Getting Your Group to Buy In: The $20 Medical Kit, By EMT J.N.

Overview
After the Katrina fiasco, a lot of my friends started to get interested in preparedness. Having some experience as an EMT and SAR volunteer, I decided to take the initiative and organize a group buy on medical supplies. This article is intended to help others who would like to put together low-cost, practical medical kits, particularly for a group.
For the short version, skip down to The Kit: Part I. Otherwise, read on.

Background
For any kind of preparedness project, it’s best to have a set of goals in mind at the outset. The goals I came up with were to build a kit that:
1. Is simple to use by lay people, with a maximum chance of helping in a crisis and a minimum chance of causing harm.
2. Contains supplies for 2-3 people to take care of themselves for 1 week in the event of a crisis (earthquake, weather emergency, flu, etc) or for one major incident (car accident, work injury).
3. Useful for the same 2-3 people during an average year of minor cuts, scrapes, and illnesses. Useful as a stand-alone kit or a module in a larger cache.
4. Easy to obtain and replenish (no exotic meds or perishable items)
5. Compact and easy to store (1 gallon Ziploc).
6. The last, and most difficult: the kit must cost around $20.
Based on experience, I felt that it would be unrealistic to expect friends and neighbors to spend $1,000 on a full-blown medic bag suitable for an expedition to Mt. Kenya, or to spend 100+ hours in EMT training. Someone who is dedicated can get to this level of preparedness, but those supplies do no good if they are locked up in your basement and not out where the hurt or sick people are.
If you happen to be the sick person or away from your cache of gear, the same rule applies.
So let’s start with the assumption that our friends are be willing to put $20 towards their own safety and maintain something that fits inside of a 1 gallon Ziploc. If copies of that kit are distributed to all of your friends, neighbors, family, deer hunting buddies, etc then there is a better chance that:
1. They will be able to take care of their immediate needs during the first critical hours of a disaster.
2. They will be there to help you.
3. As a group, you will collectively have enough supplies to stabilize someone who is really seriously hurt.

The Kit Part I – what do we really need?
A lot of papers have been written on the subject of first aid kits and what they should contain. What we’re most interested in is being able to carry out a few basic interventions that can treat the small problems and buy us time to get to a real doctor for the big ones.
So what can we reasonably do? A complete discussion of first aid measures could easily fill a book, but let’s keep it simple.
The basic things needed for a person to live are the ABCs:
  Airway
  Breathing
  Circulation
Any major interruption to the above, and you’re basically done for without immediate intervention. Going down the line, we have other common problems that can threaten our survival:
  Shock
  Hypothermia
  Dehydration
  Fever
  Infection
  Major Injury
We also have a number of minor problems that can become major ones if we ignore them. A sprained ankle may keep you from being able to evacuate. A minor cut can lead to sepsis when you’re in a dirty environment. Diarrhea is annoying, but can kill you if it goes on for longer than a couple of days.
For the kit to be worthwhile, every item should be able to help us solve these problems, and preferably have multiple uses.
After substantial research, the kit listed below was settled on as being a good compromise in terms of usefulness and cost. The supplies are grouped by categories.

Personal protection
(1) 2oz Bottle, hand sanitizer
(4) Exam gloves, Nitrile
(1) CPR shield

Instruments
(1) Splinter forceps, pair
(1) EMT shears, pair
(2) Disposable fever thermometers
(1) Razor blade

Bandaging
:
(20) 1″ Band-aids, cloth
(2) Roll, 4.5″ Kling gauze
(1) Small roll, medical tape
(4) 4×4″ gauze bandages
(1) Triangular bandage
(1) Ace elastic bandage, 3″
(10) Steri-strips, 1/4×1.5″
(2) Tincture of benzoin swabs
(2) Instant Cold Packs

Medications:
(6) Packets, triple antibiotic ointment
(20) Benadryl tablets
(20) Ibuprofen tablets
(18) Imodium tablets
(15) Aspirin

Other:
(4) Plastic vials, 2 dram capacity
(1) Bag, 1 gallon Ziploc freezer-type

The Kit Part II – What can we do with these supplies?
Here is a brief explanation of each group of items and what it might one day do for you.

Personal protection – These items are there to help keep you, the rescuer from getting a disease or worse from someone you are trying to help.
Gloves are a good precaution whenever bodily fluids (blood, vomit, etc) must be handled. The more expensive Nitrile gloves are better, as some people are allergic to latex. They are also more sturdy.
A CPR shield is a must-have if you ever expect to perform CPR or rescue breathing – it could mean the difference between helping someone without hesitation and not being willing to risk it. Don’t spend a lot of money here, as it’s also one of the least-used items and the reusable models can be harder to use without practice.
Hand sanitizer is always useful. Ask any nurse about the importance of washing up. The alcohol-based gel is not as good, but the best you can get when the hot, soapy stuff is unavailable.

Instruments – Being able to dig a splinter out, cut away clothes, or take vital signs, is one heck of a lot easier with some basic tools. EMT shears are inexpensive, heavy-duty scissors that can even cut through a penny. These, along with the other items will find many uses to an imaginative person. The forceps (tweezers) can also be used to get the cotton out of the pill bottles.

Bandaging
– Bandages are used to stop bleeding and protect wounds. An assortment of cloth band-aids can help you deal with minor injuries, while the larger gauze pads and rolls can help with bigger lacerations (cuts) and abrasions. An Ace bandage can be used to treat a sprain, hold a makeshift splint onto a leg, or wrap up a severely bleeding wound that requires pressure. An additional item that might be added is one or more sanitary napkins. Aside from their feminine use, they are excellent for soaking up blood on large injuries.
For major cuts, steri-strips are a way of closing up the skin without needing special equipment and training. Think of these as “band-aids on steroids.” They are thin tape strips, 1/4″ or so wide and 3-4″ long, coated with a super-aggressive adhesive and reinforced with cloth fibers. After thoroughly cleaning a wound (a hole poked in the Ziploc can allow you to squirt clean water deep inside), the steri-strips are applied much like sutures (stitches), across the wound to close the edges up.
Tincture of Benzoin (a sticky disinfectant swabbed on wounds) will make the steri-strips stick better. Properly applied, they will stay on for up to 2 weeks, even with showers. Don’t waste your money on butterfly bandages – these are far superior.

Medications – These are inexpensive drugs that can be bought (at least in the U.S.) without a prescription.
Antibiotic ointment (i.e. Neosporin) should be applied to cuts to reduce the chance of infection, particularly in dirty environments.
Benadryl (Diphenhydramine) is an antihistamine (anti-allergy) medication that can help treat cold and flu symptoms (runny nose, congestion), make allergies less severe, and aid sleep. (Many OTC sleeping pills contain Diphenhydramine.)
In addition, taking Benadryl early could help save your life if you suffer anaphylactic shock (i.e. a severe allergic reaction, such as from a bee sting
Ibuprofen is a pain reliever, anti-inflammatory and fever reducer. In a survival situation, being able to carry out important tasks without the pain from a headache or sports injury could be critical, as could reducing a life-threatening fever.
Aspirin is also a pain reliever, and has fever reducing effects, although Aspirin should never be administered to children with fevers, due to the possibility of a life-threatening complication known as Reye’s syndrome. Aspirin is also often given at the first signs of a heart attack in many EMS protocols.
Imodium (Loperamide) is the last OTC drug included, and it is used to control diarrhea. Diarrhea can interfere with your ability to perform tasks, but it can also be life threatening if it causes dehydration. A 2-3 day course could be life saving in an emergency.
With any medication, it is important that the full instructions be included in your kit. Make photocopies of the drug labels and warnings, and include with your other documentation. Be sure to write down the drug expiration dates as well.
All of these meds should be good for at least 1 year after purchase, but check first.
Plastic dram vials are good for packaging drugs purchased in bulk. Add a small amount of cotton if you need to protect the pills from being crushed by vibration and shaking. And don’t forget to print labels for each bottle.
In addition to the four above, you might want to pack an extra vial for your personal medications.

The Kit Part III – Being a savvy shopper!
Assembling all of this and keeping the price under $20 is difficult unless you buy in bulk.
From our research, we found that Costco had hands-down the best prices on medications. You will need to buy the large, bulk bottles and repackage them.
For bandages and related first-aid supplies, buy quantities mail-order from an EMS or medical company such as Emergency Medical Products.
Many supplies are available locally. Wal-Mart often has 2oz bottles of hand sanitizer for U.S.$0.99. The plastic vials can be purchased in packs of 25 or 100 from several eBay vendors. The razor blades can be had in 100-packs at any hardware store.
Some of the “Big Lots” type discount stores also have first aid supplies. I recently found 2-packs of Ace bandages for U.S.$0.99. But be wary of buying medications at these places, as you may find that they are close to their expiration dates.

Conclusion – Putting it all together
Once you have orders from all of your group members (20-25 kits seems to work out well on quantities for the first order) and you’ve received your supplies, you’ll need to pack them. I’ve found that the best way to do this is to have each group member come and pack their own kit. This way, everyone will be familiar with the contents and will know where everything is.
The first time you do this, you will probably lose money, owing to the odd quantities that some products must be purchased in, and occasional hidden tax or shipping charges. Think of it as a charity (or charge a bit more than you think you need to up front!)

And remember, the best survival kit is the on you keep inside your head, in the form of training. Go sign up for Red Cross First Aid/CPR training, take a First Responder, Wilderness First Responder (WFR), or EMT class. Read books, or take on-line lessons. There are several excellent, free resources on-line.

Appendix I:
Spreadsheet with kit contents. Includes a worksheet help figure out quantities to order, total cost, etc.
http://23.org/~arclight/firstaid/medical_kit_worksheet.xls
Sample Avery labels (Avery #8257) for pill bottles.
http://23.org/~arclight/firstaid/drug_labels.doc

 

Appendix II:

Optional Items:

Rehydration Mix
If you should come down with severe diarrhea, you can die from dehydration and loss of electrolytes. Stocking some Pedialyte, Gatorade (dilute to 50% with water) or the homemade equivalent could be a life saver. The basic recipe is 1 teaspoon (5ml) salt, 8 teaspoons sugar and 1 liter of water.

SAM Splint (or imitation)
These are very versatile split devices, which consist of thin aluminum on a foam backing. You can bend and use as-is, for splint arms, wrists, legs, etc or cut up with your EMT shears to make finger splints.

N95 HEPA Masks
If you’re worried about airborne pathogens, this is a good thing to have. Most hardware stores sell masks with an N95 or higher rating, and small, collapsible masks are available from medical outlets.

Upgraded CPR Mask
The $1, disposable shield will serve, but a better shield, with a one-way valve will make things easier. The CPR Microshield from MDI is good compromise, as it is superior to the thin plastic shield, has a one-way valve, and comes on a keychain.

Suction
Keeping the airway clear is critically important when someone has experienced trauma or is severely ill. Commercial suction devices are available, but a cheap, improvised solution is a standard turkey baster. For less than $2, this could be a useful addition to a kit.

Thin Sharpie Marker and paper
Useful for recording vital signs. (You do have a watch, right?) With a Sharpie marker, you can also write the numbers on the patient’s hand, so that there is no chance of the paper being lost during transport/evacuation.

Better Packaging
The 1-gallon Ziploc bag was chosen as the least costly option for getting the kit out there. You will probably want to find a better container to package it in if you expect it to last in a vehicle or other harsh environment. The basic kit can fit into a 30 caliber ammo can, a small Pelican box (1300 series or larger) or a soft bag. Harbor Freight offers a low-cost canvas or nylon bag that will neatly hold the kit. Check out items #40727-3VG, item #38167-0VGA, and item #32282-7VGA
If you really want a top-of-the-line, well organized packaging system, look at the compartment cases from L.A. Rescue, Outdoor Research, or Atwater-Carey. A search through most EMS catalogs, or a Google inquiry should turn these up.

 

Useful Web Sites:

Wilderness Emergency Medicine Services Institute (WEMSI)
Lots of good materials, including the full text of their training manuals
http://www.wemsi.org/

Where there is No Doctor (Now available on-line)
http://www.healthwrights.org/books/WTINDonline.htm

Free First Aid Guide (From SciVolutions, a medical manufacturer)
http://www.firstaidguide.net/

Emergency Medical Products
Sells a full line of EMS supplies
http://www.buyemp.com

Allegro Medical
Generic Medical catalog, offer smaller quantities of similar items
http://www.allegromedical.comBooks

Wilderness Medicine (Great reference, previously recommended here on SurvivalBlog.com)
Paul W. Auerbach
(1,910 pages, hardcover)
ISBN: 0323009506

98.6 Degrees: The Art of Keeping Your Ass Alive
Cody Lundin
(240 pages, soft cover)
ISBN:1586852345

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