Recent events in the news have highlighted the volatility of the world we live in today. Violence is a common reaction to many scenarios. As a result of violent attacks, there are often traumatic injuries that occur to the parties involved that require immediate medical assistance. This is where the blow out kit (BOK) comes into play. Often weighing less than a pound and being capable of easily fitting into a cargo pocket, purse or backpack, the BOK is a must-have item for anyone who lives outside the safety of a bubble in the world today.
What Is A Blow Out Kit?
The BOK was originally developed by the military to assist in treating significant trauma as close to the time and point of injury as possible. It was discovered that severe, life-threating injuries that led to many deaths in the ranks of the military on the battlefield could be treated effectively with a few key medical supplies. This development led to the mitigation of more than 90 percent of preventable deaths on the modern battlefield and established the necessity for a kit that could be carried by every soldier.
With the success of the BOK in the military, it was discovered that there was a need for such a tool in the civilian market as well and law enforcement agencies began adopting the practice. The presence of such kits with the Tucson Police Department on Jan. 8, 2011, is credited with saving some of the lives in the mass shooting that wounded then-Congresswoman Gabrielle Giffords. This success cemented the position of the BOK as a must-have item in the inventory of many first responders.
There are a number of commercially produced kits available that include endless options from the very basic all the way up to what seems like a shoulder-mounted trauma surgery suite. The key to a good BOK is including high-quality components. Most of the commercially available kits are extremely good, although not low in cost. A good kit can be put together with individually procured components, typically at a reduced cost.
Why Do I Need A BOK?
The modern prepper should consider including a BOK among his preparations. Not only is a BOK part of being prepared for any situation, it is also a tool that can address many of the potential risks faced by survival- and preparedness-minded individuals. As a collective, preppers tend to engage in activities that could potentially result in accidents that would produce traumatic injuries, like hunting, target shooting, construction projects, farming and working with heavy equipment. Having a BOK available could assist in reducing the threat to life of injuries sustained by the self-sufficient person.
What Goes In My BOK?
Tourniquet: The foundation of most BOKs is a high-quality tourniquet. In years past, medical guidance would suggest that use of a tourniquet would be a poor decision, except as a last resort to stop uncontrolled bleeding. Recent research and practices provide proof that proper placement of a tourniquet on an extremity to treat uncontrolled bleeding is effective in preventing death from extremity hemorrhage in many cases. The most popular tourniquets in use in emergency medicine today include the C-A-T (Combat Application Tourniquet) and the SOFT-T (Special Operations Forces Tactical Tourniquet).
Bandages: Good bandages are essential for hemorrhage control with a trauma casualty. A BOK should have at least two trauma-specific dressings in it, like the Emergency Trauma Dressing (ETD). The ETD is widely used by the military, emergency medical services and police departments across the country and has proven its effectiveness on the battlefields of Iraq and Afghanistan. While not only useful for stopping major bleeding, the ETD is also useful for the treatment of several other injuries.
Gloves: A few pairs of medical exam gloves should be in every BOK. Communicable diseases can be avoided in many cases by wearing gloves when providing first aid to someone. This is especially important when providing aid to someone that you are unfamiliar with.
Medical tape: The adhesive property of medical tape makes it ideal for better securing bandages, chest seals, splints and other medical interventions in austere conditions. With many sizes of tape available, including a roll of 3-inch medical tape in the BOK should address any situation since it can always be torn or cut down to a smaller size if needed.
Trauma shears: Effective treatment of traumatic injuries requires exposing the injured areas of the patient. The best tool to accomplish this task is a good set of trauma shears which are able to cut through clothing, shoes, belts and even metal coins. Because of this versatility, trauma shears can be useful for many tasks besides medicine. It is recommended that a dedicated pair be placed in the BOK, though.
Rolled gauze: This is another multi-purpose item that can be useful for controlling bleeding. Other uses for rolled gauze in an emergency include stabilizing impaled objects, dressing burns, padding splints and even making improvised restraints. Imagination is about the only limit to what these 4-yard long rolls of gauze can be used for.
Ace wrap: A useful item to apply pressure to wounds in hemorrhage control, Ace wraps can also be used to treat a variety of orthopedic injuries that occur in almost any situation. The 6-inch variety tends to be the most used, although there are smaller versions available.
Hemostatic agent: QuikClot and Celox are the leading brands of hemostatic agents available on the market today. Hemostatic agents are helpful in quickly initiating the clotting cascade that leads to coagulation and the more rapid stoppage of blood loss when compared to treatment using non-hemostatic dressings. While they are not cheap, there are hemostatic agents that are readily available on the commercial market without a prescription.
Upon completion of advanced medical training, there are additional items that can be added to a BOK that can significantly increase the chances of survival for persons with traumatic injuries. In many States, “Good Samaritan” laws will protect a passerby that offers medical assistance in an emergency. It is important to keep in mind, especially when it comes to advanced medical techniques that go outside the scope of first aid, that engaging in some of these treatments can be considered practicing medicine without a license. This can make your best intentions susceptible to civil or even criminal prosecution. Some of these pieces of medical gear include:
14 gauge-by-3.25-inch needle and catheter: Used for needle chest decompression, this needle and catheter combination can be used to treat and reduce the difficulty associated with a tension pneumothorax (the accumulation of air in the chest cavity usually caused from penetrating wounds that lacerate the lung). In combat casualties, tension pneumothorax accounts for about one-third of preventable deaths.
Nasopharyngeal airway (NPA): The No. 3 cause of preventable deaths on the battlefield, airway obstruction can typically be treated quickly and effectively using an NPA, an airway adjunct that is inserted through the nasal passageway to provide a secure airway for the patient. Trauma casualties can suffer from airway compromise as a result of the jaw relaxing and the tongue slipping into the back of the throat. This compromise of the airway can lead to death but can be mitigated by training and use of the NPA.
Chest seal: Penetrating trauma in the chest, back and abdomen can lead to breathing problems for a wounded person. One of the fastest and easiest ways to address these wounds is with a good chest seal. While there are a number of ways to treat such wounds with improvised materials, there is no replacement for a purpose built chest seal. With that being said, there have been a number of different products that have been developed, but the leading products available today are the Hyfin and HALO chest seals. They are the most effective and hold up to almost any set of conditions they can be employed in.
These items are commonplace in most military and law enforcement BOKs or individual first aid kits (IFAKs) because of the ability to save lives with this equipment while also being able to train most members of the organization on how to properly employ these supplies in the treatment of casualties.
A common misconception is that a BOK is limited in effectiveness if you do not have all of these items. That is completely false. What is ineffective is not having a kit at all. When someone has sustained a life-threatening injury, there is no replacement for rapid intervention. A kit that contains a good tourniquet and high quality bandages but nothing else can easily make the difference between life and death for an injured person.