Here’s a small trauma kit I keep in whatever bag I am carrying each day. If I am rendering care as a bystander this is my primary kit. If I am present in a professional clinical capacity this would be a secondary or tertiary kit.
I do not consider this kit alone to be sufficient if I am somewhere in a professional clinical capacity.
Topics covered here:
Kit overview
Flying with the kit
Carrying the kit
Kit contents
MARCH algorithm applied to the kit
Packing and human factors
Invasive interventions beyond first aid
Detailed packing list with prices
Lower cost kit
In my general travels, the most common hazards I am likely to encounter that could lead to a significant injury include motor vehicle accidents, trips/falls from height, and interpersonal violence.
I’ve been traveling with versions of this kit for nearly a year. The intent is to be able to temporize some of the top preventable causes of death in trauma, other than hypothermia. Hypothermia will be managed with the resources on hand at the moment.
This is not meant to be definitive treatment, rather bridging a gap between point of injury and professional responders. In some areas that gap is only a few minutes and others it is hours.
Flying with the kit
I’ve had no issues carrying it on domestic or international flights in the US, Europe, and South America. For a time I was carrying a Benchmade Model 8 rescue hook in the kit, but nearly every time the kit was x-rayed at an airport the rescue hook warranted a closer look by security. The hook was never taken by security. I’m guessing the shape on x-ray was too similar to a knife which warranted the extra scrutiny. Rather than continue to attract more attention I just swapped the rescue hook out for the trauma shears and the Jericho hook.
Carrying the kit
This kit could be put in a big cargo pocket but really isn’t meant to be carried on my person. If I won’t be carrying a bag I’ll usually throw a flat folded SOFTT-W in my pocket and might carry a compressed ACE wrap plus non-hemostatic gauze as well.
Kit contents
2 – TMT tourniquet
2 – Compressed non-hemostatic gauze
1 – Compressed elastic wrap
2 – Pair nitrile gloves
2 – QuikClotCombat Gauze
2 – HyfinVent chest seal
1 – Biohazard bag
1 – Gorilla tape x 5’
2 – 10g ARS decompression needles
1 – Sharpie
1 – NitecoreNU20 360 lumen rechargeable headlamp, custom headband
1 – EMT Shears
1 – Ontario Knife Company Jericho J-Hook
1 – FourSevensPreon1 80 lumen flashlight
2 – 28 Fr NPA w/ lube
1 – Eagle Creek Pack-it Sac Small
Total weight 1.618 lbs / 734 gms
MARCHing through treatment
I like the MARCH mnemonic to remember and organize the priority of work for trauma patients and I use it when packing out kits as well. A professional kit will be much more extensive and larger. This particular kit is designed as a primary item as a bystander only.
Massive hemorrhage
For life threatening extremity hemorrhage I have the two TMT tourniquets. For packing and wrapping a junctional hemorrhage I have the QuikClot Combat Gauze, non-hemostatic compresses gauze, and compressed elastic wrap. As an additional junctional hemorrhage control measure I can combine the TMT with a Nalgene bottle or other hard object to improvise a junctional tourniquet. I’ve done that in training and while it took some effort it is manageable.
With a pediatric, small adult, or canine patient I can use the elastic wrap with or without the compressed gauze as a pressure dressing to control arterial hemorrhage.
Airway
The two 28 Fr NPAs serve as a decent airway for a patient that is breathing adequately. Positioning of the airway (head tilt, chin lift or jaw thrust) or positioning of the body (sitting up, recovery position) give me some no equipment ways to improve the airway. TCCC certainly supports use of a surgical airway but that is a low frequency, high acuity invasive procedure which I would rather not do as a bystander/non-professional rescuer. Within the US that is certainly not considered an intervention covered by Good Samaritan laws and even in the developing world it could create some issues for me.
Respiration
Four chest seals plus the gorilla tape and the packaging from the chest seals (or other stuff) gives the me ability to close an open torso injury. Two 10g needles for needle decompression of a tension pneumothorax. I’ll address needles and more invasive interventions separately toward the end.
Circulation
No meds or IV access stuff. Trying to keep the kit mostly “first aid” level interventions. My priority for circulation is controlling massive hemorrhage and early recognition of hemorrhagic shock through assessing the skin, pulses, mental status, and physical exam.
Head Injury & Hypothermia
For folks with a head injury there isn’t much I can do beyond recognition of signs and symptoms, positioning of the patient (upright 30-45 degree), and evacuation. Hypothermia will be addressed using the materials on hand at the time of the incident.
Packing and Human Factors
The kit is designed to be used in an emergency so I recognize that I may be stressed and the conditions may be less than ideal. To make things a little smoother I prep items so that I can access them easily or so someone else can grab the kit from my bag. I wrote about this topic in greater length in another post, prepping gear for field use.
Specific considerations for this setup is a prioritization of compact size over ease of access to individual items. I can unzip the pouch and pull somethings out on their own but it’s packed pretty tight. I would rather make sure I am actually carrying to kit because it’s compact than a bigger kit which would be easier to access but might get left at home.
In my various bags, pouches, and kits the color red denotes bleeding control. The entire pouch is red and is the only red pouch in any of the bags I am carrying so I can tell someone to grab me the red pouch. The zipper pull on the pouch itself is white to contrast with the pouch color. The zipper pull to access the pouch on the LBT 14 L pack is red as well.
Under stress fine motor skills tend to degrade as one’s heart rate increases. It is likely that when using this kit it will be an unexpected event so I may get an initial significant sympathetic nervous system response . The bright colored pull tabs and oversized zipper pulls will help reduce the number of fine motor skills I need to use.
Invasive interventions beyond first aid
Most first aid curriculums now reflect tourniquets, pressure dressings, and chest seals as standard aspects of first aid level care. The Stop the Bleed program designed for lay rescuers includes wound packing. From a US medico-legal perspective interventions at the commonly accepted first aid level which would be preformed by another rescuer with the similar level of training in a similar situation are covered under Good Samaritan laws.
In the US and most places that follow a similar legal system, Good Samaritan laws exclude invasive interventions like needle thoracostomy or a surgical cricothyrotomy. Some patients absolutely may need those interventions and even if the intervention is successful I could incur significant civil and criminal liability in preforming those procedures.
Those two interventions are also generally low frequency events so for an off-duty kit I’m hoping I won’t need to do them. If I was only carrying this kit within urban and suburban areas in the US I wouldn’t include the needle thoracostomy needles.
Since many of the places I’ve been traveling and working lately are several hours or more from proper emergency response I have opted to include the needle thoracostomy needles. A tension pneumothorax may not kill in a matter of minutes, but with such a delayed response time or extended transport time I want to have the option even though I would be reluctant to do it for liability reasons. The needle thoracostomy needles are smaller than a surgical cric kit allowing me to add them to the kit without dramatically changing the overall size.
From a travel and flight perspective I suspect a scalpel would get pulled more readily than the needles. I haven’t tried to fly carry on with a scalpel and have flown carryon with the needle thoracostomy needles.
Detailed packing list with prices
Here’s a really quick packing list with prices and links to purchase items. None of these links are affiliate or other sorts of links that benefit me. Rescue Essentials typically has great prices for a host of emergency supplies so I just used their prices. I didn’t do any comparison shopping so some items may be available elsewhere.
If you are a little more knowledgeable and adventurous, items like compressed gauze and QuikClot can be purchased for less on eBay. Check that they are still in date and that it still appears to be vacuum sealed (packing still intact). You may be able to find some authentic CAT or SOFFT-W TQs on eBay but most will be knock offs. I haven’t seen knock of QuickClot CombatGauze yet so I’m comfortable buying that on the grey market. Going to eBay for a few bigger ticket items is especially helpful if you are building several kits as you may be able to save by buying multiple from a single seller.
Most of the stuff in my kit came out of my inventory and was not purchased just for this. Some items were previously purchased for other projects or left over from other kit builds. I wouldn’t purchase the FourSevens light again. When purchased years ago it was one of the best available. See the lower cost option for a good alternative.
Below this table is another one that is a lower cost setup.
| Qty | Item | Unit price | Sub total | Link | |
| 1 | Duct tape x 5’ (repackaged Gorilla tape in kit) | $1.61 | $1.61 | Rescue Essentials Flat Packed Duct Tape | |
| 1 | Sharpie | $1.99 | $1.99 | Rescue Essentials Sharpie | |
| 1 | Biohazard bag | $2.3 | $2.3 | Rescue Essentials 1 Gallon Biohazard Bag | |
| 1 | EMT Shears | $2.55 | $2.55 | Rescue Essentials 5.5″ Shears | |
| 2 | Compressed non-hemostatic gauze | $2.55 | $5.1 | Rescue Essentials NAR Compressed Gauze | |
| 1 | Compressed elastic wrap | $2.9 | $2.9 | Rescue Essentials Elastic Wrap Flat Fold | |
| 2 | 28 Fr NPA w/ lube | $5.25 | $10.5 | Rescue Essentials NPA | |
| 2 | Pair nitrile gloves | $7.2 | $7.2 | Rescue Essentials Nitrile Gloves | |
| 1 | Eagle Creek Pack-it Sac Small | $8.55 | $8.55 | Amazon.com Eagle Creek Pack it Sac Small | |
| 1 | Ontario Knife Company Jericho J-Hook | $9.99 | $9.99 | Amazon.com J-Hook | |
| 2 | 14g ARS decompression needles | $9.99 | $19.98 | Rescue Essentials ARS Decompression Needles | |
| 1 | HyfinVent Chest Seal Twin Pack | $14.85 | $14.85 | Rescue Essentials Hyfin Vent Chest Seal Twin Pack | |
| 2 | SOFTT-W Gen 3 | $29.5 | $59 | Rescue Essentials SOFTT-W TQ | |
| 1 | NitecoreNU20 360 lumen rechargeable headlamp, custom headband | $29.95 | $29.95 | Amazon.com Nitecore NU 20 Headlamp | |
| 2 | QuikClotCombat Gauze | $41.99 | $83.98 | Rescue Essentials QuickClot Combat Gauze | |
| 1 | FourSevensPreon1 80 lumen flashlight* | $50 | $50 | Amazon.com FourSevens Preon 1 | |
| $315.00 | |||||
*I wouldn’t buy this again, especially not at this price. I’ve had it for a while and just added it in rather than buying something new.
Lower cost kit
| Qty | Item | Unit price | Sub total | Link |
| 1 | Duct tape x 5’ | $1.61 | $1.61 | Rescue Essentials – Flat Packed Duct Tape |
| 1 | Sharpie | $1.99 | $1.99 | Rescue Essentials – Sharpie |
| 1 | Biohazard bag | $2.3 | $2.3 | Rescue Essentials – Biohazard Bag |
| 1 | EMT Shears | $2.55 | $2.55 | Rescue Essentials – EMT Shears |
| 2 | Compressed non-hemostatic gauze | $2.2 | $4.4 | Rescue Essentials – Z-Pak Gauze |
| 2 | Compressed elastic wrap | $2.9 | $5.8 | Rescue Essentials – Flat Fold Elastic Wrap |
| 2 | 28 Fr NPA w/ lube | $5.25 | $10.5 | Rescue Essentials – NPA |
| 2 | Pair nitrile gloves | $7.2 | $7.2 | Rescue Essentials – Nitrile Gloves |
| 1 | Eagle Creek Pack-it Sac Small | $8.55 | $8.55 | Amazon.com – Eagle Creek Pack-it Sac Small |
| 1 | Ontario Knife Company Jericho J-Hook | $9.99 | $9.99 | Amazon.com – J-Hook |
| 0 | No decompression needles | |||
| 1 | HyfinVent chest seal (single pack) | $9.99 | $9.99 | Rescue Essentials HyfinVent Chest Seal (single pack) |
| 2 | SOFTT-W Gen 3 | $29.5 | $59 | Rescue Essentials – SOFTT-W |
| 1 | Mossy Oak 100 Lumen AA Headlamp | $12.6 | $12.6 | Amazon.com – Mossy Oak Headlamp |
| 1 | QuikClot EMS Rolled Gauze* | $20 | $20 | Rescue Essentials – QuikClot EMS Rolled Gauze |
| 1 | Olight I3E EOS 90 lumens | $9.95 | $9.95 | Amazon.com – Olight 90 Lumen Light |
| $166.00 |
*4′ of hemostatic gauze rather than 12′ in the Combat Gauze version. If using good technique and packing directly to the source of the heaviest bleeding first 4′ will be adequate for many patients.