OK, so let’s imagine the Russians have landed, Kim Jong-un finally managed an actual nuclear attack, or society as we know it has collapsed — whatever the case may be, you just realized it’s go time. Maybe you’ve got most of your bug-out kit packed and ready to roll, but you just weren’t able to settle on which glamorous Tactical First Aid Kit to order before this SHTF event. One had more MOLLE-compatible webbing, and the other one had a really cool concealed-carry pocket for your lead medicine dispenser. Decisions, decisions.

Never fear. Everything you need to save your life and the life of the hot blonde who broke down outside your house is within reach. You just need to be willing to improvise — cue the MacGyver theme song and read on.

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You might not be able to stop the hemorrhaging with chewing gum, but you can still think like MacGyver.

Improvise, Adapt, Overcome

Working as a medical provider in some of the most remote wilderness areas in the nation, with long, steep hikes in, I have learned one thing over the last 14 years: pack light. It’s not necessary to lug around a mobile emergency room to deal with most common injuries.

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Basic EMT first aid training comes with its benefits. I am confident in my ability to save a savable life without all of the toys and interventions that weigh advanced life support providers down. That’s not to say that I’m ever sorry to see ALS on a scene, anywhere. To the contrary, getting a patient to a higher level of care is always the first priority in emergency medicine.

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However, not carrying dozens of pounds of metal laryngoscopes, liters upon liters of IV fluids, and all the latest and greatest drugs means I can reach casualties faster, but still open a compromised airway, control bleeding and move a patient quickly with less complexity. And everything I need is rolling around in my junk drawer.

Raiding the Junk Drawer

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Drawing from the multi-generational experience of combat medics and seasoned urban EMS providers alike, the contents of my bag might shock you, and not because I am carrying a 25-pound Automated External Defibrillator. Indeed, I have earned the scorn of “well-prepared” EMTs when they realize that my pack is a dozen or so pounds lighter than theirs. ABCs, I tell them. Stop the bleeding, keep them breathing and get them out.

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That said, I’ll share some of the things I carry. The basic rules of the game include:

  • Avoid most single-use items — even a blood pressure cuff can double as an improvised tourniquet
  • Avoid anything that will be obsolete in the field — try using a stethoscope near a helicopter, a running Mark III pump, in the back of a truck, or under AK fire
  • Use your brain, not just your gear
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This author makes an exception to the no-single-purpose-items rule for a lightweight RATS tourniquet.

Contractor-Grade Trash Bags

Grab a couple. Black plastic is useful on so many levels I don’t even know where to start. For treating hypothermia, burns, sucking chest wounds… you name it, the applications know no bounds.

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Not to mention you’ve now got a rain poncho or emergency shelter if the need presents itself. In a worst-case scenario, you’ve even got a body bag. And when the enemy invasion is over, you’ve got a way to clean up all those MRE wrappers littering your bunker.

Safety Pins

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You’ll need a variety of sizes, but most importantly large ones. If you’ve never seen a combat medic demonstrate how to pin a (hopefully) unconscious patient’s tongue to their lower lip to keep a compromised airway open, you’re definitely missing out. Additionally, these come in handy to help in rigging up splints, digging out splinters and obviously, repairing your pants when the zipper breaks. Hey man, we treat EVERY kind of emergency.

Duct Tape

Wrap it around your water bottle, Bic lighter, or a hollow tube around a paracord lanyard to make a mini stash for your pack. The hardware store variety will suffice, but if you’re super cool, grab a roll of mil-spec 100 MPH tape. This is obviously useful for too many splinting, bandaging, and securing applications to list, and also for keeping that excitable blonde quiet when the enemy forces approach. There’s no sense pretending that you’re gonna pack a backboard and brightly-colored spider straps on your stealthy escape. Duct tape and whatever you can scrounge for immobilization works great in their stead.

550 Cord

Don’t pretend like you don’t have one of those trendy survival bracelets on your wrist right now. This can be turned into any number of handy sling/splint arrangements with the help of a couple of sticks or the cardboard from your bunker stash of Lucky Charms cereal. The narrow paracord is less ideal for tourniquetting than the wider webbing of the RATS tourniquet I carry, but in a pinch, a braid of it with an improvised windlass will stop the bleeding. You could also use your belt, a shemagh, or any number of other items lying around.

Footwear

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These boots are made for cervical spine immobilization. The $300 combat boots you bought have just been justified. Take them off (of the patient, preferably) and use them to stabilize a suspected neck injury. Place them with instep tocheek and toe to shoulder. The ankles of the boots can be laid over the forehead for protection during transport, or positioned behind the head for padding and additional stabilization. Apply the duct tape or secure with your 550 cord. Boom. Who needs a C-Collar?

Super Glue

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No longer just for pranking your younger siblings on the toilet seat. Super glue or Krazy glue (ethyl cyanoacrylate) is now available as medical grade Dermabond (2-octyl cyanoacrylate). Either will suffice in a pinch, but the medical and veterinary formulations were designed to reduce the risk of toxicity and skin irritation. Feel free to practice suturing in your spare time, but most minor cuts and small avulsions will be kept cleaner when sealed shut with super glue. Plus, you can still prank your bunker mates when the blackout days drag on.

Conclusions

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I am a firm believer in better living through chemicals, and unless you’re a smarter version of Walter White or you know every wild medicinal herb and ointment by heart, you’ll have a hard time improvising chemical interventions in the field. Maybe normal people don’t have little stashes of ibuprofen and Tylenol in every imaginable storage space like I do. But if you don’t, it’s worth considering. Throw in some water purification tablets, aspirin for suspected cardiac events, and Benadryl (diphenhydramine) for allergic reactions. The latter is also a very mild muscle relaxant that can serve as a sleep aid and can temporarily slow contractions during childbirth.

Above all, the most important aspect of emergency first aid is a transport plan. If you aren’t moving your patient toward the definitive care they need, you are missing the point.

Don’t get hung up on the bells and whistles of emergency medical care gear in the field. The most powerful tools you have are your hands and your brain.

For further reference on traditional and improvised medical techniques, pick up a copy of the Combat Medic Field Reference book used by the U.S. Army.

About the Author

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Liv Stecker is a wildland fire EMT based out of rural northeastern Washington state, where the power is out more often than it is on. She spends most of her time cut off from civilization in one hemisphere or another. Mother of four hardcore daughters and two dogs, Liv is an avid traveler, a certified structure and wildland firefighter, and has worked as a remote medical provider for 14 years. You can keep up with her shenanigans at LivStecker.com or find her on Facebook.

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