View Full Version : The problem of medical loads with rucksacks in dismounted & long range patrolling
justanotherdude
05-21-2006, 06:38
How have you other Docs and Medics carried a full modern medical load while also carrying your non-medical sustainment gear while rucking, what are your solutions?
I have a SKEDPAK that I'm trying to get away from. The medical compartment is much smaller than a STOMP2, which eats up space in the accessory pouches that are designed to hold personal gear. Overall, this bag is too small, and needs to be bigger by 2000-3000 cubic inches. Using it with the TSSI m4 provides more space and a jump bag capability. The m4 holds CUF and minimalist TFC items, and the SKED ruck has the advanced TFC stuff. No space for overlapping BLS between the two bags.
Solutions I've come up with;
1) Kifaru MMR/EMR: No doubt it has the cubes, but pricey as hell. I'd strap the TSSI m4 to the top as a jump bag. Drop a med insert or an underloaded STOMP2 bag into the main comprtment with just the advanced TFC items.
2) BHI SOF ruck. It's big and quite a bit cheaper than the Kifaru. I'd do the same as above with a STOMP2 & TSSI m4.
3) MOLLE2 ruck w/STOMP2 attached: Remove the sleeping bag carrier, strap on the STOMP2, voila! Think it will work? Would also use the TSSI m4 strapped to the top. Will always have a MOLLE2 ruck so this is a free solution.
4) Increased use and reliance on 1st line med gear (leg rigs, med vests).
Yeah, this is a lot of black and white.
Please Advise,
Dan
Life is a movement to contact
The Reaper
05-21-2006, 08:13
Simple.
They make the rest of the team carry part of it, just like the commo man and the engineer.
You lose a teammate because he bled to death, you will carry whatever the medic says to take, even if it means dumping your spare t-shirt or one stripped MRE per day.
If your teammates expect you to treat them if they get hit, and they are travelling lighter than you, they need to be humping IVs and gear for themselves.
You might want to shake yourself down for personal gear before asking that. They catch you redistributing mission gear to them while carrying comfort items for yourself, an ass-whipping might be coming.
TR
NousDefionsDoc
05-21-2006, 17:18
Dan,
Like The Boss said, you need to go through your kit first. You are probably carrying too much crap, both medical and other. The Army's solution a few years ago was an M5 stuffed under the top flap of a large ALICE. Now you have options.
As for the Kifaru being too pricey, if you think it will solve your problem, invest the money. Never scrimp on your kit. If you don't like it, I hear the re-sale value is good on them. As long as it is coyote.;)
The Reaper
05-21-2006, 17:20
As for the Kifaru being too pricey, if you think it will solve your problem, invest the money. Never scrimp on your kit. If you don't like it, I hear the re-sale value is good on them. As long as it is coyote.;)
Funny, I happen to have a new addition to my ruck collection.
It is a Kifaru, but it isn't Coyote.:munchin
TR
Surgicalcric
05-21-2006, 21:22
Funny, I happen to have a new addition to my ruck collection.
It is a Kifaru, but it isn't Coyote.:munchin
TR
No pics Sir?
Crip
x SF med
05-22-2006, 05:35
TR-
I remeber those days - a large ALICE w/ the M5 under the flap - then we went to the 'tactical duffel bag' (lowe expedition) - and had to put the m5 under the flap. Our Team SOP was - each man carries 2 IVs, and a basic med kit to replenish a 'single use' out of the M5 - and everybody (including the 18Ds) carried commo, demo, ammo loads - nobody got off light, and the XO got the "comfy chair". Cross loading is an art - and it's a whole team responsibility IMHO.
justanotherdude
05-28-2006, 10:46
My guys carry IFAK's, very fat, tq, dressing, saline locks, ACS, TPN needle, etc. No shit right, old concept. I tie it together with a system of training & BLS in the IFAK's, First Responders & CLS guys to ensure 1) redundnacy, always have enough of the basics for every man 2) it's close to the point of injury, not at the ORP. This has worked very well in Iraq, now I'm tweaking it out for the purely dismounted role.
For operations here, though the guys have plenty of BLS in their IFAKs, I decided to carry a healthy amount of the basics myself for COBs, MiTT's, IA's, and other unit's that we work with SINCE they don't have IFAKs. I think I can downsize some of BLS qty's since we'll be working organic in patrolling operations. In other words, I kept both basic and advanced stuff in my aidbags, the Soldiers lines of care worked in conjunction but my aidbags were standalone. When we go back to the states I feel comfortable with dropping some of the BLS from my aidbag that's already in their IFAK's and CLS lines and carrying more advanced stuff in par with my training.
I'll also have to support a platoon again, more guys than an SF medic would have to, so the qty's of what I do carry will have to be proportionate.
When I bounce out of here next month I'll take apart my MOLLE 2 ruck and see how well it works with a SOTMP2 strapped on. Unfortunately, I know the Kifaru will be a constant fight with whatever chodes are in my next CoC.
Dan
I could joke and say I just loaded it on the MEDSOV, but that wouldn't contribute to the thread much.
It is what I had the ability to do in Iraq, being the primary casualty transportation platform for casualties coming to our BAS for care.
Our squads would carry 2x isralie, 2x kerlex, 1x tourniquet. Per man.
Every rifleman, and team leader, would carry a IV kit. tubing, 500ml bag, 2x 18G, saline lock, syringe.
Squad EMT would usually be a grenadier, and carry the CLS bag which when I was in that role, was clipped around my waist man-purse style, to the rear.
squad leader typically carried 2 iv kits plus some extra isralies.
Medic packed his aid bag in his ruck, and then whatever didn't fit there off the packing list, got divided amongst the headquarters section (PL, PSG. RTO and FO had enough stuff, although as RTO I'd hump some of the medics stuff because I was a pack mule)
Hit the ORP and drop ruck, cache as needed, keep the aid bag and roll out with your 'toon daddy.
In all reality, you are going to be lucky as all get out if you can cover 1 bad casualty out of your aid bag.
That's where the squad EMT's/Combat lifesavers/Ranger First Responders come into play.
That soldiers aid gear on his kit should be used first.
Then use the CLS bag.
Then when you get to him, it's going to either be touchup work and prepare for evac, or you had better be on top of your game because it's going to be your whole aid bag on this guy.
If you are carrying a skedco as a medic, you're also doing yourself an injustice. We had one per squad, and the squads carried them to just inside the breach, then they were dropped there and pushed forward as needed for casualties.
I'll also have to support a platoon again, more guys than an SF medic would have to, so the qty's of what I do carry will have to be proportionate.
You will, however, have three times the number of guys to carry stuff, so I bet it works out, proportionality-wise. You're only one guy, and while the CLSs and buddy aid guys will be able to treat the more basic injuries because of you cross-training them, you only have the ability to administer advanced treatment to one, maybe two guys at a time, regardless of the amount of supplies and equipment you carry. If you have 4 or 5 guys with near simultaneous critical injuries that require the specialized equipment and treatment that only you can give, its very likely someone is going to die, so make sure your triage is very good.
You will, however, have three times the number of guys to carry stuff, so I bet it works out, proportionality-wise. You're only one guy, and while the CLSs and buddy aid guys will be able to treat the more basic injuries because of you cross-training them, you only have the ability to administer advanced treatment to one, maybe two guys at a time, regardless of the amount of supplies and equipment you carry. If you have 4 or 5 guys with near simultaneous critical injuries that require the specialized equipment and treatment that only you can give, its very likely someone is going to die, so make sure your triage is very good.
Bingo.
I once was told this:
There's 3 types of casualties.
Those who no matter what you do, will survive and thrive.
Those who no matter what you do, will not survive their wounds.
Those who, if you do the RIGHT thing RIGHT NOW, will survive.
You're going to see all three through your time as a medic. You need to take every training event seriously, so you know what is the right thing, and when is the right time.
Training and cross loading is the best. If all your guys know the basics and have their own stuff you don't have to worry too much. Also talk to you CLS guys, make sure their checking on their guys, and they are carrying some of the minor boo boo stuff band aids, Motrin, ect ect. That will help keep people from bugging you all the time.
One of the things I've noticed is that we medics tend to grossly over pack. Do you really need that ENT kit for a ruck march? How about that IO injector/fast one, sure their all small and useful at times, but they add up and you get a heavy bag thats not much use, the majority of the time. Pack per mission, not for every possible mission.
Several medics I've known and talked with have tried to move away from relying on our aid bag. I keep mine stocked more like a aid station with only advanced stuff just in case and it stays with a vehicle or in a CCP, only carried unless all our gear is moving with us, and thats when you have cross load the heavy things like iv bags, and sacrifice some of your comfort gear.
I try to only carry what I'd really need on my person, just bleeding, and airway. However camel backs changed that a little, I have a large camel back, which leaves me really no need for canteens (bad habit, hard to gauge intake sucking through a straw) but I carry a few IV kits usually only a 500 with supplies, or a 1000 stuffed in my canteen pouches during the summer.
My drop leg kit right now has, (pretty basic,over sized IFAK)
3- CATS, 2 Israeli bandages,1 civilian israeli (smaller), 2 compressed Kerlix, 2 OPA's, 2 14GA needles, 3 Ashermans, 3 petroleum gauze, 2 NPS'a/lube, Some gloves, steri strips. In a pouch next to that I have Quick clot powder and sponge and more 'Z-pak' kerlix. With plenty of room for more. Haven't used it lately so its not stocked full.
Vest is empty at the moment but usually two bleeding pouches, with the same, just a few pre-made windlass's and cravats, and my airway kit has a little more in it face mask, ect..
Unfortunately, I know the Kifaru will be a constant fight with whatever chodes are in my next CoC.
I used a slightly modified SPEARS ruck at my last unit, the top compartment a big cls bag, and my molle 2 aid bag strapped to the back if I really needed it, never liked putting it in the ruck to hard to get out in a hurry. When they gave me trouble about it I just said it was issue, not to us there but the army does use it. Never made too big of a deal about it.
Also there are a few companys making inserts now, I have a camelback med insert that i use in my alice, its not the greatest you can keep some stuff in your ruck in one place and it easy to pull out even if its packed tight, hard getting back in though..
But really in the end, its not what you carry in your aid bag, its the training and experience that you carry, I've seen some medics do pretty creative stuff due to lack of supplies.
Hope that helps any, although I think I repeated a lot of what was already talked about.
You're going to see all three through your time as a medic.
That hit home. I'm glad it did.
Divemaster
10-24-2007, 01:54
Every man on my ODA did TC3 prior to Iraq. While in country, I never questioned my 18Ds ( they earned my trust prior, and I was the team daddy). The LAST MOS I wanted to test in combat were my 18Ds. BTW, the SR was well experienced and the JR was a cherry out of the Q less than a year. Both were totally competent. We lived well away from a FOB in a team house, but they were on the nearest FOB when a mas cal was called. The ER docs put each of them in charge of a table. Give me an 18D when I'm fucked up any day.
thefreakypimp
11-24-2008, 15:14
What about a M9 aidbag with the ruck or assault pack on top of that? It seems like it would work. I normally carry my m9 bag on top of my kit when I roll in the truck, so if I have to get out I dont have to worry about the bag getting caught on something(or me getting caught up in the moment and forgetting it). It makes sense to me. And is not horribly uncomfortable.
Surgicalcric
11-24-2008, 15:27
What about a M9 aidbag...
How about you go back and read/reread the email you received when you registered here and follow the directions contained therein.
Dont post again until you have complied; this isnt optional.
As for your post, the discussion was about carrying an aidbag and a RUCK at the same time while dismounted; mounted patrols are an entirely different animal. Also carrying the ruck on top of the aidbag makes no sense at all. Not a dig on you, but considering where you work, you may want to consider reading more about subjects that pertain to the field and post less...
Crip
The Reaper is 100% accurate
cdwmedic03
11-24-2008, 22:48
I had the same problem when I got a new tasking as a medic for my TF's DART team. I was using a TT Trauma Pack and having to pack for possibly 3 days in the field. I looked at my kit, bulk, blah blah blah. So long story short, I bought the Conterra Longbow. It's been a godsend. Almost totally customizable medical compartment (it's got a velcro panel that you can set up however you want, what medic doesn't go gaga for that). Plus the medic compartment is limited in size to the point that it forces you to cut it down to only what you really, really need.
The Reaper also is spot on with crossloading your gear with the rest of the team, I would rather have each man carry an IV (which for me makes a total of 8-10 liters on the ground for me to use), rather than carry four or five and be so heavy you don't move as fast and easy.
The longbow has a compartment for your personal gear. Large enough for the bare essentials, but not a lot of room for much else. Again this pack forces you to pack only what you need. Which in turn keeps the load light(er). The internal frame makes it super comfortable as well. Decent price too.
just my .02
Our emer med equip SOP for every man on 5 day patrol was:
Individual pill kit in compass case (antibiotic, antidiarrheal, ASA, actifed, DAS tabs)
Small field dressing in bottom of every ammo pouch/canteen cover
Cravat (worn)
A7A strap belt
5 ea 10gr MS (left breast pocket)
3" square moleskin
5 bandaids
Small tube polysporin
Small bottle HOH purification tabs taped to each canteen cap
2 large black safety pins pinned inside flap of each ammo pouch
Claymore bag (with strap cut about 8" above bag and the two straps sewn into loops to fit over harness web belt in rear) to carry blood transfusion IV set (could use for direct transfusion among team members or IV insfusion) and 500ml LR solution
If injured, you used the individual's med supplies first.
You'd be surprised how much stuff you can take care of with so little gear.
Key - spread the wealth and x-tng!
Richard's $.02 :munchin
justanotherdude
02-18-2009, 03:05
First, thank you to everyone that's taken the time to reply to this post. It's nice to see how it's developed.
I learned some truths (as also posted by those more experienced than I).
*Crossloading is an art. Someone has to see the big picture of what everyone is carrying or should be and plan accordingly. I had to take off the medic hat and wear the leader hat to truly understand this.
*Learn as many uses for a single object as you can, keep adding to the improvisation library. While the newest whiz bang stuff on the market is nice, it's also very task specific and it's better to carry the jack of all trades in your aidbag. Still can't beat the cravat, ace and kerlex.
*with all the kit spread out it went about like this...warfighters; medium size IFAK on the vest, TT FRB on/in the assault pack (every 4th). Me (medic) rucksack w/ non-medical, and Eagle A-III medic bag loaded toward the advanced tactical field care side of things.
It took a lot of trial and error, but that was the best I found. Chronologically speaking, my original intent was to be able to carry everything in my casevac platform bag (STOMP2 loaded to the gills), AKA my safety blanket, that I used in mounted operations. I wanted to retain each and every one of those treatment capabilities while dismounted with just a ruck.
It was just too big. I tried several methods to carry it, including strapping the whole STOMP2 to the ruck frame (which seemed like the most seamless way). Then trying two bags, 1 for basic TFC and another with advanced TFC, both smaller. Still ate up a ton of space in the ruck. I ditched the basic TFC bag, broke it down and gave everyone a shave bag with the basic bleeder and airway stuff. It was redundant to the point of being unnecessary.
The tipping point was standardizing the IFAK, it's contents, and also the TT FRB. Having faith in my crossloaded gear. With that basic TFC stuff crossloaded, and all the distractions removed, I was still being cautious despite only carrying the advanced kit.
Dan
Sounds like you've got your solution, but in case you haven't seen it, the SOF Medical Handbook has a packing list for a large ALICE ruck for PJ's. I used this as a general outline when I was had your same dilemna back in the day.
If you don't mind me asking, what kind of guys are you crossloading to?
I like to use lots of cordage and ingenuity. lol. Cross load it.
Whiplash
04-08-2013, 23:42
One thing I have tried and liked was rigging two CLS bags together for extended dismounted patrols and slinging them that way you still have immediate access without having to drop your gear.
Just figured I'd share this to see if it helped anyone else out. This is a setup for relatively long infils with low weight. All setup it weighs less than 30 pounds
Smoke
4 Magazines with dump pouch
Food Pouch
GP Pouch with Narcs and signalling
NVG pouch with mount, headlamp and flashlight
24 foot tubular nylon with 3 carabiners
NARP CLS bag with ripshears
Sam Splint taped behind kidney pad
3L water bladder
100 rounds 7.62 linked
X2 mortars
I also roll with a fanny pack that has a stripped down cric kit, earpro, tourniquetX2, Chest Tube Kit, Cards, Pens and Diagnostics(small wrist BP and Pulse Ox). With an IFAK on everyone, this is more than enough supplies for operations ~80-100Px with two medics carrying this loadout. It also weighs half of what fully dedicated aidbags weigh and you can take out the CLS bag and roll with it standalone W/fanny pack if needed.