As a service to gunnies, the guys at Student Of The Gun are selling an emergency kit for the wannabe medic they call the “Pocket Life-Saver.” It includes a few items they say will help you save the life of someone with a gunshot wound. While their hearts may be in the right place, as a seasoned EMT, I’d rather use this kit as a doorstop than have to rely on it to treat actual gunshot wounds . . .
Clarification: one item in the Pocket Life-Saver is actually very useful: the tourniquet (TK).
Bleeding control is essential for gunshot wounds. Recent studies have dismissed most of the fears people used to associate with the use of a TK in the field. Better to bring the patient in alive and have them lose a limb than to let them bleed out in the ambulance.
But the tourniquet SOTG provides is of an older design. It’s a little complicated for untrained providers to use and doesn’t have all of the advantages of the latest version widely in use, the Combat Application Tourniquet, or CAT.
Then there’s the tuft of gauze that’s included, which comes helpfully pre-tangled in a large clump. Pro tip: if a small patch of gauze is all that’s standing between a bleeding gunshot victim and the sound of harps in the distance, he has big problems. Honestly, a tampon would have been much more useful.
Also thrown in: some duct tape. Apparently because duct tape fixes everything. Including holes in people. Although, to give them the benefit of the doubt, you could use it, along with the packaging, to make a serviceable flutter valve to fix a sucking chest wound.
Some say that an NPA airway is a good idea to have handy, too. That’s the green thingy up there. The full term is “nasopharyngeal airway” and it’s used to keep a patient’s airway patent (i.e., keep him breathing) while unconscious.
Only one problem though: most people don’t know how to use one. NPAs are only useful if the patient is unconscious, which is a bad sign if he’s bleeding out. And in order to insert one, you have to take time away from either stopping the bleeding, calling for assistance or moving the patient towards definitive care. In my opinion, there are more useful pieces of kit to include.
What would some of those be? Here’s my suggested list of four items for treating gunshot wounds:
- Combat Application Tourniquet: Easier to use than the tourniquet SOTG provides, and more effective at stopping circulation to extremities.
- Israeli Bandage: Compression bandages with lots of sterile gauze on the inside are great for controlling bleeding.
- Celox gauze: I’m not a fan of quick clot, and Celox works as least as well, if not better. It’s an agent that promotes clotting very, very quickly and can be used to stop severe bleeding.
Actually, I lied. That’s only three, but I’m done. I might throw in the duct tape to round out the four items, but those are the only three items I’d put in a gunshot wound kit.
If you can’t control the bleeding with those items then the only thing that will save your patient is rapid diesel therapy — getting them in a vehicle and not letting up on the gas pedal until you’re at the hospital.
Maybe TTAG should market a kit like this . . .