I had a blow-out kit review performed by a “professional”. My cousin is a 1st Lieutenant in the Army, a trained combat medic, and a civilian paramedic with over 25 years of experience in one of the busiest metro areas in the country. Amongst other great conversation, I threw him my blow-out kit off my chest rig and asked for an honest assessment. Here is his candid feedback.
Note: I built my BOK very similar to Mr. Paranoid’s first attempt. Since mine lives on my chest rig, I was not as concerned about bulk (his upgrade has different operational parameters). Again, Mr. Paranoid and I are only describing what we have in our BOKs, and we are 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. Also, anything my anonymous cousin says below during his impromptu blow-out kit review, while highly credentialed, cannot be misconstrued as medical advice.
- My cousin loved the Tyr Tactical SOF IFAK pouch. Commented on the ease of accessing the tourniquet while keeping it covered. He was not a fan of the pull out tray though. Nothing specific, just “Meh.” He said the cord for attaching the tray was a great place to store a roll of good tape (see more about tape below).
- He pulled out the CAT Tourniquet and gave me kudos for having it staged properly for one-handed self-application. “Man, if I could get my guys to do this…”
- He said he likes to put a 4″ ace bandage in his kit for wound wrapping/pressure dressing. I pointed out the SWAT-T to be used in such a fashion, or as a secondary tourniquet. He said “Huh, never thought of that. Great idea.”
- “Gloves. Good.” (I carry 2 pair of NAR Bear Claws.)
- He pulled out the single NAR Compressed Gauze and said “Awesome. Definitely more of these in there. At least 1-2 more.”
- He pulled out the Celox and said “Powder. Meh. This stuff really doesn’t work.” My eyes went wide. He said “Well, of course it works. Let me qualify that statement.” He said most wounds significant enough to warrant it have a bleeder that is deep. You need to clean out the wound and get the powder down to the bleeder, which is usually like trying to fight your way down past a water fountain. He said it’s not practical. He said the powder is often misused because people can’t get it down to the site of the bleeder and end up dumping it into the top of the wound. This causes a “cap” to form, but now the bleeder is internal. Bad mojo. He said in his 25 years of civilian EMS he has never not been able to stop a bleeder with wound-packing alone (Hence the “Moar Gauze” recommendation above). He said if you can’t stop it with wound-packing and direct pressure, then you probably need significant surgery real fast. He wasn’t dissing hemostatics, he just found them difficult to apply properly. He was much more apt to carry the hemostatic-impregnated gauze, which can be forced to the site of the bleeder as part of the normal wound-packing process.
- He looked at the OLAES and had another slightly “Meh” response. He said the integrated pressure cup is nice, but it (or the ubiquitous Israeli bandage) doesn’t perform much better than regular gauze and an ace bandage (or the SWAT-T). He didn’t recommend taking it out, but viewed it more as a luxury item.
- “Shears. Sweet.” – ’nuff said.
- He pulled out my roll of 3M Micropore paper tape and said “Garbage. Not for an IFAK. Great for wound care at home, but for a combat IFAK get heavy silk tape, or better, put some duck tape in there. At least 2″ wide. Paper tape will simply not work if it encounters blood. Good sticky tape is critical for a chest seal…BTW, where’s your chest seal…?”
- So I told him the chest seal was in the OLAES and it was another “Meh”. He said “Not good enough. Too small and lightweight. My favorite thing for a chest seal is an MRE package cut lengthwise – large, heavy, durable. I carry two of them.” He said I was better off using the OLAES packaging as the chest seal, if I could avoid tearing it open down the center. He told me not to understate the importance of a good chest seal. He explained how the diameter of the wound is important and that breathing will follow the path of least resistance. If the diameter of the wound is bigger than the diameter of the trachea (about 1”), air will enter through the chest wound. Otherwise they will just breath normally through the trachea. This is why he said chest seal size is important: wounds warranting a chest seal are usually larger wounds that require coverage, and are usually messy (so paper tape won’t cut it). He said if I wanted to splurge, the ones with their own adhesive or the ones covered in vaseline are worth it, provided they are large enough (and still fit in the BOK. Requires more research).
- I don’t have an NPA and I forgot to ask.
My cousin’s much appreciated blow-out kit review will be leading to some research and a tune up. Mr Paranoid and I will keep you apprised of any changes to our kit in future posts.