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TEAM TACTICS AND THE LONE OPERATOR

HELP……….I’VE FALLEN AND DON’T KNOW WHAT IFAK SHOUD I BUY? (Individual Medical Kits)

A-wounded-woman-004A question was asked recently to the effect of “What is a good IFAK (Individual First Aid Kit) for me to get?” In all honesty that is as loaded of a question as “What rifle should I get?”  I say this because there are a bunch of variables that will significantly impact the answer. These include but aren’t limited to:

What is it for? Is it to carry in classes or on the range? Or is it to be ready for a roll over motor vehicle accident?” For the purposes of this article I’ll assume it is for shooting classes and trips to the range.

What is your level of formal Medical Training? I try not to be an elitist asshole about this but listen, YOUTUBE is NOT a source of formal training, nor are many of the courses taught by “Shooting” instructors who may not have any real training on the topics themselves.  The bottom line is that your kit needs to contain items that YOU are 100% comfortable using.

What is your budget? I understand that quality Medical Supplies seem pretty expensive for something that probably will never see real-world use….but when the day comes that you need them, you’re going to want the good stuff.  This is NOT a place to be niggardly.

So that begs the question; “should I buy a complete prefab kit or roll my own?”  Well here‘s a short excerpt from "Beating the Reaper" where there happens to be an entire chapter on this very topic.

"There are several very capable premade kits that are available on the market today. It is important to ensure that all of the components are of the quality that you require. Most importantly, you must be familiar and comfortable with the application and use of every item.

Another option is to assemble an individual kit for yourself “a la carte” from products of various manufacturers. For persons with significant amounts of medical experience, putting together your own kit allows you the freedom to select the items with which you have the most experience.

However we need to add a word of caution when doing this. We often see medical kits that have been personally assembled by individuals. They are usually overflowing with useless or nonessential items. It seems that they get into what we like to call the “Sir Packs-a-Lot” mindset and start adding every manner of “FREE” medication, bandage and gizmo that they can get their hands on. Don’t be cheap! If your whole motivation for assembling your own medical kit is just so you can save some money, don’t bother. If you are going to put one together a la cart, do it so that you get the best assemblage of items for your situation."

If you like this article and you haven’t already done so, GO BUY THIS BOOK! If you don’t like this article; GO BUY IT ANYWAY! Oh and buy a copy for those closest to you as well because remember they will be the ones treating you on your worst day.

 The basic Individual First Aid Kit needs to provide the essential medical supplies required to address the leading causes of preventable death on the battlefield: extremity hemorrhage, tension pneumothorax, and airway obstruction. Additionally when it comes to form factor we want them to be compact, rugged and accessible. 

Truth be told, there aren’t very many premade kits that approach what I would look for in an IFAK. What I’m going to do is rate each of the components of a couple of the more popular premade kits based on my experience and give a bit of commentary on a few as well.

I will rate each item from 1 – 4 stars.  I need to let you know that I give very few perfect 4 star grades so 3 stars (meets the standard) 4 stars (exceeds the standard)

 

 

DARK IFAK

Dark Angel Medical - D.A.R.K. Gen 3 kit - $174.95

Dimensions: 8”x3”x2”

The nylon PALS compatible pouch (2 pals wide) has a shear retainer on either side of the pouch and a TQ pouch on the outside, the inside is designed with a webbing pull tab that ejects the kit insert out of the pouch. This is useful if you wear your IFAK at the 6 O’clock position and need to reach it with either hand.

The entire contents of the kit are vacuum packed within a heavy 5mil plastic bag with tear notches at the corners. I would recommend putting some tape pull tabs on these to aid in opening with fingers that are slimy with blood.   

1 Tourniquet (SOFT-W or CAT) – 3.5 stars Both the SOFT-W (Wide) and the CAT are battle proven effective tourniquets. 

1 pair Nitrile gloves, size L - 3 stars Basic 4 mil thick gloves to provide some protection from body fluids if you need to treat another person. They are finally including ones that are Blue rather than “Tactical Black”, because it is damn hard to find blood on a black glove.

1 pair HALO Seals – 3.5 stars The standard HALO works very well however in accordance with the latest 2015 committee on TCCC guidance that “vented” chest seals should be used. They are offering a Vented HALO option. But I will say that NONE of the vented chest seals that we have evaluated have adhered as well as their unvented counterparts.

1 14 Gauge ARS Decompression Needle – 3.5 stars The ARS (Air Release System) is a 3.25” 14ga angio cath that is contained within a small tube making it rugged and to prevent damage of other contents from the needle. Additionally the rear “flash hub” cap is already removed to allow an immediate release of air once entry into the plural space is achieved. 

1 Nasopharyngeal Airway (NPA)  – 2.5 stars However they don’t contain any lubricant so that detracts somewhat from this kit; although you can “Lick it, then, Stick it”.

1 4” Israeli Bandage – 3 stars The Original modern field dressing and although this is an effective choice, the Izzy dressing is neither the most compact nor user friendly of this family of dressings.

1 QuikCLot Combat Gauze LE or CELOX Rapid – 3 stars Combat Gauze LE is the same a Combat Gauze minus the X-ray ID ribbon. Combat gauze has been proven to be effective in studies conducted by the US Army ISR. As well as I have used it extensively on real-world casualties and provided that it is properly applied works as advertised.    

1 H&H PriMed Compressed Gauze – .5 star This is the same “Chinese” cotton that previously was linked to fungal infections in wounded soldiers. Now H&H says it’s made in Taiwan vs China, but still the same cotton. It is also more difficult to use compared to other like products.  Honestly the inclusion of this is pretty much a deal breaker for me…..

1 Mylar Space Blanket – 2.5 stars Hypothermia prevention is a huge factor so it’s nice to see this included but remember it comes at the cost of increased size. It is also only 54”x84” so not large enough the fully wrap a casualty but it’s better than nothing.

 1 TCCC Casualty Documentation Tool – 3 stars Casualty card pretty important for the military setting but not so much for civilian application.

1 pair trauma shears – 3 stars Trauma shears are quite useful and certainly have a place in a kit. They offer a Rip-shear “Upgrade” and honestly I have been unimpressed with the rip-shears.

Bottom line: Overall this is a pretty good kit. It covers all the major areas that need to be covered as well as a few others as well. The contents are all of adequate quality sans one, the H&H PriMed gauze is not. 

 

 

ITS tall boy s

ITS Tactical - ETA IFAK “Tall Boy” $169.98

Dimensions: 9”x 3.5”x 2.5” 

The ITS “Tall Boy” pouch is made of 500D nylon and is PALS compatible (2 rows), with a double zipper pull open design to provide easy access the contents (insert) of the kit. The pouch has additional webbing on the outside for attachment of other items if that is your thing. The inside of the pouch has 3 pockets and the inner part of the flap is made to secure items with shock cord. 

The contents of this kit are vacuum packed into a heavy plastic bag however in this case the bag has the ability to be reclosed with a ziplock feature. This could prove useful in some instances. 

This kit does not come with a tourniquet. This is not really a showstopper since I truly believe that your TQ should NOT be inside your IFAK, but rather located elsewhere on your person that it is easy to access.

 1 QuikClot Combat Gauze LE - 3 stars I already commented on Combat gauze LE

 1 HALO Chest Seal (pair) – 3.5 stars The HALO chest seals performed very well with 100% efficacy in tests that we performed previously. The only detractor is that they don’t include anything to wipe all the blood, sweat, and tears off of the area around the wound before application.

 1 MojoDart Decompression Needle – 3.5 stars The MojoDart is very very much the same as the ARS commented on previously.  

 1 Nasopharyngeal Airway (NPA)  28fr w/ lubricant – 3 stars This one meets the standard due to the inclusion of a packet of lube.

 1 Israeli Bandage 4" – 3 stars As I said earlier there isn’t anything really wrong with the Izzy dressing but there are better options available.

 1 Elastic Bandage 2″ - 3.5 stars The inclusion of an elastic (Ace) bandage increases the versatility of this kit. However I would rather see a Cravat/Triangular bandage instead….I give cravats 4 stars all day long.

 1 Z-Pac Dressing – 4 stars Yeah it’s just plain gauze but its form factor is what gives it 4 stars. This is because of its very flat, flexible packaging and the gauze is “Z- folded” inside to aid in application.   

 1 Combat Casualty Card 3 stars Again this is useful but not required for civilian application.

 1 Nitrile Gloves (pair) – 4 stars This kit includes the Defender-T gloves which are 7 mil thick verse 4 mil on others and are textured. They are OD color and show blood contrast just fine….Oh and they are even textured for her pleasure.

 1 Pencil - 4 stars YES! Finally someone who gets it…. a pencil always writes.

 1 Contents List w/ TCCC Care Under Fire Instructions (on reverse) – 3.5 stars I’m not convinced of the utility of this but who knows having some basic refresher instructions never hurts.  

Bottom Line: Of the three, this kit is probably the best assemblage of components and has the best form factor. The only real detractor is that it doesn’t include a tourniquet but again that isn’t really an issue, one simply buys a CAT, SOF-T, or CavArms TQ and a pair of trauma shears and you’re done.  

 

 

TR VOK

Tactical Response - V.O.K. (Ventilated Operator Kit) $59.95

The VOK comes loose packed in a plastic bag and is not very compact. Overall this kit is pretty poor, but due to a catchy name, low price (cheap), and heavy marketing they have sold a ton of these to those who don’t know what they don’t know.  

1 Cinch Tight Compression "H" Bandage – 3.5 stars The “H –bandages is one of the few items that H&H makes that I don’t hate. In fact it like it more than the Israeli dressing because of its flat packed form factor, wound packing material and Velcro closure on the end. 

1 TK-4 Tourni-Kwik – 0 stars This is NOT a tourniquet, it is a constricting band. This has never passed any of the Army Institute of Surgical Research evaluations for TQ’s. Bottom Line “Snake Oil”  

1 PriMed Gauze (crinkle cotton) - .5 star As stated previously this gauze is garbage.

1 Nasopharyngeal Airway (30FR) w/ lubricant – 3 stars Meets the standard.

1 14ga x 3 ¼ Catheter (sterile) – 2.5 stars This is a basic 3.5” angiocath thus meets the length and diameter requirements, but loses points for soft packaging. 

1 Alcohol Prep Pad – 2 stars It’s just Not necessary. Companies often add tiny cheap items to make people think they are getting more. One could argue that this is included to prep the site for a NCD (Needle Chest Decompression) but honestly nobody ever does that in the real world.   

2 Safety Pins – 4 stars Safety pins have A LOT of utility, from wound closure to airway management.

 1 Duct Tape (2"x100" roll) – 1 star I’m glad to see some tape in this kit since they fail to include any type of an occlusive dressing.  I am also a strong believer that 100mph (duct tape) is the ONLY type to have in a med kit. But not all duct tape is created equal and this is the cheapest low quality type of duct tape that you will find. Additionally the little micro-diameter roll is very very difficult to use, whereas flat rolled tape is much easier. 

1 Set Nitrile Gloves – 3 stars Again these are just basic nitrile gloves 4 mil thick.

Bottom Line: This kit sucks.…..Aside from who it is marketed by, the fact remains that many of the contents are subpar and in total it lacks the capability to manage all of the “Big 3” preventable battle field killers.

 

 

Sua ifak 1

Sua ifak 2

Roll your own Option $156.10

The other option would be a “Roll Your Own” kit. As you can see the price of building your own kit out of quality components is on par with purchasing a premade kit; so the point is NOT to save money. What I did here is put together a list of what I consider a Tier 1 individual medical kit.

I recommend that the main contents of  any individual med kit be vacuum packed (minus the Tourniquet and scissors) this prolongs the life of the kit and also serves are a tamper indicator, so that if the pouch is torn open you will know that everything might not be there.  Your basic Food Saver vacuum-seal machine is more than adequate for this task.

I tried to make this as easy button simple as possible so everything available from  Amazon, except for the HSGI Pouch can be ordered from One Source Tactical   

1 HSGI IFAK pouch $28.00 - 3.5 stars HSGI Improved Bleeder/Blowout pouch is a PALS mountable nylon pouch similar in size and required real state as the others that were mentioned in this article. It has a double closure(fastex and Velcro)  to prevent inadvertent loss of contents. On the outside of the pouch there are webbing points for attachment of a TQ (although I recommend placing it elsewhere), there is also a channel in the back of the pouch for a pair of trauma shears that are retained with a pull the dot snap retainer. The inside of the pouch has a webbing pull tab to aid in single hand access of the insert.     

1 SOFTT-W $34.99 – 3.5 stars Between the CAT and the SOFT-W I tend to gravitate towards the SOFT-W (wide), this is primarily due to form factor in that the SOFT-W when “flat packed” is the most compact of the two.

1 ChitoGauze   $32.95 – 4 stars ChitoGauze is a hemostatic chitosan coated gauze dressings intended to stop severe bleeding and reduce blood loss while offering bactericidal and fungicidal properties. It is also z-folded for more easily packing into a wound. As hemostatic gauze goes this is my go to product and the one that I have been using for several years.

1 Hyfin (twin pack) $36.25 – 4 stars In both real world application and during formal tests and evaluations the Hyfin dressings performed with 100% efficacy. They edge out the HALO in that they include a piece of gauze to wipe the area before application; that is where the extra half star came from.  

1 ARS 14ga needle $9.58 – 3.5 stars Commented on previously.

1 Flat OLAES Bandage 4” $6.95 – 4 stars The Olaes Modular Bandage is the newest generation of trauma bandages, with features such as 3 meters of gauze, a removable occlusive plastic sheet behind the dressing pad, Velcro holding tabs every 12” to aid in management while applying and the pressure bar that can also act as an eye cup. The flat pack option is nice for placement in compact kits along with other flat items. The Z-folded gauze contained with-in the pad of this dressing replaces the need to include standard kerlix gauze in the kit, thus saving space.

1 Adjustable flange NPA airway 28fr w/ lubricant $6.95 – 4 stars NPA’s are sized to the patient based on length if it is too long it can cause gagging too short and it loses efficacy. The Adjustable flange NPA has a collar that allows it to be adjusted to the proper length of the individual. 

1 pair Defender-T Nytrile gloves $6.95 – 4 stars Previously commented on. This price is for 10 pair however only one or two pair needs to be included.   

1 Cravat $4.34 – 4 stars If I could only carry one medical item it would be cravats.

1 Gorilla tape 36” “flat rolled”  $4.95 – 4 stars This is the best tape available in my experience for field medical applications the potential applications are limitless. The price is for a 12 foot roll, then I take it and wrap it long ways on a hotel key card.

1 pair 5.5” Trauma Shears $8.95 – 3 stars I already mentioned trauma shears earlier the only difference is that for an individual kit I prefer slightly smaller 5.5” scissors to save space.  

1 SOF MISTTM Casualty Card $1.25 – 4 stars As casualty cards go the SOF MISTTM is pretty on point it is made of a water and tear resistant Tyvek material and has a grommeted wire for attachment to a casualty’s person.

1 Sharpe double tip marker $1.99 – 4 stars The double tip sharpie permanent marker provides the ability to write on the casualty card, tape or even directly on the casualty. Additionally since it has both fine and medium tips it can make for much more legible writing.

 

To be affective when the smoke clears and friendly blood is leaking you need to own the knowledge of what to do and possess the tools to make it happen.

Stay Dangerous my friends….

T.

 

 

 Sua Sponte is the nom de guerre of an active US Military serviceman who has spent many years in various assignments within the Special Operations community. And is the author of two titles available from One Source Tactical.

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