Alright, to get the important stuff out of the way:
I AM NOT A DOCTOR, NURSE, EMT, OR ANY MEDICAL PROFESSIONAL OF ANY KIND. I was a Triage Officer for the Navy, once upon a time, but that is more of a “decide who lives and who dies” job, rather than a “keep them alive” kind of thing (which, by the way, is quite a burden to throw on a fresh-out-of-college Junior Officer). NOTHING I SAY SHOULD BE CONSTRUED AS MEDICAL ADVICE. I am trained on how to use this stuff, and if you are not, you should seek training before actually using it yourself.
In light of recent terrorist attacks in Manchester, England, Mastung, Pakistan, and Pattani, Thailand – and those are only the large-casualty events last month against civilian targets – this blog post is going to deviate a little from the site’s established norm. Up until today, I focused on how to harden your home against criminal attackers. Today, I am going to talk about how to help yourself – and, potentially, others – survive mass casualty incidents.
In short, these are incidents where the local emergency responders are overwhelmed by the number of casualties. This can be a massive pile-up on an interstate, or a suicide bombing. Conveniently, these tools, and the skills to use them, may also come in handy if you are in a remote part of the world where an ambulance is minutes, if not hours away.
As always, and to build on what I said before, the tools are useless without the training to use them, so get the training. I cannot stress this enough. One outstanding source of this training is Dark Angel Medical, but the DHS themselves have some information on the topic, and the BleedingControl.org initiative offers classes all over the country.
So here is how I was thinking:
The immediate concerns for mass casualty incidents is stabilizing people – keeping them alive until professionals can get to them. The most common wounds that are working against you are loss of limbs, massive blood loss, and puncture wounds to the chest. Cardio-pulmonary resuscitation – CPR – may also be necessary, and that requires training of its own sort.
On the other hand, the perfect IFAK – Individual First Aid Kit, or “Blow-Out Kit” – is useless if it is too big to be on your person. No, you will not have time to run back to your car – after all, you may be one of the victims.
So my goal was to assemble a kit that could address the major wounds present during mass casualty incidents while also being small enough to be carried on a daily basis without being a huge encumbrance. I am not entirely happy with my solution yet, but it is good enough to throw at the public for them to take, learn from, and run with.
Nitrile gloves. You do not want what the other person has, and latex is both less resistant to temperature/aging and is also an allergy problem for a lot of people.
Celox Rapid Hemostatic Z-Fold Gauze. If you don’t know about hemostatic agents, get out there and learn, just be advised this stuff is not for the squeamish: https://youtu.be/e9xvIbKBJn4 and https://youtu.be/LCSf5Asa8rc . In short, Celox/QuickClot/etc. are pretty much the best thing to happen for “oh, hey, I’m bleeding” since the invention of the BandAid. There is also the QuickClot Advanced Hemostatic Gauze, which may be easier to pack into the pouch and is cheaper, but offers less total length.
Flat roll of duct tape. I took one of my many rolls, and proceeded to wrap around a business card for a while. This stuff can serve as a not-very-effective-but-expedient pressure bandage, it can hold the hemostatic gauze in place, or whatever else you need.
CPR Face Shield. Again, you do not want what the other person has, and this one comes with handy “this side up” instructions printed right on the shield. Likewise, with the duct tape, this can make a passable chest seal. (Note: the ones I use do not seem to exist any more, so I am suggesting these blind.)
Now this is where it gets a little more complicated. There are some very good arguments against the use of elastic or “rubber band” tourniquets such as the one I suggest below, including “it may not work“. There is also a very good argument for its use: it can be packed smaller than almost any other tourniquet on the market today, and thus stands a better chance of being on your belt. This is something you are going to decide for yourself, and I ask that you do your homework thoroughly before deciding.
RATS Tourniquet. [UPDATE: After further consideration, data, and studies, I would strongly recommend against using this tourniquet. It is strictly better than a belt, but that is about all that can be said in a positive way about it.]
Like I said, there is a lot of back-and-forth about whether or not this one is a good choice, but it is one of the most compact, and that is exactly what I was looking for in this case. As always, read and abide by the instructions, and practice.
Maxpedition PHP iPhone 6/6s Pouch. In retrospect, I probably should have gone with the PLP – it’s half an inch larger in every direction – but the PHP works just fine, and is low profile, both literally and figuratively. Also, this should fit fairly easily in most cargo pockets, if you don’t like belt carry.
SOF Tactical Tourniquet Wide. This is one of the more-common windlass-style alternatives to the RATS, and is strictly better, though much larger. Again, read and abide by the instructions, and practice. Also, be sure you buy from the official source – Tactical Medical Solutions – and, if all else fails, buy directly from them; fakes abound, and do not meet the same requirements. Also, if you go this route, I would recommend re-rigging the tourniquet itself so it ends up being wider, but flatter.
Maxpedition EDC Pocket Organizer. In fact, the SOFTT-W is sufficiently large that it takes up pretty much all the space in the PHP, so I had to step up in pouches. This is noticeably larger, unfortunately, though seems to wear just fine. You will also need to buy a few TacTies or something similar to hold it to your belt.
As a third alternative, I have been made aware of ankle-strap medical holsters, but I have no personal experience with them, so you are on your own with experimentation with them.
If you go with the RATS/PHP, the total cost comes out to about $84, not counting the negligible costs of the duct tape and the gloves. If you decide on the SOFTT-W/EDC setup, the total cost will be about $99.
On the other hand, with people literally being machete’d apart in the streets these days, being able to provide potentially live-saving stabilization – none of this is “treatment”, per se – could be invaluable. Our fears about terrorist attacks are largely a product of the availability heuristic – i.e. we see it in the news and we think it’s happening all the time – but you lock your doors to keep your house secure, despite crime not being that high. Why not carry a few more tools in order to save yourself, or someone else? (And, speaking of, be mindful of whatever Good Samaritan laws your state does or does not have, as pathetic as it is that I have to say that.)
AGAIN, I AM NOT A DOCTOR, NURSE, OR EMT. THIS IS NOT MEDICAL ADVICE. SEEK TRAINING IF YOU DON’T ALREADY HAVE IT.