med bag list

[bubba68]

i may be deploying with a grunt unit to iraq pretty soon and i was wondering if some of you fmf types that have been there recently would let me know as to what i schould carry in my med bag and what i should leave out. also, i plan on having two bags: one small one to take on ops and another larger one to keep in a humvee or at a bivouac site. any help you guys could throw my way would be great! semper fi-bubba

[BronzeBow]

Good luck in Iraq bro. Please keep us posted on how things go for you.

[HMC-FMF-PJ]

What's your mission? What's your training? Who are your patients? What can you get? How much are you willing to spend and/or loose?

We all know IED's are the #1 killers in Iraq is IED, but US drivers are the #2 killers. Make sure your Marines are wearing the appropriate personal protective equipment and employing the proper tactics to guard against both these killers. In the long run, preventing avoidable injuries and minimizing unavoidable injuries will do the most good for the most people. Training, training, training! You are going to have to train your Marines in preventive measures, serve as a role model, get leadership's support, and mercilessly correct all whom you witness doing dumb’s in a no-dumb-zone. Simple things like safe driving habits, licensed (trained) drivers, seatbelts, and properly securing vehicle doors and cargo would eliminate a large part of our OIF casualties and about 10% of fatalities.

Too many of our junior personnel act like "too cool fools" out on a weekend camping trip with a rental car they don't care about breaking. Getting everyone to simply dress for the event and keep their head in the game will do wonders to protect them from injury and make your life easier. I know you're asking for a "med bag list", but stressing the basics is extremely important.

The following gear is REQUIRED by both MCO and local OIF orders and is to be issued at gov expense to each warrior prior to deployment:
[-] Ballistic Helmet
[-] Ballistic Eye Protection (http://www.dscp.dla.mil/gi/general/safetyandrescue/Eyewear.pdf)
[-] Hearing Protection (ie. Combat Arms Earplugs (http://www-nehc.med.navy.mil/downloads/occmed/hctoolbox/Toolbox_files/Combat%20Arms%20Earplug%20-%20Navy.doc)or CEPS)
[-] Interceptor Body Armor (IBA) with SAPI plates
[-] Complete uniform with sleeves down
[-] Tourniquet and personal first aid kit

While issuing gear is a "Supply issue", anytime one of your Marines does not have his required protective gear it becomes a Medical issue. If Supply is not issuing all this stuff, then you better be bitching about it. If you need ammunition I can cite specific MCO and OIF instructions that require the gear, but your unit's deployment messages or logistic guidance (http://www.marforres.usmc.mil/MFRHQ/logistics%20messages/LOGISTICS%20GUIDANCE%20FOR%20OIF%2004.06-1%20(OIF%20III%20PHASE%201)%20USMCR%20RECEPTION%20 AND%20FORCE%20I.txt) should mention it or reference orders that do.

Even if you have to buy the upgrade yourself, get a helmet with the improved suspension system and 4-point chin strap. (Oregon Areo (http://www.oregonaero.com/p81_2001.html)type, no PASGT suspension). Use of seatbelts is mandatory in Iraq and the wearing of Under Armour type snythetic clothing is prohibited because it melts to the skin. If you like Under Armour type t-shirts, check out the 'keep cool' performance undergarments designed for professional auto racers (http://www.rallylights.com/Sparco/Nomex_Underwear.asp), tac teams (http://www.massif.com/nomex_clothing/cool_knit_t-shirt.php), or fire crews (http://www.wildlandwarehouse.com/wwcatalog/ProTech_T-Shirt_P5996C297.cfm). That stuff will keep you cool like Under Armour, but offers extra protection and won't melt to your skin because it is fire resistant or fire retardant.

Every warrior outside the wire needs to carry:
[] Combat Application Tourniquet (CAT) (http://www.phildurango.com/videos.htm)on person, standard location with ready access (the Tourni-Kwik in the IFAK is not sufficient)
[] All operators must have the new Individual First Aid Kit (IFAK) (http://www.tecom.usmc.mil/gtb/csse/MedicalProgramsO/IFAK%20Users%20Info.htm), you have your med bag.
[] A cravat in the shoulder pocket with the ends exposed for quick retrieval has proven useful at times

Preventable combat deaths tend to be 60% extremity hemmorrhage, 33% tension pneumothorax, 6% airway obstruction

Train your Marines to treat these types of problems as if your life depends on it, because some day it might. Everyone likes to have I.V. classes, but to me they are mostly a waste of time and resources that could be better spent elsewhere. If you want to teach a Marine to stab someone with a needle, teach them when and how to decompress a tension pneumothorax after you have mastered the skill. Besides, I support the theory of minimal fluid resuscitation in the field for most patients. If any of your Marines have severe allergies, you and his whole squad need to be trained how to treat for it. The Marine, you, and the squad leader should each carry any required allergy meds (ie. sting kit).

Here is a MUST READ for all Doc's:

Tactical Combat Casualty Care (http://phtls.org/datafiles/military5th2003sept04.pdf)
Chapter 17: Military Medicine, in The Prehospital Trauma Life Support Manual, Fifth Edition
http://phtls.org/datafiles/military5th2003sept04.pdf

A good browse: Operational Medicine 2001, Health Care in Military Settings (http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/default.htm)

Things to have:
[-] Combat Application Tourniquet (CAT) - on every person
[-] Special Operation Forces Tactical Tourniquet (SOFTT) in med bag & veh
[-] Cinch Tight Compression Bandages
[-] Small & Large Battle Dressings
[-] Cravats (muslin triangular bandages)
[-] Nasopharyngeal airway with lube
[-] Oralpharyngeal airway
[-] Cricothyroidotomy Kit
[-] Chest seal (occlusive dressing)
[-] Burn dressings
[-] Manual suction device (bulb syringe, toomey syringe, whatever)
[-] Needle thoracostomy/pneumothorax decompression (min 14-ga, >1.5-in angiocath)
[-] High quality EMT/Trauma Shears (no cheap ones)
[-] Tactical gloves
[-] Exam gloves
[-] Sterile eye rinse
[-] Moleskin is a must with the infantry
[-] Tincture of benzoin acts as a 'superglue' for the Moleskin (also antiseptic & other uses)
[-] Emergency Dental First Aid Kit (with dental wax)
[-] High Temp Clinical Thermometer (heat injuries)
[-] Minimum two illumination devices (colored lens flashlights)
[-] High quality socks (a must with infantry)
[-] USB Memory Stick /Flash Drive/Thumb Drive with important files and address book/contact list
[-] Multi-tool (Leatherman, Gerber type)
[-] CASEVAC cheat sheet
[-] 2001 Special Operation Forces Medical Handbook (http://www.chinookmed.com/detail.php?product_id=000290&limit_start=0)
[-] Kwikpoint Visual Language Translator (http://www.kwikpoint.com/military_translators/iraq.html)
[-] Insect Head Net (http://www.hunterspec.com/Updateable/update_display.cfm?pageID=762&categoryID=29)

Things to consider:
[-] Sewing kit
[-] Travel Alarm Clock
[-] PT Gear & Shoes
[-] Sandals for shower, around camp
[-] Camera
[-] Sharpie Pen (write MedEvac Freq & Callsign on veh window)
[-] Staedtler Lumocolor Permanent Universal Pens
[-] Staedtler Lumocolor Correction Pen
[-] Shatter Proof Travel Mirror
[-] Ammo Can Lock (http://www.armygear.net/ag/store/0517.html)("L" Bracket) for aninstant lock box
[-] Padlocks - combo type like Master Lock 175D (http://www.masterlock.com/cgi-bin/product_detail.pl?sub_cat_id=D175D)so no keys to lose
[-] Drop Leg/Thigh Pistol Holster (needs to fit Beretta 92F)
[-] Rig so you can wear pistol when not wearing other gear (ie. PT time)
[-] Hammerhead Firearm Tether (http://www.gearkeeper.com/firearms/sidearmretractin.html)& gear keepers (great idiot cords, replaces lanyard)
[-] More for trigger pullers, Atsko's Rapid-Rod (http://www.atsko.com/rapidrodkit.html)is great for clearing barrels to get back in the fight.
[-] Weapons cleaning kit (clean your weapons, mags & ammo before every patrol)
(-) Otis #750 Tactical Cleaning System (http://www.otisgun.com/cgistore/store.cgi), -or-
(-) Otis #85211-5 Deluxe Military Cleaning System (http://www.otisgun.com/cgistore/store.cgi), -or-
(-) Otis/Gerber #MFG-640-?? Military Tool Kit (http://www.otisgun.com/cgistore/store.cgi?page=/new/product.html&setup=1&ida=174&idp=0&his=0&cart_id=6 739196.5500)

This list is far from all inclusive and could simply go on and on... Its good enough to get you thinking and start the discussion though.

"Do it in the dark." Tasks that are easy in the bright sunshine suddenly become difficult at night or in a dark room. Know your gear well enough that you can get what you need and use it without the aid of illumination. Shining a spotlight isn't very tactical, functional flashlights are not always at hand, and sometimes you get crap in your eyes.

Put numbers or letters on all medical bag pockets & compartments. Not only does this help you remember where things are, but you can easily tell a Marine to get gear out of a specific pocket instead of wasting time searching and tearing your bag apart.

Moving patients by foot? The NARP Talon II quad-fold is probably the best litter if you need to carry someone in the field and it makes a great rack if you're living out of your HMMWV. If that is too much to carry for the mission, then you can easily shove a Poleless Litter in a SAW ammo bandolier (cloth bag the ammo comes in).

Each vehicle needs its own trauma supplies. An easy fix is to pull the white string out of the M16 ammo bandolier (http://www.imsplus.com/ims5e.html)and fill each pocket with battle dressings, cravats, a tourniquet, Naso & Oral airways. This can then be kept in the veh or easily carried by a Marine on patrol or a high-risk raid when extra trauma supplies will likely be needed.

Remember though, ALL GEAR IS DISPOSABLE! Regardless of how much money you spent on your toys, none of them are worth your life, so don't risk your neck for gear unless it is mission critical or essential to keep a patient alive. Just keep a good inventory so you can file a claim to be reimbursed for combat losses.

Semper Gumby

[A.R. Gomez]

wow... thanks HMC-FMF-PJ that really helped a bunch. i am going to ramadi soon and although some of this i knew, much of it is new to me and i'm sure will prove helpful once i am in theatre.

[Kaymanism]

Let me repeat...wow
WOW WOW WOW WOW WOW WOW WOW WOW WOW WOW

Thank you so much for both the time and the effort you put into this...not only does it prove a VALUABLE commodity for those of us who cant wait to go over...but will prove the sense of brotherhood that we all maintain and strive for...

Thank you for the links as well...for those of us in DEP it will give us ample time to study up and get ready for overseas...

Thank you again...your a gentleman and a scholar :)

[BronzeBow]

I'd also like to thank you for this posts, and all your others.

[bubba68]

chief, all i can say is holy wow! i really appreciate your time and effort for that reply! i've been talking to alot of docs who just got back and you brought up a whole lot of things we didn't consider! thanks again!

[hm1park]

At the risk of sounding redundant. WOW. That was truly informative.

I can't stress the importance of knowing where everything is, every time. The numbering system is a great idea. Doing drills with yourself in the dark helps me a lot. Always have your equipmentpacked and readyto go. I know inBiviouc, it's easy to leave zippers open and things disorganized. Always be organized and place things back in place once you're done with them.

Chem lights are very helpful for seeing, make sure you check your unit's SOP's concerning usage of the various colors. Green and Blue work best when NVG's are in use. Red light makes blood a bit harder to distinguish.

Concerning CASEVAC and MEDEVAC. Remember that when thatCH-46or Blackhawks dropsinto the LZ, conversation is virtually nonexistent. Figure out other ways to quickly talk and pass information on your patient.

Network with your fellow Corpsmen and Medics inyour campand share information and resources with them. We may think the government gives us a blank check for supplies. Not so for most of the FMF. You may find yourself trading 500old battle dressings fortwo bottles of 800 mg motrin. A Blackhawk Med Bag might be well worth the investment. It's easy to organize and things don't just fall out.

Meds: I'm not too high speed on the meds but here's my little list. Motrin800mg, Tylenol 325mg,Sudafed 60 mg,Guafen/PSE, Naprosyn 500 mg, Tolnaftate solution, Benadryl 25mg, Allegra, Claritin, Nasal Saline(Dry air in Iraq has given two guys of mine nosebleeds inthe last few days), Metamucil individual packets, cough drops, individual salt packets(warm water gargles), meclazine, loperamide, Afrin,pink bizmuth tabsand or Tums, Tucks hemhoroidal individualwipes,erythromycin opthalmicointment, hydrocortisone cream, and ahandful more. Grab a big handful of small meds baggies so you won't be handing out an individual motrin three times a day.

Hope this helps and thanks particularly to HMC-FMF.

[bubba68]

thanks HM1! i appreciate the imput and will be darn sure to put it to good use!

[HMC-FMF-PJ]

The Asherman Chest Seal (ACS) adhesive does not stick well on sweaty, bloody chest walls. In addition, if you have a casualty with a very hairy chest you may need a disposable razor to shave the area to help keep the bandage in place. The ACS comes with a single 4x4 gauze to wipe sweat and blood off the chest, but more cleaning is needed. Also have a Tincture of Benzoin swab to paint the chest wall to help the bandage stick better. Or tape the bandage in place with good adhesive tape or Duct tape.

So think about adding to the list: disposable razor, q-tips, tape

[HMC-FMF-PJ]

I hope this helps you train your warriors...

Combat Application Tourniquet (CAT)
Videos & Instructions
http://www.phildurango.com/videos.htm

USMC TECOM Individual First Aid Kit (IFAK)
http://www.tecom.usmc.mil/gtb/CSSE/MedicalProgramsO/IFAK%20Users%20Info.htm

Cinch Tight 'H-Bandage' trauma dressing training video
http://www.cinchtight.com/HBANDA_3.WMV

Army Combat Lifesaver Program
http://www.cs.amedd.army.mil/clsp/presentations.asp

Army Trauma Focused Individual Training (T-FIT)
http://www.drum.army.mil/sites/tenants/division/CMDGRP/SURGEON/T-fit.htm

Z-Medica's Training site for Quikclot and Quikclot ACS
Instructions & Videos
http://zmed.cermusa.francis.edu/training/default.html

[] Download QuikClot 1st Response Training Manual
http://www.z-medica.com/files/1st%20Response%20Training%20Guide.pdf

[] Download QuikClot ACS+ Training Manual
http://www.z-medica.com/files/ACS+%20Training%20Guide.pdf

HemCon Medical Technologies
Register to access HEMCON Bandage Training website
http://www.hemcon.com/

[kamon8404]

Chief, thanks for all of the great info. I'll try to get this in the right hands on my end to make sure it doesn't go to waste.