Assembling a blow out kit for tactical EMS
By Chuck Soltys, EMT-B
EMS1 Tactical EMT Contributor
With the threats currently facing today’s first responders, the need for basic tactical emergency medical skills and equipment cannot be overstated. Having the basic skills and necessary equipment to treat a life-threatening penetrating injury such as a gunshot or stab wound is crucial. It only takes between two and four minutes to bleed to death from an injury to a major artery. Even EMTs and paramedics with the best intentions (and skills) may not be able to render aid in time. For an unspecified amount of time, you will be on your own. It will be your personal skills and available equipment that will likely be the difference between life and death. You must be mentally prepared to come out of a critical incident with a life worth living, not mere survival where your quality of life has been irreparably damaged. Training and preparing to prevail and not merely survive is a responsibility that falls squarely on each of us.
Numerous companies offer high-quality individual immediate action medical kits (or blow out kits as the military cals them), many of which are offered preloaded or can be loaded to suit your own specifications. Because some kits can be prohibitively costly for many police officers, an alternative is to build your own blow out kit.
All Bleeding Stops Eventually
There are numerous companies out there that are producing high-quality individual immediate action medical kits (or blow out kits as the military refers to them). Many of these kits are offered preloaded or can be loaded to suit your own specifications. However, some kits can be prohibitively costly for many police officers. An alternative is to build your own blow out kit.
Prior to assembling a blow out kit, ensure that you have received the training and certifications required by law and department policy and procedure for the components that will be included in your kit.
Assembly of the Blow Out Kit
Assembling your own blow out kit is relatively simple and inexpensive, and should include (as a minimum) all of the items necessary to treat life threatening injuries caused by penetrating trauma such as gunshot or stab wounds.
Items Required for the Blow Out Kit
• One compression dressing (approx. cost $5-6)
• One pair of trauma shears (approx. cost $6-8)
• Two pairs of nitrile gloves
• One Sharpie marker (preferably a mini-Sharpie)
• One small Ziploc bag
• One tactical tourniquet (approx. cost $18-25)
• Eight strips of 2” or 3” Tape (100 mile an hour, duct, or equivalent)
• One roll of Paper Masking Tape
• Two 14-gauge Angiocath Needles (3” or greater in length)
• One size 28 Nasopharyngeal Airway (NPA)
• Hemostatic Agent (such as Celox or QuikClot)
The only tactical tourniquets currently approved for military issue are the Special Operations Forces Tactical Tourniquet (SOFTT) and the Combat Application Tourniquet (CAT). A military triangular bandage and tongue depressors (6” x 1” tongue depressors taped together to create a windlass) can be substituted as an improvised tourniquet to reduce cost.
Note: The materials used in the production of some civilian triangular bandages may not be strong enough to function effectively as an improvised tourniquet. They will tear before adequate pressure can be applied. In addition, an improvised tourniquet will generally take more time to properly apply which could be critical. There are currently a variety of emergency compression dressings on the market that work very well to control hemorrhaging and are suitable for the tactical environment. The OLAES Modular Bandage, the emergency compression dressing commonly referred to as the Israeli Battle Dressing, the “H” Bandage, and the Cinchtight bandage are examples of some of the most popular compression bandages available for tactical use.
As with any piece of gear, each of these items have particular advantages and disadvantages, the decision on which components to carry/use are best left up to the individual tactical EMS officer/operator. Whichever items you choose, make sure you train regularly with them. A compression dressing can be used many times for training purposes. However, items used for training should be from a blow out kit dedicated to training only. Do not use items from your duty blow out kit for training. Make friends with other local EMTs, paramedics, and hospital emergency room personnel. They may have items available to support your operations that will further reduce the cost of your blow out kit.
Be very careful when buying off-the-shelf first aid kits that are not designed for tactical applications. Often, these kits will list the necessary components, but upon examination many of the components are less than adequate for responder needs. I recommend sticking with a kit that you assemble yourself comprised of components that meet or exceed the criteria for tactical applications or purchase a pre-loaded kit from a reputable tactical medical supplier. There are many companies out there producing/selling quality products.
Assembling the Blow Out Kit
Cut eight strips of 100 mile an hour or duct tape long enough to run the length of the compression dressing package. Fold about ¼ to ½ inch of one end of each strip under (figures 2 and 3). Take the compression dressing (preferably a 6” dressing, but a 4” will suffice) and apply 4 strips of tape the length of the dressing on each side. Each of the four strips should be placed on top of each other with all of the pre-folded ends located at the same end of the dressing (figure 2). The fold will permit the removal of each strip when needed without the strips sticking together. This technique is known as “buddy taping.” The tape can be used for any number of things in an emergency such as securing a three-sided occlusive dressing over a chest wound.
Put the Sharpie and the Nitrile gloves into the small Ziploc bag. Carry two pairs of gloves so that you have a pair to offer someone that may be available to assist you, or in the event you rip a pair while trying to don them (which is quite common under stress), you have an extra pair immediately accessible.
Bundle the dressing, shears, Ziploc bag, and tourniquet together and bind them all together with the paper masking tape. Using paper masking tape will keep all of the necessary items of your blow out kit together and still allow for the easy separation of the items when needed.
Advanced Blow Out Kit
Provided you have the required training/certification/licensure, add the NPA, angiocath needles, and hemostatic agent to the bundle.
You’re done...it is that simple!
Keep the kit in a cargo pocket or in an easily accessible place in your vehicle, such as the side pouch on your driver’s side door or center console. Keep in mind that there is a considerable compromise in choosing to position the kit in your vehicle and not on your person as your duties will likely take you away from your vehicle making it difficult if not impossible to get to in the event of an emergency. I have positioned an identical kit in the side pouch of both front doors and on the tailgate of all of my vehicles. This makes a blow out kit available from three sides of the vehicle which could be critical in the event of an attack while in or near my vehicle. Under fire, I might not be able to get to one kit placed in the driver’s door, but having at least one other blow out kit placed elsewhere increases my chances of accessing life-saving equipment if/when needed.
As Police Chief and top trainer Jeff Chudwin says “We do not get to choose when and where we will be attacked, the number of attackers, the duration of attack, or how we might be injured, that will be decided for us.” However, by virtue of the oath we took, we have an obligation to be prepared. If faced with a critical injury, you can prevail!
Chuck Soltys is a 23-year law enforcement veteran. He is currently a federal agent and Tactical Emergency Medical Technician. He has been assigned to specialized enforcement groups as well as serving three tours of duty on a jungle operations team in South and Central America. Chuck holds numerous instructor certifications and has instructed extensively in the United States as well as in South America, Central America, South Africa, and Europe. Chuck is a member of the Illinois Tactical Officers Association (ITOA) Board of Directors and TEMS Committee Co-Chair, International Law Enforcement Educators & Trainers Association (ILEETA), National Tactical Officers Association (NTOA), International Association of Law Enforcement Firearms Instructors (IALEFI), as well as numerous other professional organizations. He can be reached at firstname.lastname@example.org.
The views expressed in this article are the author’s alone and do not necessarily represent the views of the United States Department of Justice or an officer or entity of the United States.
- Tactical EMS / TEMS
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