This article provides basic information concerning Individual First Aid Kits (IFAKs). The article contains background information, descriptions, and recommendations for those that wish to acquire or build their own IFAK.
Introduction – IFAK is an acronym for Individual First Aid Kit, which hails from military jargon. An IFAK is a medical trauma kit that is carried by a person and intended to be used by others to treat that same person if they become injured. One can also use an IFAK to provide treatment to others if required. An IFAK normally contains only items for hemorrhage control and other trauma treatment. Lower level first aid items should be carried in a separate kit as required.
Experience in recent wars has taught us that most combat related deaths occur from extremity hemorrhaging and issues affecting respiration such as tension pneumothorax or blocked airways. Thus a typical IFAK is designed to provide immediate treatment for these primary trauma related issues.
Not only soldiers carry IFAKs. IFAKs are also ideal for use by those in law enforcement or by civilians. While IFAKs were primarily designed to treat violent trauma, they can also be used to treat other traumatic injuries such as hunting accidents, range accidents, or work related injuries.
Build Your Own IFAK – One can buy a commercially made IFAK or one can put together their own. Commercial medical kits tend to be very good but they also tend to vary a lot and sometimes contain items that are not for use by untrained individuals. Building your own IFAK is beneficial exercise, because in doing so you will become more intimately familiar with the contents of the kit, the item locations, and how the items are used.
Design Considerations – All IFAKs are not created equal. An often overlooked requirement of building an IFAK is that the kit should be designed to suit the environment and its user. What a soldier might carry in combat will differ significantly from what a preparation-minded civilian might carry from day to day. Begin the process of building your own kit by considering the mission for the kit. For purposes of this article, we will focus on kit design for LE and civilian users. The answers to the questions below will determine the type, size, and scope of your kit.
- Are you military, law enforcement, or a civilian?
- What is your current level of training?
- What is your mode of carry – vehicle, kit bag, belt carry, or concealed carry?
- What is your environment – battlefield, LE patrol, urban/sub-urban, remote/wilderness?
When considering your IFAK, it is also important to keep in mind the priorities in responding to any violent trauma and/or employing trauma care in a high threat environment. Anything beyond what is mentioned below is “icing on the cake” and not necessarily critical for life saving.
- Prevent further injury
- Control life-threatening hemorrhaging
- Maintain airway & breathing
- Enable evacuation
IFAK types – There are typically two types of IFAKs for consideration…
- Operator IFAK – A kit designed for those who operate in higher threat environments such as law enforcement or for civilians who wish to prepare for a higher threat index. Operator kits tend to be larger, contain more stuff, and are not concealable. They would typically be carried in a vehicle, on a belt, or in a kit bag.
- Nitrile Gloves – These gloves should not be black; colors that show blood or OD such as the Defender-T type are recommended. Purpose made trauma gloves like the Def-T are also very strong and cover high up the arm. Don’t neglect the gloves. Have 2pr for Operator kits. In addition to protection from blood-borne pathogens, people will more willingly render aid with vigor when using gloves.
- Shears/Clothing Cutter – Shears and cutters are used to quickly provide access to injuries by cutting through clothing. They can also be used to cut bandaging or other materials.
- Pressure Bandage – Pressure bandages are needed to control moderate bleeding or to control bleeding in areas where tourniquets are not indicated such as torso, neck, or head. The OLAES bandage is highly recommended due to it’s proven versatility and efficacy.
- Sterile Folded/Compressed Gauze – Compressed gauze is used to provide a compact source of additional hemorrhage control material for wound packing or bandaging.
- Medical Tape – Tape is used to secure dressings and bandages.
- Tourniquets – Tourniquets (TQ) are used to control heavy bleeding from extremities (arms & legs). The use of a tourniquet is indicated in cases of heavy bleeding beyond what can be controlled with a bandage which usually results from a severed artery or vein. Windlass tourniquets such as the SOF-T or CAT are the mainstay. Compact tourniquets such as the TK4L can be used when compactness or high-thigh injuries are a consideration.
- NOTE: Operator’s carrying an IFAK should carry a self-aid TQ on their person where it can be easily reached with either hand. The intent of this second TQ is to provide immediate and unfettered access for self-aid. Additionally, multiple TQs are often needed to control bleeding on large lower-extremities or for treating multiple patients. A SOF-T wide TQ is recommended for this application, as it is the easiest to apply to a lower extremity during self-aid because it can be unclipped so that the strap can be passed around the extremity. Looping and passing over a TQ may be feasible on an arm, but not so much on a blown-out leg.
- NOTE: Every Day Ready, LLC sells SOF-T Wide TQs for $29.95 each, in addition to a variety of TQ holders/pouches to carry it on your gear or person.
- Chest Seals – Chest seals are stick-on occlusive dressings are used to control bleeding from penetrating wounds in the chest cavity in order to prevent air from entering the pleural space and causing a tension-pneumothorax. Chest seals have an aggressive adhesive that sticks through blood, sweat, and hair. Chest seals are fast & easy to apply. Non-vented chest seals work fine. Vented chest seals provide a vent that lets air & fluid escape but does not let air into the wound. HyFin chest seals by North American Rescue are recommended because they offer the largest seal available and the adhesive is extremely aggressive.
- Casualty Card – Casualty cards are used to collect information about the patient such as personal data, vital signs, and documentation of treatments administered at the scene. This information is important to EMS and the receiving hospital.
- Sharpie Marker – A marker is necessary to fill out the casualty card or to mark the time of application on a TQ.
- Nasal Pharyngeal Airway w/lube – NPA’s are used to maintain a patent airway in unconscious patients. They are easy to use and effective at preventing suffocation due to an occluded airway. NPAs are contraindicated if there is significant facial trauma. Lubricant jelly is required to insert the NPA, but saliva can be used in a pinch.
- Medical Pouch – A pouch used to contain and carry IFAK items. The type of pouch is determined by the needs of the user. IFAK pouches come in many types, sizes, materials, and colors. It is important to denote an IFAK pouch so that people know what it is and can locate it quickly if needed. A patch with a red cross on it is recognizable to all.
- Optional Items (depending on environment, threat index, and training)
- Hemostatic Dressings – Hemostatic agents and dressings use chemical agents to control bleeding. They are primarily designed for combat environments where there might be serious injuries and/or delayed evacuation times such as a battlefield. The indication for use of hemostatic agents is in extreme trauma situations where bleeding cannot be controlled with a TQ or pressure dressing. Examples include trauma to vascular organs such as the liver or arterial bleeds that cannot be controlled by tourniquet. In some cases, the use of a hemostatic dressing may complicate or delay treatment in the Emergency Room (ER) because the doctor must clean the wound of the hemostatic agent before surgery. There is also the issue of knowing what hemostatic agent might be present in the wound. For this reason, any person using a hemostatic agent in treatment should include the packaging wrapped in the dressing so that the ER doctors may know exactly what they are dealing with. In summary, the use of hemostatic agents in areas served by vigorous EMS systems should be generally avoided except in cases of extreme uncontrollable bleeding or in delayed-evacuation situations.
- Elastic Bandage – Elastic bandage can be used to apply additional pressure to a pressure dressing. It is particularly useful when applying a pressure dressing to a torso, as the typical amount of bandage in an OLAES or Israeli bandage will only circumvent the torso about two times. Applying an overwrap of elastic will increase pressure on the wound site and finish off the dressing nicely for evacuation. Elastic dressing can also be used to stabilize an extremity.
- Breathing Mask – A breathing mask used to assist a patients breathing if they are not breathing spontaneously and to protect the responder from the victim’s body fluids.
- Chest Decompression Needle – A decompression needle is used to evacuate air and/or fluid from the pleural cavity in cases of tension-pneumothorax (TPT) or hemo-pneumothorax. A decompression needle should only be used by highly trained personnel. Even highly trained medical professionals have difficulty diagnosing a TPT in a definitive medical care setting, so the untrained should leave this area alone. No need to include this in your kit unless you are a paramedic, tac-med, or military medic.
NOTE: Every Day Ready, LLC sells these operator IFAKs for $95.00 each which include most of the listed items
- Every Day Carry IFAK – a kit designed to provide the most basic hemorrhage controls in a compact package that can be concealed and most importantly is compact enough that a civilian would actually keep it on their person. In an active shooter event, the best IFAK does you no good if it is 600yds away locked in your car. An EDC IFAK is typically vacuum-packed to reduce size and protect items during carry. An EDC IFAK can be carried in a back pocket, a cargo pocket, an inside jacket pocket, a purse, a satchel, or inside the waistband like a handgun.
- Nitrile gloves (not black; Defender-T recommended)
- Pressure bandage (OLAES bandage recommended)
- Tourniquet (TK4L recommended for compactness)
- Shears or clothing cutter (Klever-Kutter recommended for compactness & easy cutting)
NOTE: Every Day Ready, LLC sells these EDC IFAKs for $25.00 each.
IFAK Carry – There are many ways to carry your IFAK, depending on your mission:
- If you are part of a team (military, LE, other), you would do well to standardize a mode and location of carry so that your team mates can located and deploy your IFAK under stress. For example…Navy Seals carry their IFAK in their right cargo pocket. If they are injured, their team mates know exactly where to go for the medical supplies.
- Military of LE operators will often carry an IFAK on a duty belt, plate carrier, or chest rig…usually in some sort of pouch. Often they will standardize the carry location across their team.
- PSD operators will often carry an IFAK in a concealed mode such as an ankle rig or in a jacket pocket.
- Civilians that do carry IFAKs (most don’t) will carry them in a pocket, satchel, or vehicle.
Training – It is not enough to simply have medical supplies on hand. An often overlooked facet of self-protection is training. Even for those that have at some point had medical training, the knowledge and skills perish over time along with their efficacy.
Basic First Aid training is something every person should have, but Defensive Medical training goes a step beyond in providing situational training regarding how to respond to a medical trauma in a high-threat environment.
Every Day Ready, LLC offers a Defensive Medical course to educate civilians in preparation and response to defensive medical situations. The 8hr course costs $150.00 and covers topics such as IFAKs, hemorrhaging, tourniquet use, bandaging, responding under fire, patient protection, and much more.
IFAK Maintenance – Medical products are affected by time, heat, cold, moisture, and expiration date. One should inspect all medical kits at least annually to ensure that they are in working order and products are not expired. This is also a good time to update kits with newer products or missing products. The annual inspection will also keep you in-tune with your kit and more able to use it under the stress of a medical emergency.
Summary – The main thing for those that wish to increase their level of medical readiness is to have medical supplies at hand as well as the training to be able to use them. One thing is for sure, Mr. Murphy will ensure that emergencies will occur when we are at the least level of readiness, so we must do all we can to elevate our base level of skills and readiness. Are you Every Day Ready?