Tom Rader - Member - The Prepared

Reply to: Best bug out bag backpack Posted April 29, 2021

Hi! I have that exact bag and have been using it as my daily carry for about two and a half months. I carried it as my main dump bag while we were filming the medical course, and then followed on with a couple of “in person” classes where it carried all of my tech gear and training aids. I think all of the RUSH bags look like they look–you’ll never “grayman” with them because of all of the PALS webbing. The color itself is fairly subdued and I found the gray to be lighter than their product shots. I think the double tap stands out less than the coyote or ranger green. As far as a pack, I like it more than the previous version. The concealed compartment is great–held what it needed to and if you didn’t know it was there could easily miss it. It organizes well. The laptop compartment is well padded and despite slamming my pack around, I never damaged anything inside. The sunglasses pouch at the top is larger than the previous version and can now hold full sized phones. I also found the shove it compartment to be more useful–swallowed up my jackets and other little bits I needed to stash quickly. Some of the complaints by others is that they removed some of the organization pockets, but IMO those were too constraining. I like having bags in my bags so I can grab and go (e.g. I carry all of my cords and wall warts in, ironically, the 5.11 med bag). I don’t need tons of little pencil/pen slots–this isn’t a student book bag. I like that they removed some of the forced constraint, but also recognize that some people like that, so your mileage may vary. Overall, I’ve found it to be a solid upgrade. In general, I like the AMP series better for blending in, but this new RUSH is just a workhorse and is my go to for rugged use. Both gear lines have their place.

Reply to: IFAK first aid kit list Posted April 27, 2021

Painfully, Baby Shark (as well as Stayin Alive and Another One Bites the Dust) have the right cadence for CPR:

Reply to: IFAK first aid kit list Posted April 27, 2021

I can concur with Robert. Civilian urban CPR is moving to the compression-only variety. Basically every time you stop compressions to breathe you are losing the blood pressure you have just built up, and blood pressure is the whole reason to do CPR–you are trying to keep the brain perfused with oxygenated blood. We have learned that there is actually enough residual oxygen in the blood for a long while and additionally if doing good compressions (which includes the release of the chest) you are creating a negative pressure in the lungs which will draw in the fresh air. That amount being pulled in is enough to oxygenate the blood for the purposes of CPR. The reality is that without early access to cardiac medications and electricity and a Cath lab in a hospital, CPR survivability is low, especially in austere settings. The best chance of getting someone back is when the heart itself is in good shape but was temporarily disrupted like from a lightning strike or drowning. If the heart failure was from a life of too many cheeseburgers or from trauma to the heart itself the underlying cause is not fixable without advanced professional care. Rescue breathing in an austere setting is pretty fixable, assuming the person has a pulse. In that case, a mask can help if you have issues with mouth to mouth with no barrier. But you don’t need a big sealable mask–there are plenty of small barrier masks which are nothing more than a sheet of plastic with a filter. Cheap and light solution.

Reply to: How to stop bleeding Posted April 24, 2021

My bad, I thought you were talking about a full gauze pack like https://www.amazon.com/dp/B009EJUFDA/ Even so, at TacMed, the OLAES is $6.95: https://www.tacmedsolutions.com/OLAES-Modular-Bandage so you could get two for $15. There are a lot of variables to consider when stopping a bleed. Depth of wound. Location. Severity of bleed. Co-morbidities (diabetes, hypertension, clotting disorders, etc). In actual use on bleeders, we still teach to hold for 10 minutes—no reason not to and a shorter time encourages the rescuer to “peek” which involves releasing the pressure. Also the instructions on the package still say to wrap the wound after the three minutes—so you still need other materials… The pressure bandage does all that for you… 😉 It looks like the use case for that specific QuikClot is a small uncomplicated wound that is not bleeding severely. The one I linked above is more appropriate for a severe bleed.

Reply to: How to stop bleeding Posted April 24, 2021

Hi Lowell, bleeding is stopped by the body’s clotting process. Our job as a first responder is to lower the pressure at the site of the bleed so that clotting process can work. That could be a TQ above a massive hemorrhage, gauze packed in a wound in a junction along area, direct pressure (or a pressure bandage) directly over the bleed, etc. The goal is to use the quickest and most direct method to stop the bleeding. Hemostatic agents are expensive “one-trick” ponies. Technically you must still reduce the pressure at the source of the bleed. What these agents do is help speed up the clotting process from whatever the active chemical is—you still have to apply pressure—just not as long. Most only speed up the process by around 30%. So if needed to hold for 10 minutes, it would just save you 3 minutes. Pressure dressings still maintain utility. I would use them where Red Cross says to use hemostatics. You can also use pressure dressings to secure remaining gauze after packing a wound. Pressure dressings can be used as a regular elastic bandage. They are one piece of gear that can do many things. Plus if you carry the TacMed OLAES, you get the pressure dressing, wound packing gauze that can be removed from the absorptive pad, an occlusive piece of plastic that can be used for a hasty chest seal, and an eye cup. You can buy several OLAES bandages for the cost of one package of hemostatic. A second TQ gives more flexibility with larger limbs or repositioning an existing TQ. It is false information that CATs, SOFTT-Ws, and other Committee approved tourniquets cannot be used on kids. They can be used on any limb that the backing can wrap around. TQs are not needed on babies. And dogs have tapered limbs that need a different shape. I hope this helps. You may want to look into a “Stop the Bleed” class as well—that material is based on the current recommendations from the committees that define policy for combat/tactical medicine.

Reply to: Best online first aid course? Posted April 19, 2021

Hi Lowell! Good on you for seeking medical training! I just spent the last week and a half teaching WFA, WFR and WFR Recertifications for Wilderness Medical Associates Intl. (in Taos, NM). Obviously I’m a little biased (since I’ve been been part of the WMAI system for a couple of decades) but I would check to see if your REI/NOLS course offers an upgrade path from WFA to WFR. WMAI offers a “Bridge” course so you don’t have to do the basic curriculum over again–that may be a cheaper option if available. Our IFAK article (https://theprepared.com/bug-out-bags/guides/first-aid-kit-list/) lists out the gear we have found to be most useful and correlates to the Wilderness First Responder level. We also show a few different ways that we carry components of the kit. Also, we have been filming our First Aid class (for The Prepared) and plan to have that available in about a month. While it isn’t hands on training, we do cover concepts that aren’t normally part of Wilderness Medical training. Most Wilderness Medical courses are designed to teach providers–meaning you are learning skills to treat other people and to stabilize them for handoff to an ambulance or to a hospital. We discuss managing injuries to yourself. We also touch on what to do when you will not be able to hand off the “patient” to someone else.

Reply to: Testing Topic Posted February 11, 2021

Test with images After both images

Reply to: IFAK first aid kit list Posted January 23, 2021

Hi Lowell! The problem in a heart attack is blocked blood vessels. The aspirin helps reduce clotting–clotting makes the problem worse–and buys time to get to the hospital and into a cath lab to solve the problem (which could be a stint or a bypass depending on the severity of the block). That is not something you can manage in the field. A tourniquet is a little different in that it buys you time to locate and stop the bleed with well-aimed direct pressure (which is the definitive way to stop bleeding). In most cases, a tourniquet can be discontinued in favor of a pressure dressing or something that does not affect the entire limb. Obviously, there are a few injuries that require a tourniquet to be left on (and then a trip to a hospital), but in our context, we want to try and remove a tourniquet as soon as possible, and can actually solve some problems in the field.

Reply to: Where do you keep your car fire extinguisher? Posted January 8, 2021

I keep two in my truck. I have one attached to a seat back organizer (Gray Man Tactical; though 5.11 makes a great one that is much cheaper and more portable). It is with reach of the driver with a little stretch or via the rear passenger door. I also have one in a cabinet on my canopy with other recovery related gear. You can see it nestled in next to the flares. Excuse the rest of the mess… 🙂

Reply to: Sutures: Can I use Vet/medical school practice ones to stock my first aid kit? Posted December 11, 2020

Hi Ismuth! The short answer is yes, those materials are probably fine assuming they are unopened and undamaged–suture material is honestly pretty standard. It is also important to source the other tools (needle driver, tissue forceps, scissors, etc). As Bob mentioned, it is important to understand the context in which sutures are appropriate–not all wounds need to be sutured. When you are not in a true, long-term, SHTF emergency, it is hard to justify the need to do it. Our guide is a pretty good primer on the techniques and rationale for the different types of closures. Suturing is an advanced skill which is also perishable–if you don’t do it regularly it is definitely more difficult. Even beyond the mechanical skill, different suture materials (and sizes), along with the appropriate needle, are needed for different applications. You’d need to stock a wide variety which can become burdensome. That all being said, I still think that familiarity with the technique is valuable. And it is most certainly better to learn and practice long before you would need to use it. The above linked article lists a decent training kit to learn the basics which also includes the tools.

Reply to: Adapting BOBs for family use Posted October 24, 2020

Totally agree that getting some experience with the gear is key. For instance we all carry radios in my group, because we can use them for comms between people. And all of carry individual tarps. We found out on a trip that want a little bit of separation. With respect to the wee ones–we are still trying to figure that out.

Reply to: Submissions from The Firearm Blog’s “Build of the Week” contest using TP’s kit builder Posted October 23, 2020

Week 4 https://theprepared.com/kits/a7cbe26d/

Reply to: Submissions from The Firearm Blog’s “Build of the Week” contest using TP’s kit builder Posted October 22, 2020

Week 3 https://theprepared.com/kits/pwpgv0hs/

Reply to: Submissions from The Firearm Blog’s “Build of the Week” contest using TP’s kit builder Posted October 12, 2020

Week 2 https://theprepared.com/kits/ad50c5fa/

Reply to: Submissions from The Firearm Blog’s “Build of the Week” contest using TP’s kit builder Posted October 2, 2020

Week 1 https://theprepared.com/kits/7z3edppf/

Reply to: IFAK first aid kit list Posted September 25, 2020

Hi Radical, sorry about the bad link. Amazon can be frustrating when they switch products on IDs like that. I was able to locate more of the dressings at eBay actually (and I updated the broken link in the article–thanks for pointing it out!). This product are getting more scarce because of the shipping and supply problems we are seeing. We chose that specific dressing because it is an XL Cravat. It is also marketed a burn dressing because it is non-adherent to wounds. It also comes with 2 large safety pins and a rubber band which can be used in other places in your kit. When possible we try to recommend products that can be used in multiple ways. In my personal kit I carry 3 smaller cravats just because they are so useful. When I go super minimal I always have a shemaugh, which can fill the role of a cravat as needed.

Reply to: Easy ways to harden your home against intruders Posted September 9, 2020

I can speak to this. We installed the 3M Scotchshield Ultra Safety & Security Window Film and it does all of the above. The back of our home faces west and it gets very hot during the summer–with this film though, the rooms were noticably cooler. We opted not to do any of the privacy style films as we wanted to keep a lower profile (and we have good blinds), but it was an option. The film is rated to withstand damage from hurricanes and blasts. Overall we are super happy with it and it has provided peace of mind against what was a weak point in our home.

Reply to: Perpetual gear finds thread Posted August 27, 2020

I bought one of these and it just came in. I am going to use it to redo an air hose I built for my truck. I will report back here with some pics and thoughts on it.

Reply to: IFAK first aid kit list Posted July 10, 2020

Hi Alicia and Clark, I can address this as one of the authors. Cold packs were specifically left out from this list because of three reasons. They are one-shot devices that only last 20 minutes or so. RICE protocol is that you apply the “ice” every 2-3 hours for 24-48 hours. Carrying eight to twenty-four ice packs is not really feasible. They are fragile. Since they are designed to activate on impact, they can be triggered inadvertently–especially in more densely packed kits. The purpose of the ice is to reduce swelling and pain. Which is handled by the Ibuprofen (or whichever NSAID is right for you). As a general rule, there are better ways to manage that type of injury that provide for longer-term care management and utilize a more stable (and smaller) product. Keep in mind that RICE involves Rest and Elevation along with the Ice and Compression. So if you are walking out with just an ice pack ace-wrapped to your ankle you are really not getting the benefit of the RICE protocol. What you are really doing is managing pain (which comes from the swelling tissues). And that can be handled with the ibuprofen. Also, there is some evidence that RICE (including the use of NSAIDS) delays healing. It gives short term pain relief at the expense of disrupting the healing factors that are part of the swelling process. Ultimately this list is a suggestion based on a consensus of best practices. That said, none of us had cold packs on our initial submissions for items on this list. If ice packs work for you, and you are willing to carry them, by all means, do so!

Reply to: About that IFAK tourniquet Posted June 24, 2020

Tourniquets are no longer a “last resort” option and have a number of uses. Their primary purpose is to buy you time until you can control bleeding with well-aimed direct pressure–though in some cases you might be unable to get that in which case the tourniquet stays on. The mindset about tourniquet removal has definitely changed though. A use case for a tourniquet might be that you put one on as a hasty intervention to stop bleeding until you can get to a safer location. We have also used them during wound cleaning on extremities–it keeps the wound clear of blood and numbs the limb (wound cleaning can be an “uncomfortable” process)–they are used in surgery specifically to keep the surgery site clear of blood. It is one piece of equipment that can significantly change the outcome of an injury and one that is challenging to improvise correctly. Plenty of science backs up the efficacy of quality commercial tourniquets. Good training helps you know when to apply it.

Review: the BOG OUT vehicle recovery device works, but isn’t for beginners

How to use a tourniquet

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Home medical supplies list

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High Altitude Cerebral Edema (HACE)

Acute Mountain Sickness (AMS)

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Submissions from The Firearm Blog’s “Build of the Week” contest using TP’s kit builder