Wednesday, March 18, 2015

Medical: Wound Care Kit

I’ve wanted to do this article for a while but have put it off. Now I will try. I have a friend who is a combat medic for a special operations team. He has lots of medical training and experience in the field. I asked him about the idea of a wound closure kit and he liked the idea. So I asked for his input. Here is some of his ideas and some of mine. May I say at first that I only have the basic of medical training. I’ve been trained in CPR and first aid. In the military they call it “buddy care”. I’ve taught basic first aid to Boy Scouts for years. But that’s as far as it goes. I had a hospital worked, laboratory technician teach me how to put in an IV and take blood. I had a MD teach me the basics of suturing. I had a nurse teach me to take temperature, blood pressure, and heart rate, but that is the extent of it. I have many children and so I’ve cared for them in the basic way we all do as parents with sick kids. So take this information for what it is, my opinion. I am not a medical professional.
If you want to properly close wounds, then you will need the appropriate medical supplies. Of course, you can use anything that you can get your hands on, but the goal of medical preparedness is to ensure you have the correct supplies for the task. First, you need to choose if you will build kits or keep your supplies in their original packaging, or a combination of both. If you have a mobile or outdoors mentality, I recommend building kits instead of having bulk supplies. If your goal is to set up a home clinic, then leave your bulk supplies in their original packaging; packaging materials for kits cost additional money. Additionally, there are different types of wound closure kits, from small kits to large kits just like the emergency room may use.
Most of the commercially available suturing kits are drastically overpriced, and will only have enough supplies for one wound closure. If you construct your own, you can build 20+ high quality kits for the same price as five commercial products. When constructing kits, purchase items in bulk. This means there is a high initial cost, but you have the ability to create many kits at a time. The more items you purchase, the cheaper it usually is; a group buy can spread the cost over multiple individuals. In some cases, it only costs a little more to purchase 50 items, than it would to purchase five individually packaged items.
A Wound Closure Kit contains many of the items needed for proper wound cleaning and closure, and provides multiple methods for closure (sutures and strips). If you are building a kit, I recommend using heavy duty bags as the external packaging. A heavy duty Mylar bag (4 mil thickness or greater) ensures the supplies are protected against light and moisture, limiting exposure which may cause some of the supplies to lose their sterilization and/or effectiveness, and can take some abuse before it is punctured. You can easily throw this kind of package in your vehicle or emergency bag, and forget about it. The bags that we use also include a zip-lock, so we can reseal the bag to protect the unused supplies.
Inside of the bag, the kit is separated into logical steps, or modules. Each module is designed for an intended purpose, however the supplies can be used in any of the steps (example – The sterile gauze sponge can be used during the flush process and/or during the closure process). Lastly, some of the supplies are loose packaged, due to their size. The modularity of the kit allows the administrator to use only the supplies needed for a particular injury, and to save the remaining supplies for a later use.
Some items were not included in this example kit due to prescription/licensing issues, to reduce the overall cost, and situation dependent reasons. Therefore, if you model your kits after ours, you will need to supplement with these durable and expendable Add-on items.
Lastly, you will need to shop around before making purchases. Most of what we purchased was on Amazon. However, do not be afraid to purchase medical items directly from manufacturer websites or eBay. Manufacturers usually have clearance specials. Most of the individuals that sell medical items on eBay acquire the items through purchasing surplus lots. Usually, these sellers are willing to get rid of the items that you need at the fraction of the retail cost.
When building any medical kit, we recommend taking a modular approach.
Flush Module
Zero Wet Splash Shield (This is to isolate your flushing to the wound)
20cc Syringe
Iodine, 10cc bottle
Pair of gloves
Preparation Module
Iodine swabs
Alcohol pads
Fenestrated Drape (A drape with a hole in it)
Regular Drape
Surgical gloves
Surgical mask
10 pac tray of guaze sponges
Closure Module
Suture 1-3/0 1-4/0
Suture PGA (absorbable)
Steri strips (1/4x3”)
Bandage Module
No stick 3X4 (2)
Abdominal pad 5X9 (1)
Self adherent bandage 2X5 yards (1)
Antibiotic ointment
Add On
Saline solution
Needle driver, tweezers, forceps
Chux pads
Lidocaine 10ml syringe, needle (prescription item)
This is just to get you started or to give you an idea for your own kit. If you have more training or feel you will have access to someone with more training, then add those items.
The Lidocaine is a prescription item but you may have access to it and the training to use it.
I hope you will consider learning new skills and getting the training needed to be effective if there is no help in sight.
Semper Paratus
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