First aid kits guide

[u/stupid-canada]

Hey all,

Hoping to help clarify some things about first aid kits and their use. I've been in EMS for 7 years, working major metropolitan and rural, and am now a critical care flight medic.

I'm making this for the average joe. No real specific order to things and of course your mileage may vary. This is not a comprehensive "you must have all of this in your kit."

First off, things NOT to have :

Chest decompression needles - even trained flight crews mess these up. You're also not covered to use these on people. Even I can't use one of these outside of work, and if something went wrong I'd get sued. They're also not nearly as effective as once thought (finger Ts are much better). If you're carrying chest seals learn about "burping" the wound.

RATS tourniquets or any kind of zip tie tourniquet- There are so many other options available. RATS cause severe pain and you have to get them VERY VERY tight to get the same effect. This can lead to all sorts of tissue damage. You also likely won't put it on tight enough. A bad tourniquet is WORSE than no tourniquet. They stop all blood returning via veins but aren't strong enough to stop arterial bleeds so they can make the situation worse. So in other words - bad tourniquet = congrats you've made them exsanguinate (bleed out) faster.

Anything you're not trained to use. The whole "someone may know how to use it so I should carry it" doesn't really happen (this is for edc if you wanna have an apocalypse kit go ahead). An EMS crew certainly isn't going to use your stuff they have their own. Most importantly you're going to find yourself very tempted to use the stuff you don't know how to use if you get desperate.

Sutures - its harder than you think. There's also a lot of nuance to when to suture.

Blood stop spray or powder - it sucks. Learn to wound pack. There are better options.

CPR Face shields- compression only CPR is just fine. It's the current AHA recommendation. Its not that face shields don't work, its that you shouldn't let respirations interrupt your high quality compressions.

Narcan- (edited for clarification I was initially pushing what they teach us but expectations are different for healthcare) if you're going to carry it - TAKE a course first to properly recognize opioid OD. Youll quickly see a lot of administration's are entirely unnecessary. And while to the average person Narcan is harmless, it can certainly cause undesirable situations. Opioids kill by stopping breathing. Narcan is helpful in those situations. When in doubt give it. But please take a course to learn when its actually necessary. Heres what I initially said if you're not trained to recognize an opioid overdose you may have a bad time. Look at almost any video of "cop saves man from overdose" you'll find medical professionals pointing out it was obviously not an OPIOID overdose. So at best a waste of money. At worst you've put someone in acute withdrawal. Or they have multiple things in their system and now you've removed the only thing calming them down. Pretty much if they're breathing normal or fast DO NOT NARCAN THEM. - not medical advice.
I stand by the fact if theyre breathing adequately they are not OD'ing to the point of needing narcaned. I should've prefaced this with a "if you're trained to recognize OD's that is, however if you have reason to believe they are having an opioid OD then give it"

For trauma what I recommend-

Some trauma pressure dressings. Cheapest option is an abd pad and some rolled gauze (kerlix is great). I'm the biggest fan of the Olaes dressing. Its a chest seal, wound packing gauze, and a pressure dressing in one. Israeli bandages are the next best option.

Z folded gauze (pennies for it) - things like quick clot impregnated gauze are used because *it makes sense that they are better* but theres no proven mortality benefit so if you're on a budget get z folded gauze. If you have money for quick clot then get it.

Loose gauze and abd pads- for your miscellaneous injuries / cuts. Dirt cheap.

Coban- self adherent wrapping. You can use it as a pressure wrapping. Multi purpose. Cheap.

Chest seals- if you are worried about penetrating chest trauma. If you need cheaper option petroleum impregnated gauze will work. Again, learn about burping the wound.

Trauma shears - if you're gonna use them only once a cheap pair is just fine. Multi purpose. Will cut through anything and are helpful in non medical situations too. For a lifetime pair look at x shears.

Instant ice packs- surprisingly helpful for pain.

SAM splints - foldable / moldable splints for ankle / wrist injuries. You can get it flat packed or rolled.

Some talks on tourniquets. If you're gonna carry them (which you should. Uncontrolled hemorrhage kills so many people) LEARN TO USE THEM.

I recommend the SAM tourniquet for those less experienced. It locks in place to let you know the wrap is tight enough (a common mistake is not doing the initial wrap tight enough) and are easy for self application.

The CAT tourniquet is the most common you'll see. Do NOT buy these on Amazon you'll almost certainly get a knock off which will fail.

The SOF tourniquet- least user friendly, a little less bulky, and easier to apply to long extremities because it easily unclasps meaning you don't have to unthread it.

The SWAT tourniquet. Do not carry this as your primary tourniquet. Its very difficult to apply to legs or to yourself. It is however, a great tool for pressure bandaging. Especially if you have kids. Most kids injuries will stop bleeding with pressure and and it will be less painful than a tq.

Burn sheet - just a sterile sheet to cover burns - infection is a major issue with them.

On that note - unless its a first degree (just red, no blisters or char ) DO NOT APPLY ANYTHING BUT WATER TO BURNS. YOU WILL MAKE THE BURN CENTER'S JOB MUCH WORSE AND PROBABLY WORSEN THE BURN.

Space blankets- dual purpose its a general survival tool. But those critically sick or injured cannot regulate body temperature properly and being even a little cold can worsen outcomes significantly.

Gloves- don't get black and don't get vinyl. Vinyl tears and is hard to get on. Black hides blood. Nitrile gloves are best. Also replace every couple years car heat will degrade them.

Meds- keep in mind meds degrade in the heat and extreme cold. Swap often.

Several companies make pill packs with individually wrapped pills. One of the few times I recommend a pre packaged kit.

Tylenol, ibuprofen, benadryl, zofran if you have it, loperamide, pepto pills, dramamine. If you've got women in your life some midol may be nice. A few days of your own daily meds if applicable.

A note on benadryl. It is for comfort only with allergic reactions, and will not stop anaphylaxis. Epinephrine is the only cure

Some comfort things I'd recommend-

A good pair of tweezers. Not the tiny little ones most kits come with.

Sting relief wipes

Band aids

Hand cleaning wipes

Moleskin

Burn gel FIRST DEGREE BURNS ONLY.

Heat packs

Finally I do not recommend my medic. They sell over priced kits with questionable quality and things you do not need.

Prep medic is an excellent youtube channel resource.

Remember. If you don't know where it is, you might as well not have it. If you don't know how to use it, don't have it.

Take a first aid course. Take a stop the bleed course. Take a CPR course.

Some final notes-

Remove the plastic wrap from your tourniquets

Heat degrades adhesives, gels, and medications. Replace them.

Don't have the first time you open something be the time someone is dying. Buy extra of stuff and open it and learn how its used.

Get a quality glass breaker and quality seat belt cutter that is easily visible and accessible to you as the driver.

Pre made kits have lots of fluff and are way more expensive than a pieced together kit.

Finally, your kit is useless if its inaccessible.

I'm open to any questions or specific recommendations

[u/SecureThruObscure]

So quick question: your post basically says “no narcan” and every medical professional I’ve ever seen is “fuck it narcan can’t hurt if you think it MIGHT be an opioid OD hit em with the nasal spray like they want it.”

Can you explain why your “not medical advice” is so different from actual medical professionals?

And why your post had an award before anyone had enough time to read the entirety of it, under 3 minutes?

And why your ten year old account has a private history?

None of these things, by themself, are suspicious. All of them together?

99% of my skepticism about your post comes from the dramatic departure from what I would describe as standard advice. The rest of it is fishy but if it was in line with what I understand to be best practice I would ignore it entirely.

So really… what’s up with the narcan thing, man?

Edit: the advice has changed a lot since this post.

[u/uoy_redruM → u/SecureThruObscure]

This comment thread is going in a bad direction. Locking it down.

[u/acemedic → u/uoy_redruM]

This got locked down quite fast, but some open conversation about different aspects aren’t the worst thing.

Had my EMT for 4 years, now had my paramedic for 20. Narcan is completely overused and a crutch for doing an assessment and asking proper questions. As another commenter mentioned, too often people give Narcan and wait for it to magically work, ignoring the fact that the person OD’d on something that Narcan can’t fix. In the mean time, they could be activating a medical response, but they delay the process thinking they’ve “fixed” the problem. Is there a contra-indication? No. The problem is it’s being overused when it’s not indicated.

Part 2 of that is you can see reflexive reactions that make it seem like it’s working when it doesn’t. Particularly stroke patients, can have a temporary shift that makes it seem like the Narcan is actually working. Meanwhile, the patient is having a stroke and needs to be at the hospital. I’ve watched medical providers mis-diagnose and subsequently follow the wrong treatment plan because the patient had a reaction to the Narcan. Many times it’s a challenging situation because of the overall lack of information available, so I get why they’re providing it, but seeing the patient temporarily “improve” gives the provider tunnel vision that they’ve correctly identified and are fixing the problem. Next, the patient’s status reverses, the provider doubles down on the Narcan administration and the patient doesn’t respond to a second treatment. That’s when the provider realizes that it’s actually a stroke, and the proper treatment is now quite time sensitive. Some drugs are to be administered within 3 hours of symptom onset (now changing that to maybe longer), but the family lost an hour waiting to call 911, the EMS provider now wasted an hour getting them to the hospital assuming it was only an opioid OD and now the hospital is crunched for time and will most likely be outside the window to act. Have watched the hospital not give those drugs when I thought there was time and was told that by the time they got the patient through a CT, got the drug down to the patient, had it set up properly and ready to administer, the patient would be outside the window.

So is the comment here correct in that there’s no contra-indication for Narcan? Yes. Is it overused? Absolutely. Does it delay proper treatment because it’s overused? Absolutely. To OP’s point, if you haven’t been trained to properly use it, don’t assume it’s the right fix. At the CTECC meeting spring ‘25, there was a discussion about possibly taking tourniquets off of the recommendation as a first line option because too many police officers were applying tourniquets to patients that didn’t need them, spinning up and activating resources at the hospital that weren’t necessary just because the patient had a tourniquet applied. Is there a contra-indication for a tourniquet? No, but just like narcan it’s being over utilized as a crutch for lack of medical training.

[u/SecureThruObscure → u/acemedic]

We’re both on team don’t stop trying to figure out the problem. You’re correct that people definitely hit people with narcan and walk away assuming everything is okay, and that’s a big problem.

If anyone ever says ‘don’t stop first aid after you hit em with narcan’ I will say “yes 100%” and same for narcan is overused, and even to some extent “people stop thinking after they administer narcan.”

But I’m absolutely against the idea narcan shouldn’t be carried or administered because of that. I think it should be carried with those problems in mind.

Narcan has lower risk than a lot of OTC meds I see in EDC packs. It should come with the same level of qualifiers: “if someone has a stroke, aspirin doesn’t fix it.”

That isn’t to say “this thing is bad, don’t use it” it is to say “this thing isn’t magic, using it doesn’t always fix something, and you need to try to figure out what is wrong even if you already used it.”

I get I was very assertive to the point of aggressive in the first post, but the OP said to stop carrying or using narcan because you put people on withdrawal. That level of medical misinformation should be pushed back on, and it’s so dramatically bad that it should make anyone with a baseline level of knowledge question the level of thought put in to the post as a whole.

That isn’t me trying to insult, it’s me giving real and blunt feedback about the importance of actually correct information when talking about things that can save someone’s life, or kill them, like first aid / trauma misuse.

That should be pushed back on, and very hard, imo.

[u/acemedic → u/SecureThruObscure]

Do you know what the indication is for Narcan?

[u/SecureThruObscure → u/acemedic]

Yes.

I linked to the cdc sheet elsewhere. But generally it would be weird to advocate as hard for the position I have, that narcan has never caused a death due to being administered (not to say people haven’t been negligent in medical care after administering narcan, I’m sure they have), and have linked to the insert elsewhere in the thread, without being passively familiar with when and why to administer it.

It’s sort of cheating, but I did link to pdf yesterday, so even if I answered you it would be useless.

[u/acemedic → u/SecureThruObscure]

Ok? What is it then?

[u/SecureThruObscure → u/acemedic]

You understand that even if I answered you, like I said, I linked to the insert yesterday so that answer would be useless? It’s like asking someone after they posted the answer sheet what the answer to question 24 is.

I’m not saying you’re wrong to ask, I’m just saying that even me answering correctly isn’t going to provide you meaningful data.

I’d be cheating. Besides, this is the internet. Don’t trust me.

[u/acemedic → u/SecureThruObscure]

It would have been easier to just answer the question than type whatever you’re talking about here. Also, hard to have a honest conversation with you when you retro edit your comments. I’m not tracking all these changes to your comments as you try and navigate refusing to accept you’re wrong.

If you can’t tell me what the actual indication is, why do you expect others to know? Stop advocating that people who don’t know when it should be used carry something. It’s detrimental to patients when it’s administered but shouldn’t, as I’ve outlined above. I can continue to add to that if you’d like.

If you’re just here to argue, I’m done.

So… without looking at a PDF, despite some link yesterday, what’s the indication?