my sar medical bag

I was having a discussion with some folks about this topic so I thought “hey Eric, you should sit on your ass and write about it, bro.”

I really think buying medical equipment that you’ve never trained on is a bit silly: it’s akin to buying random tools at the home improvement store thinking “well you never know, I might just need this rivet gun one day.” Everything I carry is something I’ve used in the field or at home, and was part of my training from either basic first aid, my WFR, or my WEMT. When some dude is bleeding in front of you is not the time to stare at the piece of gear you got from Amazon and try to figure it out: take a class.

Also, our sar team has its own medical bags which I often use instead. We have a “first out” bag which carries basic airway, bleeding, and assessment gear. We have O2 tanks we can bring in, litters, vacuum splints, etc. But there’s only a couple of bags and if we’re on a search or otherwise not in a simple “the single injured person is at coordinates xxx.yyy, sss.tttt”, I don’t like running around in the field with my own personal wimpy backpacking first aid kit (my team’s minimum for me personally). Also, I use this for my family and keep it in my truck for whatever randomness the world provides.

For starters, you can see it’s pretty small. The bag itself is sort of a piece of crap but it works and if something breaks on it I won’t be sad.

I put the stethoscope on top because I didn’t like how it was getting bent inside the pack. If I’m going to use it I’ll throw it down my shirt while I get other stuff ready so I’m not freezing someone to death with a 0 degree piece of plastic on their skin.

So here’s my list of what’s in there, trying to group things:

Assessment, since you can’t fix problems you don’t know about and handing off patients to paramedics/hospitals with a “I dunno” response makes you rightfully look like an idiot.

• BP cuff. I keep a pediatric at home and if I needed I can toss this on a kid’s thigh and get X/palp with a pedal artery.
• Pulse oximeter. Handy not only at altitude up here, but also gives you a pulse nice and easy so you can move a bit quicker.
• Thermometer. Temple and forehead, I won’t lie: this is mainly for home use with sick kids. It also doesn’t work under 50 degrees F.
• Stethoscope. Getting good lung sounds is pretty important for diagnosing HAPE, pneumothoraces, etc.  Plus you can say “auscultate” which is pretty tight.
• Pupil light. More often than not I use it to read something or stare down a patient’s throat.
• Emergency Spanish for Fire/EMS. Small booklet, but good luck doing anything if you can’t talk to someone.

Bleeding. For the most part, by the time a sar team gets to you a massive arterial hemorrhage isn’t going to be treatable. Most sar responses are well outside the golden hour, but that doesn’t mean all hope is lost. Also, I have this kit with me in my truck and have been to enough motor vehicle accidents to know that I can actually be there fast enough sometimes, even if just in a good samaritan role.

• Tourniquet. Spooky and dangerous, these are actually back in vogue and for my training was the preferred mechanism of stopping an uncontrolled bleed. Refer to your training for usage and ischemia management.
• Gauze. One roll because if you need more than one roll you need like a million, or a tourniquet.
• Triangle bandages (x3). So these can double-duty as crummy gauze.
• Bandaids. Sometimes it’s just that easy.
• Povidone iodine pads. In my WFR training (where you may not have sterilized water) these little bastards can be squeezed into a water bottle killing off germs and making a diluted wound irrigation fluid that won’t harm skin.
• Medical tape. Good for taping gauze/stuff down on wounds. Also good for deadlifting days to put on your shins so the bar doesn’t cut you up when lifting heavy. #SubtleBrag

Airway. This is actually fairly legit (in my opinion) to carry because for sar you tend to have long carry outs and if homeslice loses consciousness things can go bad quick.

• I used to carry a whole mini-fleet of OPAs but a single NPA with a lube pack is way lighter, smaller, and more versatile. Yanking an NPA out takes a second and if someone is U on AVPU I’d rather have an NPA in than an OPA. Pulmonary aspiration of vomitus is a big deal with scary high death rates.
• Valve mask. More applicable to motor vehicle accidents and random urban life than sar.

Medications. This is all about your protocols, your prescriptions, your scope of practice, and how much liability you want to handle. Again, some of this stuff is for me and my family’s use: do your own math and consult your training.

• Aspirin, chewable 81mg. If a patient is having a heart attack you might just save their life or add a decade (or more) to their clock.
• Diphenhydramine. Allergic reactions are common and life threatening ones aren’t the rare rainbow-unicorns from twenty years ago.
• Electrolyte tabs. It’s pretty normal to find people exhausted and cramped up. An hour’s rest, some electrolytes, and fluids can make the difference between walking someone out and carrying them.
• 500 MG amoxicillin (x6). Not for sar, but if on an extended trip into the boonies this buys me two days of bacterial combat to get them (or me) handed off to higher care.
• Prednisone. Again nor for sar, but I’ve had my own life saved by this stuff so I keep it on me.

Doo-dads. Rounding out the edges, things that are handy.

• My protocols, written down, staring at me in the face. It’s so easy to get carried away in the moment.
• Pencil, rite-in-the-rain EMS vitals sheet. Use some of that medical tape to secure your notes to an unresponsive patient’s leg.
• Gloves, cloth mask. BSI, PPE, scene safe! I put gloves everywhere so there’s no excuse not to wear them. Open the top pouch: gloves. Open the waist belt pouches on my frame pack: gloves. What’s up my butt? Gloves! Gloves everywhere, baby. Combined with a sharpie you can make cool balloon animals for kids with gloves too.
• Tweezers.
• Trauma shears. Nothing says “I care” like cutting someone’s $300 GoreTex pants off of them.
• Vet-wrap for stability. The colorful stuff that you see on a horse’s ankle is called “vet wrap“. Dirt cheap, multicolored, and self-adhesive. You won’t be sad if you never get it back.
• Triangle bandages. They come with safety pins and can double duty as gauze or making slings/wraps.
• Burn gel. I’m not into most goofy creams and ointments but burn gel really does work and people really do burn themselves.
• Antibiotic ointment (speaking of goofy creams). I know most hospitals like to work on non-gooey wounds so this isn’t really a sar thing. But if you’ve got a dirty environment and a couple of days until definitive care I can’t see this as a bad idea.

So there you go, that’s what I keep with me most of the time. Starting back at the top I recommend that you go out and get your training: WFA, WFR, EMT, RN, MD, DO, witchdoctor, alternative Eastern healer, whatever. Just learn how to treat others and yourself and equip yourself with tools for jobs you know how to do. Otherwise you’re that dude with an inch of dust on your rivet gun and no idea when or how to use it.

Oh, and a word about batteries. For my sar radio I have a six AAA spare battery pack in my pack, made up of lithium batteries which are really your only option in the cold. My pulse ox has two lithiums in it at, put the thermometer is so limited I keep the batteries out and just pop them in if I’ll use them, which is normally at home with a sick kid.