In a modern combat or survival situation, a medic is not typically the first line of response as they are not always present, but instead each team member is trained in remote medical care; aiming to defeat preventable death by use of first aid. In order to do so successfully, an individual first aid kit (IFAK) is required, along with the necessary contents. So what items are considered common, and what do you really need in a compact IFAK that can be carried without nuisance?
IFAK contents often vary from one user to the next, but certain items should remain consistent across the board, all covering the same most common fatal injuries. These contents are designed to stop catastrophic bleeds, manage an airway, assist in breathing control, and help to ensure that blood and oxygen are circulating around the body as it should.
Over the years I have carried many IFAK’s in different configurations, remaining within arms reach of an IFAK around 70% of my time – whether at work or on leave. As for the remainder, I am always able to get to an IFAK within seconds – I make sure of this. On completion of this two-part blog, I hope that you will consider follow the same (or similar) procedures.
Part I: Contents of an Individual First Aid Kit: What Do You Really Need In Your IFAK?
Warning: the information given in this article is intended for use by trained professionals. Always seek professional medical training before attempting any of the following techniques.
IFAK Contents: For A Compact First-Class Med Pouch
As we have already mentioned, IFAK contents may vary from one person to the next. Below is my list of recommended items for a compact medical pouch that can be carried on a belt, grab bag or plate carrier setup, without being a nuisance.
- Emergency Bandage
- Gauze Bandage
- Hemostatic Dressing
- Chest Seal
- Decompression Needle
- Nasopharyngeal Airway Tubes
- Lip Balm
- Duck Tape
- Medical Tape
- Surgical Gloves
- Trauma Shears
- Sharpie / Marker Pen
- Combat Casualty Card
- Super Glue
The following images display the contents of two separate IFAK’s that I carry. They are both considered to be fairly compact kits, and for this reason the tourniquets and medical shears/ knife are carried in separate pouches or sheaths. The remainder all fits securely inside the med-pouch’s elasticated compartments for retention when ripped free during use.
So now that you have a good idea as to which items are considered to be common to the IFAK, let’s discuss what each item is used for.
1. The Tourniquet
A tourniquet is a device that is used for stopping the flow of blood through a vein or artery by compressing a limb with a cord or tight bandage.
Some useful tourniquet tips are as follows:
- Always keep at least 2 tourniquets on your person
- Store your tourniquet somewhere visible, so that if you lose consciousness others around you will see it
- Always fold, prep and store your tourniquet for one-handed use
- When using a tourniquet, the latest rule of thumb is to place it high and tight. Placing the tourniquet high and tight may prove to be life saving during instances where an elastic vein retracts deeper into the body. Do not concern yourself with trying to save extra limb by placing the tourniquet close to the wound; let the professionals deal with saving the limb during surgery
- Never place a tourniquet over a joint or over items in clothing pockets
- During training, practice methods of making and securing DIY tourniquets with clothing and accessories around you
- Do not buy cheap generic tourniquets, and always test your tourniquet to make sure that it works.
WARNING: once a tourniquet has been applied, it must not be removed! Only a trained professional may remove a tourniquet, otherwise septicaemia (blood poisoning) may very well spread throughout the body resulting in fatality. If the tourniquet comes loose or blood flow starts once again, a second tourniquet must be placed above the existing one.
2. The Emergency Bandage
Otherwise known as a Field Dressing, Battle Dressing, Battle Bandage, Pressure Bandage or Israeli Emergency Bandage, these emergency bandages are needed to control moderate to severe bleeding or to control bleeding in areas where tourniquets cannot be used, such as the torso, groin, neck, or head. They are specially designed to stop bleeding from hemorrhagic wounds caused by traumatic injuries under battlefield conditions.
Note: these bandages come with a white, sterile pad which covers the wound. This sterile pad must remain clean. Avoid touching it with your hands, and do not let it come into contact with any surface other than the wound.
3. Gauze Bandage
Gauze Bandages are used to help keep a wound clean while still allowing air to ventilate the bandage and skin and help the wound to heal. The woven fabric nature of the bandage is what makes it effective in ventilating. It also makes it absorbent which is useful as it helps prevent excess moisture around the wound site.
Gauze bandages come in many sizes and types. They can be used on wounds where infection is already present and in the process of treatment. In addition to securing dressings and keeping wounds clean, gauze can be used to pack wounds and apply direct pressure to a catastrophic haemorrhage.
Gauze has been around for centuries and is very affordable. There are many variations of gauze types for different purposes. Some are multi-layered while others are more simple.
4. Hemostatic Dressing
Hemostatic agents and dressings (sometimes referred to as Combat Gauze) use Kaolin (a chemical agent) to control bleeding. They are primarily designed for combat environments where there might be serious injuries and delayed evacuation times. The indication for use of hemostatic agents is in extreme trauma situations where bleeding cannot be controlled with a tourniquet or pressure dressing. Examples include trauma to vascular organs such as the liver, or arterial bleeds around the body’s joints, such as the groin and arm pit.
Note: in some cases, the use of a hemostatic dressing may complicate or delay treatment in the Emergency Room because the doctor must clean the wound of the hemostatic agent before surgery. There is also the issue of knowing what hemostatic agent might be present in the wound. For this reason, any person using a hemostatic agent in treatment should ideally include the packaging wrapped in the dressing so that the ER doctors know what they are dealing with.
5. The Chest Seal
Chest seals are fast and easy to apply stick-on occlusive dressings that are used to control bleeding from penetrating wounds in the chest cavity in order to prevent air from entering the pleural space and causing a tension-pneumothorax. We will discuss the tension-pneumothorax in more detail later on.
Chest seals have an aggressive adhesive that sticks through blood, sweat, and hair.
- Vented chest seals provide a vent that lets air & fluid escape, but does not let air into the wound
- But non-vented chest seals work fine as well
Tip: carry two chest seals in your IFAK at all times. A vented chest seal for any entrance wound, and a non-vented chest seal for an exit wound will work perfectly.
Note: chest seals can also be used to cover injuries and lacerations to the neck or other areas of the body that require a quick dressing in order to prevent further bleeding from capillaries and exposure to dirt and debris that may cause additional infection.
6. Decompression Needle
A decompression needle is used to evacuate air and fluid from the pleural cavity in cases of a tension-pneumothorax (TPT) or hemo-pneumothorax – more on this later.
Note: a decompression needle should only be used by highly trained personnel. Even highly trained medical professionals have difficulty diagnosing a TPT in a definitive medical care setting.
Ideal Needle size: 14-gauge with 3.25-inches or 8.25cm in length
7. Nasopharyngeal Airway Tube [NPA]
A Nasopharyngeal Airway, also known as a NPA, is a type of airway tube that is designed to be inserted into the nasal passageway to secure an open airway.
NPA’s come in various sizes, and it is important to correctly size a NPA to a casualty before use. This is achieved by measuring from the tip of the casualty’s nose to the tip of their earlobe, and matching this up with the NPA. We will discuss this in more detail later on.
Note: a water based lubricant should be rubbed over the NPA with a clean glove before insertion.
8. Lip Balm
Lip Balm, otherwise known as Chapstick or Vaseline (petroleum jelly) is a wax-like substance applied typically to the lips to moisturize and relieve chapped or dry lips, angular cheilitis (inflammation of one or both corners of the mouth), stomatitis (inflammation of the mouth and lips), or cold sores.
Aside from the obvious uses mentioned above, lip balm has many additional uses under medical and survival conditions.
- Lubricates a Nasopharyngeal Airway Tube prior to insertion
- Seals small cuts, preventing infection and creating a natural barrier to dirt
- Prevents blisters and soothes nappy rash on babies
- Protects exposed body parts, keeping dirt out and preventing moisture loss. Ideal in cold, dry, and windy air
- Prevents chafing when skin rubs against another body part or clothing
- Used to treat Eczema
Tip: rubbing a small amount of lip balm against your knife blade will protect it against the elements and prevent rusting.
9. Duck Tape [or Duct Tape]
Duck tape, also called duct tape, is a cloth or scrim-backed pressure-sensitive tape, often coated with polyethylene. There are a variety of constructions using different backings and adhesives, which all play an important role in medical and survival scenarios.
Medical uses include:
- Use as an improvised Chest Seal (click here to see an image)
- Use as a Band Aid. Use a piece of gauze, tissue or clean piece of cloth to cover the injured area and keep it clean
- A makeshift Butterfly Suture can be made using duck tape and cotton thread or string (click here to see an image). First stop the bleed and then clean the wound, then use this method to close the wound if there is no nearby medical assistance. If no string or cotton is available, use thinner strips of tape
- Used in conjunction with two sticks to create a Sling, Brace or Splint
- Used to cover or prevent further Blisters. A blister on the foot can prevent the ability to run or walk. Place a small piece of duck tape over hot spots, or pop and drain large blisters and then cover them with tape. Make sure that the area is clean first, and do not allow any creases in the tape
Tip: wrap layers of duck tape around marker pens, lighters, and various other tools in your IFAK or Grab Bag to save space. You can see an example on our marker pen in the image above displaying the contents of an IFAK.
10. Medical Tape
Medical Tape, otherwise known as Surgical Tape, is a type of pressure-sensitive adhesive tape used in medicine and first aid to hold a bandage or other dressing onto a wound. It often contains zinc oxide, which is added to help prevent infections.
11. Surgical Gloves
Surgical gloves act as a protective barrier to prevent possible transmission of diseases and cross-contamination between medics and casualties.
Tip: gloves should not be black, but instead chose a colour that will show blood and assist you when conducting a blood sweep, such as blue or white.
12. Trauma Shears
Trauma or Medical shears and cutters are used to quickly provide access to injuries by cutting through clothing. They can also be used to cut bandaging or other materials.
13. Marker Pen
A marker pen is often necessary to fill out a casualty card or to mark the time of application on a tourniquet. It can be used to inform medical services that a tourniquet has been applied by placing a “T” on the casualty’s forehead.
14. Combat Casualty Card
Combat Casualty cards are used to collect information about the patient such as personal data, vital signs, and documentation of treatments administered at the scene.
This information is important to EMS and the receiving hospital.
15. Super Glue
Super Glue was first used in the Vietnam War (in a spray form) as a hemostatic agent that would temporarily patch the internal organs of injured soldiers until conventional surgery could be performed.
Even today Super Glue can be used to close wounds. In remote areas, the glue can be used to replace conventional stitches or staples.
Dermabond is a medical skin adhesive which is less toxic than Super Glue, preventing a slight burning sensation during application that may otherwise be experienced by Super Glue.
It is one thing having an IFAK when needed, but another knowing how to properly use it. Our sequential blog – How To Use Your Individual First Aid Kit [IFAK]: The Primary Survey & First Response Plan – was written to serve as a refresher for those who have undergone proper training through certified institutions.
The information is in no way preparing or instructing readers to replace trained medical professionals and trained first responders, but rather to prepare you to provide life saving medical care if you happen to be the first responder on scene in a remote area.
Always seek help from a professional when you are dealing with a casualty, and remain concurrent in your ability to provide first aid should you be the first person on scene of an accident – this means regular training and refreshers in medical care.
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