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Topic Review (Newest First)
11-13-2012 10:33 PM
hosejockey61
Quote:
Originally Posted by CombatDiver View Post
Laws don't vary by attorneys, rather state by state if you're worried about good Samaritan laws. And as long as you are operating within your realm of your training you're fine (which according to everything I have read thus far in this thread the things being suggested don't exceed basic EMT which don't require operating under anyone else's license).
Obviously I was being fecitious, but in the end when you get sued, the attorneys are the ones that will string your butt up and let the jury know you were the one responsible. And yes, even as a EMT basic, you need to have a sponsoring physician for anything invasive i.e. IV's, meds, airways etc.

Quote:
Originally Posted by CombatDiver View Post
Thanks for calling me out on my taking my family on a vacation staying in a hotel rather than a wall tent (which is normally where we spend vacations). If makes you feel better you could belittle me for going only to the Hilton when traveling to Colombia because it's the only 5 star Hilton...but apart from being envious I don't know what that has to do with anything.
Ummm...not belittling anybody. There was a commercial out here for a long time where...well, just watch and then you'll get what I mean by the "Did you stay at a Holiday Inn Express last night?" comment...lol

Holiday Inn Express Commercial - YouTube

Holiday Inn Express Meltdown - YouTube

Holiday Inn Express Helicopter commercial.wmv - YouTube

Jeopardy Commercial - YouTube
11-12-2012 10:12 PM
CombatDiver
Quote:
Originally Posted by hosejockey61

Listen dude, like I said in an earlier post. I'm not trying to be an ass, just realistic. I've been in the fire service/EMS field in a big city for over 20 years. I have seen what works, what might work, and what might not have chance in hell of working.

Like I also said earlier, you can be very highly trained at the paramedic level. But if you don't have a sponsoring agency/doctor, then you just can't practice your medicine. As the good samaritan law varies from attorney to attorney, you would only be covered for the basic things that any other citizen might do. The good samartian will NOT cover you if you choose to intubate somebody just because you know how.

And get off the couch in the TV room? What's that all about? We don't have couches at the fire house...just lazy boy recliners.

Keepin' it really real...er

Edit: I see you are a whiny fire fighter/paramedic trying to stir the pot. Nice work. High five.
Well my years are bigger than your years in the medical field (in addition to being more).

Laws don't vary by attorneys, rather state by state if you're worried about good Samaritan laws. And as long as you are operating within your realm of your training you're fine (which according to everything I have read thus far in this thread the things being suggested don't exceed basic EMT which don't require operating under anyone else's license).

Thanks for calling me out on my taking my family on a vacation staying in a hotel rather than a wall tent (which is normally where we spend vacations). If makes you feel better you could belittle me for going only to the Hilton when traveling to Colombia because it's the only 5 star Hilton...but apart from being envious I don't know what that has to do with anything.
11-12-2012 08:55 PM
BlueRidgeYJ
Quote:
Originally Posted by BAP
training is the best tool in your med kit----that being said every kit needs tampons..
Remind me not to go wheelin where you do, lol.
11-12-2012 09:13 AM
BAP training is the best tool in your med kit----that being said every kit needs tampons..
11-11-2012 10:16 PM
myquite BLS before ALS no matter what! and....BLS is something that anyone with a few hours of training can receive. So we wouldn't have to worry about going above our level of practice or practicing medicine without a sponsoring physician. Just my .02
11-09-2012 01:00 PM
chirurgus Nice discussion. IMHO a first responder is more likely to save someone having an MI in the field with quality BLS, rather than using advanced techniques on a major thoracic or abdominal trauma. A good kit with bandages and the like for minor trauma is nice to have. The BP cuff can actually be used as a nice tourniquet to prevent exsanguination from an extremity vascular injury (when used appropriately of course). Other than those basics, the best way to save someone is timely transfer to a trauma center for definitive care. Going nuts in the field with a scalpel is likely to create more damage to a person who will live anyway despite your efforts, or needlessly mutilate someone who unfortunately will die despite the best efforts after transfer to a hospital.

And I did stay at a holiday inn express last night....
11-08-2012 01:32 PM
hosejockey61
Quote:
Originally Posted by ontheedge View Post
The only pot i'm stirring is the crock pot with the beef stew for tonight’s dinner.
mmmmmmm....beef, it's what's for dinner! .....wait....your medics cook???

Quote:
Originally Posted by ontheedge View Post
I do so with the blessing of my medical command physician.


Most do not know they have to have this. This is why I am trying to warn them not to get too far in over their head or it could be very bad. A fresh EMT right out of school with no sponsoring agency could be a very bad thing!

Quote:
Originally Posted by ontheedge View Post
Be safe, sorry about the couch comment- I just couldn't pass up taking a shot at a truck/ engine guy.


You be safe too. No worries, my skin is as thick as a crocodiles!

All in all, I like the fact that people want to help others on the trail. That is great, I think we all want to help. I'm just trying to state that 1) be smart about it, and 2) the best thing after providing for airway and bleeding control is to get professional help.

I am not saying you are not "professional" help due to your line of work. What I am saying is, activate the EMS service that covers the area you are in. If you pulled up on a MVA in your city while off duty, would you tube the guy and transport him to the hospital just because you had the training and some handy supplies? Or would you provide the care you could while also calling 911 to get assistance?
11-08-2012 01:04 PM
ontheedge
Quote:
Originally Posted by hosejockey61 View Post
Listen dude, like I said in an earlier post. I'm not trying to be an ass, just realistic. I've been in the fire service/EMS field in a big city for over 20 years. I have seen what works, what might work, and what might not have chance in hell of working.

Like I also said earlier, you can be very highly trained at the paramedic level. But if you don't have a sponsoring agency/doctor, then you just can't practice your medicine. As the good samaritan law varies from attorney to attorney, you would only be covered for the basic things that any other citizen might do. The good samartian will NOT cover you if you choose to intubate somebody just because you know how.

And get off the couch in the TV room? What's that all about? We don't have couches at the fire house...just lazy boy recliners.

Keepin' it really real...er

Edit: I see you are a whiny fire fighter/paramedic trying to stir the pot. Nice work. High five.


The only pot i'm stirring is the crock pot with the beef stew for tonightís dinner. My issue is with you insinuating that any of the posters (holiday inn Express doctors or years of experience) stated that they were better than the common jeeper for having training or ever suggested that any provider (experienced or not) perform any skills outside of their level of training or certification. As an experienced provider I certainly donít need a lecture on the legalities of my scope of practice and what it covers (it not the point of the thread). I, as well as other posters carry well equipped first aid bags, as well as an AED. I do so with the blessing of my medical command physician. As I would hope any provider does. Your comment with the statistic that only .02% of people survive a cardiac arrest may be accurate but it lends itself to telling people not to get involved because it wonít make a difference so why bother trying (or getting involved). I donít see the point of lecturing those who are involved in emergency services, when you have the opportunity to educate those who have a need/ or desire to learn from you and your experience.
Be safe, sorry about the couch comment- I just couldn't pass up taking a shot at a truck/ engine guy.
11-08-2012 11:12 AM
hosejockey61
Quote:
Originally Posted by ontheedge View Post
Well Hosejock, since you're the resident expert with all the answers, why dont you create a sticky post on the proper administration of first aid and the use of the equipment. I know I could learn a lot from someone like you, that is if you can find the time to get off the couch in the TV room. Just keeping it real.
Listen dude, like I said in an earlier post. I'm not trying to be an ass, just realistic. I've been in the fire service/EMS field in a big city for over 20 years. I have seen what works, what might work, and what might not have chance in hell of working.

Like I also said earlier, you can be very highly trained at the paramedic level. But if you don't have a sponsoring agency/doctor, then you just can't practice your medicine. As the good samaritan law varies from attorney to attorney, you would only be covered for the basic things that any other citizen might do. The good samartian will NOT cover you if you choose to intubate somebody just because you know how.

And get off the couch in the TV room? What's that all about? We don't have couches at the fire house...just lazy boy recliners.

Keepin' it really real...er

Edit: I see you are a whiny fire fighter/paramedic trying to stir the pot. Nice work. High five.
11-08-2012 08:37 AM
Medic005
Quote:
Originally Posted by ontheedge View Post
Well Hosejock, since you're the resident expert with all the answers, why dont you create a sticky post on the proper administration of first aid and the use of the equipment. I know I could learn a lot from someone like you, that is if you can find the time to get off the couch in the TV room. Just keeping it real.

I would suggest taking a First Aid and CPR course, your local community college , Red Cross or EMS station may have the classes in your area.
11-07-2012 09:56 PM
ontheedge Well Hosejock, since you're the resident expert with all the answers, why dont you create a sticky post on the proper administration of first aid and the use of the equipment. I know I could learn a lot from someone like you, that is if you can find the time to get off the couch in the TV room. Just keeping it real.
11-05-2012 04:49 PM
joeuncool However, with the Wilderness First Aid training that this kit recommends, I think this kit is an excellent idea for clubs. A club can put the money together to get a few volunteers trained, buy a few kits, and make sure they have one at least one of the trained people with them when they go out on club sponsored events. We all know that there are a lot of dangers in this "hobby".

As for the average Jeeper? I think it is up to you, but I definitely wouldn't purchase the kit without the training and knowledge how to use everything in it. Of course, in the article, training is the first thing they recommend.
11-05-2012 10:55 AM
BlueRidgeYJ
Quote:
Originally Posted by hosejockey61
...What will change in the care that you give if you don't have that equipment? My point is, that it doesn't matter whether you use a BP or palp his abdomen...the care will be the same. The only thing you can do for this person is get him to a surgeon.

Don't forget that just because you have a higher training level than the average jeeper doesn't mean you can go off doing advanced procedures. ... Don't think that the good smaritan law will save your @ss because it won't if you try to do anything other than basic life saving skills.

Yes, a basic first aid kit is a great idea.

Not trying to be an a$$, just trying to be realistic.

Exactly.

Exactly. Practicing medicine illegaly is a bad thing.

For certain, but equal to your training.

You are (realistic, that is).

Only thing I would add is lightning cpr (or similar) may be benificial moreso than cardiac arrest from a weak heart but even then it is knowledge, not equipment. Agree completely on all counts, though.
11-05-2012 10:40 AM
hosejockey61 To all of you Holiday Inn Express "doctors" with "years of experience", you know d*mn well that doing CPR in the back country is not going to be successful. Less than .02% of CPR results in a "save" where the person goes on to lead a normal life (usually with deficits)...and that's when pre-hospital care can be there quickly. Imagine having professional help more than an hour out....and you are pumping and blowing. You aren't going to have a good outcome.

Let's say you are a doctor. Let's say you happen to be in the right place at the right time, and you have a medical bag with your stethoscope, BP cuff, airway kits, etc. Let's say you determine that a person has an internal bleed. What will change in the care that you give if you don't have that equipment? My point is, that it doesn't matter whether you use a BP or palp his abdomen...the care will be the same. The only thing you can do for this person is get him to a surgeon.

Don't forget that just because you have a higher training level than the average jeeper doesn't mean you can go off doing advanced procedures. As a paramedic, you still have to work under a sponsoring physicians license aka your medical director or physician advisor. Don't think that the good smaritan law will save your @ss because it won't if you try to do anything other than basic life saving skills.

Yes, a basic first aid kit is a great idea.

Not trying to be an a$$, just trying to be realistic.
11-04-2012 07:38 PM
free78 I was a combat medic in the army. Got out in November of 2005. I recently went back and got my emt basic again after letting everything expire once I got out of the army. In the Army I was able to perform things that paramedics, nurses or doctors would do in the civilian world. Let me tell you guys, getting my basic this time was hard. I had to learn what I couldn't do now that I'm just a civilian. I carry a good bit of stuff in my aid bag. If it is in my bag I have been trained, used it before in combat and am comfortable using it. If you are going to get a bag to carry in your rig, please get some training. You can do more damage than help without the training. Know your skill level and know your equipment. If you ride with a group make sure every one knows where the aid bag is, have a couple people appointed to help if needed before the ride starts, have a couple people appointed for crowd control.
11-04-2012 07:04 PM
BlueRidgeYJ Not to pick nits, but if in the front country, they should make the golden hour or at least have an equipped ems squad within that time. All you need to do is keep air and blood moving until they arrive. In the backcountry, do you really expect a doctor to come along with no medical bag? Without proper training, a big bag of tricks doesn't help. I would not count on running into a w-emt on the trail.

Checking vitals requires no equipment. HR, RR, LOC, Time, Skin temp/color/moisture in the neck or axillara is all you need to determine evac status. Checking palpatory(? - ankle) pulse shows adequate bp to circulate. Pupils show head trauma. SOAPnote/patient assesment is the most important thing you can do - learn it! (obviously not you emts )

A little training goes a LONG way.

And so we are clear, Im not talking about trauma pads or cpr masks - thats very useful. Im talking about bremans, scalpels, bp cuffs, stethoscopes, and other ambulance equipment, itd be great to take one of those collars for immobilized cpr with ya hiking, but it isnt feasable.
11-04-2012 06:49 PM
CombatDiver
Quote:
Originally Posted by ontheedge
Not to what if this, but "what if" the next jeep to come apon an accident had a trained EMT, paramedic, or nurse (bottom line- someone who nows how to use the equipment) would it not be better to have the extra equipment and not need it then to need it and not have it?

As a paramedic with 25 years of service in both inner city and rural we have had incidents were the info feed back to us from the scene to dispatch, to us responding is crucial and important. Having vital signs (bloop pressure, pulse, respirations, and level of consciousness) will determine whether a medivac is coming in or ground and pound units are going to carry out a patient. It doesn't matter if you know how to use the equipment in most cases, 911 centers across the country can assist you by talking you through most any emergency.
Ditto.

And yes we (both highly trained medical professionals) stayed at the Holiday Inn Express (after camping in a tent about 100 miles south the weekend prior). If you can determine things like internal bleeding then you know whether or not something like life flight is what you should be shooting for or not. I would always recommend having more than you need so those of us who happen upon you on our short hikes while spending the night at the best hotels we can find in the area have more than enough. My medical bag for deer camp was far more robust than it was for Moab last weekend.
11-04-2012 04:04 PM
BlueRidgeYJ I just noticed the first recomendation on that page is a WFA course. So true.

The breman airways aren't a good idea without training, and like I said a bp cuff and stethoscope don't do much good. Pulse and skin condition will tell you the same, and requires no equipment - if you know how to check. Knowledge is key. Unless you can clear a spinal injury, the cervical collar isn't a bad idea, but if you are prone to be in those situations (kayaking, climbing, etc), you should know how to. Or at least know how to turn a blanket / towel / jacket / sweatshirt / hat into a collar. Carry a sharp straight blade and alchohol or a lighter, no need for a scalpel or surgical knife (though you won't need one anyway).

Education requires less equipment then ignorance is my point. Nobody wants to lug needless equipment around, unless they are nuts.
11-04-2012 03:47 PM
lindel It would be very hard for me to justify some of the things in that kit, just on the off chance that a qualified medical person happens by, especially if I'm out on a trail! Far better to address bleeding you can see, immobilize the victim and treat for shock.

Call for help, or make arrangements for transport out as quickly as possible. If you've got qualified medical help handy, all the better.
11-04-2012 10:09 AM
sparky Why would someone carry gear that they do not know how to use. It's a waste of money and space. I agree it's important to be prepaired but there is a limit on how much can be carried.
11-03-2012 03:58 PM
ontheedge Not to what if this, but "what if" the next jeep to come apon an accident had a trained EMT, paramedic, or nurse (bottom line- someone who nows how to use the equipment) would it not be better to have the extra equipment and not need it then to need it and not have it?

As a paramedic with 25 years of service in both inner city and rural we have had incidents were the info feed back to us from the scene to dispatch, to us responding is crucial and important. Having vital signs (bloop pressure, pulse, respirations, and level of consciousness) will determine whether a medivac is coming in or ground and pound units are going to carry out a patient. It doesn't matter if you know how to use the equipment in most cases, 911 centers across the country can assist you by talking you through most any emergency.
11-03-2012 08:59 AM
BlueRidgeYJ http://www.soloschools.com/
http://www.nols.edu/

Get trained first. Without training you DO NOT know how to respond.

The patient assesment system and SOAP note are the most important things you can do in a wilderness trauma. It is not like a front country trauma. You do not need the typical boo boo kit, you need something more. A bp cuff or stetho is petty useless backcountry unless you are ALS certified. Even so, it doesn't do much good. The NREMT-B Wilderness EMT with ALS cert & WFR instructor I know who does hiking and caving guided trips doesnt carry one of either, and he knows how to use them.

How to determine they are bleeding out? Decrease in BP, and a hole in them. Plug the hole, evac asap. Rigid abdomen, evac asap.
But what to do with fractures? Frostbite or hypothermia? Hyperthermia? Can you identify a brake vs a sprain? Can you clear a spinal injury? Treat a snake bite? Recognize a concusion? What about lightning strikes? Someone passed out in their tent? Know the 7 causes of spinal injury? What about the rest of he group? What should they do? Allergic reactions, epipens, diphenhydramine, and the "death gap"?

Answer those and more, then buy a kit that matches your answers.

Don't act beyond your training; it can easily make a bad day much worse. And the training is what keeps YOUR brain busy during a traumatic situation, which has physcological effects on all parties. Can you help a stranger or friend screaming while his hand is on the ground, or will you scream too? What about a hiking pole stuck through your loved one? Pretty scary thought.

Even getting help requires knowledge. Where they are, what the injury is, what the vitals or stats were until rescuer left, etc. Do you hike with radios? Give one to the TWO people you send out for help, then you can update patient status longer. They can also hand the radio off to EMS or SAR at the trail head, giving them the earliest contact possible. This lets a plan happen before they get onsite.

WFA, CPR, AED certified
HAM operator
Jeep Owner
Grew up playing in the deep woods of GA
Sometimes I feel unprepared.

This is the base of the kit I carry. I have personalized it with other equipment. I think the airway kit is all I took out, though I have no intention of using the torniquet other than as a retention strap or splint strap.
http://www.amazon.com/DixiGear-Respo...rds=trauma+kit
11-02-2012 10:40 PM
hosejockey61 Did everyone happen to stay at a Holiday Inn Express last night?

"determining internal blood loss"? Seriously? Let's talk real life here. EVEN if you were to determine that there was internal bleeding....what are you going to do for that? That person needs a SURGEON, not anything else you can provide in the field. Hemo/pneumo? What, are you going to decompress his/her chest with your McDonald's straw? This person ALSO needs a SURGEON. (You could certainly add a 10g decompression needle to your kit but one piece of equipment always leads to another...)

Don't get me wrong, first aid in the field is absolutely beneficial. It is important to control bleeding, maintain breathing, etc....BUT to start adding items to a kit for advanced procedures is kind of pointless. Combat? sure. On the trail? C'mon. Even with proper medical training, there is only so much you can do for a person with major injuries. Stick to basic trauma life support.

The BEST thing you can do for a seriously injured fellow jeeper is to get help, whether that be a satellite phone, CB, cell phone or whatever. If you cannot get a signal or reach anyone on a radio, then you will probably either have to send someone out or transport the person to a location where a signal can be obtained and call in the professionals (ground or air ambulance). Obviously, you would need to know your approximate location or at least give them the name of the trail you are on.

OFF SOAP BOX
11-01-2012 08:34 PM
CombatDiver Get the kit and get the training for all its components (that's how it's done in the medical field) or get training and you'll buy more than you know to use. Having responded to accidents while not in a professionally and better equipped status I can say having some things to use on some already on hand helps. Remember that in the back country people make decisions to go without certain things and I bring what I expect I might need and not much extra. However, in low key outings I find people who are in more dire situations than I expected to be (ie do to extended exposure dehydration and needing an IV/fluids). Granted most cases it's my kit that determines how much I can do but sometimes others have kits with the extra stuff I chose not to bring and that is helpful. So moral of the story is have a kit and as much of a kit you may need.
11-01-2012 07:00 PM
silver rubi
Quote:
Originally Posted by keschete

Hehe, I am a NP, but also certified in Emergency Nursing, Trauma, Pediatric Advanced Life Support Instructor and Advanced Cardiac Life Support. I am also a snake and spider person and can identify poisonous critters.
Where are you located? I need PALS! lol
06-12-2012 08:28 AM
keschete
Quote:
Originally Posted by silver rubi View Post
would you happen to be EMS lol?
I agree!! The best thing you can do is take someone with you who is trained to handle emergencies.
Hehe, I am a NP, but also certified in Emergency Nursing, Trauma, Pediatric Advanced Life Support Instructor and Advanced Cardiac Life Support. I am also a snake and spider person and can identify poisonous critters.
06-11-2012 11:48 PM
silver rubi would you happen to be EMS lol?
I agree!! The best thing you can do is take someone with you who is trained to handle emergencies.

Quote:
Originally Posted by keschete View Post
Nice kits, but I agree, there is a lot in there that isn't usable for the regular Joe. If I was taking a kit into the wilderness the main thing I would take is something with a IV set up with some LR and NS. If they are bleeding out or dehydrated, you can feel for a pulse and see if its thready and start the IV. Also some bandages, saline and betadine.

The best thing you can have is training.....wilderness survival, first aid, CPR, the sad thing is that you really can not do anything much out in the wild except stabilize and stop bleeding.

I do agree it is a very good idea to have first aid equipment, but bring someone who is trained to handle emergencies.
06-11-2012 07:44 PM
keschete Nice kits, but I agree, there is a lot in there that isn't usable for the regular Joe. If I was taking a kit into the wilderness the main thing I would take is something with a IV set up with some LR and NS. If they are bleeding out or dehydrated, you can feel for a pulse and see if its thready and start the IV. Also some bandages, saline and betadine.

The best thing you can have is training.....wilderness survival, first aid, CPR, the sad thing is that you really can not do anything much out in the wild except stabilize and stop bleeding.

I do agree it is a very good idea to have first aid equipment, but bring someone who is trained to handle emergencies.
06-11-2012 07:22 PM
silver rubi It looks like a great trauma kit for an EMT-Basic. I think I'd carry a few additional items in mine though. (I'm a Paramedic student)
06-11-2012 06:46 PM
DFW6ER It'd be a good kit for an ECA or EMT basic...even an ex-military medic/corpsman. Good Samaritan laws cover you to the extent of your training. If your training was 25 years ago and you haven't laid hands on a patient since, realize your limits and don't use the more advanced stuff. It'd be easy to piece together a kit that'd meet the needs of your group, though...possibly cheaper as well.
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