Pt 2: "Level 2" First Aid Kit Review" by Nutnfancy
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- Опубликовано: 23 апр 2009
- Part 2 of 5 ////////////////////
My experiences in the outdoors led me to my Level 2 First Aid Kit concept. More capable in depth and breadth than my also-reviewed "Level 1" First Aid Kit, my Level 2 kit will weigh more and be bulkier but can better handle medium medical emergencies. The kit shown focuses on capabilities in ROL (Rule of Law) situations where the priority is to stabilize the patient and effect transport to better facilities and care (when necessary). In group or vehicular outings, the increase in weight and size of the Level 2 makes the extra capabilities more do-able. Similar to the Level 1, this kit still has an emphasis on stemming blood loss, disinfecting, pain stoppage, wound dressing, and bandage exchange. Size and weight are still players in this 5 lb kit and I don't achieve the capabilities of Level 3 or Paramedic-level lifesaving kit. As I say in the vid, that type of kit requires medical training and its use comes with extra liability and concerns as a first responder. However I have the Level 2 kit shown has handled my encountered medical situations adequately and absolutely blows away any other kits I've encountered along this POU. Components of the kit and the foundational "Nutnfancy" philosophies involved are explained. An annotated list of my typical Level 2 Kit may be forthcoming (another project!). Compared to even a quality first aid kit, like ones from Adventure Medical Kits this version has more depth i.e. multiples of common use items which can better handle longer duration scenarios. It is difficult for makers like AMK to make kits to this level because of the markedly elevated cost in doing so (and then they won't sell well because of that). As noted, my kits are transitional in nature and will include improved medical technologies that have merit and can improve or simplify my treatment capabilities. Handling medical emergencies on your adventures is your responsibility and help may be far away. You will also find that few people even carry a First Aid kit with this much capability and you will be the on-site medical expert since you're prepared (been there). Having such a kit will minimize pain, injury, and maybe even save a life... possibly yours. Be prepared. 
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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.
Great video as always. Only videos I can watch for 10+ videos every week or so on RUclips. Keep it comin
Nutn -
Having fun spending down time catching up on your VAST repository of vids. Good stuff! Thanks for sharing your experiences and recommendations.
U mentioned a home first aid kit. A video on that would be really cool.
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
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.
Just tried out some Tegaderm for the first time, its incredible. Thanks Nutn, you really are paving the wave.
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.
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!
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.
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.
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
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!
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
Again, outstanding kit Sheepdog!
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
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.
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.
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.
@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.
@Outdoorsmen44 Yep I love that Blackhawk Medic roll. Fits a lot of stuff and easily visible.
you can also pull apart a tampon or pad, and use the interior fibers and padding for fire starting
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!
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.
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!
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.
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
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!
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!
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)!
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.
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.
thanks for the help
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.
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.
nutnfancy you can also use the camo form material to also wrap the gause pads.
is there a place where we can download the list of contents for all the level kits?
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!
Anyone know where to find those clear mylar bags nutn uses in these and other kits?
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...
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.
Thanks for the videos, very helpful!!
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.
would rubbing alcohol be better than peroxide because it kills everything and you can use it for fire if needed. i have a travel bottle full of it in my first aid bag. should i replace it with peroxide?
Coban is pretty much your camo stuff! Its good to cover wound that go around the circumference on top of kerlix.
How do you purchase the water proof document bags? Checked really quick through google and looks like only mil surplus companies sell them to "members"
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.
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.
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 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.
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.
hey question to nutn or anyone that might have an answer..... could you say that bigger is the safe way to go with gauze i mean could i just by bigger pads and more of the bigger ones and be just as functional as having different sizes or is this a bad idea?-ninja
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.
Great video! Full of information that deepened my understanding of first aid. Stay safe, Keep learning, and always improving. Sheep Dogs rule!
good info,nice vid, and the song fits haha
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.
Best tip for water proofing; keep the kit in a waterproof stuff bag. They are expensive but very effective for the price.
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
love the tunage
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.
would love to see an update on this topic. IE anything you have replaced by something else and why...
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
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.
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.
hey does anyone know if quikclot would be a good idea?
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.
Ummmmm What about if you add some more items like Snake bite kit or something that you can control for snake bite on the go & skin stapler so you can close the minor wounds more quickly in the remote area. Thankz !
How much is the estimated amount you spent on the blackhawk medical roll for the roll and all the medical supplies ?
@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.
personaly ive had alot of experience with duoderm as a kid & love the stuff. have you ever messed with it?
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.
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).
what is the thing he has on
23m50s ?
@WorldAccording2ME I believe the bandage you are referring to actually helps with th clotting of the blood as well.
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.
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
Any chance of an update on the first aid kits nutn? cheers
@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
What improvisation have you made? What have you learned from your experiences?
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.
if u had a rlly bad cut couldnt u just cautorize it then treat it with some burn ointment???
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.
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
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.
very nice kit. Do you train with is kit,as doing first aid train?
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,
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
@jonatancardoza , from all the research I have done, yes. The over the counter type is good, but the old military/LE kind that produces tons of heat works best. Have to be either military or law enforcement personnel to buy it though, or know somebody.
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.
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.
@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
@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!
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
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.
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.
hey i love u guys i just got out the army 11 yrs served i have pretty much a leval three kit in my car i have an iv bag with all the trimmings and many turnickets u can add a turnicket in a level 2 wich will help the blood loss problem ..my question is where can u get iv bags in the civ world.. my med kit is tricked out i even have quick clot airway and blood i have everything
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..
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.