SAR aid kit

[yowzer]

I'm in the middle of the training academy for a volunteer SAR group. Once through the training, I'll be able to practice as an EMT on missions. I'm starting to put together a BLS aid kit for my 48 hour pack. Caveats are that we have to pay for everything ourself, and whatever I pack will be on my back for hours or days while looking for the victim, and again while packing them out to a trailhead or a LZ for airlift. So, AED and O2 are pretty much ruled out. (If we have someone who needs an AED, or otherwise immediately life threateningly ill or injured, it's going to turn into a recovery mission, not a rescue.)

I'm starting with the basic first aid kit that's served me well in years of hiking and backpacking:

Assorted bandaids, some 4x4s and 5x9s, a few rolls of gauze, some triangle bandages, alcohol wipes, ace bandage, gloves.

And adding some additional trauma and medical supplies:

c-collar, sam splint, baby aspirin, glucometer, tube of glucose gel, penlight, occlusive dressing, shears, penlight.

Things I'm seesawing over and need advice on from people with experience in the field:

Blood pressure cuff and 'scope? Weight versus getting more complete vital signs. I'm leaning towards a no; I don't think knowing the BP will result in any major changes in treatment plans.

BVM? I can compress one into a surprisingly small space, but see above about critical patients: Anyone ill enough to need one isn't likely to survive with or without one.

Small chemical cold packs: Temporary relief while they last.

Also, suggestions for a small waterproof bag to store everything in? A normal jump kit is way too big to fit in my pack, especially with all the other gear in it. (Not everything'll go in the bag (*cough* c-collar *cough*), but I want to keep most of the stuff together.)

[John E]

I'd skip the BP cuff but keep the scope, good for breath sounds as well heart sounds. I'd leave the cold packs, lot of weight for little return.

What does that glucometer weigh?

John E.

[yowzer]

I'd skip the BP cuff but keep the scope, good for breath sounds as well heart sounds. I'd leave the cold packs, lot of weight for little return.

What does that glucometer weigh?

John E.

Scope only? Hmm. I don't really care about heart sounds (Do they have a pulse? That's all I need to know.) Breath sounds, now...

My glucometer weighs only a few ounces; doesn't take up much space either once it's out of the bulky carrying case and in a ziploc bag with a few test strips and lancets.

[ffemt8978]

I'd keep the cold packs (only a couple, and maybe add a couple of hot packs also). After all, hypo- and hyperthermia are very real possibilities that you could be facing.

I'd skip the BVM, but maybe add a pocket mask.

Maybe a KTD also, in the event that traction would be needed.

[yowzer]

I'd keep the cold packs (only a couple, and maybe add a couple of hot packs also). After all, hypo- and hyperthermia are very real possibilities that you could be facing.

I'd skip the BVM, but maybe add a pocket mask.

Maybe a KTD also, in the event that traction would be needed.

Forgot to mention that one of the fobs on my keychain is a disposable cpr face shield, so I always have it on me.

*googles KTD*

Hmm. That's not a style of traction splint I've seen before; it looks quite packable, and affordable. I'll definitely consider it.

[W1IM]

On the issue of a BVM, I'm picturing several people carrying a person down a mountain on a stretcher/backboard. I can't think of a better way to provide respirations while moving than a BVM (1 person holding, one squeezing the bag). Using a pocket mask/barrier doesn't seem like it would work because the person doing the respirations would probably trip or get taken out by a tree, and although you could use a demand valve, you would need an O2 tank.

Anyone else have ideas?

[Jolt]

I have some very minor SAR experience, but my friend and I (he's an EMT-I) have been trying to put together a team medical kit of some sort. Let me see if I remember what was in it:

Two oral glucose tubes + tongue depressors
Trauma shears (I tend to also keep a pair in my pack)
Various 4x4s and 5x9s
An OPA set
A barrier device
We both carry several pairs of gloves
Tape
Sting kit
An adult select collar
A few padded board splints
I like to keep a stethoscope/BP cuff
Trauma dressing
Burn sheet
Sterile water
SAM splint
ACE bandages
Kling wrap
Triangular bandages
Alcohol wipes
Pen light
2 hot and 2 cold packs

That seems like what we assembled. I don't really feel that there's any need to keep a glucometer on hand unless you have a diabetic on the team, or it's really light and you want to take it.

We tried to pack based on the assumption that we would likely be helping out a teammate rather than a survivor we found in the woods, but the equipment is useful both ways.

Please tell me if you find anything to be particularly useful in the field.

[rgnoon]

The Cold/Hot packs are nice, but don't tend to last very long at all. With wilderness EMS and SAR, extended transport and extrication times are the norm, so don't expect too much from them.

Having one or two hot/cold packs in your pack isn't going to do a whole lot on anything more than a ten minute transport out, however, if everyone one of your medical personnel on the SAR team carry a few, they can add up fast.

Also, the hot packs feel nice and warm, but actually using them to rapidly warm a hypothermic pt can be very difficult and near impossible when in an especially cold environment (even with the pt properly insulated and packaged).

We definitely carry aneroid sphygmomanometers as trending can tell you allot about a subject/pt's condition.

As for the bag, I'm sorry that I can't make a recommendation as for a bag in particular, as I'm not very happy with my current solution. Perhaps someone else can offer further input.

[John E]

so far. I still think cold/hot packs are a waste of space and weight but you'll have to make that call.

As for a bag, if you want something that's really waterproof that you can toss in or lash onto a backpack, you might check out Ortleib. They make a line of waterproof duffles and other types of bags. I use them for carrying gear on my motorcycle. They're about as waterproof as you'll be able to find.

I'm thinking that one of their small size duffles could hold all your gear and either fit in your main pack or could be lashed onto it. They come with their own removable shoulder strap so you could carry it by itself if the need arose.

Most trauma type bags/kits aren't waterproof, they look like they might be but unless they're using completely non-porous cordura or nylon, they'll leak. The Ortlieb stuff won't.

Of course, a water-resistant bag might be okay if it's carried inside your main pack, especially if you have a non-porous rain cover for the pack.

John E.

[certguy]

Hot and cold packs definitely ! The idea of having several people carry them is a good one especially if you have multiple victims ( plane crash , train crash , 4x4 accident , multiple rafters in the water , etc. ) I would go with a Seager splint instead of a KTD as it only takes 1 person to apply , can be used bilaterally , and is less bulky . I would also recomend cardboard splints . They're cheap , very lightweight , and can easily be put in a backpack ( along with the Seager ). The aluminized survival blankets would be a good idea , they're cheap too , and very light and small so you can carry several . Blood stoppers wouldn't be a bad idea either .

[certguy]

Keep in mind if you have hypo or hyper thermic pts. , you will need at least 4 of each pack , not 2 . 5 is better . Hottest body points are armpits and groin (both sides ) , and neck .

[yowzer]

I would also recomend cardboard splints . They're cheap , very lightweight , and can easily be put in a backpack ( along with the Seager ). The aluminized survival blankets would be a good idea , they're cheap too , and very light and small so you can carry several . Blood stoppers wouldn't be a bad idea either .

I'm leery of cardboard splints. Cardboard and water don't mix very well. Between rain, rivers, snow...

Blood stopper stuff isn't in our protocols.



Everybody uses hare traction splints around here, and they are way too bulky for my needs; I've never seen a sager and hadn't even heard of a ktd until this thread. I wish I could handle examples of the two before deciding if I want to pick one up.

[certguy]

Hi Yowzer ,
The bloodstoppers I'm talking about aren't the stuff that aids in clotting , they're a dressing with roller guauze attatched to provide a quicker pressure dressing . As for the cardboard splints , an idea I've been considering but haven't tried yet is dipping them in melted parafin wax to waterproof them . I wonder if Campdry would work on them ? I have an old Forest Service hose pack full of them for disasters and I've been wondering how to waterproof them beyond putting them in plastic bags . You can do the same with them as with a SAM splint and all it costs is the effort to find the boxes to cut up .

[certguy]

Yowzer ,
I forgot to tell you I've trained with the Saeger and it's got advantages over the Hare . I haven't used it on a scene yet as the companies I worked for all had the Hare , but when I played with it in my last recert class , I was impressed . It's easy to apply with 1 rescuer , a lot less bulky , and can be used bilaterally ( comes with 2 ankle harnesses ) . The only downside I saw was that if you have a male pt. make sure everything vital is out of the way of the crotchpad or he'll have an even more uncomforable day . I wish I had one on my rig .

Have a good one ,

Craig

By the way , started out in search and rescue on a Civil Air Patrol ground team for 3 years in high school . Pennsylvania wing ranger team .

[Jolt]

By the way , started out in search and rescue on a Civil Air Patrol ground team for 3 years in high school. Pennsylvania wing ranger team .

I figured I'd eventually see a reference in this topic.

[Arkymedic]

Yowzer ,
I forgot to tell you I've trained with the Saeger and it's got advantages over the Hare . I haven't used it on a scene yet as the companies I worked for all had the Hare , but when I played with it in my last recert class , I was impressed . It's easy to apply with 1 rescuer , a lot less bulky , and can be used bilaterally ( comes with 2 ankle harnesses ) . The only downside I saw was that if you have a male pt. make sure everything vital is out of the way of the crotchpad or he'll have an even more uncomforable day . I wish I had one on my rig .

Have a good one ,

Craig

By the way , started out in search and rescue on a Civil Air Patrol ground team for 3 years in high school . Pennsylvania wing ranger team .

I did too Cert but in Kentucky, Alaska, Missouri, Arkansas from age 12-21. I was a Hawk Mtn Ranger School and PJOC grad. In Alaska my composite squadron in Fairbanks ran a minimum of about 2-3 missions every single week.

[certguy]

Small world . I went to the winter school and the first aid school at Hawk Mtn. I wish I would've gone to the summer school . I was always too busy .

Craig

[LucidResq]

Ok I'm a little confused... does your SAR team provide ANY medical equipment? I'm a sergeant and the "e-care officer" (I work with the medical director and a paramedic, my main duties are inventory, QI and training) for a SAR team and although most members carry at least some first aid in their personal packs, we take a devoted, team-use e-care pack to every mission. It stays in the trucks and if a person is found we can take the e-care pack out to them by ATV (rare circumstances have required taking it in by foot).

The pack has all your basic junk... 4x4s.... bandaids... aspirin... SAM splints... but it also allows us to carry traction splints, 02 tanks, BP cuffs, stethoscopes, multiple c-collar sizes, etc etc without concern for weight. Obviously, we are also able to carry higher quantities of the basics like 4x4s which can be important in a long carry out.

As far as your pack, I would suggest adding a couple of the smallest size of tampons, mole skin, eye wash, multiple pairs of gloves, goggles, and several heat pads. Tampons are good for nose bleeds on long carry outs, mole skin is good for you because nothing sucks more than carrying when your feet are killing you, and heat pads are good for hypothermic pts. I know that they're not terrible effective but they can be better than nothing. Eye wash has come in handy for me many many times. Extra gloves are critical because you'll find that in the backcountry they get shredded easily. The goggles are for the patient, not you. When you're strapped down in a litter getting rushed through the woods nothing sucks more than getting a bunch of twigs, dirt, snow or whatever in your eyes.

Remember that a lot of the stuff you already have in your pack can be used for first aid. For a hypothermic pt you can strip down a bit and hop in your sleeping bag for a while to warm it up and then stick the pt in it. I've seen excellent splints made with sticks, clothing, and duct tape. Remember to have enough food and water for you and a victim.

[TheAfterAffect]

Ok I'm a little confused... does your SAR team provide ANY medical equipment? I'm a sergeant and the "e-care officer" (I work with the medical director and a paramedic, my main duties are inventory, QI and training) for a SAR team and although most members carry at least some first aid in their personal packs, we take a devoted, team-use e-care pack to every mission. It stays in the trucks and if a person is found we can take the e-care pack out to them by ATV (rare circumstances have required taking it in by foot).

If the organization he's referring to is the Civil Air Patrol, then no, The SAR Team does not provide any Medical Equipment. Sometimes you get lucky and the Medical Officer for the Ground Team has some spare stuff, But since the organization is mostly all Volunteers we have a tight budget and only so much is issued.

Personally, Im a NJ Wing Member, and our SAR Teams usually have a Paramedic/EMT with them who are members. They just carry their first response bag, And if we are lucky to have some Hawk Mountain Medic Course Grads or PJOC Grads they might have a litter, or some more serious duty medical supplies. Most missions Ive heard off, we have brought a litter.

The pack has all your basic junk... 4x4s.... bandaids... aspirin... SAM splints... but it also allows us to carry traction splints, 02 tanks, BP cuffs, stethoscopes, multiple c-collar sizes, etc etc without concern for weight. Obviously, we are also able to carry higher quantities of the basics like 4x4s which can be important in a long carry out.

That is essentially what is brought on a Mission with the CAP. Sometimes things are cut out, as we do not use ATV's to maneuver, so for weight factors items are cut but usually its all of the above with more.



And now for a Pointless plug, Since the topic was brought up, Anyone interested in More Info about the U.S. Civil Air Patrol can contact myself via forums PM or any of the other former/current members who may have replied on this thread.



Chris Kendall, Flight Officer
NJ Wing
Civil Air Patrol

[Jolt]

I just threw some medical stuff into an ALICE pack and now we're going to use it for any CAP missions we go on. I'll make a list of everything I have in it if anyone's interested.

[BossyCow]

A few things I haven't seen mentioned. You need some sort of irrigation device. The big issue in wilderness, SAR first aid is that there can be several days of walking out which means infection, infection, infection. There are several available models of irrigation devices that are made for this purpose, or a couple of syringes, you want to be able to force water under pressure into a wound to clean it out.

Also, for the hot packs, ignore the commercial hot packs because they leak, get accidently crushed and when you go to use them, they are past date or damaged and they no longer work. We carry dry de-icer in ziplock bags. It creates an exothermic reaction when added to water and doesn't need to have clean drinking water to activate. The powder is light and pretty easy to keep dry in either a zip lock or in one of those vaccum pack food sealers. If you fill up a couple of water bottles with that de-icer and water combination, they fit nicely between the legs on a stokes, or up into the spaces around a pt. They also stay warm a lot longer than the commercial hot packs.

Moleskin is another must have. Use it for padding around splint edges or for ambulatory pts. where the blisters show up.

There's also a telescoping femur splint that doesn't have the nerve, vein damage issues of the Sagar and Hare splints. You can also do a modifed traction splint using cravats and the stokes.

O2 and AED are for urban rescue or for base camp. They are of little use in the backcountry. Same with the BVM.

[Outbac1]

I've been in ground search and rescue for 12 years. Its what pushed me into paramedicine. Most wilderness first aid courses will teach you how to make a traction splint if you need one. I wouldn't carry one for the few times its needed, although the KTD is a nice little rig. The usual 4x4s, roller gauze, aces, bandaids, tape and the like will do most injuries. A b/p cuff and scope is good to record trends with very ill pts. A glucometer and supplies( 6 should do) don't weigh much. If some glucagon and oral sugers will fix the hypoglycemic pt so they can walk out, it beats carrying them. Kendal makes a P2 sharps shuttle that will carry a glucagon and protect it. ASA and nitro could be useful, if you can give it. Epi 1:1000 could be good too. 1ml ampules are WAY cheaper than the epipens and only need a 1cc syringe and two 23ga IM needles,(one to draw and one to inject). Also you can get 3 x 0.3ml doses from one ampule. SC and IM injections are standard PCP training.
Break similar stuff up into clear ziplock bags and put in a nylon stuff sack in your pack. If you want waterproof go to an hiking store and get a dry bag. Some are coated seamsealed nylon and are very light.
Thats what I carry and fortunatley I've never needed much of it.

[Summit]

I find I adjust my personal pack by the season... but we have substantial primary packs provided by our volunteer agencies. You really should get your sponsoring agency to have a communal main kit that has O2.

[cfrench]

Zip lock bags are cheap and easy for stuff. Another thing to consider is vacuum bags. You can toss the gauze and other soft items in them. They are great at making things more compact.