First Aid kits

Jay Ashworth

Well-Known Member
I'm rebuilding mine, since it's gonna be a REAL busy first-season-back-after-COVID... assuming BA.5 doesn't shut us all back down again. And as I go through everyone's "10 things", "20 things" and "30 things" lists (I hit about 90% without looking), it's occurred to me to wonder:

How does one go about getting naloxone and epipens to put in such a bag? Do you need a script? How would you get a script, if so?
 
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In a related story: JEEZUS is that stuff expensive. $200-600 per dose?

Yeah, ok, I get it; the alternative is dying, but even so...
 
I'm sure the procedure for obtaining naloxone varies from locale to locale.. but google "Standing order naloxone"
it can be obtained otc without a prescription. Pretty sure epi pen also has a "standing order" provision, but it appears on quick perusal that most of that distribution is geared toward schools.
Most fire departments in many mid to large size metro the firefighters are also paramedics.. might be a good first ask.. the local firehouse How do I??
Naloxone carries less potential adverse effect than epi if you are wrong and the patient doesn't really need it. So I'm thinking the reins might be tigher on the epi.. ie first responders school nurse etc.
 
It varies by state, but generally Epi pens are not widely available without specific medical licenses or a prescription. Narcan/Naloxone is generally easier to get OTC though.

Also a general word of caution. If you're going to be putting together a large trauma/first aid kit (especially one with medications in it), it's worth checking the relevant laws in your state/jurisdiction and being aware of if and how they might cover you in your situation. Not all state's Good Samaritan laws are the same.
 
It varies by state, but generally Epi pens are not widely available without specific medical licenses or a prescription. Narcan/Naloxone is generally easier to get OTC though.

Also a general word of caution. If you're going to be putting together a large trauma/first aid kit (especially one with medications in it), it's worth checking the relevant laws in your state/jurisdiction and being aware of if and how they might cover you in your situation. Not all state's Good Samaritan laws are the same.
An excellent point, and one that will probably make me stop short of those two items.

I don't think benadryl and loperamide can get me in too much trouble.... :)
 
An excellent point, and one that will probably make me stop short of those two items.

I don't think benadryl and loperamide can get me in too much trouble.... :)

I can't discourage this second statement enough and now you've put it on the internet forever...

Does it morally suck that the system makes it prohibitively dangerous to help another human in a time of need absolutely, but that's the rub...

most "Good Samaritan" laws are incredibly restrictive and cover the "victim" significantly more than you.

here's what YOU CAN DO...

Get training, especially for department heads, full timers and anyone with responsibility of Life/Safety. There should be a local Red Cross affiliate / American Heart Association that can provide appropriate first aid / CPR training. They can also cover local municipality and state laws that vary place to place.

You may also have laws that prohibit storing, distributing or providing things as simple as acetaminophen. It's a thing in NYC for most "venues". You can't have ibuprofen in a first aid kit. (does everyone do it? absolutely. Is it technically a violation? YES.)

Take the appropriate steps to be able to provide the appropriate help in a time of need.
 
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This is, for the record, my personal bag, and I'm only barely a department head anywhere I work, and all of those as overhire. I simply got tired of it taking 15 minutes to hunt up a bandaid when I scraped up my own finger on a pipe.

As far as "you can't have analgesics in a first aid kit, well, that state government will look really foolish on the national news.

I don't propose, though, legally, to "dispense" any of these items.

They're just *there*, in the corner, in a box. If anyone sees fit to take something out of it, that's no nevermind to me... :)
 
Yeah an amusement park I used to work at had a "weird" rule for Aspirin and other pain killers.
They could sell it to you in the gift shop but they were not allowed to hand it to you in first aid, even by the registered nurses they had working.
But they also had a container of pre-packed dosages (same they sold in the gift shop) sitting on the counter of first aid. You could grab one yourself but they were not allowed to hand it to you. I am guessing (though don't know for sure) that the moment it was handed to you it was dispensing, but if you grabbed it yourself it was fine.
 
Yeah an amusement park I used to work at had a "weird" rule for Aspirin and other pain killers.
They could sell it to you in the gift shop but they were not allowed to hand it to you in first aid, even by the registered nurses they had working.
But they also had a container of pre-packed dosages (same they sold in the gift shop) sitting on the counter of first aid. You could grab one yourself but they were not allowed to hand it to you. I am guessing (though don't know for sure) that the moment it was handed to you it was dispensing, but if you grabbed it yourself it was fine.
I'm inferring such a legality, yes. Lawyers... <sheesh>
 
Good sam talk reminds me. I once witnessed an older patron step backwards off a step at a local barn theater, just a few feet from me. It was the whole time slows down slo mo.... ohhhh nooooooooo. Couldn't get to her, and she hit back of the head first. I made her stay down, got someone on the cell phone to call the para meds. Family got her up to a seat but paramedics arrived. She checked out basically ok.. was mobile and lucid.... I really pushed the family hard into having her take the ambulance ride, because I saw the head strike and no one else did. Few months later she literally charged up to me in the church parking lot to thank me. She had CT.. sub dural hematoma.. they drilled and drained. Without the ride and the check, she would have gone home laid down and never gotten up again. So yes I was pushy and a busy body... and someone probably could have sued me if everything checked out OK for an un necessary ambulance ride. But sometimes lawyers be damned, you have to do the right thing. I probably am in a more precarious liability situation being a Veterinarian, but you'd probably rather be shipwrecked with me than your dentist. :)
 
.

You may also have laws that prohibit storing, distributing or providing things as simple as acetaminophen. It's a thing in NYC for most "venues". You can't have ibuprofen in a first aid kit. (does everyone do it? absolutely. Is it technically a violation? YES.)

Thats fascinatiing as we had a contract first aid kit contractor at Brooklyn, would come in periodicaly and re-stock the first aid kit, which had acetaminophen in it. I assume he was unaware of that particular NYC law.
 
Good sam talk reminds me. I once witnessed an older patron step backwards off a step at a local barn theater, just a few feet from me. It was the whole time slows down slo mo.... ohhhh nooooooooo. Couldn't get to her, and she hit back of the head first. I made her stay down, got someone on the cell phone to call the para meds. Family got her up to a seat but paramedics arrived. She checked out basically ok.. was mobile and lucid.... I really pushed the family hard into having her take the ambulance ride, because I saw the head strike and no one else did. Few months later she literally charged up to me in the church parking lot to thank me. She had CT.. sub dural hematoma.. they drilled and drained. Without the ride and the check, she would have gone home laid down and never gotten up again. So yes I was pushy and a busy body... and someone probably could have sued me if everything checked out OK for an un necessary ambulance ride. But sometimes lawyers be damned, you have to do the right thing. I probably am in a more precarious liability situation being a Veterinarian, but you'd probably rather be shipwrecked with me than your dentist. :)
Nice.

And yes, in the lifeboat, the *person who read the medical textbook* does the emergency appy.
 
One other resource that may be useful to you or others who want to carry Naloxone. Try your county (or other municipal) health department. In our area in western NY there is an effort to provide training and free doses to the public. You show up for the training and leave with a dose. One thing to note is that storage temperature for Naloxone is recommended 68 degrees F to 77F with occasional exposure of up to 104F. Depending upon the season and geography it probably shouldn't live in a car based kit all the time.
 
As a Paramedic who dabbles in stagecraft, here's my $0.02.

1. Any medical provider other than a physician is governed by a scope of practice and set of protocols that are established by state and local authorities. Anything we do requires a standing or direct order from a physician. Hence the reason I cannot carry common OTC pain relievers or other meds and give them out. I can, however, leave them on the table for a person to self-medicate.

2. As stated above, Narcan and EPI have very specific temperature ranges and shelf life. In most states, Narcan has a standing order for general public administration, Epi does not. In most EMS systems anyone other than a paramedic can assist a person to take their own EPI Pen (though that is changing to allow EMT's to use their own)

3. When you build your kit, there are 2 scenarios to plan for - Bo-Bo's and trauma. For Bo-Bo's the usual stuff - BandAids, Gauze, splints, etc. For Trauma, add a Stop the Bleed Kit (https://www.bleedingkits.org/all-products/personal-stop-the-bleed-kits.html) that contains a tourniquet, Chest Seals, Wound packing gauze, and pressure bandage. Buy these kits from a reputable supplier - NOT Amazon!! The $19.99 tourniquets are not of high quality or tested and will fail. Spend the extra $10 and go to a vendor like North American Rescue for a COTCCC approved device.

4. In addition to a CPR, AED, and First Aid Course, take a Stop-The-Bleed course to learn and practice using the kit contents. There are other courses such as Trauma First Responder that go into more depth.

You are working on stage with power tools and working at heights so the risk of major lacerations and falls is always there. That is what the second part of the kit is for.

John D
 
On point 1, *you* have a license to lift, which, presumably, I don't. This matters? "There's probably some helpful stuff in my bag" was my planned stance; I *know* my limits in First Aid. :)

3. Thanks for the link.
4. I gotta check if my new house has AEDs; it's gotta for $15M, right? :)

My older house does.
 
On point 1, *you* have a license to lift, which, presumably, I don't. This matters? "There's probably some helpful stuff in my bag" was my planned stance; I *know* my limits in First Aid. :)

3. Thanks for the link.
4. I gotta check if my new house has AEDs; it's gotta for $15M, right? :)

My older house does.
Jay:

Agreed. when i am away from my department, i function as an overqualified standard first-aider,

If your house has an AED, get them to add a Stop the Bleed kit to it as well. (and take the course)

To answer your first question - the reason for the post, after many years of traveling with small children, Scout troops, Marching bands, and youth groups I developed a small hip sack that serves as a walking first aid kit. Contents are as follows:

Front compartment - small flashlight, whistle, and compass (also space for keys, etc.) Also, an energy gel can be useful

Rear compartment
2x Nitrile gloves (your size, NOT black)​
Tourniquet​
Chest Seals​
4x4 Gauze pads​
5x9 gauze pad​
3" Kling (self-adhering gauze)​
3" Ace bandage​
Triangle bandage​
Ziplock bag for bo-bos with various forms of Band-Aids, Benzalkonium Chloride wipes, and Triple antibiotic ointment​
Ziplock bag with unit dose packs of common meds (Advil, Tylenol, Benadryl, Imodium, and Rolaids) to be made available for self-administration :)
Tools - small bandage scissors, tweezer, safety pins, tick remover​
If I carry tape, it needs to be replaced frequently. I would add a small knife but it needs to be TSA compliant.​
Obviously, I have other kits built for other purposes, but this is the minimalist one.
 
Jay:

Agreed. when i am away from my department, i function as an overqualified standard first-aider,

If your house has an AED, get them to add a Stop the Bleed kit to it as well. (and take the course)

To answer your first question - the reason for the post, after many years of traveling with small children, Scout troops, Marching bands, and youth groups I developed a small hip sack that serves as a walking first aid kit. Contents are as follows:

Front compartment - small flashlight, whistle, and compass (also space for keys, etc.) Also, an energy gel can be useful

Rear compartment
2x Nitrile gloves (your size, NOT black)​
Tourniquet​
Chest Seals​
4x4 Gauze pads​
5x9 gauze pad​
3" Kling (self-adhering gauze)​
3" Ace bandage​
Triangle bandage​
Ziplock bag for bo-bos with various forms of Band-Aids, Benzalkonium Chloride wipes, and Triple antibiotic ointment​
Ziplock bag with unit dose packs of common meds (Advil, Tylenol, Benadryl, Imodium, and Rolaids) to be made available for self-administration :)
Tools - small bandage scissors, tweezer, safety pins, tick remover​
If I carry tape, it needs to be replaced frequently. I would add a small knife but it needs to be TSA compliant.​
Obviously, I have other kits built for other purposes, but this is the minimalist one.
Unsurprisingly, that's a pretty big IFAK. :)

I don't do things by half-measures, and I had some free cash; my bag is the big orange Damero (https://www.amazon.com/gp/product/B09FZ7J29R/?tag=controlbooth-20) with no big silly cross or labelling. I picked it because of the flip up and flip down lids -- the competition didn't have those -- and a couple other things. It's almost full, and almost at maximum load (I suspect); I'll post an inventory here in the next day or two; been out sick most of the week.

[ On reflection, that's one notch up from an IFAK, isn't it? ]
 
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Unsurprisingly, that's a pretty big IFAK. :)

I don't do things by half-measures, and I had some free cash; my bag is the big orange Damero (https://www.amazon.com/gp/product/B09FZ7J29R/?tag=controlbooth-20) with no big silly cross or labelling. I picked it because of the flip up and flip down lids -- the competition didn't have those -- and a couple other things. It's almost full, and almost at maximum load (I suspect); I'll post an inventory here in the next day or two; been out sick most of the week.

[ On reflection, that's one notch up from an IFAK, isn't it? ]
Jay - that's a nice looking bag - similar to what we use as a "first In" bag. I will be interested in your inventory
 
A really important thing to consider in this discussion is the respomse time of EMS in your area. In my case the fire department is about 2 minutes away. I need to call 911 and keep the victim alive 3 minutes until the professionals can take over. So my primary 1st aid kit is just an AED and a bleeding kit. In the back, I have an extensive minor injury kit (ace bandages, ice packs, band aids, gauze pads and tape, etc).

Also remember if you are working in a school or around children you probably should never give them any medication. Check into the local rules carefully.
 
So, probably outside the realm for most... but we pay a service to do this for us. We have 5 kits throughout the building, all very well stocked and checked quarterly. Takes care of the OSHA requirement and requires no staff interact. Costs about 2 grand a year to do all in.

 

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