First-Aid Kit SAK

[Nix]

I would figure out how to get one if I spent more time in the wilderness. I'm just surprised they don't sell them over-the-counter in sporting goods stores.

Fair question, but, you know, the Government knows what's best for you.

I could see kids abusing epi. Or people using it in conjunction with alcohol to keep "partying". Kids today will abuse just about anything.

It could be a life saving addition to a first aid kit.

[Etherealicer]

Why a SAK?

When I was about 14, I was running downhills in the forest, tripped and impaled myself on a tree-branch ripping out a piece of flesh from my upper arm. It was a shallow, but jagged wound that did not bleed too bad.
2 Problems
First, I was wearing a pullover, that had to go and for that you either need good scissors or a good knife. I favor a blade over scissors because I also had to cut a friend out of his jeans and you need large/good scissors to do that quickly. The scissors have the clear advantage of cutting with less support though.
Second, having torn out a piece of flesh gives a rather large wound. So I commonly pack a 10x10cm wound patch and some tape.

What I use:
Small kit (Altoid size): blunted Victorinox bakers knife and a Classic
Medium kit: Trauma shears and either a Victorinox Hunter XS or Spyderco Rescue
Large kit: Big ass trauma shears and either a Victorinox Hunter XS or Spyderco Rescue

[Etherealicer]

I would figure out how to get one if I spent more time in the wilderness. I'm just surprised they don't sell them over-the-counter in sporting goods stores.

Fair question, but, you know, the Government knows what's best for you.

I could see kids abusing epi. Or people using it in conjunction with alcohol to keep "partying". Kids today will abuse just about anything.

It could be a life saving addition to a first aid kit.

It probably would be mostly athletes and wanna-be athletes that would abuse an epi-pen. The danger with it is, that it might trigger a fatal heart attack if you have an underlying condition.

[Don Pablo]

I would figure out how to get one if I spent more time in the wilderness. I'm just surprised they don't sell them over-the-counter in sporting goods stores.

Fair question, but, you know, the Government knows what's best for you.

I could see kids abusing epi. Or people using it in conjunction with alcohol to keep "partying". Kids today will abuse just about anything.

It could be a life saving addition to a first aid kit.

It probably would be mostly athletes and wanna-be athletes that would abuse an epi-pen. The danger with it is, that it might trigger a fatal heart attack if you have an underlying condition.

Epi pens are expensive things to abuse... So not kids.

[Etherealicer]

I would figure out how to get one if I spent more time in the wilderness. I'm just surprised they don't sell them over-the-counter in sporting goods stores.

Fair question, but, you know, the Government knows what's best for you.

I could see kids abusing epi. Or people using it in conjunction with alcohol to keep "partying". Kids today will abuse just about anything.

It could be a life saving addition to a first aid kit.

It probably would be mostly athletes and wanna-be athletes that would abuse an epi-pen. The danger with it is, that it might trigger a fatal heart attack if you have an underlying condition.

Epi pens are expensive things to abuse... So not kids.

Well, part of their price is that they are restricted. Were they not restricted their price would probably drop.
In Europe EpiPen are a good deal cheaper than the US in fact they are in a similar range than party drugs (30$ a pop / ok, maybe a bit more expensive, but not massively).

It seems in the US you can get them cheaper too:
According to this you can get a 2-pack for 10$ but you need a coupon.

[Tired_Yeti]

So, in reading through this, I'm wondering something.

We're going round and round, but I'm not sure I know where we're going? Yeti, can I ask you to give the exact parameters you have in mind, define the mission as exactly as possible.

To me, a knife isn't as much needed in a large or medium sized FAK is a pair of lister bandage scissors and one or two pairs of trauma sheers. Maybe a razor-blade type letter opener or a utility knife with a carpet hook blade for zipping open clothes.

As I had said in the OP, I know we have a few medical professionals onboard here so I expected a variety of opinions and insight. While I was posting some questions and comments, I have hesitated to get too into details because I wanted to hear all the views on it--especially from the non-medical laymen--to get some ideas about a simple set up.

I've seen ideas and suggestions on things that are really well beyond the realm of First-Aid. Things ranging from cricothyrotomies and chest tubes to amputating trapped limbs! Those procedures are outside of what I was considering. Those are invasive procedures and surgical procedures, not First-Aid.

As an Army medic, EMT, and now a nurse I'm aware of the many complications of those procedures. I hope no one without the training and credentials in those procedures is seriously considering gearing up for that. It's easy to do more harm than help. The people who expect to do that, and know what they're doing, will pack sterile surgical kits and suture kits; not a SAK.

I'm thinking of the Home or Car FAK. Simple things like splinters, cuts, minor burns, sprains and strains, aches and pains, etc. So I was thinking toward a SAK for minor wound care, bandage/dressing prep, improvising splinting materials, opening packages, etc.

Now, if someone else is looking beyond that, that's OK too. I'd like to hear those ideas too; however, we could be growing beyond the FAK into the "jump kit" or trauma kit. I'm sure we all saw the movie where James Franco amputated his trapped hand. Unless the alternative is certain death, I strongly caution against even considering that option. The likelihood of quickly bleeding to death is VERY high.

So now you know what MY idea of a FAK is, but I don't really want that to guide everyone's contributions. I'd like to hear ALL the ideas people have (and I'm not sitting in judgement). I really like the pics too!


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[Nix]

As an Army medic, EMT, and now a nurse I'm aware of the many complications of those procedures. I hope no one without the training and credentials in those procedures is seriously considering gearing up for that. It's easy to do more harm than help. The people who expect to do that, and know what they're doing, will pack sterile surgical kits and suture kits; not a SAK.

I have mad respect for Army medics, having served with several excellent medics, including one who lost his life while trying to treat a fellow soldier while under fire. 

I agree that several of the ideas I brought up are extreme. Best left to trained personnel, true, and well said. Those ideas were generated in part by asking about having a knife in a FAK. When do you really need a blade in a first aid situation? Scissors make way more sense. Except for a few, extreme situations. Of course, if you don't think about the extreme situation before it happens, how well will you do if it does arise? Do you ever practice BLS/CPR? I keep a tourniquet on my motorcycle at all times. I don't expect to need it, but I also know that life happens.

Let me ask you, given your knowledge and training, in an extreme situation, say where an airway is obstructed for whatever reason, e.g burn or trauma, and cricothyrotomy is an option, would you not attempt a cricothyrotomy if all you had was a scalpel or SAK? You have the knowledge. You don't have a sterile surgical kit. Help is only 10 minutes away.... And what will they do when they get there? How much time does your victim have?

If you would attempt the cricothyrotomy, what would you rather have, a Classic or a Compact? This was my point. I can imagine an extreme situation or two wherein a small 58 would be more useful than a 91 or an 84. A 91mm blade seem fairly useless to me in a first aid situation (except in the self-amputation scenario, even more unlikely.).

Thanks for a great thread!  And thank you for your service!

(BTW, I've trained to do all the procedures I mentioned. My skills are way out of practice, but none of them are that hard. I'd be way nervous, to be sure.  )

[Tired_Yeti]

...Let me ask you, given your knowledge and training, in an extreme situation, say where an airway is obstructed for whatever reason, e.g burn or trauma, and cricothyrotomy is an option, would you not attempt a cricothyrotomy if all you had was a scalpel or SAK? You have the knowledge. You don't have a sterile surgical kit. Help is only 10 minutes away.... And what will they do when they get there? How much time does your victim have?

Thats a good question that needs to be asked. Like the other person asked me what my mission for my FAK is.
My opinion is that your FAK should be planned, at least in part, on how far away from help you are. Some people like to a keep huge stock of things at home and travel light. I'm probably the opposite of that.
At home, I have quick access to an ambulance service and several nearby hospitals and ERs. So for things beyond First-Aid, I'd call for help or take the person to the hospital.
The further away from help I get, the more serious my kit becomes. Also, the more dangerous my activities get. We can't carry an ER and a team of nurses with us, so I have to limit myself but what I think I can *reasonably* expect. For example, in a deep woods kit or gun range kit, I'd keep a tourniquet, QuickClot, and things like that for very serious injuries (GSW) or where help is hours or days. At home, the fire station is walking distance from the house, the police station is even closer to me. So it depends on stuff like that--to me.

If I was going to be the only medical person on the team and we were going out deep, I'd have surgical kits and suture kits, etc. So I understand the ideas and I think they're good to look at. I was just *personally* looking at the At-Home kit for me. I wanted to see what you guys were doing to give me ideas that I hadn't thought of.

I think another point (which might be "major") that influences it is my legal parameters under my license. At home, with the ambulance parked 6 blocks away and 2 ERs within a mile, I'd be in huge trouble if I was at home inserting invasive airways. Many other people on here might not have a license at risk and could have more legal liberty to "play doctor". So I hope people don't let MY opinions or inventory influence theirs too much.

P.S. Just a fun fact: A quick trick to do a cricothyroidotomy is simply to cut the drip chamber of an IV tubing set in half and puncture with that. It's sterile, it's a sharp hollow spike, and your BVM will fit on it so you can ventilate.



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[Nix]

P.S. Just a fun fact: A quick trick to do a cricothyroidotomy is simply to cut the drip chamber of an IV tubing set in half and puncture with that. It's sterile, it's a sharp hollow spike, and your BVM will fit on it so you can ventilate.

Slick trick. I've seen it done with a 10 fr needle, but who can breathe through a 10 fr?

I think you and I are of a similar mindset here. (Funny, when I go to the range, I always make sure I have a trauma kit with a SWAT-T TK, combat gauze, Israeli, and Abd pad. Range is about 30 min from the hospital with shaky cell phone reception.) At home, I'm generally thinking of the hospital ER for major issues. Small stuff I can fix myself. But here in Montana it can be easy to end up hours from a med center and critical help will arrive by air-ambulance, and you know how long that can take to arrange. So a bit more self-reliance is required. Pack accordingly.

The other thing of concern here is that we drive fast (speed limit is 80mph on highways and 70mph on two-lane country roads, you can imagine how fast we actually drive.), drive badly, and drive drunk. So in terms of per capita accidents we end up with a lot of bad accidents. It's always in my mind that I may be first on the scene.

You touched on a tragic irony: those with knowledge and licenses may be handcuffed by those licenses and the lawyers who'd go after them. Good samaritan laws are not much comfort.

True story: I was on a commercial airplane when a passenger had a heart attack. The flight attendants made a plea for anyone with medical training to come help. Who do you think got out of their seats to help this guy who had gone hypotensive, grey, and clammy? Yeah, me, an ex-Navy Corpsman, and an Army medic. I still wonder if there was a radiologist or peds nurse who thought it was more prudent to sit that one out. What are the odds that the only "responders" on a civilian flight were three people with military service/training?

p.s. As far as I know the passenger did fine. We got him O2, aspirin, and connected him to an AED that had an EKG display (one lead). Monitored vitals and reassured him (while secretly preparing to do CPR in the aisle). We were close to our destination and so didn't divert. Had EMS meet us first thing. He was awake and a bit more pink when they carried him off, hopefully for a successful angioplasty.

[Tired_Yeti]

So a bit more self-reliance is required. Pack accordingly.

Exactly. One reason I'm really enjoying the posts is seeing what other guys are packing. It's helping me reevaluate my own set up. Also, hurricane Harvey has been a wake up call to me. Most days are not a big deal, but during the hurricane, our local firehouse was flooded and ambulance service was...delayed...at a minimum.
One the right in this shot, you can see the flagpole. Directly to the right of that is the firehouse with a flooded apparatus floor. 3 feet of water.

You touched on a tragic irony: those with knowledge and licenses may be handcuffed by those licenses and the lawyers who'd go after them. Good samaritan laws are not much comfort.

Yes. The threat is real. I've been a victim of the "Armchair umpire" after action review 2nd guessing. I actually lost a job from it once. Good Samaritan laws protect laymen; not professionals. They'd look at my actions and ask if another nurse with similar training and experience and resources would make the same decisions.
But you already knew that.

...and now, back to our regularly scheduled program.

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[Nix]

Here's a kit a I threw together for my motorcycle saddlebags before a ride across Canada:



The little green "Embrace the Suck" pouch is mounted on the frame.



I think this kit needs to be updated. It has tweezers and small scissors, no SAK. Of course, I'd have a SAK with me. . It probably could benefit from a larger dressing. Might be a good project for this week to improve it.  Space is always an issue on a bike, so I've tended to go more minimal.

The TK's may seem a bit overkill, but I've heard two first hand accounts of guys who went down and ended up with life-threating lacerations. One guy nearly had his leg severed by a wire fence he slid through. So, I'm a little over-cautious there. I like the SWAT-T's because they can serve as either a TK or a pressure bandage or an 'ACE' wrap depending on how they are applied.

In addition to the FAK, I always have a bandana, a SAK, and a Leatherman Charge with me when I'm traveling on the bike.

[Tired_Yeti]

I LOVE this!!

Sometimes that's the only way to stay motivated. LOL! Love it.


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[Tired_Yeti]

Throwing another question in here because I just thought of it.

Isopropyl alcohol dissolves the celloid scales, but Alox scales don't include tweezers or toothpick (that I've seen) and they don't include Plus scales for the pen (that I've seen)

So do you risk damage to the SAK with alcohol and use celloid scales?
Or do you sacrifice some small tools to have a corrosion-free SAK in the FAK?

As it stands, I don't yet have a SAK in either of my FAKs so I'm still thinking about all the posts so far...then this question came up.


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