School Me on Field Dressings

[Combat Controller]

I'll text him

[doc Russia]

Have no idea how I missed this thread for two weeks!
I am a tactical physician who works with several SWAt teams, and am a former Marine.
I have not read all the comments, but just scanning them, let me weigh in;
Tourniquets have been shown to be useful in decreasing morbidity and mortality in the field. Please reference "the Baghdad study."
I recommend the Oales bandage since it is almost over-engineered. Not only is it a bandage, but it contains the makings of an occlusive dressineg, an eye shield, and the stuffing can be used to pack a wound, as well. It also has strips of velcro, so that it will only unroll a section at a time to keep it from completely unraveling in the field. It also comes in a vacuum packed container which cuts down on bulk, and is waterproof.
They are also cheap enough that you can afford to buy one and ratf*ck it figuring out how it is put together.

The Baghdad study:
http://journals.lww.com/annalsofsurgery ... top.1.aspx

[doc Russia]

So, looking more closely through the responses, let me throw this out there:
Those lists I put together which are linked are kind of old. As I have grown in training and experience, I have found myself carrying less and less.
Along those lines, here is what I would recommend for a GSW blowout kit.
Tourniquet
Oales bandage.
Combat guaze
14 or 16 guage angiocath (this if for someone to use on you, who knows what they are doing).

For tourniquets, I recommend a SOFT-TW.
You may also want to add a SWAT-T (because they are cheap and multi-purpose)
If you are on a really constrained budget, then forget the needle and the combat guaze, and just get a SWAT-T and an Oales. SWAT-Ts are $11 last I checked, and the Oales was $6.50 at chinook medical.
Presto! an $18 Blowout kit.
It is limited because the tourniquet realistically requires two hands, but it is the most "bang for your buck."

If you want to get fancy, add some trauma shears, and put the kit into this:
http://www.skdtac.com/ATS_Low_Profile_M ... 1&CartID=0
Kind of a neat idea; just fold the thing up and put it into a dual mag pouch, or a pocket.

[workinwifdakids]

doc, we're lucky to have you here! Thank you for the advice and - like I told the other guys - thank you for setting me straight on tourniquets.

In fact, I just won my bid on a CAT tourniquet on eBay!

Now, if you don't mind - should I spend the money for QuikClot in the powder form?

[doc Russia]

Now, if you don't mind - should I spend the money for QuikClot in the powder form?

The Magic eightball says "doubtful"

Powder prothrombics are kind of falling out of favor for a few reasons. First, they spill. Second, they can get blown around in the wind. Third, they have a danger of having a small portion form a clot which actually enters circulation, and then floats, or embolizes, either to an end vessel, causing local ischemia, or back up through the vasculature into the lungs. Fourth, once administered, it is a real bitch to get out at a tertiary care facility. The bruns they can cause have largely been addressed.
This is why I recommend combat gauze (http://www.botachtactical.com/zqucoga.html) if you are going to start using stuff like that. Since the material is actually embedded in the gauze, those issues are negated.
The big downside is the price.

Hope this helps.

[Evyl Robot]

I am way behind on this stuff, and it's made me nervous for some time. Where we like to go shooting is a little remote, i.e. the closest hospital is about half an hour away and we can't very well count on an ambulance finding it. So far we keep a basic first aid kit in the car, but I've been thinking that it would be good to add a couple of IBDs and tourniquets to the deal. So far, any and all injuries that have happened out there have been non-firearm related (besides a Webley Eyebrow that was easily treated with a band aid). We are extremely conscientious about firearm safety - especially that far from medical help.

[Jericho941]

This is all interesting stuff.

One thing that always concerns me when it comes to bandages (and tourniquets) is how complicated they can get. Maybe I'm just retarded in the spatial reasoning department, but a bunch of straps and clips are overwhelming. I was always one of those idiots behind everyone else up when it came to learning knots in cub scouts. Israeli bandage? I get that. I even did okay at making an improvised tourniquet in basic. But the actual tourniquet? That thing confused the hell out of me.

Just what is this thing supposed to do? I get the twisting, and the... oh what is this? Velcro?! Nobody said anything about Velcro! How does that even work?
"Hey dumbass! Loop it through that thing there."
What thing- oh. This still doesn't look right.
"No! The other way- aaargh! He's bleeding out! He's dead now, great job! You! Show him what he's doing wrong."

[Kommander]

In fact, I just won my bid on a CAT tourniquet on eBay!

You need to make sure that you did not buy a counterfeit one. There is, or was, a Chinese airsoft manufacturer that was making copies of the CAT. A few somehow ended up in combat zones and cost some people their lives. If you Google it up you can even find a step by step guide to ensuring yours is real.

[workinwifdakids]

In fact, I just won my bid on a CAT tourniquet on eBay!

You need to make sure that you did not buy a counterfeit one. There is, or was, a Chinese airsoft manufacturer that was making copies of the CAT. A few somehow ended up in combat zones and cost some people their lives. If you Google it up you can even find a step by step guide to ensuring yours is real.

I haven't been schooled like this in years! The learning curve around here is steep, Kommander!

I ran off and checked it out. Here's what people are saying is the DoD PPT (in PDF format). Whoever's doing that forgery ought to get their pee-pee whacked. That is not cool in the least bit. Looks like I got the original deal, if the pic is good (and it looks to be). Thanks for letting me know.