1. Training
This is the first and most important item in your kit. The majority of my training and experience in trauma care is in TCCC or Tactical Combat Casualty Care, which goes hand-in-hand with wilderness medicine. I am by no means a medical professional, and I do not teach trauma care, but there are some basic principles that those who travel to the remote wilds of the world should understand when emergencies arise. Most of the traumatic medical emergencies I have treated include gunshot wounds, stab wounds, cardiac arrest, or injuries from car accidents. Keep in mind that you may come across these injuries anywhere, and you may be the first responder on scene before a professional can arrive, and the care a person receives in the first few minutes are the most critical to their survival in most cases.
Every leader should possess the skills and have the basic equipment to handle these emergencies. This is by no means an exhaustive list of items to carry in your kit, but it does lay out some basic gear that is simple to understand and use with basic training requirements. Assess your patient, and provide care, beginning with the most urgent trauma…
MARCH: this is an assessment tool to help you prioritize the treatment you give your patient.
M- Massive Bleeding
A- Airway
R- Respirations
C- Circulation
H- Hypothermia/ Head Injuries
2. Tourniquet
Tourniquets are essential in controlling massive hemorrhaging (bleeding) from arms and legs by synching around the limb, cutting off blood loss. I keep several of these on hand and always somewhere accessible. Remember to place “high and tight”. A tourniquet can be fashioned out of a variety of materials in a pinch.
3. Rolled Gauze/ Israeli Bandage
Gauze is versatile and used to pack wounds where you cannot place a tourniquet or to wrap less severe wounds or bleeding from hard to dress areas such as the head.
4. Occlusive Dressing/ Chest Seal
These are intended for placing over penetrating wounds into the thoracic cavity (chest cavity). I have most commonly applied chest seals on victims of gunshot or stab wounds, but these wounds can happen in other ways too. Chest seals are essential in preventing tension pneumothorax, which is when air is sucked into the chest cavity and trapped there, severely reducing your patient’s chances of survival. Consider keeping vented chest seals that help relieve pressure by venting.
5. Nasopharyngeal Airway
If you aren’t breathing, you’re dead or very close to dead. A nasopharyngeal airway is a quick and effective way to open an airway to allow respirations. It is a piece of tubing that slides into the nose and nasal passage to keep it open.
6. Trauma Shears
Rapid trauma assessment is vital, and often times, you need to cut away clothing to find and treat wounds. You may not find the problem until you have done a thorough assessment.
7. Emergency Blanket
Hypothermia can happen even in warm environments. Trauma leads to shock, shock leads to hypothermia, and at that point, your body will begin to shut down. Also consider that you may not receive help before nightfall or eve the next day if you are in a remote environment. Controlling body temperature is vital.
8. Quick Litter
A quick litter is a tool similar to a stretcher that is capable of folding up to be easily carried into out of reach places. In any situation, your patient is going to receive the best care if you can quickly get them to medical help. As soon as your patient is stabilized, evacuate them to safety.
9. Gloves
I put these last on the list, not because they aren’t important, but because I know that if my loved ones are bleeding out, I don’t care if I get their blood on me. I’ve had plenty of strangers’ blood on me because they were dying and needed help, and I wasn’t going to stop to dig for gloves before doing what I could. That being, said, if you have them on hand, wear them. Please keep yourself safe so you can help others for years to come.
-Isaiah
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