IFAK Contents | What Do you Really Need in Your IFAK?

Let’s be honest; there are some ridiculous first aid kits out there with everything from a single piece of combat gauze to almost anything you might find in an operating room.  But what do you actually need in there?  There are a lot of pre-packed kits on the market that I think fall short, mainly because the purposefully omit life-saving products in order to reach a certain price point.

Before we go much further, let me make the statement “IFAK kits will be expensive.”  Expect to pay at least $200 for your IFAK and accompanied medical items.  I know this may sound like a lot, but if something dire happens to you, you will spend the rest of your short life wishing you had splurged on the good stuff.

The Aggressor

 

What does IFAK Stand For?

IFAK stands for Individual First Aid Kit or Improved First Aid Kit.

MARCH Algorithm

The below-recommended contents are based on years of real-world experience, actually seeing what does and doesn’t work.  These items will fit in a small IFAK and will provide necessary life-saving options.  I will expand on this and say that none of the below medical equipment will do you any good if you don’t know how to use them.  I’d argue that knowing how to use these items is more important than actually having the items themselves.  While I could go into all the recommended courses available, I will save that for a later post.

I will make my IFAK list based on the MARCH algorithm.  The military’s MARCH algorithm varies from the traditional ABC (Airway, Breathing, Circulation) used by civilians.  MARCH stands for: massive hemorrage, airway, respiration, ciruclation, hypothermia/head injury.

Massive Hemorrhage

The military puts Massive Hemorrhage at the top of the treatment list.  This means that if you arrive at a patient, you’d want to treat a massive hemorrhage first before moving on to any other injuries.  Now, it’s important to note that a massive hemorrhage means a sizeable arterial bleed is dumping copious amounts of blood onto the ground.  This isn’t a cut that is dripping on the ground; it is large volumes of blood loss that could lead to death in less than a minute or two.

Airway

This pertains to being able to draw air into the lungs.  Airway would be something like an obstructed airway due to debris, a tongue of an unconscious patient or mouth and throat burns.

Respiration

This pertains to the actual breathing process. Standard treatment for respiratory ailments would include something like a collapsed lung or a sucking chest wound.

Circulation

At this stage of the algorithm, we go back to general bleeding and lacerations to keep lots of cuts from leaking precious blood out of the body.

Hypothermia/Head Injury

This last piece of the algorithm is a little bit contentious in that many healthcare providers believe you should treat hypothermia throughout the MARCH treatment process. I agree with this method of thinking, but it is always wise to reassess for hypothermia after all the holes have been plugged.

With the above algorithm in mind lets look at what items are going to treat those issues.  Keep in mind this doesn’t address things like spinal cord injuries, burns, smoke inhalation or other possible non-visible injuries that you as a civilian might encounter.  However, those are injuries that you as an everyday civilian wouldn’t be able to treat with anything out of your IFAK anyways.  So these items cover things that you can personally manage and potentially use to save someone’s life.

Massive Hemorrhage

Tournaquets don’t always work, especially if you’re dealling with a mass hemorrhage. If you run into this, you will most likely have to resort to something known as wound packing to help control the bleeding. You can do this with compat or combat gauze. If you want to learn how to do this, there are some great videos on Youtube showing you how to pack a wound properly.

Compact Gauze

I’d say this is probably the most critical piece of medical kit you can carry.  It’s cheap, small and has a ton of different applications.  If you have a sizeable massive bleed gauze is the only thing that can fill a large cavity and provide the pressure needed to stop the bleed.  You can wrap gauze, stuff gauze, use it as a sling, use it to splint and a multitude of other applications.   I would suggest carrying at least two packages of compact gauze.

Combat Gauze

Combat Gauze is probably the most expensive piece of kit you could add with the cheapest versions starting around $20.  However, if appropriately used, Combat Gauze can be crucial in stopping a massive bleed.  Combat Gauze works by putting an agent in the gauze that causes the blood to coagulate and in theory stop the bleeding faster than just gauze.  The problem with this product is that it only works if applied correctly.  If you merely stuff the gauze improperly into the wound or lay it on top, you won’t be helping out the situation.  The gauze must be applied to the cut artery to work.  However, when overseas, I like to carry a lot of packs of these in place of compact gauze because they can offer the same functions as compact gauze and I don’t have to pay for them.  For this, I’d recommend carrying at least one.

Tourniquet

Arguably more important than gauze is a tourniquet.  Tourniquets are a quick fix to a complex problem.  They are relatively inexpensive, easy to carry and fix most extremity bleeds.  While there are a ton of tourniquets on the market, we sell and recommend the RATs.  However, the CAT and the SOF-T are both great tourniquets that will do a phenomenal job of stopping an extremity bleed.  At the end of the day, I recommend finding a tourniquet you are comfortable with, know how to use and trust and buy that.

Airway

Nasal Pharyngeal Airway (NPA)

NPAs are probably the best item you can carry to treat an airway.  This inserts into the patient’s nostril and creates an airway.  These are inexpensive, easy to use and easy to carry.  While there are other airway items you can carry like a King Airway or Cricothyrotomy Kit, the NPA is the most practical item to carry with minimal training.

Respiration

Respiration issues could require anything from simple to advance paramedic skills. If you don’t know how to decompress a tension pneumothorax, we recommend you don’t go cutting into someone’s chest wall. Doing so could cause more harm than anything. So, what you put in your IFAK should be based not only what you can carry or what you’re most likely to encounter, but what you have the skills to do.

HALO Chest Seal

The HALO Chest seal is designed to fix a sucking chest wound by applying a self-adhesive occlusive dressing.   These are easy to use and can usually stick to skin with hair, sweat or blood.

Tension Pneumothorax Kit

These are designed to treat tension pneumothorax, a complication that takes place when there is a hole in the lung.  These are crucial in longer-term care where a tension pneumothorax is expected, however, this does require some advanced training.  There are great to add to your kit if you’ve had the chance to practice with one.

Circulation

When it comes to circulation, your goal is to keep someone from bleeding out. There used to be a time where it was recommended not to turn a tourniquet too many times or you’d cause a person to lose his or her arm. However, for life-saving reasons, we’ve gone away from this type of thinking. Would you rather lose a leg or lose your life? Good items to carry in your IFAK to help control bleeding are compact guaze. You don’t have to worry about cutting off circulation, but you’re still controlling the bleeding. Trama tape is another great option outside of a tournaquette. We like to add these items to our list because circulation management with iV/iO access requires you to have a lot of gear you probably won’t have room for in an everyday IFAK.

Control Wrap

Like compact gauze, control wrap/Ace wrap has a ton of different applications.  One of these is helping provide the necessary pressure for bleeds.  I prefer control wrap over ACE wrap because it’s a unique design that allows the user to get the wrap extremely tight.

Trauma Tape

Athletic Tape or Trauma Tape is essential for your IFAK since it too has a lot of multiple uses.  I prefer Trauma Tape because it allows the user to record the patient’s vital signs without having to carry additional paper or cards.  The tape can also be written on with almost any kind of pen.

4 Comments

  1. Pretty spot on. The ex EMT in me recommends adding treating for Shock to the “Hypothermia/Head Injury” section. Not much you can do for hypovolemic shock with an IFAK other than elevating limbs so that hey are higher than the heart.

  2. Two issues really need more investigation and thought.

    First up is the R.A.T.S. Both aid-under-fire courses I have taken, taught by veteran combat medics, have said to avoid the R.A.T.S.; recommend only utilizing equipment that has a proven track record; and have highly recommended the SOF T-wide. During both courses we only utilized the SOF T-wide, and after several days had no problem applying them with either hand, one-handed, on either upper arm or upper thigh. They are larger and you have to learn a bit more about how to fold-to-store them and how to deploy them with one hand, but with training and practice they work, and work WELL.

    Second issue is perhaps an oversight. Where is the OLAES? After experiencing first hand what this thing can do, you have to wonder why anyone would NOT have one in their kit. And there is no substitute for experience.

  3. @JWS Second Issue OLAES… Totally agree. Each of my kits has at least 2. I interpreted ‘control wrap’ to be the reference to OLAES, but it could be stated more clearly. On the first, I carry both a CATs and RATs. I carry the RAT in case I have to deal with smaller limb circumferences like a child or pet (or a friend’s SAR dog), which as I understand it, was why it was developed. I’ve tested both on myself and the CAT is definitely easier to use, but with practice I have found that the RAT can also be effective.

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