Trauma and Egress Kit

[Steve Pierce]

Does anyone carry a trauma and egress kit in their airplane. A local pilot, EMT, military veteran put together a very nice, compact and easy to carry trauma and egress kit to carry in the airplane, car etc. I have been educating myself on how to use some of the items like the needle used for a compressed lung, kinda scary. But the tourniquet, gauze, egress tool etc are pretty self explanatory. I have usually carried a small first aid kit but this is a little more complete in case of something more traumatic happening. Some of the flying my friends and I like to do you never know what could happen. Since I fly mostly with only my dogs and the back seat removed I fastened it to my rear seat carry thru along with my shovel and machete using the Velcro panel on the back of the pack. It also come with several Velcro straps.

Jim will be at the Airmen Show this weekend and also has a website with more information with what the kit includes. https://guardianseven.com/ Hope some of you will stop by and say hi to him and his wife at the show.
Curious with what others with more trauma experience think and I am anxious to attend one of Jim's Wings Seminars to learn more about the proper use of the items in the kits in case something does happen.

[stewartb]

Some injuries require a trained medical professional. My goal is to stay alive until the Air Guard arrives since they have a battlefield medic in every crew.

When I reconfigured my panel 10 years ago I got three glove boxes as a bonus. One has a dedicated use. I still carry a first aid kit in my survival gear, too.

[DENNY]

I have a very basic one. The needle and airway are simple things to add. Lots of medical types flying so even if you are not good at saving the red cells the next guy/gal buy might be.
DENNY

[WindOnHisNose]

I like the compact size, am not sure about what all is included in the kit...will do more research. My only concern is that this should not replace the survival vest...what we carry on our person is quite possibly the only thing that we will be taking out of the plane in an emergency.

Next year's Great MN Aviation Gathering will be having a presentation on preparing a survival kit. Your post provides another way to deal with a survival situation. Thanks!

Randy

[OLDCROWE]

Living 40 minutes away from the nearest ER, I bought a half a dozen of these and keep one in each airplane, car, 4 wheeler, in the Mule and in each building plus a much more complete kit in the hanger that travels... even keep one in my bird hunting bag.

https://www.adventuremedicalkits.com...-quikclot.html

[WindOnHisNose]

I looked at the website, here are the components.

G7-Alpha Kit Contents:

• CAT Tourniquet
• ARS Needle for Decompression
• Nasal Airway
• 4" Emergency Trauma Dressing
• 3” Rolled Gauze (X4)
• Trauma Shears
• HyFin Chest Seal Twin Pack
• Quick Clot Z Fold Hemostatic Gauze
• Triangle Bandage
• Roll of Medical Tape
• Black Talon Glove Kit (L)
• Leatherman Z Rex® Tool
• Permanent Marker
• Mylar Blanket
• Paracord Handle
• Straps with Buckles (X2)
• Medical Patch

I honestly think that you can go to a Walgreens to assemble much of this, go to REI to purchase a really small daypack, and add just a few things (Small roll of duct tape, SAMS splint, 3 mil black garbage bag rather than the mylar blanket, another pack or two of QuikClot, safety pins) for a lot less than $225.

It is always instructive to see what other medical professionals feel should go into a emergency pack, and I appreciate that this company has done a good job of keeping it simple.

Randy

[SchulerJL]

Will a Leatherman Z Rex actually break plexiglass? I thought it would only break auto side windows?

[Steve Pierce]

Will a Leatherman Z Rex actually break plexiglass? I thought it would only break auto side windows?

It will, I saw where Jim tested it. Unfortunately Leatherman discontinued that tool so he designed his own and has a local machine shop manufacturing them. He was testing it last week

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[CharlieN]

Will a Leatherman Z Rex actually break plexiglass? I thought it would only break auto side windows?

Plexi breaks pretty easy, at least in the thin materials used in lightplanes, it is Polycarbonates such as Lexan that are tough to get through.

[schnell49]

As an air guard “battlefield medic” (really called a PJ, Pararescueman, Pararescue or Guardian Angels)
we are nationally certified paramedics.

Basics of what i carry are: few bandages, a 14g needle, scalpel and ET tube for a ‘cric’ in someone’s trachea, some big shaped C like needles if I need to grossly sew something up (great too for stitching outdoor equipment-using the 80lb gut strings of 550 cord), a tourniquet, steri strips and some tincture to make them stick, bandaids, some epi for those bee sting types, and some cravats—basically medical bandannas (love those for splinting etc), med scissors and some other things I can’t remember—pack is no bigger than what’s sitting on the seat in the pic of the first post

couple of those items are advanced but knowing how to use the equipment and why you’re using it is more important than the contents IMO....tourniquets are easy but easier to mess up—amazing what a bandage and a properly tied cravat can do to include just raising the affected limp above the big blood pumper...

Simple things like betadine and alcohol pads make a difference to keep things from getting infected when you cut your thumb open on the first of 8 days of your moose hunt while chopping up potatoes!!

Dont think i carry a sam splint—I have lots of “dirt medicine” training and there are 30 things around I’ll have at my disposal to use to temporarily splint a break.

I would say basic wound care/management for extended ops and learn about bleeding out—like donning your O2 mask above 30k needs to happen really fast, be knowledgeable and proficient ie time limited—treat and ID bleeders the same way—someone that bleeds out from a wound of the limb would be a real bummer—gut shots, arm pits and groin/hip areas are just a bad day and tough to see and get control of if someone is bleeding out.

Big or internal trauma etc and even i will be limited what I can do until I hear the thwapping of that HH-60!!

This is me personal and not endorsed by the DoD

[Gordon Misch]

A consideration re Schnell49's post, which I certainly would not criticize, is that he is there in a rescue/stabilize/transport capacity.

If it's just me out in the boonies, waiting for guys like him, my priorities might include shelter, warmth, and some means of being useful to myself (sam splint??) etc.

Thank you Schnell 49, for what you do.

[cubpilot2]

My son was a combat medic and he said that it was a common practice to ensure that his guys had tourniquets strategically sewed into their uniforms for quick access and use in tense situations.

Makes me think that having a couple gently sewed into my flight vest might not be a bad idea.

[okmike]

One thing I carry I didn’t see mentioned was a couple of israeli bandages. I also carry a Sams Splint and both Quit Clot gauze and powder, caution using the powder if it’s windy as it could get in someone’s eyes.

[WindOnHisNose]

I had a PM from one of you folks wondering about adverse effects of using QuikClot. A couple of years ago I did some research into the literature on this substance and found very, very rare adverse effects.

Having written that, it was pointed out that QuikClot is extremely effective in stopping bleeding. It is also difficult to clean out of a wound. It has been suggested that if you think you will be able to get the victim (yourself?) to an ER relatively soon, try to use direct pressure to slow down the bleeding. If you think it will be some time, or that the bleeding is too significant to control with direct pressure, use the QuikClot.

Here is a study out of the NIH that is representative of other studies...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268478/

I'll start a thread soon on techniques to stop bleeding, including use of tourniquets, direct pressure, QuikClot, etc.

Regarding Sams Splint, it is extremely useful and does not have to be removed in order to take xrays of the isolated limb. It is also extremely lightweight.

Randy

[Mark_Moyle]

In addition to a trauma kit with quick clot...bout the size of a child’s lunch box. I also carry 2% lidocaine, a single use suture kit and Toradol.


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[guardianseven]

Thank you for the compliments Randy! We tried to keep it as simple as possible using TCCC guidelines established by our military following the MARCH protocol. It is great to see that most folks on here do carry some form of trauma equipment. I do understand that you can find similar items at lower costs, however, I do encourage everyone to do their research on the products they carry that could one day save their life or the life of a loved one. One primary example is the CAT Tourniquet, there are a lot of less expensive tourniquets out there that "look" like a CAT, but are made from cheaper materials that can lose strength in harsh weather conditions. All of the major bleeding control items are manufactured and distributed to us by North American Rescue, a great company who stands behind their products 24/7.

[stewartb]

I had a PM from one of you folks wondering about adverse effects of using QuikClot. A couple of years ago I did some research into the literature on this substance and found very, very rare adverse effects.

Having written that, it was pointed out that QuikClot is extremely effective in stopping bleeding. It is also difficult to clean out of a wound. It has been suggested that if you think you will be able to get the victim (yourself?) to an ER relatively soon, try to use direct pressure to slow down the bleeding. If you think it will be some time, or that the bleeding is too significant to control with direct pressure, use the QuikClot.

Here is a study out of the NIH that is representative of other studies...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268478/

I'll start a thread soon on techniques to stop bleeding, including use of tourniquets, direct pressure, QuikClot, etc.

Regarding Sams Splint, it is extremely useful and does not have to be removed in order to take xrays of the isolated limb. It is also extremely lightweight.

Randy

The bad reports about Quik Clot that I've seen were about dumping the powder into a wound. All of my Quik Clot packages have the product impregnated into wound dressings, either sponges or gauze. I haven't seen the powder in stores for quite some time, but I haven't looked very hard. Maybe the powder is available to medical professionals?

[DENNY]

Feminine hygiene products such as a maxi pad are great to have in the kit. They can be used as intended or as a dressing. A Thermarest pad can be cut and use as a splint or padding as needed. The more use an item has the better.
DENNY

[spinner2]

I met Amy Alton last winter at a trade show. She’s a Nurse Practioner and her husband is an MD. They have an online store and sell kits as discussed here. I bought this one:
https://store.doomandbloom.net/first...act-grab-n-go/
for $100. And she included a Quick Clot package at my request.



It weighs 1.5 pounds.

[TurboBeaver]

I met Amy Alton last winter at a trade show. She’s a Nurse Practioner and her husband is an MD. They have an online store and sell kits as discussed here. I bought this one:
https://store.doomandbloom.net/first...act-grab-n-go/
for $100. And she included a Quick Clot package at my request.



It weighs 1.5 pounds.

Regardless of which kit you go with and you go onto floats in the summer
months. Get out your Vacuum Sealer and slid your Med Kit into it and seal it up . It will keep all your stuff that may save your life bone dry, when you have a problem in the water!

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[Farmboy]

As mentioned before plexiglass is near bulletproof and lexan pretty much is.

You’re not egressing through the windshield unless it’s already broken.

FAA report excerpt - pilot died due to complications from fire :

The airplane continued to slide across the grass until the right wing dug into the ground; the airplane then flipped over and caught fire. Both occupants tried to open the canopy, but it was jammed. The passenger then tried to kick out the canopy but could not break the glass. Several bystanders ran to the airplane, helped open the canopy, and helped the two occupants egress.


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[JohnnyR]

Best thing remote area operators can do to prepare for medical emergencies is with their minds. Wilderness First Aid (WFA) courses are offered throughout the year by NOLS, Wilderness Medical Associates, SOLO and others. Knowing how to differentiate an emergency from an annoyance is key; so is how to utilize simple lifesaving equipment like an airway, etc.

http://wildmed.org/
https://www.nols.edu/en/coursefinder...irst-aid-WAFA/

[CharlieN]

As mentioned before plexiglass is near bulletproof and lexan pretty much is.

You’re not egressing through the windshield unless it’s already broken.

FAA report excerpt - pilot died due to complications from fire :

The airplane continued to slide across the grass until the right wing dug into the ground; the airplane then flipped over and caught fire. Both occupants tried to open the canopy, but it was jammed. The passenger then tried to kick out the canopy but could not break the glass. Several bystanders ran to the airplane, helped open the canopy, and helped the two occupants egress.


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All the homebuilts I have built in the past have been low wing with lifting canopies. Over the decades I have grown a fear of being trapped inside. A year or two back when an RV got off the side of the ice runway on Alton bay NH and flipped over, it proves how nice it is too have people around, especially aviators who understood what they watched since the group of them lifted the plane so the couple could egress. But I think I want screw tires as we run in some ice race classes just so a plane can be maneuvered when slippery.

But where I am going with this, I have decided to build my first high wing with more than commonly seen structure around the occupants. And I might just carry at least a .22 to break the windows if needed. Guess I should check if the .22 is enough to break the Lexan just so I do not shoot myself

[krines]

As a cardiovascular anesthesiologist that is advanced trauma life support certified, advanced pediatric and cardiac life support certified, I carry no first aid kit in my plane. I take care of trauma patients all the time in the hospital. I seem to have all the luck as I have been first on the scene for multiple car crashes and even gunshot wounds with a total of 4 deaths and 4 saves. The only thing of interest to me in these kits would be a tourniquet but I carry paracord as part of my survival kit. I have attended many emergency trach and cricothyroidotomies in the hospital and they are often **** shows even when done by trained professionals when not using specially designed kits to perform these. I have witnessed one death as a result of a poorly performed cricoidotomy. That death was completely physician induced and was completely unnecessary. A 14 gauge IV for needle decompression of tension pneumothorax is of interest to me but diagnosing that in the field is going to be difficult at best, and if you needle somebody who doesn't have that you can actually cause the same problem. There is a rule in trauma care that revolves around the Golden Hour. If you can get transferred to a trauma center within one hour your chances of survival improve dramatically. Therefore transfer is the most important thing you can accomplish. In Montana I receive trauma patients sometimes from 400 miles away and I kind of laugh because if they survive that lengthy transfer they probably aren't all that sick. Another saying we have is the only bleeding you have to worry about is that in which you can hear it. A tourniquet is great for that, anything else tear up a shirt or rag, stuff it in and hold pressure until help arrives. Of the 4 on scene deaths I attended the paramedics when they arrived didn't have enough stuff in their ambulance to alter the situation. What I am relying on is my 406 ELT, my SPOT, and my ADSB so the Blackhawk can get me to the hospital ASAP which probably wont happen here in Montana as the distance and time to care is likely to be great. The added weight of a kit is more of a danger to me than the benefit ( I better get off that short gravel bar when it is 90 degrees out ). One last thing when applying a tourniquet it must be applied super tight to the point that it is quite painful. If it is not applied tight enough it will promote venous bleeding. A properly applied tourniquet will have the patient screaming at you within 15 to 20 minutes.

[JohnnyR]

You are throwing the "wilderness baby" out with the "urban bathwater," and you've given poor advice for many aviators who travel +2 hrs from definitive care. It's forgivable, though, as many of us have that mentality of "someone will rescue me." What do you do while you're waiting out weather, distance, rescuer availability, etc.?

There are a multitude of easily and effectively treatable issues that can occur well prior to full-blown trauma care scenarios.

And, there is a huge gap between treating someone in the hospital with all the gear and diagnostics and treating someone in the field. In the field, you are typically not providing definitive care, but there are still plenty of situations where basic medical knowledge and some basic first aid equipment can save lives or in the very least make someone more comfortable.

Take it from someone who has been in combat (with both walking and non-ambulatory wounded inside hot areas), around an airplane wreck in the wilderness, and often provided long term medical care (multi-weeks away from definitive medical care) for little boo-boos that could become big boo-boos: some first aid supplies and the knowledge of how to use them can be immensely helpful.

I once had an emergency room physician and director of three ER's tell me that he'd rather have an EMT nearby to treat his kids at a crash site than an ER doc - one is different than the other.

As a cardiovascular anesthesiologist that is advanced trauma life support certified, advanced pediatric and cardiac life support certified, I carry no first aid kit in my plane. I take care of trauma patients all the time in the hospital. I seem to have all the luck as I have been first on the scene for multiple car crashes and even gunshot wounds with a total of 4 deaths and 4 saves. The only thing of interest to me in these kits would be a tourniquet but I carry paracord as part of my survival kit. I have attended many emergency trach and cricothyroidotomies in the hospital and they are often **** shows even when done by trained professionals when not using specially designed kits to perform these. I have witnessed one death as a result of a poorly performed cricoidotomy. That death was completely physician induced and was completely unnecessary. A 14 gauge IV for needle decompression of tension pneumothorax is of interest to me but diagnosing that in the field is going to be difficult at best, and if you needle somebody who doesn't have that you can actually cause the same problem. There is a rule in trauma care that revolves around the Golden Hour. If you can get transferred to a trauma center within one hour your chances of survival improve dramatically. Therefore transfer is the most important thing you can accomplish. In Montana I receive trauma patients sometimes from 400 miles away and I kind of laugh because if they survive that lengthy transfer they probably aren't all that sick. Another saying we have is the only bleeding you have to worry about is that in which you can hear it. A tourniquet is great for that, anything else tear up a shirt or rag, stuff it in and hold pressure until help arrives. Of the 4 on scene deaths I attended the paramedics when they arrived didn't have enough stuff in their ambulance to alter the situation. What I am relying on is my 406 ELT, my SPOT, and my ADSB so the Blackhawk can get me to the hospital ASAP which probably wont happen here in Montana as the distance and time to care is likely to be great. The added weight of a kit is more of a danger to me than the benefit ( I better get off that short gravel bar when it is 90 degrees out ). One last thing when applying a tourniquet it must be applied super tight to the point that it is quite painful. If it is not applied tight enough it will promote venous bleeding. A properly applied tourniquet will have the patient screaming at you within 15 to 20 minutes.

[eskflyer]

We also carry a AED. None of us are young anymore and you never know when you might need one . If you are not trained for basic med firstaid / cpr/ aed. Do it for you your family friends.

fly safe fly low fly slow
but stay outta the trees
JP

[stewartb]

As a guy who's had his share of remote outdoors injuries? First aid kits are way better than nothing. Especially if they include some potent pain killers. Sometimes you don't call for help. You just limp home.

[JohnnyR]

For entertainment, here's a recent wilderness medicine exam https://wmiquiz.com/index.php that you can take online.

Topics covered in a typical wilderness first aid or first responder course (this list from www.wildmed.org ) are :

• The General Principles of Wilderness and Rescue Medicine with an emphasis on the prevention and identification of medical emergencies, appropriate technology, and risk management.
• Patient assessment and emergency care including CPR, basic Life support, and the emergency treatment of anaphylaxis and asthma.
• Environmental Medicine including altitude illness, hypothermia and heat illness, frostbite and cold injury, lightning, submersion, and environmental toxins.
• Backcountry Medicine including the assessment and treatment of common medical problems.
• Musculoskeletal Problems including unstable and stable injuries overuse syndromes, and dislocations.
• Wound management including open fractures, lacerations, burns and blisters.
• Practical skills including splinting, bandaging, litter packaging and medical kit preparation.
• WMA International Wilderness Protocols including wound cleaning and exploration, spine injury assessment, dislocation reduction, CPR in the remote setting, and anaphylaxis and asthma.

[StuBob]

Another anesthesiologist here. I agree with a lot of what krines says. People with training have a hard time getting airway management right. We get paramedics coming to us for some sort of periodic recertification. Some of them can’t intubate and none of them can mask. Giving someone a cricothyrotomy kit is a recipe for disaster. Same with a needle for pneumothorax (collapsed lung) — how will you diagnose it? Which side is it on? Like someone said, “First, do no harm.” It applies to first responders, whether professional or ad hoc.

OTOH, anyone can control bleeding (if it’s controllable) with a tourniquet or direct pressure. So bandages, tape, tourniquets, and Kerlix wrap are very worthwhile. I imagine scalp lacerations are pretty common in off-airport misadventures, and they can bleed impressively. Kerlix is good for that, since you can’t put a tourniquet around the victim’s neck (!). Quick Clot in a bandage might be worthwhile. I think the powder might be no good, though. It’s probably hard to clean out, leaving a continuing source of infection for some time after the event.

The tl;dr version: I don’t carry a first aid kit, but my survival vest has lots of bandages and wound care stuff.

Oh, and.....I think the AED is a great idea.

[stewartb]

I’m not a medical professional but I carry a good first aid kit. I guess it’s parallel to how I’m not a mechanic and I carry a tool kit. I use them both fairly regularly. I don’t expect to do major repairs with either one but they sure pay dividends for the common every day stuff.

[JohnnyR]

This adult airway takes 5 minutes to learn how to use and is “almost” idiot proof. A $0.20 piece of plastic that can save a trauma victim with an obstructed airway. Beyond this, you’re talking advanced techniques that are unlikely to be available or used properly.

Do no harm is definitely a primary goal and no way am I recommending a layman try to utilize advanced airway techniques. The doctors are right in that even ALS guys can have trouble implementing.

On the other hand, a backcountry pilot should have basic first aid supplies aboard, particularly for remote and/or overnight excursions. If not for oneself then for passengers. A decently comprehensive kit weighs less than 16 oz. and can handle many issues. That weight equivalent of 1/6 gallon of avgas might be the difference between an enjoyable trip and a day or two of misery.

Example: Minor burns and lacerations (most common camping injuries) can often be handled on site, but if they aren’t handled properly those wounds can quickly become infected and then move from minor inconveniences to possible major concerns. Would you want to give up the last three days of a weeklong moose hunt you’d been waiting for all year because your buddy refused to properly clean, treat and bandage a first day 1” gash in his hand? (Just rub some dirt in it - it’ll be fine...)

Example 2: your passenger and fishing buddy becomes lethargic, confused and seems to have a case of the “umbles.” (Stumbles, grumbles, mumbles, tumbles, etc). You know they’re diabetic but don’t know what their medication/care regimen is; however, you know that no harm will be done by giving them sugar, so you grab the sugar source you keep in your first aid kit, administer, and 20 minutes later he’s taking care of himself. You’re now freed up for the task of flying home.

[Gordon Misch]

Hospital care and field care are different. Neither the in-hospital Docs, nor the field EMTs and Paramedics should confuse the two. Analogously, a mishap scenario where rescue is imminent, and where it is a day or two off, are different in their requirements for injuries. Blanket generalizations that blend the two raise caution flags. I'm speaking from the perspective of being a former fire department EMT in Ak. I distinctly remember a highly respected local Doc there saying essentially the same thing in an EMS training session.

Edit: I have no idea where that smiley at the top came from, and I can't seem to delete it. So please ignore it!

Edit again: I'm going to run my mouth here, but - - - For you anesthesiologists- You seem to denigrate field care - both by amateurs and by professional field medics. Your profession and that of EMTs and Paramedics are worlds apart. I strongly suggest that you do a ride-along with a fire department ambulance crew for a few days, and begin to acquaint yourselves with the nature of field medicine. You seem to focus on airway management. Well, some Paramedics do just fine with intubation, while some Docs are klutzes. My wife is a Critical Care Charge-Nurse, and my son is a Fire Dept Lead-Paramedic: they would each corroborate that. I have great respect for your profession, and you, in turn, should have great respect for field medicine.

There - I've shot my mouth off enough for one day. Thanks for listening.