Most of the time when people talk about EDC or every day carry the list contains a gun, ammo, knives, wallet, phone, keys, etc. What’s not usually included is much, if any, PPE (personal protective equipment). In the new world of heightened infectious disease awareness (thanks to the novel coronavirus), PPE is something that everyone needs to be concerned about on duty, off duty, when on vacation, or out for relaxed personal time. To find out what is recommended and what changes have been made in recent months, we reached out to Deputy Tom Perroni, NREMT, NAEMT Instructor for TCCC, TECC & PHTLS. Deputy Perroni is also an International Trauma Life Support Instructor, a DHS/FLETC Tactical Medical Instructor and has experience as a SWAT Medic.
Deputy Perroni’s first response was surprising. We started talking about what had changed with the reality of COVID-19 in our day to day lives. “Nothing has changed much at all,” he says. The reality of personal isolation using facial barriers and gloves has been practiced for roughly half a century now. Washing our hands and/or using hand sanitizer (a secondary acceptable option if you can’t actually wash your hands with soap and hot water) has come into a greater focus but is still nothing new.
Axioms to remember
• Plan for worst-case scenarios.
• Unless you’re on fire or drowning, there’s no such thing as too much ammo.
• It’s better to have it and not need it than need it and not have it.
• Two is one and one is none. Always have two.
Now when you talk to most EMTs or medics about what they carry off-duty, you get a very different answer from when you ask the average law enforcement officer. Where the average officer will likely carry a gun, spare magazine, knife, and maybe a limited list of trauma care items (tourniquet, hemostatic gauze, pressure bandage, etc.), the EMT/medic list becomes quite expansive by comparison. It’s not a surprise to find an off-duty EMT/medic carrying a bag instead of wearing everything on his belt. There’s just no way it’s all going to fit—unless you have a pretty big utility pouch.
Throughout our discussion of what is in Deputy Perroni’s off-duty sling bag, he expressed the need for redundancy and planning for worst-case scenarios. The spare ammunition was mentioned first: his three extra rifle magazines and five extra pistol magazines. While some might consider that excessive, there’s an old axiom when it comes to figuring out how much ammo is enough: Unless you’re on fire or drowning, there’s no such thing as too much ammo.
Moving on to the first-aid or medical care items, the need to have sufficient PPE to treat several people was a common thread in the discussion. The list of PPE and other equipment carried was obviously created to treat a minimum of two people, but even with just two patients, a lot more than two of a given item might be needed. For example, it’s good practice to change gloves when changing from patient to patient and even if only two need treatment, several more might be examined or given primary assessments. Gloves need to be changed in between every patient so one thing in Deputy Perroni’s bag is ten pairs of nitrile / non-latex gloves. Non-latex is important as many people have a sensitivity to latex and contact with it can cause them to have an allergic reaction. That only adds to whatever injury or challenge they’re already suffering from and needs to be avoided.
Because CPR may be a necessity, there are two CPR masks in his bag as well—one adult size and one infant size. Deputy Perroni commented that he’d never had to perform CPR on an infant as yet in his career, but it’s better to have it and not need it than need it and not have it. The mask he specified is available from numerous sources and has a one-way valve so no breath from the victim can come back into the rescuer.
The type of injury that might need to be treated can never be assumed, but given the nature of law enforcement work, the most common injuries are puncture or gunshot wounds, severe lacerations, and blunt trauma or crush injuries that cause internal bleeding. For the treatment of gunshot wounds and lacerations, the typical “blow out” kit will contain a tourniquet, a pressure bandage, a chest seal, and some type of hemostatic gauze. Still, in the hands of a capable and properly certified medic, there are other life-saving supplies that are invaluable to have:
Trauma dressings. Because sometimes a hemostatic agent or some gauze just isn’t sufficient.
Chest seals. The “sucking chest wound” that so many of us have seen Hollywood treat incorrectly in movies is a real thing. Chest seals and the decompression needles to go with them can save lives BUT you have to be properly trained and certified in their use or you could end up doing more harm than good.
Nasopharyngeal airways. Most of us can’t intubate a victim and even fewer know how to do emergency tracheotomies, but an airway is always important. It’s relatively easy to learn how to insert a nasopharyngeal airway and if you have a couple of them available it can save a life.
Mylar blankets. No, not just “space” blankets but specifically mylar blankets. If an injured individual experiences body temperature reduction to 90 degrees F or lower, death is inevitable. Having one mylar blanket available to keep a patient’s body temperature up can definitely save their life. Having two means being able to potentially save more.
Sheers. One pair of rescue or EMT sheers should be available. While a great many officers carry a knife and will tell you it’s for the express purpose of cutting a victim’s clothes out of the way, the knife is not well suited for the task. If the patient moves, circumstances surprise you, etc. you can end up cutting the patient and doing even more damage than you set out to treat. Have a good quality pair of sheers at hand and learn to use them.
A Sharpie. Yep, a good old fashion indelible marker. Times and treatment can and should be written on the patient (usually the forehead). This passes along valuable and necessary information to other care providers as the patient moves out of your care and into a higher level of treatment. It avoids lost information. In medical care, lost information can be fatal.
While that seems quite the extensive list of equipment, bear in mind that we’re talking about what an off-duty officer who is also an EMT or medic might consider having at hand. Deputy Perroni carries all that in a sling bag that he reports taking with him everywhere he goes. I’ve done the same thing in the past with not quite as much medical gear, simply for lack of training and certifications.