Trauma Kit

[Mess6311]

After responding to a serious RTC last night, i am wondering if there are additions to our standard kit we could look to make. We currently carry 1 x CAT tourniquet per bag and various ambulance dressings but they are not substantial enough in my opinion for major trauma or blast type injuries. So my question is this;

• Do you carry CATs in your brigade? If so how many?
• Do you carry blast dressings/israeli dressings in your frontline bags? again if so how many and what size?
• Do you carry any further major trauma equipment to deal with casualties prior to ambulance arrival?

I realise that Ambulance have primacy  and there are the national workstreams on co-responding, so not wanting to overstep lines, but whilst we carry trauma equipment it should reflect the types of injuries we are likely to attend, sometimes on our own for prolonged periods, due to ambulance service pressures.

[JonesMrJones]

We have one CAT in each trauma pack. 

Also a couple of Israeli bandages and the new Prometheus Olaes trauma bandage. They are the standard size and I think maybe one large one. Also a load of regular type bandages and other standard FPOS type kit including Russel cheat seals 

I asked a few weeks ago why each firefighter doesn’t carry a CAT and Olaes bandage each as standard. No one really knew why but I got told that we could do as it was just a case of ordering more. 

[Mess6311]

28 minutes ago, JonesMrJones said:

I asked a few weeks ago why each firefighter doesn’t carry a CAT and Olaes bandage each as standard. No one really knew why but I got told that we could do as it was just a case of ordering more. 

Guessing it's just a cost issue?

Cheers for the info mate

[Carl]

@Mess6311 Get Martin or yourself to put it on the system (AMS) with full details. Having attended the RTC with you last night, I will back it up with some further comments and pass it onto out Trauma Department  

[Mess6311]

We have had a chat and we will AMS tonight mate. I have also emailed the trauma dept to get their views on it. Cheers Carl, with no disrespect to Avon and @JonesMrJones but if they are carrying kit like that surely we should be too?!

[Carl]

Totally agree. What we need is evidence like this that we can take forward to put some validity on having more kit. With ambulances stretched as much as we are these days, we are finding ourselves first on scene for a lot longer, so we need to adapt accordingly. 

[Luminoki]

West Mids have one tourniquet in the trauma bag, along with israeli dressings and celox gauze ( a dressing with a clotting agent inbuilt ) Im grateful that i havent had to use either so far. In regards to blast injuries and major penetrating trauma the celox is a handy thing to have

Celox training video (Warning, you will need to sign in due to content)

[Mess6311]

Celox is great stuff, used it in a previous life, but at £40 a dressing not sure GMC would stretch that far.  We don't even carry israeli dressings though.

[Lummox]

We’ve got the olaeus and tourniquet in our main bag, we also carry a ‘battle bag’ consisting of blast dressings and oleaus as well as multiple tourniquet. 

Im sure you can guess what the last bag is on the truck for but it’s there if we need it. 

[Geeta77]

Anyone using Penthrox? 

[Mess6311]

Weren't cheshire looking to implement using it?

Edited February 24, 2019 by Carl
Quote removed. Please see FAQ in respect of quoting.

[Becile]

Here's ours..there's been a few changes since this was published.

Surrey Trauma.zip

[Geeta77]

20 minutes ago, Mess6311 said:

Weren't cheshire looking to implement using it?

Yes. Not happened as yet though, but is being used widely in the UK and wondered if any other FRS now had it as part of their trauma response

[AmboJelly]

Penthrox does have it’s benefits but it has been removed by several of the ambulance services that implemented it. It is contraindicationed in most elderly patients due to there kidney impairment or cardiovascular disease and can not be used in a confined space so not particularly useful in and entrapment so it use may be limited.

[Geeta77]

Not heard the can't be used in a confined space one. Kidney impairment definitely yes. Interesting one that. I'll check with our Medical Director his thoughts on that

[Mess6311]

On 24/02/2019 at 11:19, Becile said:

Here's ours..there's been a few changes since this was published.

Surrey Trauma.zip 423.79 kB · 2 downloads

Are these on all frontline appliances? That a very in depth kit. What trauma course do you undertake to be able to use it all? Is it a FREC/FPOS course? 

The bleeds element is the kind of stuff i think we should carry, but the obs stuff is way more than we have. Are the meds for asthma and cardiacs?

[OscarTango]

These are on all pumps yes. Kent carries a near identical kit, the two brigades have similar approaches to IECR with a five day initial course undertaken, initially overseen by Secamb (which covers both counties and we follow their clinical governance). It is essentially an FPOS enhanced course and covers 

Surrey extensively took up co responding and Kent closely followed their approach. Although co res is suspended much of the obs gear is a legacy from that. Co responding still happens at sone stations in Kent though as this was a seperate program that predates the EMR trial. 

We used to carry Salbutamol administered via a nebulizer but that has currently been with drawn until Secamb update their training for it. 

Until there's a clearer picture of our future relationship with all things medical I can't see there being much change. Good to hear of haemastatic dressings being adopted though, they are few and far between. 

As for penthrox, what adavantages or or contraindications does it have versus entenox? 

[Becile]

It's also in all the fds response cars, defibs as well.

[JonesMrJones]

Found out today that our trauma packs are changing. 

They are going to be re jigged to make it easier to use regards to the modules and better colour coding. Currently they don’t make sense as bleeds is a green bag, burns are red and a few other odd things. Keeping roughly the same kind of kit in them though. 

Its going to be based on a military style trauma pack by the sounds of it. 

Also talk of changing DRABC to MARCH for the new FPOS/Medical course that will be run. 

[AmboJelly]

On 25/02/2019 at 18:31, Geeta77 said:

Not heard the can't be used in a confined space one. Kidney impairment definitely yes. Interesting one that. I'll check with our Medical Director his thoughts on that

My understanding was that reason is it can not be used in a confined space was that it can give off a gas that can effect bystanders, the carcoal filter helps to reduce this but my understanding was it didn’t completely eliminate it. Happy to be corrected as my knowledge of it is brilliant as it’s never been ustilised in my trust

1 minute ago, AmboJelly said:

My understanding was that reason is it can not be used in a confined space was that it can give off a gas that can effect bystanders, the carcoal filter helps to reduce this but my understanding was it didn’t completely eliminate it. Happy to be corrected as my knowledge of it is brilliant as it’s never been ustilised in my trust

*mean’t to say my knowledge isn’t brilliant