In a combat situation, the medic is not the first line of response. Each member of a unit is trained on how to save their lives and the lives of the people around them.
During a Tactical Combat Casualty Care (TCCC) scenario, the first step is Care Under Fire. During this stage, the number one treatment of a casualty is fire superiority: clearing the immediate area of the hostile threat thereby allowing the wounded to be evacuated to receive comprehensive medical care.
Operators wounded while under fire are expected to keep themselves alive and/or the guy next to them, by applying basic life-saving techniques. Applying a tourniquet, nasopharyngeal airway tube, or a necessary needle thoracentesis, could mean the difference between life and death. This is where the Individual First Aid Kit (IFAK) and properly located tourniquets comes in to play.
The leading causes of death on the battlefield are hemorrhage and an inadequate airway. An IFAK is designed to address both of these combat injuries.
Of course, applying first aid is nothing new to the foot soldier. If we looked back centuries ago, we’d see soldiers carrying around bandages, oftentimes nothing more than shreds of torn cloths, used to cover up wounds and stop bleeds. As time progressed, so have combat first aid kits.
The first standard-issue first aid kits became a reality for the U.S. military in 1890. Some of the items found in these first medical kits can still be found in the most modern IFAKs. Nonetheless, these early-day first aid kits didn’t have some of the items required to save the life of a person with life-threatening combat-related injuries.
Fast forward to 2003. In comes the first real IFAK, just in time for the invasion of Iraq. It was first fielded by the Army and quickly followed by the Marine Corps and Navy.
Initially, the Army used squad automatic weapon (SAW) 100 round magazine pouches to carry the IFAK contents.
As time marched on, IFAK technology improved, and therefore changes were made to enhance the life-saving capability of these one-pound kits. During my time in the Navy, I went through at least three different styles of IFAKs.
Items found in an IFAK can vary based on the branch of the military, the mission, and location of deployment. A typical IFAK today has the following:
- Nasopharyngeal airway tube
- Chest seals
- Needle thoracentesis needle
- Israeli pressure dressing/curlex dressing
- Combat gauze
- Medical tape
- Tactical Combat Casualty Card
- Medical gloves
- Strap cutter
In the Navy, we were all about free-thinking with each operator setting up their gear in a way that was comfortable to them. Yet, this didn’t apply when it came to the location of the IFAK and tourniquet on each person’s kit. There are two major requirements when determining where to put tourniquets and IFAKs:
First, these items need to be in a place where they can be grabbed with either hand. If an individual sustains a blast injury and loses the function of an arm, it is paramount that a tourniquet can be applied with the non-injured arm and hand. This could mean the difference between life and death: After all, it only takes minutes to bleed out and die from a severed femoral artery.
The second requirement is that the IFAK and tourniquets be placed in identical locations on all operators within a unit. The time to be grabbing around looking for someone’s tourniquet or aid kit isn’t when they are on the ground, in the dark, and profusely bleeding. And no, operators shouldn’t use their IFAK on someone else, unless they have to. The keyword is INDIVIDUAL first aid kit.
IFAKs are awesome. They have saved countless lives and undoubtedly will save many more in the future. And they can go beyond the combat zone. Anyone that regularly participates in high-risk activities should consider carrying their own version of an IFAK.