How To Build Your Own First Aid Kit
First aid is a skill that’s applicable in so many contexts, but the kits you buy at the store are usually full of crap you don’t need. From a basic “ouch pouch” to a blowout kit on duty, to a full on setup in your car, here is a comprehensive guide to building your own IFAK.
First off: There are different tiers of first aid
This isn’t going to be some super duper badass field surgery kit. You’ll notice common things that advanced providers carry on duty such as NARCAN won’t be on here. The point of civilian/off duty first aid isn’t to be an advanced provider. You’re simply maximizing their chances until advanced providers get there. This is also applicable for my fellow officers in their blowout kits– even if you can’t treat a patient’s junctional bleeding or administer an IV drip, there is always something you can do to help boost their chances until EMS arrive on scene and take over.
Something that was originally conceived in TCCC (Tactical Combat Casualty Care) for military that I find translates very well to civilians and most officers is an anagram called MARCH.
Massive bleeding – Blood pressure is more important than oxygen in order for a human body to continue operating. See, human bodies are pressurized and there’s 8 gallons of blood in an adult body. This also means that serious bleeds are going to be coming out in great pulsing gushes (knife wounds), spraying out in mists (gunshot wounds), being sliced off cleanly then suddenly coming out at once (fatal car crashes), and more. As any of you who have seen life threatening bleeds already know, it doesn’t look all neat and proper. It looks like something out of a B-list horror film.
Airway – Oxygen does come after blood pressure! Need to make sure their airway is unobstructed from debris, fluids, etc so they can breathe properly. This also includes elevating them in certain ways, turning their head so they don’t choke on vomit, etc.
Respiration – Obviously the airway being clear isn’t enough. We want to tangibly confirm the individual is breathing without any difficulty. This is where things like chest seals will come into play.
Circulation – Blood pressure is the biggie, but we also want to make sure blood is getting to all parts of the body. I’ve seen places only teach the MAR part since this is several rungs below blood pressure and oxygen, but still worth understanding because it can help you catch anything you missed. For example, let’s say you’ve tourniquetted a limb. Is there any discoloration to the flesh below the tourniquet? Can they still feel past the tourniquet?
Homeostasis (or head) – Lastly this is the silent stuff such as body temperature/hypothermia, shock, etc that aren’t immediately fatal but absolutely complicate injuries further down the line. This is where things like emergency blankets and head braces come into play.
So now comes the biggest question:
Where can I get first aid gear?
This is a bit tricky because this is one of those things were there aren’t any set rules. For example: You can buy cheap stuff like nitrile gloves and rubbing alcohol in bulk off places like Galls and Amazon, but you want to steer clear of Amazon for tourniquets since so many of theirs are cheap Chinese knockoffs that will break in a real world situation. The main 3 I recommend are:
North American Rescue – I trust this brand always. Good people and if you order through their website they will give you a discount if you’re a first responder (and I think if you’re military as well, I don’t know because I’m not military and I never will be)
Medical Gear Outfitters – Don’t let his accent and appearance fool you, SkinnyMedic is a GREAT source for first aid equipment. He has a YouTube channel full of information where he does stuff like break down real world incidents where first aid is applied, reviews new products, and even drops information on classes he teaches. His store is equally great and revered among EMS all across America.
SOLATAC – Definitely the most obscure of these 3 but just as great is SOLATAC. Started by a highly experienced career paramedic in Lousiana (who goes by the moniker “Demp”), this store has tons of great gear for various niches. Need a blowout kit? You can buy quality fully made ones here. Tiny kits? You betcha. Big ass first aid kits? Demp delivers. Just looking for individual supplies? Demp’s also got you covered. Demp is also working on a YouTube channel for SOLATAC as well.
All 3 of these I carry and rep when I’m on duty and for my EDC. I wouldn’t recommend it if I didn’t trust my life to it myself.
Kinds of First Aid Kits
As valuable as Dr. Gary Roberts is, I completely disagree with his “one size fits all” approach to many things, including first aid kits. His idea of a first aid kit looks something like this:
And while a lot of that gear is very, very quality it usually isn’t feasible for people to be hauling around a loadout meant for a combat medic. (This is how Dr. Roberts got his start before becoming a very accomplished trauma surgeon, by the way. Again, this isn’t discounting his research and work, merely the contexts in which they are applied.) As I’ve mentioned before: everyone’s circumstances are a little bit different. So, first aid kits are going to vary. Keeping with the theme of commonality, as I have with my other articles, I’m going to break this down into 4 main categories. They are:
-Car Kit/stationed in a building
Let’s get on it.
Ouch pouch, PFAK, basic bitch bleed kit. Whatever you want to call it, this is the smallest one and a simple thing to EDC. For basic boo-boos, to allergic reactions, to controlling common kinds of bleeding, this is going to be the most useful most of the time and can easily be customized to suit your needs. For example: I know some people who easily fit an EpiPen into their Ouch Pouch, I carry burn creams in mine when I’m at the range (we all know that one guy who accidentally grabs a hot barrel or suppressor).
SOFT-T Wide Gen4
Normally, the tourniquet I recommend across the board is the CAT Gen7 from North American Rescue. It works fantastically on adults, children, and animals. It’s easy to apply to yourself as well as others. It’s simpler and much more durable than its previous iterations (simpler is better for a high stress scenario). The shortcoming however, is that it’s a bit bulky. The SOFT-T Wide Gen4 is second only to the CAT Gen7, and as this picture taken from ITS Tactical show the SOFT-T Wide folds up very small. I’ve linked ITS Tactical on previous blog posts, too. Good source for information.
Chest Seals (compact)
The purpose of the chest seal is to cover any penetrating wound in the lungs. If left untreated, air will keep sucking into the chest wound and eventually make the lung collapse on itself. This is called Tension Pneumothorax and it’s one of the biggest killers of officers and civilians who have been stabbed or shot.
North American Rescue is a brand I trust always. Their HyFin Vent Chest Seals are fantastic and come in a variety of different configurations for whatever your needs are (which is one of the two main reasons I’ve chosen them over the equally great HALO Chest Seals). The other reason I choose HyFin Vent is they can be purchased in packs of twos, so if you have a gunshot wound you can dress entrance wound and exit wound.
Celox comes in a variety of different configurations, what you’re going to want in a basic Ouch Pouch are the small packs of granules. You can pour this into jagged wounds that come from a variety of everyday injuries such as cutting yourself on broken glass.
Here is me using said packets after a friend tried teaching me a trick with his new knife:
And this was just a minor knife wound! Remember what I said about human bodies being pressurized and blood going everywhere?
Kerlix (small) and tape
Kerlix is one of the most vital things of first aid kits. Most of those fancy dressings you can buy off of shelves? Those are just some specialty bandage with kerlix. Get some proper training with kerlix and you can do some much- wrapping wounds, threading it into wounds, etc. As you can see, it comes in different sizes. Definitely grab the small one for your EDC. We’ll be using the larger sizes for our blowout kits. Another tip: Try tying a power ball at the end of your kerlix. Fine motor skills are the first thing to deteriorate when your adrenaline spikes, this will make it much easier to thread it into a wound if you aren’t used to doing it like advanced providers are.
As for the adhesive, normally we can use wraps (I’ll get to those later) but for our EDC we want it as sleek as possible. Some 3M tape will do ya just fine.
There’s a smorgasbord of different kinds of band-aids out there. Pick one, any one. Customize them based on the kinds of booboos you think you’ll be getting. You can take these everywhere, hell if you got the room throw some Neosporin or Advil in there as well.
Nitrile Gloves (x1)
Nitrile Gloves are good to double up on when you’re on duty, but for on body EDC you can get by with just one pair. It’s for the sake of the patient as well as you- don’t want to risk cross contamination or exposure to any number of pathogens and diseases out there. I have been bled on, spit on, pissed on, thrown up on, had people throw feces at me, even took someone into custody who shit themselves. Bodily fluids and close contact are virtually unavoidable when it comes to first aid. (And for my fellow officers, you definitely want to be getting tested for HIV, herpes, and hepatitis every 3 months. Can’t ever be too sure in this line of work, and those are the 3 you’re most likely to be exposed to in the line of duty. And on that note, if you think you have been exposed to HIV you definitely want to get prophylaxis immediately at a hospital or clinic. You got about a 4 to 12 hour window before it reaches your lymph nodes, and when it does you’re pozzed for life. Prophylaxis can kill the virus before it reaches your lymph nodes. Workers Comp covers it for all public servants, at least here in Texas, and I know many clinics will have your insurance cover it if you’re a private citizen.)
We use nitrile gloves because some people have latex allergies. The only other requirement I have for gloves is that they DON’T be black. If we touch someone and the hand comes away covered in blood, that is a visual confirmation of injury. However, it’s difficult to see blood contrasted on black gloves. Much easier to see them on another color (see below). North American Rescue makes them in these little packs so the gloves don’t get separated, but you can also buy medical surplus and station them in a number of ways. I carry a pair in a pocket on my person, another pair in a pocket on my jacket I wear on duty, and at least 2 extra pairs in my IFAK.
Lastly we’re gonna need a reliable way to transport our gear. Some stuff like bandaids fit into pockets, but for most of this we’re gonna want it all in one place, organized, and we know when we take the first aid kit out that everything will be in the place we expect it to be. Don’t just haphazardly throw all your gear into a bag- when someone is bleeding out, you don’t want to be fishing around for that other glove or something.
The ankle holster has by and far become the most popular way to EDC a first aid kit in the recent years, I also know officers who carry their Ouch Pouch like this in addition to the blowout kits on their duty belts or body armor. As for the kind of ankle holster out there, there’s a ton. Find one what works for you, the holsters themselves are usually inexpensive. Some differences include quality of materials, how breathable it is on your skin, etc.
This is your standard IFAK that is a bit too cumbersome to easily and discreetly carry but absolutely rides easily on your duty belt, chest rig, plate carrier, etc. This is going to be oriented towards those in the line of duty but every single thing you see here can absolutely go into the Car Kit as well.
I recommend an IFAK or at least an Ouch Pouch for all officers if for no other reason than once you put someone in handcuffs, they are now under your care and well being. You are accountable for what happens to them. (Ain’t gonna say responsible, and any experienced officer knows why. Accountable.)
When it comes to the available tourniquets on the market, the best of the best is the CAT Gen7 from North American Rescue. On top of what I mentioned above, there are a number of ways to carry them including a new rigid holder (also made by North American Rescue) that is standard among officers here in Texas. Even if you don’t carry any other first aid gear on you, if you are an officer and you do not carry a tourniquet then you are wrong. There’s no other way to say it.
Personally, I’d recommend doubling up. One on your person and one in your IFAK. Hell, carry a CAT Gen7 on your person and fold up a couple SOFT-T Wide Gen4s to store in your IFAK. Can do whatever you want, just remember that two is one and one is none.
Trauma shears are arguably the most important part of the kit. You can improvise stuff like a tourniquet, it’s not optimal but you can do. You can’t improvise a pair of trauma shears. The point of these is so you can cut clothing off without wasting time getting them off and potentially complicating the injuries. You just slice the clothing off quick and clean. And I’ll tell ya: If you go nonresponsive around me, everything from the waist up is coming off. You can yell at me for it after I save your life.
I have the North American Rescue brand shears pictured because 1) they’re inexpensive and 2) NAR is a brand I trust always. It’s the pair I run, though I’ve not got much experience with their scissor leash. I know paramedics love having means of retention so it’s muscle memory to get their shears. If you’re willing to throw down the extra dosh, the Leatherman Raptor is a folding pair of high quality shears (picture below). They just cost over double what the NAR shears do so it’s up to your budget constraints what you want to do.
Kerlix & ACE Wrap
As mentioned above, you want to take some larger rolls of Kerlix with you as well as a quality wrap. The wrap I recommend is the ACE wrap, which also comes in sizes comparable to Kerlix roles. (That is no accident.)
Another viable option for wraps is the Coban wrap (picture below), which also comes in size comparable to Kerlix as well as a small size if you want to use that for your EDC instead of the surgical tape. They’re both made by 3M and they’re both good. Whatever provides optimal buoyancy for your seafaring vessel.
No need to really go over the chest seals again, much like the Kerlix you can take bigger ones with you. Can also take the HALO chest seals with you, I know some guys like them because you can cut them in half.
Celox and/or QuikClot
As I mentioned above there’s a variety of Celox out there, another viable option is QuikClot. I would recommend at the bare minimum carrying the Z fold gauze from either maker in your blowout kit, I personally carry both Celox granules and QuikClot gauze in mine when I’m on duty.
Nitrile Gloves (x3)
Do I really need to include a picture with these again? Like I said, I carry at least one pair on my person, so I don’t have to rip my IFAK off the velcro and reattach it. I can quickly slip these gloves on before I go hands on with a suspect or something. I also carry at least 2 pair in my IFAK. Double up on these, two is one and one is none.
Also worth carrying pocket sized hand sanitizers with you. I keep one in my jacket and one in the vehicle always. Sanitizing after you take the gloves off goes a long way. In fact, one time I gloved up before giving someone first aid… I pulled their lips back to check their airway which is when I discovered that this particular patient was having an oral outbreak of herpes. Because I wore gloves, did not directly touch any of the effected area, and sanitized immediately afterwards it negated any risk of exposure. This isn’t just an anecdote for the sake of it, either. Like I said earlier: The likeliest things you’re going to be exposed to in the line of duty is HIV, herpes, and hepatitis. This shit’s important, y’all.
An often overlooked item of an IFAK is a pen light. Pick one, any one. Plenty of options out there, I personally prefer the Fenix LD05 pen light. Fenix is a very good brand for lights, not a single one of their products is bad- simply oriented for different purposes. You can hold a pen light in your teeth while you give someone first aid, you can use it to check specific wounds. More light is always good for first aid, this fills that niche without blinding you or your patient like some of the duty lights officers often carry will do up close.
“Ever wonder why Super Glue sticks to ya fingers so well? It was used to patch up broken soldiers during Vietnam.”
Super glue is an easy skin seal when you don’t have the time, tools, or skills to give someone stitches. And much like our friend Pvt. Cooper said, it has been used on the battlefield for decades. (Prior to Super Glue, woodsmen and hunters would often use pine sap.) It’s still being used today, too. That sealant that hospitals use? It’s literally just Super Glue that’s been run through their sterilization process.
ARS Needle (*)
This one comes with an asterisk because it’s a little higher than basic first aid. Advanced providers know the importance of a needle chest decompression, especially if a person has gone a while before getting a chest seal put on a sucking chest wound. But this ain’t just for EMS- I’d advise all my fellow officers to get any level of training and exposure above basic first aid and especially learn how to use these. You can even give a needle chest decompression without taking someone’s body armor off. Useful stuff.
And of course, a means of carrying everything is also needed. The basic velcro patch is the most copied design, and for good reason. I recommend the one made by Condor, because you can weave it into MOLLE or attach it to a duty belt in any number of ways. Gives you lots of flexibility, and it velcros on with a tab. Comes in a variety of colors so I’m sure you can find something that will be within regulation of your agency. And even then, most let them fly. Like my agency I’m currently with requires all black, but they gave me a pass on the OD green Condor pouch.
Another thing worth looking into is the new SOB (Small Of Back, you dirty minded SOB) kit. Which has conveniently been reviewed by SkinnyMedic.
This gonna be your big ass 20lb bag that would be impractical to carry around everywhere but can easily be put in your trunk or under a seat. Everyone should carry first aid equipment in their car, as for nonsworn and off duty in America (and most any Western, developed country) the likeliest emergency scenario you’ll find yourself in is a car crash. This is also applicable to be stationed in buildings as well.
For example: My main job is currently as a School Resource Officer, working additional security on the side where needed. One of things people don’t tell you about mass shootings is that most of the casualties aren’t immediately fatal. Most of the deaths come from exsanguination or tension pneumothorax. See, Fire and EMS won’t go in until Police secure the perimeter, which can take 45 minutes to several hours.
“This isn’t what we signed up for!” Actually, it is. If you wear that uniform, you gotta be brave. This includes going into warm zones to evac wounded. (I train with a pro who trains police and security, but he also trains Fire and EMS to do this very thing. If you’re in Texas like I am, hit this guy up. Robbie Allmon of P2 Concepts) As it stands right now, even if you’re not chasing down the active shooter you can still do something to help. Some first aid tips to help treat wounded and stop the bleed are available everywhere, I can site both another TKB contributor as well as SkinnyMedic again.
As I mentioned above, everything that you can fit in an IFAK can also be carried in a Car Kit, except you aren’t burdened with carrying it around everywhere so carry more and carry bigger. Other things to consider:
While this could feasibly be carried in an officer’s IFAK, it’s absolutely necessary for a car kit. These are used to secure the airways of an unconscious or nonresponsive person. The most often times where these has been needed, at least in my experience, has been for car crash victims. You can also buy these in bulk and practice on your friends.
Oral ones also exist (picture below) but my experience with them is limited.
While originally invented for camping, these are very good for carrying in your vehicle or in a public building like a school. Remember how I said hypothermia complicates injuries? This is particularly the case if someone has a life threatening bleed. DON’T move them into the shade. Keep them somewhere warm, be it in the direct sunlight or next to a fire or a car’s warm engine block. Emergency blankets are also good because you can wrap them up so they don’t get burned on the asphalt of the road. (I can’t say where you live, but here in Texas during the summertime when it goes over 100 degrees that asphalt gets HOT. I’ve seen injured people lying on the road get first degree burns from it.) As usual, double up on these. Two is one and one is none.
Bag isn’t as important as the pouches are since you won’t be carrying this on your person, but still important. You got a lot more leeway, so long as you know where stuff is stationed, the regular people you interact with know where this stuff is stationed, and it remains where you stationed it even when the bag gets jostled around from the road or whatever. My personal recommendation is the Lightning X bag, but there are plenty of options from other makers like 5.11 and Uncle Mike’s. (Don’t let their holsters fool you, Uncle Mike’s actually makes some really quality duty bags. They’re kinda like Blackhawk- they get a bad rep because their holsters are hot garbage, but their other stuff is good.)
While not necessarily a first aid kit per se, it’s useful to keep these around in a public building or perhaps in your car if you live in a remote area. A lot of these are very idiot proof, but still get some proper training. At least a BLS (Basic Life Suppport) course which covers these and giving CPR. Choosing the right AED can be a daunting task though, so here is a helpful little article to refer to.
On that note, CPR is a very, very, VERY violent and physically exhausting procedure. As in, if you don’t break or crack their ribs you aren’t doing it right. The human heart is a very powerful muscle- it takes a lot to keep it going and to kickstart it. CPR is only about 1/3rd the usual BPM of a normal human heart, for those who were unaware. Like I mentioned at the beginning, the point isn’t to resuscitate. You are simply maximizing their chances until advanced providers arrive on scene. Let’s say it takes 7 minutes for EMS to get there, that’s still 7 minutes without oxygen or blood flow if you do nothing. But with CPR, you are greatly increasing their chances. (On that note, North American Rescue does make a microshield mouth barrier for CPR.)
PoliceOne is a great resource for all police and security. Here is an article talking about first aid courses for cops on there. Here is another one that is very information dense but a good resource nonetheless.
Tactical Rifleman channel on YouTube is managed by a Special Forces medic who is part of his own training group called T1G. They teach advanced first aid stuff, such as the above mentioned ARS needle for all my fellow officers. They also have some excellent videos such as setting up an IFAK, how to keep a blowout kit in a plate carrier, going over TCCC, reviewing tourniquets, and much more. I say it all the time: most military stuff doesn’t necessarily translate to police work (some of it translates very well to security work moreso than police work) but first aid is something that’s useful in many different contexts.
Some of the Tactical Rifleman medic’s own words: “As a Special Forces Medic (18D), I was taught to clamp bleeders and all kinds of other great ways to stop bleeders. We were taught that Tourniquets were a last resort. We were taught WRONG. This little 15 year war (thanks politicians) has cost us thousands of lives, and has been a great case study on the treatment of trauma on the modern battlefield. We now teach TOURNIQUETS IMMEDIATELY.”
Just because you read this article, watched all the videos, etc doesn’t mean you are equipped to give someone first aid. Constantly be practicing and seeking out additional instruction and experience. Because if you walk up on an injured person, and they ask you what your experience is, and you say “none” they’re going to (rightfully) tell you to go pound sand. Something I can absolutely recommend is volunteer work with your local Fire or EMS department. Many of them will give free first aid training in exchange for part time or volunteer work, some will even let you do ride alongs as well. Like doing a weekend of ride alongs once a month, that will serve nicely for regular training and exposure. I guarantee that they’re shorthanded and will appreciate the help regardless as well.
I’m a lot more anal about proper first aid skills and setup than I am shooting, because while shooting MIGHT yield tangible benefits (most officers will go their entire careers without ever shooting someone) first aid is useful in so many contexts and it’s something anyone of any caliber can learn.
If you want to talk to me more, you can follow me on Twitter here. Fair warning though, I am a lot less active on it now as I focus on my work and stuff happening in my life. (I also get suspended fairly regularly for antagonizing racist, sexist, homophobic twats but what can I say? I’m a contrarian bastard.) But I do keep open DMs for anyone who has any questions. You’re never burdening me if you want information.
I’d also recommend you follow Jarv who has appeared on KommandoBlog livestreams and has verifiable TCCC experience in the Canadian military before he got out and went into the private security sector. The above mentioned Demp of SOLATAC is also on twitter and very active like Jarv is. (Demp also sent me some free swag and first aid stuff for supporting him and doing some networking for him, thank you Demp.)
Other people on twitter worth talking to are Solus who is a former EMT and security guard, Wandering who is a former career paramedic, Michael who is another KommandoBlog regular and an EMT himself, and BFT who is a current active paramedic and despite a falling out that she and I had (long story and it’s water under the bridge by this point) she is very knowledgeable and useful.
As usual, I am supporting charity as well. This one comes from a local Texas officer who I have worked with in the line of duty by the name of Damon Cole. He has his own charity where he dresses up like superheros and goes to sick kids anywhere in the country to cheer them up and spend time with them, entirely on his own dime and at no cost to the families. When people ask “Where are the good cops at?” this is one of them right here. He’s doing the good work.