Courtesy Nick Leghorn

[Warning: Nothing in this article should be considered medical advice. If you are injured, you should immediately seek medical attention from a properly licensed and accredited professional.]

As much as we drill the rules of firearm safety into our heads, anytime we step onto a range the possibility for injury is ever-present. The highest risk isn’t even posed by the firearms themselves, but instead by the range and the environment surrounding it. Some of these risks include . . .

Gunshot wounds: I’m sure every one of the readers is well versed in firearms safety, but what about the shady guy down the line? Even though the probability of a gunshot wound is miniscule the consequences if it happens are so enormous that it deserves some attention.

Broken Bones: Some of the better ranges in the United States are three miles down a dirt road, up a mountain pass and hidden behind a cliff face. Getting to these ranges sometimes requires a bit of walking over uncertain ground. What would happen if someone slipped and broke their arm?

Lacerations: This is the most common injury at a range. Tons of moving parts, splinters and staples from the target stands, flying bullet fragments off steel targets… It’s like the entire range wants to cut you. And it will, eventually.

Insect and animal bites: Ranges are typically outdoors. This means there are bugs and animals present, some of which you may cause an allergic reaction. Anaphylaxis is not fun.

What makes things even worse is that because ranges are typically in isolated locations (to keep the noise from annoying the neighbors), help could take a long time to get there. In order to mitigate some of the risk posed by a long waiting period before help arrives, I keep a personal medkit in the back of my car and take it with me every time I go to a range. I thought it might be useful to share the contents of my bag with you, the readers, ranked in order of greatest return on investment.

Field Guide: Even if you’re a trained EMT like myself, what happens if you’re the victim and can’t treat yourself? Even if you have no other equipment, just knowing what’s wrong and how to fix it is a huge improvement. And remember, knowing is half the battle!

Pen and Paper: Some injuries or illnesses progress so fast that there are only a few minutes between when they start feeling symptoms and when they become unconscious. Asking a few questions immediately might help the doctors treat the patient later if you can get them before the patient can’t answer questions anymore. Look up “SAMPLE history” and “OPQRST” for the full list of things to ask, but at the very least remember to ask for any allergies, medications, or previous conditions the patient has.

Non-Latex Gloves: EMTs have three little letters drilled into their skulls from day one: BSI, or Body Substance Isolation. Making sure that, at the end of the day, you don’t get HIV or hepatitus or some other nasty bug from the person you stopped to help. Use non-latex gloves just in case the person you’re helping has a latex allergy.

Sterile Dressings: As soon as someone starts leaking (or bleeding, if you want a technical term) the first priority is to plug the holes. Massive bleeding is one of the fastest ways to die on a range, and something that can typically be stopped with direct pressure and enough material. Small bandages, 4×4 gauze pads, gauze roller bandages, and trauma dressings are the way to go here; make sure to have at least 3 of each.

Trauma Shears: Sometimes too much of a good thing is bad. For cutting tape and gauze down to size, nothing beats a good pair of trauma shears. Also, if no dressings are available, you can use them to cut up clothing to make dressings.

Medical Tape: One of the most vastly useful things in the world. Any tape will do, duct tape better than most, but “medical tape” is designed to come off easily when it’s not needed anymore.

Triangle Bandages: Another massively useful tool. The two main uses are as a sling for broken appendages and as a tourniquet. Yes, I said tourniquet. Remember in Boy Scouts they said to never ever use one? Well, sometimes you have no choice. If help is more than 10 minutes away and the bleeding isn’t slowing with direct pressure, you might want to consider using one. This should be a technique of last resort, meaning you’ve tried everything else before using it, and the injury is on an appendage (NOT THE HEAD! NEVER TOURNIQUET A NECK!). Make sure to look up its proper use before adding triangle bandages to your kit.

Wound Cleaning Agents: If you get a cut in the middle of the woods, in a place with a lot of lead and particulates floating around, putting some disinfecting cream on it isn’t a bad idea. It’ll seal the wound against any further contamination and keep it from getting infected.

Bag: Keeping everything in one convenient place is a great idea. When things go bad, only needing to grab one organized bag is much better than rooting around in a trunk or range bag and wondering where everything went.

Those items will cover the vast majority of situations, and might even fit into a glovebox. In addition, however, I like to carry a couple other things to round out the supplies. Unlike the list above, these items do not effectively reduce risk in a cost benefit analysis, and might just be downright useless (or even harmful) to those without proper training.

Flashlight: A SMALL flashlight is useful for doing pupil dilation tests (look up “PERRL”) and looking at things in the dark. I usually carry two, one low intensity flashlight for looking at the patient and one high intensity light for looking at the scene. Patients don’t appreciate it when you blind them with your gigantic tactical flashlight.

Signal Flares A lot of the outdoor ranges I go to are 30 minutes from the nearest hospital, which for a gunshot wound is downright unacceptable. Thankfully, ranges provide oodles of open space for helicopters to land and speed up transport. 4 flares 100 feet away from each other in a square is the standard landing zone formation for LifeFlight’s helicopters. Also, on unmarked dirt roads at night a helpful signal flare will help direct the ambulance right to your location.

Clotting Agents: There’s a lot of discussion out there about various clotting agents. The ambulances I ride on don’t use them, but I include a packet or two in my kit because arterial lacerations are the single thing that scare me the most. It’s basically spending $40 to make me feel better.

Oral Glucose: Diabetic emergencies suck, and oral glucose is the only drug in my arsenal I can carry and administer without a prescription. One tube should be enough to keep hypoglycemia at bay until more competent and well equipped help arrives.

CPR Mask: The cold hard facts are that CPR is only effective in about 10% of the cases where it’s employed, and even then most people aren’t trained to do it properly. If you have a CPR certification, go ahead and get one if you really want. If not, don’t waste your money. A rubber glove with a slit in it does almost as well anyway.

[Nick Leghorn is a licensed EMT-B in the states of Pennsylvania and Virginia and is currently a volunteer EMT in Fairfax, VA.]

12 Responses to Emergency Medicine on the Range: Making your Bag

  1. Patients don’t appreciate it when you blind them with your gigantic tactical flashlight.

    I’m going to take a wild guess that they probably would prefer to be blinded by it, rather that realize it’s still attached to your Glock.

    • That’s one of those items where the cost benefit analysis didn’t really pan out.

      Their primary use is as diagnostic devices, meaning they don’t actually interdict any specific condition. The only real benefit from having them on hand in their normal capacity is helping recognize signs like hypo/hypertension and abnormal breath sounds, signs which typically are accompanied by a chief complaint that is easily recognized (examples being “feeling faint” or “trouble breathing,” respectively). At the point where the chief complaint emerges you should already be packing up and leaving the range. Common sense is cheaper than tools.

      One secondary use for the BP cuff is as a makeshift tourniquet, but the triangle bandage does a much better job and is a whole lot cheaper.

      Finally, most people aren’t trained to properly use these items, meaning that they would have spent the money but not be able to use the tools.

      A cheap set of BP cuff and stethoscope costs around $30, and really doesn’t do much good for the average person. Compare that to a gauze pad which costs a couple cents and could stop some bleeding and you can see the difference in the cost benefit analysis and why I chose not to include it. Its uses are very limited and if you don’t have the tools or training to act on the information they provide then there’s no real point to have them. In the end, however, it’s up to you.

  2. My brother-in-law spent a while in Iraq running around with front-line Marines as a Navy corpsman. He’d buy loads of tampons before getting deployed, because they’re apparently good for bandaging gunshot wounds. Who would have thought?

  3. This is an excellent post. A quality primary first aid kit is something everyone should have in their car.

    Here’s a similar guide that I’ve followed when putting together just such a kit. It’s well worth the time it takes to watch the video.

    http://www.youtube.com/watch?v=0dboVSTCkuw

    Oh, and this guy backs up Guido’s point about the value of tampons and maxi pads as good, inexpensive wound dressings.

  4. Good article. I’ve never brought this kind of kit to the range, but it’s very similar to what I used to carry on long hikes and mountain bike rides, where the risk of severe injury was even higher than at my range.

  5. The most common injury I see at the range are cuts. Usually because someone have a finger or thumb where it shouldn’t be and the gun “bites” them.

  6. I find it interesting that as far as I can tell, in the civilian world tourniquets are the worst thing somebody can use; always a last resort type of thing. In the military they’ve taught us the exact opposite, even saying “throw anything you learned in the civilian world out the window”. When in doubt, tourniquet. End of story. Leg blown off? Tourniquet (obviously). Gunshot? Tourniquet. Small cut? Tourniquet. Stubbed your toe? Tourniquet. Your job is to stop the bleeding. Let the doctors do the pretty work.

  7. +1 to Guido,
    tampons( fit in bullet holes pretty nicely) and pads( soak up a lot of blood to start the clotting process, never remove the pad, just keep stacking them on to staunch the flow) are excellent bits to have in your kit or field expedient first aid when with the fairer sex.

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