos, and a lot can be learned from them. I just want to hear Nutn's philosophy about the subject. Thanks for the tip though! -Nax
@NaxTactical 10 year or more. The packages can usually be opened at both ends, have large tabs, and can be opened with gloves whether warn in combat or for the elements. And remember if you have to take your eyes off the situation to figure out how to open a package, your risking loosing situational awareness. They not only have a great tourniquet which you can apply easily and FIRMLY with one hand to your own arm or leg (reference John Ralston here for the need to do that) but they have
great stuff NF there are sam splints that you might want to look at. small compact. what do you have to treat for shock. if you dont treat it dead. rember if the face is pale lift the tail, and if the face is read lift the head. nice vids though. you should also look into volume expanding fluids. iv's not much to learn eazy to do could save a life
@OliviaSST I couldn't agree more with you. I am dreaming about buying some of their products. Unfortunately, I live in Belgium. Not only are the shipping costs very expensive, but also the products are kinda' expensive to me. As a minor I don't have a big budget to spend, but I buy equipment and gear when it is available for a low price and near me. Thanks. -Nax
I Just wanted to say, I looked up the PolyMem wound dressing you mentioned. I looked at their research results, and they're pretty awesome in terms of healing time, granulation formation and fluid absorption. I think I'll have to stock a few of those in my med room, despite the crazy cost ($35-$100 per box depending on size on Walgreens website).
Also, directed at Nutnfancy, including a CPR Mask would be a good idea, however you do not need to invest in a large or bulky design that would violate SAWC. They offer very slim, single-patient, clear plastic models that fit over a patient's face and would also take up very little room in your Level 2 (or Level 1, even) Kit. However, just being realistic from experience and training, if someone's heart stops that far from Advanced Care and Defibrillation, their chances are slim... very slim.
Nutn, Something I haven't heard yet, although I'm not finished watching, I read people talking about tampons... I always pack some sanitary napkins. They're sterile in the packages and soak up LOTS.
black hawk should design another bag to put this roll in that is water proof, like one of those silicone impregnated nylon dry bags except in black or camouflage.
Nutnfancy, As a USAF PJ we are using Quickclot (mil spec version) as the main blood stopper, and it works on animals as well hint. What is great about this product is that not only stops the bleeding in seconds, it is anti bacterial and Fungal, and this is critical in the backcountry or bugout kits, home use, or major incident kits. Once on the site also check for zmedicaproduct pdf, it gives you the numbers, I tried posting the urls and that doesn't work
@OliviaSST NAR also makes a bag valve mask that can fit in your pocket, so it would be sure to fit inside of his Lvl2 First aid kits since he doesn't like the taste of vomit (tongue in cheek).
Yep. An enormous aspect of both working in, and living through, emergency situations is the ability to think rationally, logically, and with a razor-edge level of stoicism. As hibob841 was saying, if you resuscitate someone with direct mouth-to-mouth and you contract a potentially chronic illness... no matter what the outcome is for that Patient, it's still negative for you.
also you might want to consider the tackle boxes at walmart... the bigger ones have 4 trays with adjustible sizes for each square. and several easily checked pockets, and a clear pocket on top of the main opening. they got mesh and pockets all over it. could hold a bunch of stuff plus it's insolated so you don't have to worry about stuff expiring do to heat or cold generally unless it's exposed for a long time... and the price... 25-55 dollers. can't beat that. not lvl 3 though.
i'm having the same problem. I have the vinyl bags that i have used for items around the house but i cannot find the mylar bags anywhere. The vinyl bags are ok but i think the mylar bags are much stronger and have a better build quality.
Nutn have you looked into coban? Its self adhesive, a little different than tape, but pulls double duty as tape and an ace wrap, and can be re-used. They also sell it in multiple colors and at animal stores. I first learned of it when I hand hand trauma, they used it so I could use my fingers for rehab/therapy so I didn't lose motion. I'm not very far in, but I am pretty sure I don't see any. If you have it, sorry bro! Btw, I work as a nurse. Lot of your info is good!
polymem is not for emergency use!! you don't want to absorb blood nor is that what polymem is for. when treating bleeding....you want to STOP the bleeding!! polymem is used to promote wound healing in clinical settings for those that do not heal well; i.e. diabetics.
Duct Tape & Crazy Glue is all you need Nutn! What are you doing with all these new fangled Tegaderms & Polymems!?! lol Seriously though, I just ordered some on ebay, It's good stuff! Tegaderm ,Polymem, Celox & Quik Clot are like Speer Gold Dots, They're Expensive & you don't want to train with them, but when your life or the life of a loved one is on the line, don't scrimp... get the good stuff!
@deadcell8081 The thing I do with blown up packages or really big packages is taking a normal needle, and punching a couple of holes in the packaging in my kitchen, when it is pretty clean. Then I put it in a vacuum bag with a foodsaver. This reduces the size with 1/3 to even 2/3 It's amazing! Try it! -Nax
NUTN! DUDE! WHERE ARE YOUR TOURNIQUETS!??!
I'm a line medic in an airborne infantry battalion and I have to say man, there is a gaping hole in the capabilities of this kit to treat arterial extremity injuries & other gunshot wounds. Tampons WILL NOT cut it for a severed artery; whenever running and gunning, you NEED some form of tourniquet capability, and you need it readily accessible. preferably 6-8. You also want some form of chest seal capability.
Nutn, two notes with Tegaderm that I was taught in my NOLS First aid course:
1. You can use suture strips underneath the tegaderm for lacerations
2. It does not stick well to skin with a lot of hair.
Regarding tegaderm, the entire under surface is adhesive. The border is primarily used to keep it from sticking to itself when applying. It can be used as described in the video atop scrapes etc. But if applying to a laceration, you can place it over folded gauze (above a nonadhesive dressing like adaptec) to achieve compression. This is commonly done in the inpatient postoperative setting.
I got the Blackhawk medic roll based on your review. I loaded up my first aid stuff and threw it in the Jeep. Not two days later a guy at work laid his arm open and all we had in the first aid cabinet was 2 x 2 gauze pads... not sufficient for this cut. The Blackhawk really makes it easy to find what your looking for in a hurry (and labeling is a plus as well). Anyway, thanks for all the good info and honest review.
U mentioned a home first aid kit. A video on that would be really cool.
Nutnfancy - I've not very experienced with first aid but I have patched myself and others up on a few occasions as I grew up doing barn work and working with dangerous machines and large animals. Making a first aid kit is very expensive but a way I found that help immensely with the cost issue is to buy vet supplies from equine or other large animal shops. You can usually find the same stuff for a fraction of the price. Just something you might want to check out.
Something that I believe we should all have, that I bet Nutn has no incorperated into his kits is some Quickclot. It is proven itself to be one of the best life saving tech to come along in years. I feel it is the most important part of my first aid kit.
Good kit! As an EMT, I would also recommend a couple of hemostatics (QuickClot, Celox etc.) Gauze is key, several rolls. you can improvise any dressing you need and pack wounds. A big multi-trauma dressing is good to have, you can always cut it down.
A CPR mask and CAT tourniquet are essential, if I could only have two things it would be those.
Good old-fashioned triangle bandages are still great. You can make a sling, secure a dressing, whatever. They're compact and about $1/apiece.
I believe the Adaptac bandage is a actually an occlusive bandage for sealing an injury to the chest cavity. They use Petroleum Jelly to seal the wound and the old school thought was they should not be completely sealed to the body on all sides so they were not normally coated with an adhesive. You attach the bandage on three sides so that during exhalation some air could escape and thus help to inflate or maintain inflation of the lung.
Great video as always. Only videos I can watch for 10+ videos every week or so on RUclips. Keep it comin
After watching this vid I went to the store looking Maxi pads. I was comparing few different options(looking for the most absorbent) and was holding all of them in my hands. Then I noticed I was getting weird looks from few ladies shopping in the same aisle. I got embarrassed and ended up putting everything back and walked out of the store quick as I could. lol Thanks for the great videos
+Sitting Duck (SittinDuck) So true. This morning, for the first time ever, I was actually shopping for those things at WM. Had no idea what to look for, but bought some anyway. I actually opened one up, at home, just to see what the damned things looked like. And I'm 65 years old!
i love your vids and as a result have purchashed a medic roll for myself. had a situation recently that showed how ill-prepared i was and how i needed more supplies. thanks
In reference to the Tegaderm adhesive dressing, I've used it MANY times for certain wounds I've had (I'm a paraplegic and have had dozens of pressure sores), and a really good example of when Tegaderm is used is when you have a skin graft the surgeons will place a sheet of Tegaderm onto the DONOR sight and leave that same piece in place for two or three weeks, allowing it to heal without scabbing up REALLY badly, which would make the donor sight take way longer to heal, months instead of weeks.
Nutn -
Having fun spending down time catching up on your VAST repository of vids. Good stuff! Thanks for sharing your experiences and recommendations.
Being a navy corpsman I would recommend tourniquet especially the cat tourniquet. I would also replace your blood sponges for israeli bandages or H bandages. They also sell combat gauze as well. and for a little pointers you don't want to worry able stuff that soaks up blood supplies that would stop it like the ones I mentioned
Tegaderm also a replacement for using tape silk or paper for holding IV catheters in place as opposed to using field goal technique or other learned techniques for securing catheters. Of course as Nutnfancy mentioned that a vaseline dressing is good for "dressing" a bandage, especially for sucking chest wounds.
3 most common combat causes of death Extremety bleed, tension pnumo thorax, airway obstruction. you will see a lot of those same injury in a traumatic situation PLUS abdominal and head injury, so having a squared away kit and training to use it can save lives, seconds do count. thanks Nutn for making these vids
First of all Very good and comprehensive video. Second To my understanding (correct me if I'm wrong) Tegaderm is only used on non bleeding wounds. What i mean by that is a wound that you stopped the bleeding on and is not a deep cut or hole. more like on scuffs and mat burn (used in lack of better word i know). I'm not saying it wont work, but it will firstly not stay on as long and secondly for deep cuts its better to use the standard options. Tegaderm is more used like second skin.
Greets.
A lot of times, you can use your smaller gauze pads and put the tegaderm over it. It is often used in the hospital over IV ports so we can check the IV site to make sure that the integrity of the IV site is still good. Also if you have a large enough tegaderm, use the oil emersed gauze for a chest/lung wound to keep the pressures from going further berserk, like this person said, a sucking chest wound is one, so the person could breathe using pressures, until medics arrive.
Several months ago I had an infection develop on my forearm that needed to be lanced. Being in an awkward spot, a plain Band-Aid wouldn't work. The Tegaderm bandages are awesome. However, be advised that when placed on top of hair, it isn't too comfortable to remove.
I had a chronic wound on my leg for two years. The wound care specialist gave me some Tegaderm patches to use (at one phase of the healing) for when I showered to keep it dry.
FYI: it was very difficult to get it watertight/germtight with the hair on my legs and I did have some failures if I didn't have a smooth shaven area on my leg.
If you've got some extra adhesive to aid sealing then bring it. Bring a razor too (if you're carry knife isn't "shaving sharp" as Nutn likes)!
That CamoForm tape you have, I used the quick-release straps on the outside of the bag and ran those through the same tape and then buckled it up and it makes a great fit
One way of water proofing everything in it could be to just put the whole bag into a Ziploc storage bag and squeeze/suck all the air out. It looks kinda dumb but it keeps everything fairly well water-proofed. And it adds hardly any weight.
I've done it with my laptop. When I'm driving my truck in the rain and there are so many people in there that I can't drive with it in the cab, I throw it in a bag I have and lay it in the bed. Works great. Don't know about underwater though.
I get my bags from the local thrift shops for two or three bucks a piece. Every once in while you'll come across an actual medic's bag (or a part of one like a paramedic fanny pack etc.) lots of hiking and school/college backpacks too. It makes it so much easier to afford the stuff that goes in them when the bag system is only a few dollars. BTW, I find that the insulated nylon "lunch" bags work great for helping to keep first aid items dry. Couple bucks for those at thrift. Thanks for vid!
The large bandage around 19:49 is a Kerlix bandage. It's ore commonly used to pack a wound, the kind of severe bleeding wound where just covering it isn't sufficient to stem blood flow because there could be a cavity inside the wound. The Kerlix is unraveled and stuffed inside the opening, its' as if you're bandaging the wound on the inside.
Just tried out some Tegaderm for the first time, its incredible. Thanks Nutn, you really are paving the wave.
Another thing you can use for bleeding are feminine pads - sure, not macho, but they are built to absorb blood. In a remote area, sterile isn't as important and let's face it, the cost is greatly less than sterile pads. They are bulkier, but for direct pressure to wounds, they work VERY well. I really like these practical kits (I'm a nurse and a retired Navy Corpsman). Another, rather pricey way of stopping bleeding is Quik Clot, which is made from ground shrimp carapaces.
Absolutely. You can even get a CPR shield that stows in a tiny pouch on your keychain. There's really no excuse not to have one within reach, if you're trained. It sounds cold, but I'm not sure I would risk rescue breathing on a stranger without any PPE. What if that victim has drug-resistant TB or some other nasty bug? You want to help, but you have to think about your own safety too. First day of EMT class: 1) Your safety. 2) Your crew's safety. 3) Patient's safety. It's cold, but logical.
you can also pull apart a tampon or pad, and use the interior fibers and padding for fire starting
You can use small gauze pads under a Tegaderm. They're most often used in hospitals to secure IV's to skin. They do not stay adherent very well in flexion areas (i.e. fingers, knees, etc.). Benzoin may help but not a lot.
From personal experience I highly recommend BSI or body substance isolation (ie: gloves, mask, apron) protection as Nutnfancy recommends always consider yourself and your patient's survivability as the primary focus as in any scene size up! Also in the heat of the situation "from personal experience," I realize gloves can be a foregone BSI technique." At least at the end or in between please use some sort of sterilzation technique.
@MayuraSakai, we use Tegaderm to cover large and deep wounds after they are packed with Seasorb or the like. But yes, you want to get the bleeding under control before applying. It works in the way you are describing as well for abrasions, etc.
EXCELLENT Vid Nutn! I can personally vouch for the effectiveness of the combination of oil emulsion/Adaptec bandages with kerlix gauze rolls. A few years back both of my legs were severely burned (2nd and 3rd degree mixed) - my left leg circumfrentially and my right leg partially. The combination of the aforementioned wound coverings probably helped me keep my legs! Sure they're expensive, but a worthy investment indeed. Thanks again Nutn!
Hey Nutnfancy, they make tegaderm with pads in them, and I think it would be nice to have a pad inside because after you stop bleeding and clean the wound, the wound will continue to Ooze body fluid. So I just wanted to let you know if you didn't already.
Sorry, chimed in before the end! Good job, Nutn... There are definitely lots of options in first aid. Learn to look around you for stuff. Heck, a clean T-shirt is better than nothing!
I actually use a foodsaver machine to seal all the stuff in the kit. They actually have small bags that can be ripped open now after the contents are sealed.
in the horse world you're aways having horses getting into trouble and you're aways dressing wounds. The bandage warp that we use a lot is called VET warp, that might be a good item to include... just a thought
the self adherent ace banadage (stuff) is sold as a product called Corban or Coflex - honestly I prefer it over actual adhesive tape for holding dressings in place. If flexes with the body and, if wrapped correctly, will hold the dressing right were you want it. I also use the "paper" micro-pore (not plastic dura-pore ) to secure the dressing from shifting, but then wrap with corban. that's just me, my skin is sensitive to the glue used on most medical tape. I've found it works well.
I busted out laughing when you brought out the maxi-pads. They really do work for blood stopping, and it's certainly better then a dirty old rag or a sweaty shirt/jacket.
tegaderm and polymem is perfect for that kind of thing because it essentially replaces the lost layers of skin and soothes the raw surface of the injury.
As a medic, I strongly recommend you get a tourniquet. If you come across a serious hemorrhage, most first aid kits are rendered useless without a TQ.
Personally, I carry and recommend SOF Tactical Tourniquets..
just a little input, but athletic prewrap and athletic tap works great in a med kit to help hold bandages or to help create a splint of sorts...
Best tip for water proofing; keep the kit in a waterproof stuff bag. They are expensive but very effective for the price.
Tegaderm is also great for severe burns, I had a wicked chemical burn under my left armpit from when I was shot in Iraq. It wasn't from the bullet, but from the Quikclot chemical powder that was applied to my entry wound to stop the bleeding (which saved my life, btw I love Quikclot and would be dead had it not been for that miracle powder, plus it burned and hurt like hell which kept me awake). The nurses only had to change that dressing over my burn just once a week. Tegaderm is good stuff!
Tegaderm works wonders for cuts, and gashes. I work at a hospital, and if I have a cut on my hands or something like a hangnail, i cover it with the tegaderm. it's a great way to protect yourself from infections.
Tegaderm is quite nice. However (at least here in Sweden) the whole thing is adhesive, not just the edges.
Also, if the cut/wound is deep, I'd sugest something to absorb the blood. And as we're talking new materials, perhaps Sorbion. A bit expensive perhaps, but very absorbant. Plus, it encapsulate the blood etc. into the pad.
Very nice, from personal experience.
I've started buying almost all Kendall from my local pharmacy. 7.5x8 Abd pad for $.45 a pop. Cheap, sold individually, and made in the usa. Its basically a bigger surgipad. My only criticism of Kendall is their packing is a bit big, but it can be folded or compressed.
Correction on Tegaderm: The whole surface of the sheet is adhesive. What you were calling the adhesive is a removable strip of backing that runs around the edge to make it easier to manipulate it during application without it sticking to your fingers or getting all wrinkled or sticking to itself. Benzoin (Friar's Balsam) is not necessary (or recommended) with them as long as the skin is clean and dry, it does however work very well with Steri-strips which have less adhesive power.
Tegaderm sounds similar to chitosan. I'm not sure if it's the same thing but it is also shellfish-based. When in BCT the medic running my CLS class stressed that chitosan dressings were superior to things such as quickclot. His philosophy was that quickclot causes more harm then good (as it causes tissue damage in order to seal the wound). As far as I know, chitosan has a membran that reacts with your blood to create a seal over the wound. If one doesn't stop the bleeding, you can use up to 3.
An easy 'all waterproof' bag would be to simply get a contractor garbage bag (bought at any hardware store such as Home depot) and when you suddenly come on heavy rain pack the bag in one of those. In any camping situation I always make sure to have plenty of large, durable garbage bags. They're worth their weight in gold imo.
Tegaderm may prevent infection, but it will not promote wound healing. When you remove the tegaderm to change the dressing, you will most likely take much of your skin with you as it is a very sticky bandage.
Nutnfancy, I love your work and keep the videos comming. However I think it would be good for you to include a couple packets of Quickclot in your pack. They are well worth the ability to stem arterial bleeds
Nutnfancy is probably the greatest philosopher on RUclips and all his videos are excellent sources of the best info available....however I could not hold laughing 0:30 - 0:38
Nutn, I know you pretty much have a gun with you where ever you go, so I was waiting and waiting to make sure you had a contingency for a sucking chest wound!! But of course you had thought of everything haha!! Nice work with your kits, I am a search and rescue tech for my state as well as a flight medic, and I have to say I am impressed... great work!! Im digging that black hawk bag... and you make me want to post a vid of my kit!! Have a great weekend!
There are also two newer types of tegaderm called Tegaderm plus pad. One kind has an absorbent gauze in the middle and the other has a non stick absorbent gauze in the middle. The size is about an inch square.
Thanks for the videos man! I like to keep my first aid kit on a thigh rig on my WEB gear. It has some pretty advanced (for me) components but it's deffinitley a level 1. Now I'm really considering making a level 2. Here goes another paycheck!
Coban is pretty much your camo stuff! Its good to cover wound that go around the circumference on top of kerlix.
you could add some aluminum emergency sheets, the are prety cheap (about two dollars each) and they are made as emergency sheets that can conseve the body temperature over 6º celsius than the envioremental temperature, they are also very compact (they can fit in your pocket). they are very useful in case of hipotermia.
Having watched these videos SEVERAL times, I totally agree with your philosphy. One question though. Could you please do a video about a Tactical First Aid Kit, but not like for a group, more like an IFAK, to carry on your person for yourself. Thanks a lot! -Nax
tegaderm and polymem is better for use on large abrasions. That is probably a very common type of damage/injury people encounter from hiking. A person carrying a heavy pack, climbing up or down a steep hill, they step on a twig, it rolls, they fall and fall hard, potentially averting another more serious injury like rolling down the slope and breaking a bone or spraining a wrist by breaking against the ground with elbows, knees, or buttocks. Dirty, silty, gritty, scree will buff your skin off.
i start kind of hating the soundtrack but by the third video it kind on grows on you XD. shaking it old school style!. Great videos, there is always new to be learn. Thanks
Also, Benzoin Tincture is a bit redundant for Tegaderm. The white portion you mentioned as being the only adhesive portion is incorrect. The white portion is actually on the non-adhesive side. It works as a border of sorts so you can clearly see where the edges are(it can be removed as well). The WHOLE underside of Tegaderm is adhesive, from edge to edge and it is extremely sticky. At Ft. SH, we'd actually shave the inside of our arm so the tegaderm wouldn't rip the hair out when DCing IVs
Hi nutn great vid as always I was just thinking that you might want to consider "quickclot" packs as a good addition to your level 2 first aid kits. It's easy to use and can quickly stop a really bad wound from bleeding you out. It's a bit heavy but is well worth it in my opinion. I assisted in a car accident where a passenger was thrown from a vehicle and piece of the side of her face was sliced off by the window. The quickclot that I had saved her life, works well when you don't have time.
nutnfancy you can also use the camo form material to also wrap the gause pads.
You can also discard the packaging altogether, if you need to. Sterility is not the primary concern for first responders--we're worried about immediate life threats and minimizing suffering, that's really it. Infection is not going to present for a couple of days, the hospital can deal with that. Stop the bleeding with whatever you have--a clean dressing (rather than sterile) is just fine. NEVER withhold immediate care over concerns about sterility!
In my level 2.5 first aid kit, I keep my blood stoppers in an old fashioned video cassette box that I sealed with duck tape and then keep that in a aloksak bag.
Yes you can but a training is needed to use some items and medication that you would find in a trauma kit, you can do more bad than good if you try to help but you dont know what you are doing.
Basic first aid is more about learning what not to do than what to do.
Level 1 would be the a small kit that you can take anywhere.
Level 2 a bigger kit for use at home or that you can carry when you know you may need it.
Level 3 would be a "trauma kit" like the ones use by paramedics, you will need to be a certified EMT to use most of the item in that kit.
I would not leave tegaderm on for an extended period of time because it will leave you suseptable to anerobic infections. Putting it on for long enough to hike back out of the woods would be great though.
@Outdoorsmen44 Yep I love that Blackhawk Medic roll. Fits a lot of stuff and easily visible.
i dont carry a first aid kit as im not to good with wounds and have no training .
would be interested in learning a bit now thought after these vids.
@hibob841 As an EMT-B, soon to be W-EMT, myself, I wholeheartedly agree.
Several Triangular Bandages are essential in the Backcountry, particularly when travelling in a group.
Falls are bound to occur, particularly when transversing boulders, cliffs, muddy terrain, etc. and fixing a Sling and Swath is essential to treating broken limbs, particularly when you may need to hike in excess of 20 miles back to civilization for extended care. Ballsy or not, no one wants to do that without a sling!
Direct pressure>pressure with elevation>pressure elevation and pressure points>tourniquet as a last resort. Ask tactical about the latter two he can show you better than I can explain
@wolfinside I think he mentions Quickclot and some of the TIA/Stroke ,etc, risks associated with it. But I agree it should be in your bag and if you use it and someone is transported to a medical facility that it should be mentioned to the attending staff there. You may also wish to mention to someone ELSE you use it on that if they have been diagnosed with any coronary disease, have had a previous stroke, or are taking blood thinners that they should seek medical attention immediately.
Forgot to mention that tegaderm is not adhesive only on the sides. The whole surface area of the product is adhesive, it seems tho that it doesn't stick on wounds.
There is also another type of tegaderm called Tegaderm +Pad which has an absorbent gause in the middle and another one that has a non stick gauze in the middle.
I think as a contingency you might want to carry some quickclot. In my personal kit I carry quickclot silver and battle bandages, the quickclot silver has an antibacterial agent along with the clotter....good kit though similar to my jump bag as an EMT
Nutn, as far as the hydrogen peroxide, I've been told by many medical experts that it works great as an initial antiseptic. Continual use is not recommended. It's a great, super cheap way to clean a wound.
@WorldAccording2ME I believe the bandage you are referring to actually helps with th clotting of the blood as well.
@OliviaSST I have known NAR for several months, and I couldn't agree more with you. They have clent videos, and a lot can be learned from them. I just want to hear Nutn's philosophy about the subject. Thanks for the tip though! -Nax
@NaxTactical 10 year or more. The packages can usually be opened at both ends, have large tabs, and can be opened with gloves whether warn in combat or for the elements. And remember if you have to take your eyes off the situation to figure out how to open a package, your risking loosing situational awareness. They not only have a great tourniquet which you can apply easily and FIRMLY with one hand to your own arm or leg (reference John Ralston here for the need to do that) but they have
would love to see an update on this topic. IE anything you have replaced by something else and why...
great stuff NF there are sam splints that you might want to look at. small compact. what do you have to treat for shock. if you dont treat it dead. rember if the face is pale lift the tail, and if the face is read lift the head. nice vids though. you should also look into volume expanding fluids. iv's not much to learn eazy to do could save a life
@OliviaSST I couldn't agree more with you. I am dreaming about buying some of their products. Unfortunately, I live in Belgium. Not only are the shipping costs very expensive, but also the products are kinda' expensive to me. As a minor I don't have a big budget to spend, but I buy equipment and gear when it is available for a low price and near me. Thanks. -Nax
I Just wanted to say, I looked up the PolyMem wound dressing you mentioned. I looked at their research results, and they're pretty awesome in terms of healing time, granulation formation and fluid absorption. I think I'll have to stock a few of those in my med room, despite the crazy cost ($35-$100 per box depending on size on Walgreens website).
Also, directed at Nutnfancy, including a CPR Mask would be a good idea, however you do not need to invest in a large or bulky design that would violate SAWC. They offer very slim, single-patient, clear plastic models that fit over a patient's face and would also take up very little room in your Level 2 (or Level 1, even) Kit.
However, just being realistic from experience and training, if someone's heart stops that far from Advanced Care and Defibrillation, their chances are slim... very slim.
Nutn, Something I haven't heard yet, although I'm not finished watching, I read people talking about tampons... I always pack some sanitary napkins. They're sterile in the packages and soak up LOTS.
black hawk should design another bag to put this roll in that is water proof, like one of those silicone impregnated nylon dry bags except in black or camouflage.
Nutnfancy,
As a USAF PJ we are using Quickclot (mil spec version) as the main blood stopper, and it works on animals as well hint. What is great about this product is that not only stops the bleeding in seconds, it is anti bacterial and Fungal, and this is critical in the backcountry or bugout kits, home use, or major incident kits. Once on the site also check for zmedicaproduct pdf, it gives you the numbers, I tried posting the urls and that doesn't work
@OliviaSST NAR also makes a bag valve mask that can fit in your pocket, so it would be sure to fit inside of his Lvl2 First aid kits since he doesn't like the taste of vomit (tongue in cheek).
Yep. An enormous aspect of both working in, and living through, emergency situations is the ability to think rationally, logically, and with a razor-edge level of stoicism.
As hibob841 was saying, if you resuscitate someone with direct mouth-to-mouth and you contract a potentially chronic illness... no matter what the outcome is for that Patient, it's still negative for you.
They do sell compressed ace bandages at the local stores here, I could help you locate some if you wanted.
also you might want to consider the tackle boxes at walmart... the bigger ones have 4 trays with adjustible sizes for each square. and several easily checked pockets, and a clear pocket on top of the main opening. they got mesh and pockets all over it. could hold a bunch of stuff plus it's insolated so you don't have to worry about stuff expiring do to heat or cold generally unless it's exposed for a long time... and the price... 25-55 dollers. can't beat that. not lvl 3 though.
i'm having the same problem. I have the vinyl bags that i have used for items around the house but i cannot find the mylar bags anywhere. The vinyl bags are ok but i think the mylar bags are much stronger and have a better build quality.
Great video, man! Have you ever considered quikclot? its been good to me.
Nutn have you looked into coban? Its self adhesive, a little different than tape, but pulls double duty as tape and an ace wrap, and can be re-used. They also sell it in multiple colors and at animal stores. I first learned of it when I hand hand trauma, they used it so I could use my fingers for rehab/therapy so I didn't lose motion. I'm not very far in, but I am pretty sure I don't see any. If you have it, sorry bro! Btw, I work as a nurse. Lot of your info is good!
Again, outstanding kit Sheepdog!
polymem is not for emergency use!! you don't want to absorb blood nor is that what polymem is for. when treating bleeding....you want to STOP the bleeding!! polymem is used to promote wound healing in clinical settings for those that do not heal well; i.e. diabetics.
Great video! Full of information that deepened my understanding of first aid. Stay safe, Keep learning, and always improving. Sheep Dogs rule!
Duct Tape & Crazy Glue is all you need Nutn! What are you doing with all these new fangled Tegaderms & Polymems!?! lol Seriously though, I just ordered some on ebay, It's good stuff!
Tegaderm ,Polymem, Celox & Quik Clot are like Speer Gold Dots, They're Expensive & you don't want to train with them, but when your life or the life of a loved one is on the line, don't scrimp... get the good stuff!
@deadcell8081 The thing I do with blown up packages or really big packages is taking a normal needle, and punching a couple of holes in the packaging in my kitchen, when it is pretty clean. Then I put it in a vacuum bag with a foodsaver. This reduces the size with 1/3 to even 2/3 It's amazing! Try it! -Nax