Blow-out Kit – First Attempt

After my recent fight with my chainsaw, which thankfully I won, I decided that I shouldn’t participate in any potentially limb-severing homestead activities until properly equipped for self rescue. Brother Harold and I took a rescue course some months back where we learned the proper use of the supplies in a blow-out kit, and it seems like a perfect time to put this newly acquired knowledge into action.

But first – time to brush up on my disclaimer. I’m only describing what I have in my BOKs, and I’m not advising that you build one without the proper training needed to use the contents. Anything you do or don’t do with this information is strictly at your own risk.

A person with a major leak is in a seriously bad situation. Getting the blood flow stopped as quickly as possible is the key to survival in such an injury.

So what’s a blow-out kit? Basically, it’s the medical supplies needed to plug up a major leak in a person. No Band-aids, no triple antibiotic ointment – just the supplies needed to control major hemorrhage. Another name for it could be an “Oh, shit! Kit”. Contents vary, but the core supplies typically include a combat tourniquet, some sort of trauma dressing, a hemostatic agent, and gauze for packing wounds. Some people chose to stock additional items, such as tools to manage an airway, or special dressings for major chest wounds.

The centerpiece of the BOK is the combat tourniquet. Tourniquets have a bad rap among those who’ve had basic first aid, because they’re taught that tourniquets are only to be applied as a last resort since they will necessarily result in loss of the limb. Even if that were true – and it’s likely not, since tourniquets are routinely used for hours in knee replacement surgeries – so what? I’d rather lose a leg than my life. Also, combat tourniquets are designed to apply force evenly to the circumference of the limb, and spread the force out so no tissue is crushed. Not so with field-expedient tourniquets made out of a belt or paracord.

The other big components of a BOK are the trauma dressing and hemostatic agent. The trauma dressing is often the venerated Israeli Battle Dressing, but could also be the¬†IBD’s more capable cousin, the OLAES. Both dressings¬†incorporate a pressure bar into a large absorbent pad with an elastic bandage, kind of like a wide ACE bandage. They both allow you to apply serious direct pressure to a wound, which is the first step in staunching the flow. The hemostatic agent is usually either Celox or QuikClot, both of which are designed to accelerate the clotting cascade and slow the flow of blood.

A person with a major leak is in a seriously bad situation. My near-amputation might have severed my femoral artery, and if it had, my guess is that I would have started losing consciousness within about two minutes. Once I blacked out, I would have pumped out a fatal amount of blood within maybe four minutes. Getting the blood flow stopped as quickly as possible would have been the key to survival in such an injury.

So, a blow-out kit needs to be instantly accessible under extremely stressful situations. That means deploying the kit physically on your person in a pouch that can be rapidly opened when you’re knocked on your back or butt – chances are that’s where you’re going to end up with any injury severe enough to require a tourniquet.

IMG_1144For my first BOK, I went with a SOF-IFAK pouch from TYR Tactical (tip o’ the hat to Br. Harold for doing the research on that.) Not cheap – the pouch alone was about $45 – but you get what you pay for. This is serious tactical gear, and although I’m never likely to be a tactical operator of any kind, I still will likely put this kit through a lot of abuse, so it’s probably a good investment.

I chose to deploy two C-A-T combat application tourniquets in the front pouch. I discovered in class that I couldn’t always cut off the pulse in my foot with just one tourniquet, and besides, two is one and one is none. Here I show the tourniquet pouch flap open; notice that the C-A-Ts are instantly accessible on the front of the pouch without digging around inside anything. Time is critical.

57cpzNot that opening the kit is exactly a chore. The pouch has a wide Velcro closure on the top, and two sturdy zippers that go down along each side. The flap on the top has a stiff bar sewn into the lip, which is easy to grab and rip forward. Once you’ve got the Velcro ripped apart, the zippers peel open and the front of the pouch flops down to expose the contents. Inside, there’s also a removable platform that holds all the supplies. The platform is held to the pouch by more Velcro, and when it’s ripped free of the pouch, it’s retained by a long piece of shock cord. That keeps it from falling completely away in a high-stress opening. They’ve pretty much thought of everything with this pouch.

Click for larger image
Click for larger image

As for interior arrangement, I’m still playing with it. While I really like the OLAES dressing over the IBD, even vacuum packed, the OLAES is quite bulky, and really puffs out the pouch. I may switch to an IBD when I make my next kit, which I want to be more compact. Regardless, this kit has the two C-A-Ts, an OLAES, a 35g pouch of Celox powder, a nasopharyngeal airway, a roll of compressed sterile gauze, a roll of plain Kerlix sterile gauze, and two pairs of heavy-duty tactical nitrile exam gloves. I may lose the Kerlix – it’s kind of redundant – and relocate the gloves to make it a little more compact.

My main problem now is finding a way to carry this BOK conveniently, especially given its bulk. My current thinking is to get a MOLLE compatible hydration pack and mount the BOK to the left shoulder strap. I probably should be wearing a hydration pack when I work in the yard anyway, and if the pack has a few pouches for snacks and such, I should be able to work outside for quite a while before returning to the house. Positioning the kit somewhere to the left of my centerline and somewhat below my sternum should put it in nearly an ideal position. It should be easy to gain access to the pack by reaching across and ripping it open with my right hand.

If I still have my right hand, that is.

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