So I'm a high school teacher and obviously the recent events have caused me to reevaluate my own personal procedures regarding school shooting.

I want to stock my classroom with a first aid/trauma kit. I mean I have your average household kit right now for cuts, scrapes, etc. That isn't going to do me much good if I or one of my students is suffering from a gunshot wound.


Since this board is frequented by plenty of military and LEO any of y'all have any recommendations on kits I could buy? Something that could help me keep an injured person alive just a little longer in case EMS can't get in right away. Or if you have tips on what I could stock my classroom with that I might need in such a situation that would also be helpful

burrito post said:

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So I'm a high school teacher and obviously the recent events have caused me to reevaluate my own personal procedures regarding school shooting.

I want to stock my classroom with a first aid/trauma kit. I mean I have your average household kit right now for cuts, scrapes, etc. That isn't going to do me much good if I or one of my students is suffering from a gunshot wound.


Since this board is frequented by plenty of military and LEO any of y'all have any recommendations on kits I could buy? Something that could help me keep an injured person alive just a little longer in case EMS can't get in right away. Or if you have tips on what I could stock my classroom with that I might need in such a situation that would also be helpful

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If you're stocking up in preparation for a school shooting or some other mass casualty event then what I recommend would be:
Tourniquets
Pressure Bandages
Gauze
Tape


That's all I would recommend. That's basically all I carried in my IFAK over seas. Your biggest concern will be stopping bleeding so I would focus on that.

Learn how to use these items. Learn CPR as well. Take a Red Cross class and get certified.

Im a coach and do red cross CPR and First Aid certification every year.

As far as the packs go, I see some with regular gauze and some with hemostatic gauze. Is there a difference and is one better than the other?

You can buy all sorts of kits online, but knowing how to use the stuff in it is far more important, because you can improvise if you know what you're trying to do. A lot of non-military agencies are teaching TCCC (Tactical Combat Casualty Care) courses modeled after the military's course. This course has been credited with saving quite a few lives and decreasing severity of casualties. It's made for every soldier/sailor/marine out there. Everyone from the fresh recruit out of boot camp to military doctors go through it. I would take that course before you build a kit.

As far as kit contents go, I'd echo the above. No better way to stop an extremity hemorrhage than a properly applied tourniquet high and tight on that extremity. I'd get a handful of those. And make sure you buy quality ones. There have been stories of EMS crews buying fake chinese ones that have broken when being used.

A lot of Kerlix gauze and a little bit of combat gauze (gauze impregnated with a pro-coagulant to help stop bleeding). Combat gauze is great for packing a wound, another skill to learn.

If you anticipate having lots of hands around to hold pressure you could possibly bypass the pressure bandage. Localized pressure applied by hand is far superior.

Agree on the tape. I'd also add in a couple space blankets. When people get cold, blood stops clotting like it's supposed to. Probably not that big of a deal in the time it would take EMS to arrive though.

Now, if you're worried about gun/knife trauma to the chest, it wouldn't hurt to have a chest seal on hand. Fairly simple and easy to use, hard to do more harm with them.

Anything beyond the above, I'd recommend formal training. Like don't go stabbing someone in the chest with a needle because it's in a kit you bought online, if you don't know what you're doing.

burrito post said:

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As far as the packs go, I see some with regular gauze and some with hemostatic gauze. Is there a difference and is one better than the other?

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I've talked with combat medics that think Kerlix is just as good as hemostatic gauze. They think they only reason they carry hemostatic gauze is because someone knows someone in Congress. But studies do show the hemostatic gauze to be superior in stopping bleeding when used effectively. That means actually getting the stuff to the site of the bleeding. Someone has a bullet wound, there is no difference in just applying the two to the skin and applying pressure. When you actually pack the wound, and get the gauze up against the site of the bleeding, that's when you'll see a difference.

But, direct pressure is typically just as effective. I've stuck my finger in a bullet hold to someone's femoral artery when a tourniquet failed, was able to stop it with not a whole lot of direct pressure.

Hemostatic is supposed to help with blood clotting. At one point my first aid kit was supplied with a brand called "Quick Clot" but for some reason we gave that back and got standard gauze that you could buy at any pharmacy. The whole point of it was to just pack any bullet hole with the gauze, and by pack I mean just filled the bullet hole and keep packing it in. Another good item to buy would be maxi pads. We had those in our first aid kit for Boy Scouts growing up, and as far as I know I am the only to have one used after I sliced my leg open pretty good. Might be silly, but its designed to absorb blood so there's that.

The biggest thing I will reiterate is to stop bleeding. Apply pressure and learn pressure points. If you put a bandage on or a even a tourniquet for that matter and it doesn't stop the bleeding, don't remove it. Pout another one on over it ( in the case of a bandage) or just below the original tourniquet. Apply tourniquets as close to the torso as possible, and be prepared to cause tremendous pain when using one. (they really really hurt for the record)

JABQ04 said:

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Another good item to buy would be maxi pads. We had those in our first aid kit for Boy Scouts growing up, and as far as I know I am the only to have one used after I sliced my leg open pretty good. Might be silly, but its designed to absorb blood so there's that.

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I understand you mean well, but this is incorrect information. Feminine hygiene products have no place in a trauma kit.



As has been stated, tourniquets from a reputable manufacturer and dealer are the immediate go-to for extremity hemorrhage.

Junctional TQ's are good for occluding the femoral in an inguinal bleed, or adequately packing the wound with a homeostatic impregnated gauze. Axillary still require packing. Junctional TQ's take up considerably more space and are more expensive than QuickClot Combat Gauze, so most trauma kits are not likely to have one.

Occlusive dressings (chest seals, Halo or HyFin are my preferences) on thoracic wounds.


Really though, if you were to bet on what you're most likely to see or treat in the world, knowing CPR, basic first aid, signs and symptoms of a heart attack/stroke/anaphylaxis are all more helpful than expertly packing a wound.

After seeing your expertise is in medical trauma of course I'll leave the expert advice to you. But one question as to why a feminine hygiene pad wouldn't be good in a kit in a pinch? Surely you would agree anything to stop bleeding should be used if needed, and an ace bandage and a pad together can be an effective pressure dressing if absolutely needed.

And maybe I'm an idiot but I have no idea what most of the words you threw out mean. I'm no doctor or even a medic, but have used and seen what Combat Lifesavers Course can do to save a life and that IMO is very basic first aid.

JABQ04 said:

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After seeing your expertise is in medical trauma of course I'll leave the expert advice to you. But one question as to why a feminine hygiene pad wouldn't be good in a kit in a pinch? Surely you would agree anything to stop bleeding should be used if needed, and an ace bandage and a pad together can be an effective pressure dressing if absolutely needed.

And maybe I'm an idiot but I have no idea what most of the words you threw out mean. I'm no doctor or even a medic, but have used and seen what Combat Lifesavers Course can do to save a life and that IMO is very basic first aid.

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Better than absolutely nothing? Sure, I guess.
If you're buying/making/soliciting quotes for a medical kit, the purpose built medical gear is incredibly more effective.

These articles are geared more toward the "tampon for bullet wound" myth, but they're worth reading:
http://havokjournal.com/fitness/medical/your-tactical-tampon-is-useless-for-life-threatening-hemorrhage/
https://www.personaldefensenetwork.com/article/severe-bleeding-first-aid-misconceptions-tampons/
http://starlightcdn.blogspot.com/2018/01/myths-in-tactical-medicine.html

I doubt you're an idiot, so if there's anything you'd like me to expand on, let me know. If you're in Fort Worth, I don't mind meeting with you in person and going over anything you're unsure of.

I've instructed the Army's CLS course to my unit before deployment, and it's a good baseline course. That said, "best practices" are always evolving, and most CLS classes change with time. CoTCCC releases new guidelines, changes, etc constantly. Here's the Aug 2017 release: http://cotccc.com/wp-content/uploads/TCCC-Guidelines-for-Medical-Personnel-170828.pdf
And here's some more good reading, if you're interested: https://rmf.ims.allogy.com/pf.tlx/SWJSFgSvGDPH

My personal opinion is that the quickclot gauze works great for a slow bleed but is no better for a hemorrhage than regular gauze and pressure. We still had quickclot in our trauma kits in the AF when I got out 2 years ago. Can't say about now.

I had a trauma surgeon I trained under tell me the best advice: "Los dedos man". If you get in a jam use your damn fingers to apply pressure.

I cannot second enough getting training. Another option other than TCCC is getting a WFR (wilderness first responder) certification. Those courses are great at putting the pathophysiology into everyday terms for the general populace and are all about improvisation.

Maxi pads are pretty much the same thing as abd pads, which are commonly used in medical settings. I typically throw them on oozy wounds that I want to keep from making a mess.

Apparently maxi pads are close to sterile, but not quite. But much cheaper. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539027/)

But tampons are a definite no go for wound packing.

I don't disagree with ^ that post, but it was my understanding we were discussing GSW trauma? That's what I was basing my posts on.

Thank you so much for all the responses. I agree that I need training on this stuff. I'll be looking for courses in my area. As far as the kits go what do you think about something like this

https://www.narescue.com/community-preparedness/public-access-bleeding-control-5-pack-vacuum-sealed

Im not sure if that would be good or if its a good price.

NAR makes good stuff, but that's pretty expensive for what you're getting.

I'll see if I can find something less expensive and update.

Just because

2 Cat Tourniquets - 56.84

4 Israeli Bandages - 30.20
[url=https://www.amazon.com/PerSys-Medical-Israeli-Emergency-Bandage/dp/B00E9S2AUW/ref=pd_sim_328_7?_encoding=UTF8&pd_rd_i=B00E9S2AUW&pd_rd_r=Z1CPKBYDYWB4SGBP70D1&pd_rd_w=24Eae&pd_rd_wg=bE1c6&psc=1&refRID=Z1CPKBYDYWB4SGBP70D1][/url]
Trauma Sheers - 11.99

Rolled Gauze - 15.95
https://www.amazon.com/Rensow-Sterile-Crinkle-Type-Bandage/dp/B00KGIUOES/ref=sr_1_1?s=hi&ie=UTF8&qid=1519131866&sr=1-1&keywords=rolled+gauze&dpID=51Y0poy804L&preST=_SY300_QL70_&dpSrc=srch

Total - 114.98

Find some latex gloves to toss in and a bag or plastic box that you already have.
Maybe order an extra Israeli bandage so you can take it out of the package and play with it and learn how use it if you have never seen one.

*Texags doesn't like adding multiple links apparently

All good stuff above. Keep it simple.

Also, I would advise that you read up on shock and how to help offset it. Should be covered in any decent first aid course but it is a big one to me. If in a situation where paramedics can't get there quickly, shock is usually the biggest danger after the ABCs are covered and is one of the hardest to detect and combat outside of a prepared area.

On the subject of budget supplies I love the Maxipad argument. Happens everytime! My bid would be on tourniquets. You don't need a $40 CAT. I promise. They are very nice and if you can afford them, by all means. But Tourniquets are easily made and stored. Plus, to be blunt if a rampage happens in a classroom, one or two CATs will likely not be enough. Frontline infantry invaded Iraq with cut up tshirts and metal dowels. Technique, placement, and constant monitoring matter far more than anything.

Here's a tourniquet that has pretty good reviews, about half the price of the NAR CAT tourniquets. I have never used one, so can't vouch for them, but at this price you could buy a couple to test out and a couple to keep in your kit and still come out cheaper.

https://www.amazon.com/Recon-Medical-BLK-1PAK-FBA-Tourniquet-Pre-Hospital/dp/B01MS9PDA3/ref=sr_1_3?ie=UTF8&qid=1519172865&sr=8-3&keywords=tourniquet

This tourniquet is the same price as a CAT, but works slightly differently. Slightly wider than CATs too, which is good. These are a a bit sturdier, and I would trust these if used more than once (once for training and familiarizing yourself with it, and once in an emergency). I've reused CATs during training without an issue, but they don't compress as well/easily after their first use.

https://www.amazon.com/Tac-Med-Solutions-XMS-S7/dp/B00E3W3BK2/ref=sr_1_1?s=industrial&ie=UTF8&qid=1519173038&sr=1-1&keywords=softt-w+tourniquet+1.5

I've seen this one used once by EMS and it worked really well. Pretty cheap.

https://www.amazon.com/Tourniquet-Pack-Orange-Latex-Free/dp/B01CKJEHXY/ref=sr_1_4?s=industrial&ie=UTF8&qid=1519173118&sr=1-4&keywords=swat+t+tourniquet

You could get one of each, watch youtube videos of each, see which you'd be most comfortable using, and go from there. Like Eliminatus said, you can also improvise, though that approach also has its drawbacks. Just don't go rushing into a purchase of some big fancy kit, or something you're unfamiliar with because someone online recommended it.

For tourniquets, stick to what has been proven to work, not what is cheap on Amazon.

https://nextgencombatmedic.com/2017/09/14/buyer-beware-selecting-your-everyday-carry-tourniquet/

Quote:

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Committee on Tactical Combat Casualty Care (CoTCCC) has thoroughly studied and approved of three TQs for use in combat,
1) the Combat Application Tourniquet (C-A-T) (North American Rescue, Greer, SC) (Figure 1),
2) the SOF Tactical-Tourniquet Wide (SOFTT-W) (Tactical Medical Solutions, Anderson, SC), and
3) the Emergency and Military Tourniquet (EMT) (Delphi Medical Innovations, Vancouver, BC).

Their civilian counterpart the Committee on Tactical Emergency Casualty Care (C-TECC) follows similar guidelines.

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I dunno. I used to think that as well, but NAR and a few others have a monopoly and charge prices that make it hard for people to get potentially life saving interventions. There are some alternatives out there that are absolute trash, but there are some that are legit. It'd be nice to see more competitors to bring prices down.

bigtruckguy3500 said:

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I dunno. I used to think that as well, but NAR and a few others have a monopoly and charge prices that make it hard for people to get potentially life saving interventions. There are some alternatives out there that are absolute trash, but there are some that are legit. It'd be nice to see more competitors to bring prices down.

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I agree. It seems like NAR (et al) price their products for agency purchases so they can "discount" quantity purchases.

All great advice above. In a prehospital field setting for a GSW, there are only a handful of thing you can do to save a life. Stop bleeding, stop bleeding, stop bleeding... you see where we go with this. Nothing about airway and breathing here. Might also add that you hope your not in Coward--- er--- Broward County Florida....

Having been down range as a trauma surgeon in Afghanistan here is what I keep in my truck:
- 2 CAT Tourniquets
- 2 14g angiocaths (decompress a chest)
- semi occlusive dressing for sucking chest wound
- Combat gauze and an Israeli compression bandage.

Get some training on how to use the above. TCCC is a good resource.

that's about all you can do. Anything above the pelvis or proximal to the shoulders is either going to live or die regardless of what you do.

Thanks for all the advice. I have reached out to a company that offers TCCC training and certification. I am looking at getting a group of my coworkers so we can do it together.

Definitely take a TCCC course. You will probably be given an IFAK/blow out kit with all the necessary bandages, gauze, etc... after you finish the course.

NAR has their small kits on sale for Stop the Bleed! day.

https://www.narescue.com/national-stop-the-bleed-day-bleeding-control-kit

Great little compact kit for not much money.

I bought a couple of IFAK kits from Chinook medical and added/subtracted from it as necessary.

They also sell IV kits for anyone who might have partied too hard the previous night, who don't see medic friends every day