Scenario 1: You and your engine company are the first unit to arrive at a reported house fire. It’s a two-story, single-family dwelling with heavy fire showing from upper floor windows on Sides A and B.
Laying in the front yard is an unconscious 50-something woman. The ambulance responding on the alarm is several minutes out.
Scenario 2: Several fire companies are engaged in fire suppression in three apartments on the third-floor of a multi-family dwelling. A sudden smoke explosion rocks the scene and the Division 3 supervisor reports two firefighters are seriously injured.
Division 3 tells incident command they’re moving two injured firefighters to the second floor and requests additional personal and medical gear. The ambulance committed to your incident is operated by a private-sector EMS company; that is, they don’t have PPE or training for entry to the hazard area.
Life-saving kit
These are just two scenarios that make the case for small, lightweight medical response kits that give firefighters the tools to manage the patient’s ABCs — airway, breathing and circulation. This isn’t a typical EMS-response gear bags, but rather something on the order of smaller individual kits carried by soldiers so that they can render life-saving care to a fallen comrade before medics arrive.
Think about it. One minute the soldier is in the tactical operations mode — combat — and in an instant they must leave that role and become a care-giver to one of their own. The firefighters in the two scenarios above would find themselves in a very similar position.
These EMS quick kits can be carried aboard all apparatus, even those that may not be designated as EMS vehicles in your department. The goal is to have the kits available anywhere, anytime and from any unit.
They would be small enough to be part of a unit’s RIT/RIC equipment cache or a high-rise hose pack. Several kits could be stored at different locations on the apparatus so that they are readily available.
Here’s the recipe list for just such an EMS quick kit. The emphasis here is on functionality and cost-effectiveness, that is, it works and it’s cheap to make.
Airway and breathing
- (3) Adult-size oropharyngeal airways. One size fits all. This is a quick fix to keep an airway open.
- Pocket mask with one-way valve
Circulation
- Pair of trauma scissors
- Trauma dressing pads, 5- x 9-inch
- Roll of 3-inch self-adhering gauze
- (1) 3-inch elastic bandage
- Petroleum-jelly dressings, 4- x 4-inch
- Triangular bandage
Other
- (2) Microbial hand wipes
- Pair Nitrile gloves
- Triage tags
- Black permanent marker
There’s the functionality part. Just the basics necessary to stabilize problems with the ABCs until the patient can be removed to a safe area or more formal EMS resources arrive to assume patient care.
To package the EMS quick kit contents, all you need are some clear plastic, one-gallon size, zip-lock bags. Really. Here’s why:
- Low cost.
- Allows personnel to quickly see the item they’re looking for.
- Many of the situations where the kit will be needed will likely result in the unused items of the kit being trashed. Since you won’t have a lot of money invested in the equipment or the storage container, it’s more economical to dispose of the unused and contaminated pieces.
Assembling the kit
For each kit, make a set of saddlebags using two gallon-sized zip-lock bags. Here are the materials you’ll need to complete each kit:
- (2) Gallon-sized, clear plastic, zip-lock bags.
- Standard office stapler.
- Roll of 1- or 2-inch masking or painter’s tape.
Open the bags fully and hold them together at the zip-lock. Use the stapler to connect the two bags; put the staples below the zip-lock so that each bag still opens full and both zip-locks work properly.
Place the airways, breathing and other category items in one side of your clear plastic saddlebag. Use the other side bag for the circulation supplies. Finally, wrap your newly created EMS quick kit with masking tape a couple of times across the middle — vertically and horizontally — to ensure the two bags stay together during storage and deployment, but can still be easily opened.
I’ve become a fan of the blue painter’s tape that’s now on the market for this function. It looks better and comes apart more easily after a long time than does standard masking tape.
Budget friendly
Certainly, you can spend more money on off-the-shelf products that are widely available, but why would you? In the words of Gordon Graham, noted subject matter expert in the field of risk-reduction for emergency responders, you’re designing equipment to meet the needs of a high-risk, low-frequency event.
I first learned of this type of kit in 1986 when I attended Fairfax County (Va.) Fire & Rescue Department’s fire officer school. Lt. Mike Reilly covered multiple casualty incidents and included a description the contents and construction of an MCI kit.
Several years later, the Virginia Office of EMS adopted the same kit for use in the state’s medical disaster and MCI response plan. I had the opportunity as an EMT Instructor for that agency to deliver the supporting training program for that plan many times across the state and within my own organization. We eventually had an MCI kit aboard every vehicle in the fleet.
All of which just goes to show you that good practical solutions to everyday challenges are really never out of style, are they?
