The Executive's FAK

[doc Russia]

A few points;
First, the easy one;
Early and continuous compression CPR is being recognized as perhaps the most important aspect (outside of early defibrillation) of cardiac arrest resuscitation. My personal experience is limited, but I have seen a growing trend of evidence to support this. It is now to the point where I do not think that you should interrupt compressions to do rescue breaths. For this reason, you may have noticed that I have not included a face shield in the kit. You can get small ones which I could fit in, but they are not necessary, in my opinion. this could be proven wrong in later years, but the best evidence right now establishes a primacy of good continuous compressions over all else. So, remember to do these three things for good CPR;
1: rate of 100. ...sing "row, row, row your boat" and compress during the beats to get an appropriate rate. If the rate gets over 140 beats a minute, survivability plummets.
2: 2" depth. compress for a full two inches. If you break ribs, keep driving.
3: Full recoil (should be easily remembered on this board) allow the chest to fully recoil between compression
There is a program now to teach CPR in 5 minutes. That is because we are finding that the important things are simple. It only takes 5 minutes to figure out how to do it right.

Combat gauze price: as above. it's the impregnation of the fibers which makes it spendy. You will naturally ask why powders are so much cheaper. Well, it's not only that they require less processing since they are just floating free, but that most agencies are going to the impregnated gauze, so there is a glut of powders on the market, and companies are trying to offload them to Mall ninjas as fast as they can.
Another option is the quickclot sports clotting sponge, which is not a roll of impregnated fabric, but a pouch of the powder. It's not as good because you cannot deploy it linearly, but it is another option.

Price?
Probably around $100 with everything. Lemme see:
Aloksak 4.5 x 7" is about $3
Combat gauze is $44
SWAT-T is $9
needle is $15
NPA is $4
Scalpel $2
It's hard to calculate the 2 each of some assorted pills, but it must be less than $5.
Still comes out to just $83 by my math.
The problem is the bag and the pills cannot usually be bought individually packaged, but you might be able to find small plastic baggies, like the ones that are for small parts, and just put it together yourself.

btw, I added steri-strips since they can be used for wound closure, and, in conjunction with lube, you can cut the bag into an occlusive dressing. What I would really like is a half dozen 4"x3" seals, but nobody makes such a product.

If you want me to make one, I can probably do that, but I would nick you for $100 to cover shipping and taxes. I would also want to know how many people would want one since I would rather do a batch of them, than singles here and there.

I am going to send an Inquiry to Chinook medical to see what it would cost them to do it.

[randy]

1: rate of 100. ...sing "row, row, row your boat" and compress during the beats to get an appropriate rate.

I understand that Queen's Another One Bites The Dust gives you a good rhythm, but not recommended for singing out loud if the victim's family is present.

[Denis]

1: rate of 100. ...sing "row, row, row your boat" and compress during the beats to get an appropriate rate.

I understand that Queen's Another One Bites The Dust gives you a good rhythm, but not recommended for singing out loud if the victim's family is present.

You are a sick, sick man.

[workinwifdakids]

I've heard that one. "Stayin' Alive" also gives you the right pace for compressions.

I *just* ordered Ibuprofin and Tylenol in single-use sealed packets. The Ibu (w/o S&H) comes to $0.16/ea, and the Tylenol (w/o S&H) comes to $0.11/ea. These are both generics. I gave up on vacuum-sealing my own, or putting them in a baggy; it was just to much mess to deal with.

Doc, what's your position on the CAT Tourniquet vs. the SWAT-T? The weight is negligible, the price is excellent, and it's dual-use role as a pressure hold for bandages and gauze makes this look really attractive.

SWAT-T - $10 vs. CAT - $30
SWAT-T - 3.36oz vs. CAT - 2.7oz
SWAT-T - multipurpose vs. CAT - single purpose

I can't find any information on size (bulk), but the SWAT-T looks appreciably smaller that the CAT.

[doc Russia]

You may want to hold of on spending money...

I just got off the phone with Chinook Medical (http://www.chinookmed.com/). I have used them as a vendor from time to time, and we may have a deal.
In the next few days I will know more, but they are interested in what I put together as an idea. Seems they have something similar Here: http://www.chinookmed.com/cgi-bin/item/ ... ----------
But what I have put together might be more widely useful.
So, right now we are talking about them offering the same kit with the following modifications:
No needle.
No Scalpel.
Add HALO chest seal.
Add plastic tweezers.
This will remove the liability issues associated with the needle and the blade. If you want them, you can order them separately and tape them to the outside of the pouch. The way they do their modules is to vacuum seal them, but they also have a ziploc seal, so when you do open them, you can close them again.
They will offer it on their website, and while I will not get a percentage, I will probably be able to negotiate at least a one-time discount for members of this forum.
I may also be able to brand it "doc Russia's Executive FAK"

So, watch this space, and I should know more by the end of the week.

[doc Russia]

oh, and the kit will probably be a little cheaper than $83

[Kommander]

Chest seals are something I'm still not comfortable with. I mean I get the gauze, you poke it in the hole. I get the bandage, you wrap it around the wound per the instructions for that specific bandage. I get the tourniquet, apply 4" above the wound if possible and crank down until the flow stops. I don't get the chest seals. I mean I know what they do and why they are used, but I don;t really get how to tell a sucking chest wound that need a seal versus a chest wound that needs gauze and a bandage.

[Mud_Dog]

Chest seals are something I'm still not comfortable with. I mean I get the gauze, you poke it in the hole. I get the bandage, you wrap it around the wound per the instructions for that specific bandage. I get the tourniquet, apply 4" above the wound if possible and crank down until the flow stops. I don't get the chest seals. I mean I know what they do and why they are used, but I don;t really get how to tell a sucking chest wound that need a seal versus a chest wound that needs gauze and a bandage.

Frothy blood is what they told us in the military. Basic first aid for a sucking chest wound is apply a plastic patch(like a cut up MRE bag) with tape, one side left open to drain.

Not sure if that's correct but that's how they taught us to do it.

[Aglifter]

When hunting, a lung shot is "pink, frothy" blood - no idea if its relevant, but its pretty distinctive.

[doc Russia]

Chest seals are to keep air from outside the body from going into the space between the lung and the chest wall through the wound. For any wound over any rib, you throw an occlusive dressing onto it. Usually, they are small. If it is large, like a crater or a chunk blown out, then put the combat gauze on first, then pack to level with the surface, then throw a seal over it, then another pressure dressing and finally a bandage on top of that. If the patient starts to show signs of a tension pneumothorax, take it off. This was why they said to tape down three sides; if air was entering the pleural space from the injury on the lung side (as opposed to the wound on the chest wall side) you should remove it to let the air escape. I get the fact that this piece of gear and wounding pathology is not intuitive, and people don't understand it. In those cases, I say that you should just think of it as a huge band-aid with the cotton part removed.