A Medic of Last Resort – Part 3, by Tunnel Rabbit

(Continued from Part 2.)

Category #2, Group Medical Supplies for Wilderness/Retreat Locations

Emergency Medical Supplies for Wilderness Situations are for stabilizing the injured at a remote location for the purpose of transporting the injured to where they can be properly cared for.  This is a compact kit sized for the number of persons, and designed to handle the most common injuries.  With broken bones, a simple fracture that could become a compound fracture where the bone could sever a vein or artery and protrude from the skin, and therefore be potentially life-threatening.

There can also be ankle sprains, burns to the hands and arms, foot blisters, lacerations, and possibly gunshot wounds. A specialized multi-compartment bag, or small backpack can house the kit that is loaded with separate 1 gallon size zip-lock, or other small bags to organize and moisture-protect the contents. It can be used in conjunction with an IFAK. We can substitute like-in-kind, or equivalent items, and improvise if necessary. It could be simplified, or made more complex, but it should treat at least one or two persons, and is always carried whenever a group of persons travels away from their retreat, or base camp location, when and where no motorized vehicle can quickly transport the victim.

In the case of a gunshot wound or other trauma that requires a tourniquet be applied to an extremity, we have no more than 7 hours to get to an emergency room in the hope of saving the limb. At no time release the tourniquet as the toxins in the affected limb can cause traumatic shock and death.

As a gold standard example of an advanced kit for a small group that a professional could administer, here is a video from a former Special Forces Combat Medic who is a PhD.  I model my self-guided education and training on the Special Forces. In the long term, I might be able to in part, acquire this level of training and kit. It is good to know what that might look like as it sets a high standard for the humble Medic of Last Resort to aspire to.  Please see the video linked below and take notes that can greatly improve your kit. It far outclasses my own and any other pre-packaged kit that I have seen for sale.  We cannot buy this pre-packaged. We’ve got to make it and learn how to use it:

Tactical Medical Bag: Medium-Sized Group

Medical Supplies for Aspiring Medic of Last Resort on a Budget

(A Emergency Wilderness First Aid/Trauma Kit)

4 or more CAT, or SOFTT tourniquets (use one with a windlass, or ratchet)
2, 3 inch wide elastic/compression bandage (Ace bandage type)
2, 6 inch wide elastic/compression bandage (Ace bandage type)
1 or 2 each, 4 and 6 inch wide Israeli compression/emergency bandage.
2 to 5 Triangular Bandages, Non-Sterile 40″ x 40″ x 56″, Safety Pins
2 ampules/wipes of Tincture of benzoin (adhesive for butterfly/steri-strips, and moleskin)
3 different thickness of moleskin
1, 3 inch wide Coban or other brand equivalent self adherent elastic wrap. (substitute for adhesive tape, and rolled gauze)
1, 4×4 Burntec or similar substitute, or
1, 4oz tube of Hydrogel with 1 roll of plastic cling/burn wrap.
2, 2×3 inch sterile non adherent pads
2, 3×4 inch sterile non adherent pads
2 each, 4×4,3×3,2×2 sterile 12ply sponges
2, 2 or 3 inch x 2.1 yard sterile stretch/conforming gauze rolls (best serves upper extremities)
2, 6 inch x 2.1 yard sterile stretch/conforming gauze rolls (best serves legs and torso)
1, 1oz. tube of triple antibiotic, or Bacitracin antibiotic ointment (tubes, or disposable packets)
1, 1oz. bottle of 2 percent tincture of iodine (can disinfect water for irrigation, drinking, and disinfect deep puncture wounds)
2, ABD/Combine Gauze pads, sterile, 5 inch x 9 inch
1, trauma dressings, Sterile, 10″ X 30″
1, package of 10 each 1/4″ x 4 inch Steri-strips, or equivalent butterfly type bandage
1, package of 1/8″ x 3 inch Steri-stips, or equivalent butterfly type bandage (facial lacerations, optional)
1, 60cc syringe for irrigation
1 pair of forceps (wound debarment)
1 pair of small sharp scissors (wound debridment)
1 small fresnel lens (wound debridement)
1, small package of nitril gloves
1, emergency blanket (to prevent hypothermia due to shock)
1, poncho liner, or MSS patrol (green) bag (to prevent hypothermia due to shock)
1, closed foam, or inflatable ground pad (to prevent hypothermia due to shock)
1, fire starting kit
1, 2 inch wide small roll of duct tape (3M, or Gorilla brand)
1, 2 inch x 10 yards, roll of wide athletic adhesive tape
1, cordage, a combination of paracord, and multi-stranded nylon.
1, canvas or sail needle
1, EMT sheers
1 to 2, 36 inch moldable aluminum SAM Splints, or less expensive generic brand
1, 18 inch SAM Splint for arms and wrist, and possibly an ankle.
1, 9 inch SAM Splint for an arm and wrist. (finger splints can be cut from a larger splint)
2 or more finger splints (finger and arm splints can be cut using EMT sheers to a smaller size)
1, Small package or bottle containing 800mg of ibuprofen and 1000mg of acetaminophen
5, Large size alcohol antiseptic wipes, and
5, BZK antiseptic wipes
2 or more individual 5″ x 7″ Towelettes, or equivalent (baby wipes)
1, Headlamp
1, Small bar of soap, or hand sanitize,
1, large lap sponge, or bag of folded paper towels, or both (provides clean working surface)

Category #3, Bulk Wound Care Supplies

As I was a complete novice it took many days of study to get an idea of what I should buy, and how to use it. The budget was around $200 for this part of supply.  After purchasing the components that are used in the best IFAKs, and a wide selection of oral antibiotics, I still needed the basics materials for long term wound care.  Although pushing the limit of what I can afford, the cost savings of 50 to 100 %, or more when buying by the case at ShopMedVet.com, made the effort and purchase worthwhile.

Given current world events, I would rather do without specialized medical supplies, and use what little money I have to spend now, rather than wait and run the risk of not having at least the basics. What we consider as the basics today, is superior to what was available during the decades following WW2.

Although small in quantity, I would establish a baseline of essential supplies.  To be without basic items could mean that a moderately severe wound is not properly cared for, and could become seriously infected, and require the use of what could be scarce, if not, nonexistent topical, or oral antibiotics.

Dressings need to be changed at least twice a day. Improvising bandage materials is a chore in and of itself, and eventually, we would run out of bed sheets to tear up and boil.  For minor lacerations and punctures, as a shade tree mechanic and carpenter, I do know that duct tape and paper towels work as bandages, yet for serious wounds, I want sterile nonstick, and other specialized bandages.

This is an important part of my current health care planning, as well. I can not afford to see a regular doctor.  With the Lord’s help, I’ve managed to avoid the expense, at least most of the time, saving many thousands of dollars in medical bills and all the while increasing confidence in one’s ability to take care of themselves.

Instead of buying a kit, the idea was buying in bulk as much as possible to obtain the ‘mostest for the leastest’ money. This forced me to learn about each item, and how it might be used.  If I do not know how to use it, then it is not worth putting out the scarce funds. This means that funds are not wasted, and I have the opportunity to learn during the process.  Perhaps at a later date, I will be able to expand, and deepen this supply.  And one can improvise as well, but we should try to avoid that, especially if we are treating serious wounds that will take weeks and months to heal, and all the while we are risking a potentially life-threatening infection.

As purchased at shopmedvet.com. This supply will be divided and will be used in primary and secondary kits, and some components will be used to build an emergency wilderness kit that can be used in the field. And some of it will be in caches (contingency). There is certainly more that needs to be purchased, yet the budget could not be exceeded.  It is certainly enough for long-term care of at least one or more moderately severe wounds. Dressings will be changed 2 or 3 times daily and amount of material used could be more than expected.  Better to have too much than not enough.

As it is I might still have to improvise, yet this supply would take care of the first part of the healing process. Purchased separately, I’ve accumulated: triple antibiotic ointment, hydrogen peroxide, betadine, iodine, and many other items as well. This is only the bandages and gazes, and few other items that was recently purchased given a budget of only $200.  It is only the beginning in an effort to build a larger and more comprehensive medical supply.  I also have many other medical items, and equipment not listed or mentioned in this article.

Qty Item # Name Price
1 APREP-L ALCOHOL PREP PAD,LARGE,70%, 100/BX                $1.94
1 CTA6 APPLICATOR,COTTON TIP,N/S,1000/BX                      $5.99
1 EB3X10 BANDAGE,ELASTIC,3″,10/PACK                                $5.00
2 EB6 BANDAGE,ELASTIC,6″,EA                                        $1.88
1 ABD8X10 COMBINE PAD,ABD,8″ X 10″,N/S,50/BAG             $7.46
1 NA3X4 DRESSING,NON ADH,3X4,100/BX                             $8.78
2 NA2X3 DRESSING,NON-ADHERENT,2″X3″,100/BX                        $10.98
4 7-905 FORCEPS, ADSON DRESSING, 4-3/4″                          $3.96
1 PK224X3 GAUZE, SPONGES, 2″x2″ 4-PLY, NON-WOVEN, 200/PKG, 3/PK $3.87
1 PK312 GAUZE,3X3 12PLY,N/S, 200/PKG                            $3.04
1 PK412 GAUZE,4″x4″ 12-PLY,N/S,200/PKG                                $5.95
1 212STRL-1 GAUZE,STERILE 2X2 12PLY 1’S 100/BX               $2.30
1 312STRL GAUZE,STERILE 3X3 12PLY 2’S 40PK/BX            $3.64
3 412STRL GAUZE,STERILE 4X4 12PLY 2’S 25PK/BX                $8.04
1 X494BULK GAUZE,STRETCH, 4″ x 2.1YDS,NS,BULK,96/CS         $13.95
1 492BULK GAUZE,STRETCH,2″X75″,96/CS                      $12.96
1 496BULK GAUZE,STRETCH,6″,48/CS                                $14.72
2 MSC6104HX2 HYDROGEL,SKINTEGRITY,4 OZ TUBE,2/PK                $31.04
1 L4-331 SCISSORS, IRIS, ECONOMY, 4-1/2″, CURVED                $1.99
4 3-170 SCISSORS,BANDAGE,UTILITY,7.5IN,ECONOMY,EACH                $15.80
2 SS412 STRIP, CLOSURE, WOUND, MEDI-STRIP, 1/2″X4″,6/PKG        $2.84
2 SS314 STRIP, CLOSURE, WOUND, MEDI-STRIP, 1/4″X3″,3/PKG        $1.20
2 SS414 STRIP, CLOSURE, WOUND, MEDI-STRIP, 1/4″X4″,10/PKG        $3.56
2 SS318 STRIP, CLOSURE, WOUND, MEDI-STRIP, 1/8″X3″,5/PKG        $5.26
2 PT2 TAPE,POROUS CLOTH,2″X10YD,6/BX                          $21.44
1 1301 TOWELETTE,CLEANSING,INDIVIDUAL,5″x7″,100/BOX                $3.02

Subtotal: $200.61
Shipping Rate: $5.00
Total: $205.61

If I did not have these things already, I would in addition, also purchase the following. (This is not a complete list.):

Over the counter (OTC) drugs:

Imodium AD
Anbesol or Orakel (for tooth pain)
Benzocaine
Ibuprofen
Acetaminophen
Benadryl
hydrocortisone
laxatives
Diphen Antihistamine
Diotame Tablets
and more…

Other items:

Israeli, H and H, or North American Rescue (NAR)  4″ and 6″ trauma dressings. (Get as many as affordable.)

Brown in color 3″ and 6″ wide nonsterile rolled gauze

4 Multi-trauma dressings, sterile, 10 x 30″

Several large lap sponges, sterile

10 ABD/Combine Gauze pads, sterile, 5 inch x 9 inch

Box of 100 5×7″ BZK antiseptic wipes (Benzalkonium Chloride)

Box of Betadine antiseptic packets

Box of povidone wipes

Various sizes from extra large to smaller adhesive bandages (band aids, a convenience item)

Surgical face masks (keeps spittle from getting into the wound)

Eye Pad

2″ Surgical Tape

Several rolls of Guerrilla tape (fixes anything)

Disposable Razors

Stethoscope

Digital thermometers

Curved and straight forceps

Tincture of benzoin

Moleskin in bulk

Coban or Coflex, or other brand, self adherent elastic wraps, 3 and 6 inch wide

Prepackaged, compressed, and sterile Emergency/Trauma bandages and gauzes of various types and sizes.

Penlight (for inspecting pupils)

Headlamp (for first aid and evacuation during hours of darkness)

Assorted oral and topical antibiotics and antiseptics to be discussed and listed in the following paragraphs

(To be concluded tomorrow, in Part 4.)