Gauze and Water: A Combat Medic’s Guide to Preparedness Medicine, by Walker

First a little background: I am an Army Medic with combat experience. I have been a prepper since before I knew what prepping was. I teach wilderness survival and self reliance to the youth in my community as well as hunt, smith and homebrew. This is my personal take on the medical supply situation on a thirty six to seventy two hour bag basis. I have noticed that there have been several articles not just on this site but just about every other site I frequent about first aid kits and the ideal supply list. First off I have to say that many Americans may not be able to afford, let alone use 90% of some of the things I have seen listed. Now, granted, a band aid is a band aid and Neosporin is a cultural must in most American homes, but the addition of a c-collar or a NPA can be downright dangerous in the hands of a mall ninja. Secondly, some of these items are mostly hard to get and expensive. A collapsible liter is an item that I have seen recently, they can run you more than $100 apiece. C collars that are high quality can be $45-$50 dollars or more, and Lidocaine is something that you have to have a prescription for in most places. My third and final point is that a well stocked first aid kit is going to weigh in at upwards to 45-to-55 pounds… trust me I know. (I carried one for a total of 26 months in the desert.)

Now that I have gotten the rant out of my system, I will get down to brass tacks. Statistics show that in a disaster situation the three most common injuries are orthopedic injuries to long bone and small joints, lacerations to face, head and hands, and hypothermia. Once you get out beyond thirty six hours there will be infections, dehydration and stomach illness to worry about. So, in a nutshell I have eliminated most of the supplies that you would think to put into your gargantuan bugout bag.

The title of this article is “Gauze and Water.” This is an old medic’s [half-joking] guideline when packing for short jaunts into hostile fire territory. It eliminates the need to carry all the superfluous gear that we would normally take with us and it helps movement by lightening the medic’s load into something that is tolerable. For example, my jump bag has very few things that would be considered “advanced” first aid gear. My list is as follows:

  • One IV kit with 1000 ml normal saline
  • Four roller bandages (Kerlix)
  • Two medium Israeli combat dressings
  • One abdominal dressing
  • Two S.A.M. splints
  • One roll of three inch silk tape
  • One Combitube airway
  • Two rolled Mylar blankets
  • Three triangular bandages
  • Two C.A.T. tourniquets

With this kit I can treat up to five seriously injured patients to include airway and C-spine consideration. As most statistics show, combat wounds these days are primarily gunshot and shrapnel type wounds that cause severe blood loss. This method of injury causes the body to go into Hypovolemic shock and can kill in a matter of minutes if not seconds. Secondary injuries are long bone and digital injuries from blasts and vehicular damage that translates into bodily injury. Hypothermia comes in the later stages of shock and also as we all know is a big killer. Mostly we can treat any bugout situation as a combat situation in that your life is more than likely on the line.

For the seventy two hour period we can add in some Neosporin, Tylenol, Ibuprofen, Vagisil, and some Loperamide to treat about ninety nine percent of the small injuries and illnesses that may occur. Tylenol and Ibuprofen can be taken together as they are processed through different organs in the body but do the same thing, they alleviate pain and ease damaging inflammation. Ranger cocktails are 625 mg Tylenol and 800 mg ibuprofen every 6-8 hours. This combo can bring pain relief to most injuries that may occur. Neosporin or Bacitracin can be used to prevent and to treat some minor wound infections. The Vagisil is for fungal infections, such as athletes foot, jock itch and yes, vaginal yeast infection. Loperamide is a medication that is used to treat diarrhea. Again, please keep in mind that I am a medic and not a doctor so please do not let this serve as medical advice, this is just to inform you of treatments that are used for minor upsets and illnesses.
Off all the equipment in the list so far, the most challenging things to acquire and utilize will be the IV kit, and the Combitube airway. These are advanced interventions and as such , it would be best if you took a course to teach you the proper methods and indications for use. As for everything else there is nothing there that does not belong in a basic first aid class. With it you can stabilize most any patient, whether it be yourself or a loved one in a bugout situation. Special consideration must also be taken for anyone in your family or group that may take sustainment medications, such as High Blood Pressure meds, Diabetes meds, Neurological disorder medications or even contraceptives. Most of these medications can lead to a serious health issue or even death if the patient does not take them. Also consider that if you are taking anti anxiety medication or anti depressants and you aren’t taking them during this high stress bugout situation then you may experience a nervous breakdown at the wrong time or perhaps a psychotic break. Either way it will not be pretty or beneficial to the situation.

Now that I have outlined a more practical…. let’s say, concise, first aid kit. I want to relate a story about some of the injuries that have been treated with this very same “Jump Kit”. On patrol in Iraq, my unit was hit with RPG fire and a small arms ambush from about two hundred meters away. As you would expect, there was more than enough chaos without hearing “Doc!” coming from three different directions. As I made my way around our position I noticed that there were a total of four men hit. Two were serious head and facial trauma from the RPG blast, one was a bullet wound to the leg and the other had impaled his right forearm on a piece of rebar. Because I was more concerned with the soldiers with head and facial wounds I threw my tourniquets at the soldiers tending the bullet wound and the impalement so that they could perform the task of stopping serious blood loss from occurring.

Upon reaching the two soldiers that were injured in the blast I saw that one was conscious and the other, not. Since the one that was conscious could still talk, one must assume that his airway was fine so I moved on to the unconscious soldier. He had severe lacerations to his head with some bruising around his left temple as well as a large chunk of flesh from his lower jaw was missing. I immediately secured his airway with the combitube and applied a Kerlix to stop the bleeding from the jaw wound. With a little help from a ventilation bag, we kept the patient alive while I dressed his wounds and the other head trauma patient. Once that was done I assessed the other injured soldiers and used the S.A.M. splints to secure and pad the impalement and used one of my Israeli dressings and my last Kerlix to dress the gunshot wound. Once the dust had settled and we were ready to evac, I used one of my Mylar blankets to ensure that the soldier that was intubated was covered and warm. I still had not used up a few of my supplies and I didn’t have to drain the evac crews supply when they resupplied me.

Hopefully I have shown you that there is no need to go out and buy everything and the kitchen sink to stock a great first aid kit. Don’t concern yourself with band aids, the uses of kerlix are amazing and with the silk tape with the kerlix you can make miles of band aids of any size and configuration. The minor upsets that may plague you can be no greater than what you have prepared for with the few meds you will have to carry. And with all that space saved you can carry extra water and socks, and perhaps a small flask of scotch to sit back and relax with… or sterilize a wound with. So now, go out and prepare for your personal disaster and be prosperous. Think logically, and do not let prepping become all consuming, you still have a life to live.