I hope this is somewhat useful.

My father had some health eccentricities, but they were usually fairly straight forward and moved relatively slowly. He had his fevers after chemo, but they were predictable and generally resolvable. He had episodes of AFIB, but he was also usually aware of it and was pro-active about it.  A home auto blood pressure device, thermometer, and some CamelBak Elixir were all we really needed.

He was also, for lack of better words, self aware and could answer most questions regarding medical history, medications, etc. Trips to the ER were generally straight forward - I just needed enough food to get me through it, which came in the form of Soylent. I kept some at work so I was always near some and could grab it and go. All I really needed to have on hand was a tube of Elixir, which I had in my pack anyway. No big deal.

When he passed, I quickly learned that I wasn't going to get any rest. My mother also had a history of AFIB, but she also had a history of MI, CAD and severe aortic stenosis. Her heart did strange things. Her blood pressure was a clusterfuck. She was also in denial about some medical conditions (specifically the MI, CAD and Aortic Stenosis), and wasn't squared away on her medications at all. Despite having a history of MI and CAD, she'd not been seen by a cardiologist since the mid 2000s when the MI happened.

Problems could brew up in an instant, and they required significantly greater problem solving ability than what my dad's issues had required. I needed to put together something I could have on me all the time that would give me the tools needed to determine whether or not getting her checked out was warranted, and also to survive the trip to the ER. Her ER trips were significantly more taxing as I had to fight conflicting stories from a verbally abusive patient. They also tended to be longer. I needed to be able to refuel mid flight for lack of better words. I made due by stuffing extra shit in my EDC pack and stuffing my pockets before heading to the ER.

Then one day I get a call at like 6:30 AM. She was hallucinating her ass off, and her auto BP kicked out a reading around 80s/60s. When we got to the ER, her BP was back well within normal and the low BP reading was disregarded as just a shitty home auto BP reading. I get it, the problem doesn't exist in the ER and is therefor not exactly an ER concern. The problem is that everyone systemically disregarded the reading. I decided I had to learn how to take BP manually - at least then they'd have to tell me I was unqualified garbage rather than simply blame it on a machine that I knew was fine.

I'd need something dedicated to carry this shit in. I've dealt with Hawkepaks previously, and I decided to see what they had. I've owned several of their products, and they've all been well made. They're also very reasonably priced. I ordered an EMS-5 Delux WaistPak for $39.95 - and it came with a decent set of trauma shears and a triage quick reference card.

Exterior dimensions are roughly 10"x6" and 5" thick with two main pouches and a flat front pouch that is divided for a couple Sharpie sized objects and the aforementioned trauma sheers. It also has some velcro closure pockets where the belt joins the main pack which turned out to be fantastic.

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The stripes are unreasonably reflective, which is nice. I also picked up one of their glove straps and hooked it into one pull of both main compartment zippers. You never know when you might need some real gloves, and it also served to keep the two zipper ends I didn't intend to move in place.

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I'd intended to put some red paracord pulls on the other zipper ends, but I never got around to it. As mentioned, the side pouches were fantastic. I kept CVS hand sanitizer wipes in one and NAR Bear Claws in the other.

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The front pouch section got a little rework from a seam ripper. The compartment happened to be just the right size for a 6"x9" heavy duty plastic bag.

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I kept a hard copy of the truly critical items. The "Patient Information" sheet is actually a half page of cardstock that has name, DOB, emergency contact, medications and known drug allergies on it. The back of the card has medical history. I kept 2x of these cards in the bag so I could pass one off if needed. I also clearly labeled the other documents in the bag by printing on the back of the last page.

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This compartment wasn't rigid though, so I picked up a sheet of kydex and cut it down to fit. It worked out fuckin perfectly to protect the documents from the inside of the WaistPak. I got a sheet of it off Amazon for dirt cheap.

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The front setup worked out extremely well, I could just grab the whole packet and pass it off to the Docs, Pharmacy Techs, etc.

Moving on, I decided to split the two main compartments into Problem Detection and Problem Solving. Due to the pocket layout, the front compartment was "Problem Detection". The space has a rather large center cavity with two half width pouches on the back and one full width pouch on the front.

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Contained within, I had a Littmann Cardio IV, a Welch Allyn DS58-11, Flexiport air hose, 3x BP cuffs, and a Nonin Onyx Vantage 9590.

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Now I didn't know shit about shit when I got this stuff. I took to the internet, learned what the fuck a Korotkoff sound was, and went from there. It wasn't hard, but it certainly took some finesse. I learned. Not shown, but also included was a Kardia Mobile which was linked to my personal cell phone. While it may not kick out a true EKG, it is certainly good enough to tell whether or not someone is in AFIB.

These tools are all simple enough to start using, but fairly hard to master. SERIOUS respect to folks who can get a BP off anyone at any time without needing a Cardio IV to do it. I HAD to use the bell side or I wasn't hearing shit. User error for sure.

I'm not remotely qualified to speak about the equipment itself, other than to say that the shit is bomb proof. The DS58 has a 60" drop rating and a lifetime calibration warranty. Having the flexiport system wasn't THAT useful, but it was nice to be able to swap out cuffs if I needed to. It also all stored reasonably well.

The engraving on the bell of my Cardio IV pretty much sums up the last 4 years of my life:

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The wisdom of Pat Rogers is etched into the tubing: "WE DO NOT ASPIRE TO MEDIOCRITY"

 

Moving on to the back section; the Problem Solving section. The front side has 6 elastic loops, the back has the same two half width pockets from the front section.

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I decided to make this post while I was unfucking the pack. It hasn't been used since September, and I've scavenged some shit from it. I wanted to sort it out, get it stocked back up, and run some PMCS.

In the back we have the most basic of basic items: Something to write with and something to write on. The two sharpies take up an elastic loop across from the notepad. In the compartment with the note pad, I also kept 2x RX Bars. They were pretty critical when ER trips started to stretch into 6-8 hour adventures.

The NUUN isn't as good (in my humble opinion) as the CamelBak Elixir, but it works. I kept two vials in the elastic loops next to the sharpies. Not shown is an assortment of Pedialyte powder sticks. I had 8oz and 16oz mixes. Next to the NUUN is a bright orange Thyrm CellVault full of goodies - and by goodies I mean some benadryl, some advil, some tylenol, some extra Valium for me, and some extra anti-psychotics for my mother. They're all bound up in little baggies with appropriate prescription labels as needed. Also not shown is a pen light that has walked off.

Inside the last pocket is a CLEER Medical 4" Trauma bandage from the folks Eleven 10 gear. These are unreasonably compact for what they are. My understanding is that they're a flat folded NAR 4" ETD with a shortened tail. Not shown is a package of QuikClot that fit right in there with it the Trauma bandage. Floating in the middle of the compartment, upright at the end is a CAT.

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I COULD fit an 8" tablet down the middle of the back compartment, but it got pretty tight. My go to was a 10.5" iPad Pro with LTE connectivity. A hard copy of all the critical stuff was on hand. A digital copy of EVERYTHING else was just a touch away. With the iPad Pro, I could also take notes. I can't even begin to cover how much capability the iPad added to the over-all package. We could go anywhere and I had full a complete medical history package on me ready to rock and roll.

As a reminder of my station in life, the background image shows what real heroes look like. Hard men and women doing hard work on a dark night in Ferguson, MO.

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My very own prepackaged just add water Goat Rodeo Survival Kit - ready to go at a moments notice 24/7. My pants were carefully staged over my shoes like turnout gear. All I had to do was throw on socks, step into my shoes, pull on the pants and I was out the door.

The hard part was not learning to use the equipment, it was solving riddles in real time. It was knowing my mother's eccentricities and behavioral patterns. The equipment being WAY above my pay grade was helpful for the most part. The needle on the Sphyg would start to dance a bit right before the Korotkoff sounds started.

The Cardio IV let me truly understand what a "musical" murmur was after the ER Docs looked at me like I had a dick growing out of my forehead. Yeah, you could hear the Aortic Stenosis from orbit and it meshed together with the mitral valve regurgitation to make her heart sound like a runny shit rather than having any hint of the sounds one would expect to hear in a healthy patient.

The Kardia Mobile gave me peace of mind when things seemed sideways. It was fairly late to the party. It never caught anything, and I'm willing to suggest that keeping electrolytes reasonably under control helped with this to some degree.

My mom was difficult. She had chronic diarrhea - which she'd flatly deny - and it would impact all of the things that I could measure. I learned that I could compare the measurements relatively and get a pretty reasonable picture of how bad off she was. She'd complain of being cold despite an ambient room temp of 78F. Her heart rate would be slightly elevated, but also somewhat erratic with random swings of up to 20BPM. I'd throw some 50% cut Pedialyte her way and within an hour or two her heart rate was stable, her oxygen was back up to her normal and she was abusive toward everyone about how hot it was - at the same unreasonable 78F that she'd been freezing cold in. You know, back to "normal".

Like I said with my father - data can only help you. If it isn't useful, then fucking ignore it. However, comma, you can't reference data you did't collect. Every individual is unique and has their own individual norms. It is my opinion that a care provider has a duty to recognize these norms and keep them in mind when solving problems.
Hawkepaks has impressed me over the years. I bought a Quick N Dirty Essentials bag and a QnD Small bag from them several years ago. They're well made and are pretty well thought out as a grab and go rifle support bag. The internal divisions are sized for a standard AR15 magazine. I'm seeing more and more things like IFAKs that are made to fit AR mag pouches. A little imagination goes a long way.This Waistpak has been outstanding. It isn't dirty or remotely fucked up, but it saw DAILY use for well over a year.I also picked up one of their Mini Utility pouches - a 7"x4.5"x1.75" single compartment stand alone pouch with a velcro flap similar to the WaistPak. I don't have it completely stocked, but it is looking like a sold "throwable" IFAK pouch that you can pretty easily toss in a pocket.

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"A pistol is what you carry when you do not expect a problem. If you expect a problem you can't avoid, and you are not taking a long gun, you are not very smart." - DM

 

Joined: 04Nov2007         Location: Indiana

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Awesome post. Good on you for taking things into your own hands and learning what you can to help. You wont regret that Littmann. I bought one of those back when I was a PFC and more than 10 years, ( including two deployments and nursing school) later the wife and I still use it when one of us or the kids are sick.

Squared away kit.

"Here I abandon peace and desecrate law. Farewell to treaties. Fortune it is you I follow... From now on, war will be my judge."

Great post man!

you are the chosen one that’s for sure...you won’t regret honoring your mom and dad like that. 

I was in your shoes with my pops...while he had 3 kidney transplants, shingles and almost every illness known to man...I stood by his side till the end...

Wipe that stethoscope down every few months with Armor-All & it will last you a lifetime. 

 

"Number 7 was interesting. My third leadoff homer in three games. I had used the same bat for the first two homers. I had planned to keep using that bat until I broke it. But while I was on deck, I put it back & took out another bat. You want to know that it's you and not the bat."- Brady Anderson, Baltimore Orioles.

 

Home: Eugene, OR. USA

That's not bad.

BTW, patients that arrive with relatives like you in-tow are an ER Doc's dream... a far cry from the mystery demented patient that sometimes arrives from the nursing home, who comes with no documentation, there's no run report, and the patient is non-verbal. 

 

“One sometimes gets the impression that the mere words ‘Socialism’ and ‘Communism’ draw towards them with magnetic force every fruit-juice drinker, nudist, sandal-wearer, sex-maniac, Quaker, ‘Nature Cure’ quack, pacifist, and feminist in England,”  -George Orwell-

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