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Three Tiered System

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  • Ian McDevitt
    replied
    Sorry guys, been busy. I wouldn't bring the suture kit because I am not proficient at suturing. Suturing is a very perishable skill and whn not practiced regularly, it deteriorates. I also believe that the process of setting up a sterile field prior to wound closure is absolutely pivotal. Instruments and the wound can be contaminated, then sutured closed and become quickly infected......Then your in trouble. Therefore I just manage the wound instead of suturing. I pack it or place a drain and allow it to heal from the inside out. Dressing changes and setting up a sterile field are extremely important skills that are ten times more important than suturing.........Grab a medical book that has nursing skills in it with alot of pictures, STUDY DRESSING CHANGES AND PRACTICE.....................LEARN TO SET UP A STERILE FIELD.

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  • Ian McDevitt
    replied
    I have to finish up with an EMT-Basic class this AM but will make a long post tonight...........I would leave the suture kit at home. I'll explain later. I like Celox as my hemostatic agent. I liked WoundStat but that's another story. I'll be back later.

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  • slowz1k
    replied
    Wow! Quite a resume'. Glad to have you here.

    My med bag is very basic... but then again so is my medical knowledge.

    OTC pain meds
    Burn gels
    assorted gauze pads
    rolled gauze
    chemical ice pack
    gloves
    water
    tape
    alcohol and swabs
    neosporin
    ace bandages
    a few suture kits
    and a scalpel or two

    Anything more and I would do more damage than good.

    Your thoughts on quick clot? The newer version not the old "I'd rather bleed to death because it feels like someone just poured muriatic acid in my wound" version.

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  • Ian McDevitt
    replied
    Some products that I like and use:

    I use Celox as my hemostatic, I like the Celox-A and would without question inject that into a penetrating bleeder on myself. I like the celox gauze and Celox-D because it's not celox impregnated bandage material, IT IS CELOX.

    I use both the Israeil dressings and the cinch-tights, doesn't matter.


    I use alot of ace wraps

    I use the SWAT-T and the SOF-T as my tourniquets

    otherwise I use whatever is there for me, I improvise alot and don't winge and wine about what gear I have. I just make the best of it.


    To give you an idea on how many patient's I see and have seen. I have been on the street for 23 years, a Paramedic since '91. I spent a year in Saudi in '92 as a remote medic for the Saudi MODA, did time in Afghanistan and a failed job just recently in Iraq. Did some Central America also. I have advised about two dozen federal agencies, alot of foreign ones also. I now hold my EMS down to 40 hours a week on the street doing Intercepts and 10 hours a week teaching.
    Last edited by Ian McDevitt; 05-12-2010, 08:02 PM.

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  • Ian McDevitt
    replied
    sorry guys, forgot my airway stuff. I have a pocket mask with NPA's or Nasopharyngeal Airways and a laryngascope with two blades, ET tubes and tube tamer. I know I'm forgetting some other stuff....................

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  • Ian McDevitt
    replied
    Like I say, questions are no problem. I'm happy to share any knowledge and exchange ideas. I want to learn also......No, I don't carry a skin stapler normally but I would put one in my survival medicine or wilderness medical kit. The thing about the stapler is that you have to be familiar with wounds and their debribement to use a stapler effectively. Alot of wounds have to heal from the inside out and may need to drain and those are NOT the type of wounds you want stapled closed. having said that, a visistat (wound stapler) should be included in your kit.........Now for my second line bag. As I said, I use a Tac Tailor First Responder Bag. When I am at work, like now, I have it on the passenger seat next to me and it has mostly ALS or advanced life support gear in it. Catheters of diffrent sizes to start IV's, Saline locks, saline flushes, tegaderms to use as IV dressings, and tape. I also keep some initial first contact injectable meds in here, like, benadryl, epi 1:1000 multi dose vial, toradol, and narcan. I keep a nebulizer and albuterol / atrovent in here also. Smuggled in this work bag I keep a GSW kit in there for me, in case I get hit and am still able to move. In that kit I keep a SWAT T, and two doses of Celox-A. I also keep two Emergency Bandages (Israeli's) in there. Last but not least I keep my little Nonin pulse Ox that I procured from the clinic in Balad, Iraq before I split. That's kind of my TT First Responder rigged out for ALS work. When I am going somewhere, like, say, vaction with the wife or away with the family for a few days, I empty it and rig it out as a kick ass first aid kit. I'm lucky because my wife is a retired firefighter, EMT and currently a Trauma Nurse so she can use any of the stuff in the bag with ease............Ask questions guys if you have any.

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  • Ian McDevitt
    replied
    No actually, thanks for the questions. I would really like to participate here so if anyone else has some, let 'em fly. I will answer yours later today, I have to go grab my intercept vehicle right now and get on duty.

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  • slowz1k
    replied
    Great info! Thanks!

    Any chance of getting an item list on the other bags?

    I'd love to see some pics of that SAS bag too.:cool:

    Just curious... Do you carry a staple gun? If so what kind?

    I know... I know... I'm high maintenance. Sorry :o

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  • Ian McDevitt
    started a topic Three Tiered System

    Three Tiered System

    I've been around the block a few times Pre-Hospital EMS-wise and what I have found out is that a "Three Tiered System" of aid bags works best for me. What I mean by three tiered is that I have an initial MOLLE pouch that basically never leaves my side that has some emergency-first contact gear in it. That pouch goes on my belt and gets slipped on the belt every day along with my multi-tool, small fixed blade EDC, and flashlight (invariably a BRITESTRIKE now). The pouch I use now is from emdomusa.com and is one of their small, non-descript models. I choose an earth tone like brown or green. In that little sucker I put a SWAT-T Tourniquet, a pair of gloves, a cravat, some spare batteries for my flashlight, some band-aids, and some single dose meds like motrin, loperamide, ASA, and benadryl. some times I'll pack a roll of pri-med gauze in there. The contents of the little belt pouch can change. If I'm going out and away from the house, I may even throw in some injectable meds and a syringe or two. The contents is very fluid. The Emdom pouches are very, very durable.
    The second tier is my Tactical Tailor First Responder Bag. I was given three of themover these many years by Logan before he passed away. Two of them I have actually blown the zipper out on and I can estimate that I have more than likely seen in the neighborhood of 10K patient's in 5 countries with that little bag on my shoulder. The third bag was sent to the best commando unit in the world, the SAS as a gift to a Patrol Medic. I like the fact that the little bag opens around the top and nothing spills out. You can set it down and open it like a barrel. I also like the bright orange lining and the small zippered glove pouch on top. The contents of that shifts also depending upon where I am and what type of environment I am operating in..................More later
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