First Aid: More than Meets the Eye
By C. Todd Lopez, Army Staff Writer, in coordination with DoD Vision Center of Excellence
This article appeared in the Q1 2014 issue of Combat & Casualty Care magazine.
The Individual First Aid Kit II (IFAK II) contains all the supplies of the old kit, with the addition of a second tourniquet, a tactical combat casualty card to annotate what kind of first aid was applied to a wounded soldier, a marker, an eye shield, a rubber seal with a valve for sucking chest wounds, and a strap cutter. The kit fits inside a custom pouch that can be mounted out-of-the-way on the back of a soldier’s Improved Outer Tactical Vest.
“That’s typically low-rent real estate there,” said Major Peter Stambersky, assistant product manager of soldier clothing and individual equipment at Program Executive Office Soldier, Fort Belvoir, VA. “Guys don’t use it too much.”
The pouch has “US IFAK” printed on its rear, so soldiers may easily identify its contents, Stambersky said. The individual tourniquet pouches also contain customizable removable tabs that allow soldiers to hand write their blood type or unit on the kit.While the new first aid kit can be mounted on a soldier’s back, it is designed to be easily accessible when needed for both right-handed and lefthanded soldiers.
The IFAK II can be removed from its container pouch from either side by pulling on one of two tabs and slipping it out of its case. The tabs also have small “flaps” on them, so that when a soldier is reaching for the kit, he can get some tactile feedback that lets him know he is pulling on the right tab, Stambersky noted. When removed, the foldable kit remains attached to the pouch by an elastic tether.
The kit also comes with two removable tourniquet pouches that can be mounted to the kit or to other parts of a soldier’s gear. Stambersky said soldiers might even remove one of the tourniquets from its separate pouch and store it in a cargo pocket on their uniform pants or in a sleeve pocket.
“You can take this out and walk around with them in your pocket, which a lot of guys are doing in-country now,” he said, while waving the un-pouched tourniquet in the air.
The kit is already in Afghanistan in small numbers, as part of a previously initiated limited user evaluation involving 4th Brigade, 3rd Infantry Division, out of Fort Polk, LA. In September, units at Fort Bragg, N.C., received the kits through the Rapid Fielding Initiative in advance of their own deployment.
Stambersky said the Army added the Tactical Combat Casualty Care card and a small Sharpie marker to the kit as a way for soldiers who have administered first aid to a fellow soldier to indicate to follow-on medical professionals the kind of assistance that was rendered. The card, once marked, is meant to be attached to the uniform of the afflicted soldier. The new method, he said, is better than the old way.
“What you would do if you found me on the battlefield and you applied a tourniquet to me is you would write that on this card and attach this to my body,” Stambersky said. “In the old days, the technique was to take blood and write ‘T’ on your forehead. But that will get smudged with sweat or water; it’ll rub off.”
Also included in the new kit is a rubber seal that looks much like a stopper to put over a sink drain, but with a valve in it to let out blood. The seal is meant for soldiers who are suffering a sucking chest wound. That happens when a bullet, for instance, has pierced their chest and lung, and as a result of the new hole they are unable to properly draw air into their lungs. In the past, soldiers might have been directed to bandage a soldier’s ID card or other piece of flexible plastic over the wound to cover the hole. The new seal now fills that role.
Pouches inside the IFAK II are left empty so that soldiers may also be issued QuickClot Combat Gauze when they receive their kit. The gauze, due to its shelf life, is not distributed with the kits.
Eye on the Fly
Also in the kit is an eye shield, which is a small, curved aluminum disk with padding on the edges that can be placed over a soldier’s wounded eye. The shield is meant to keep pressure off a wounded eyeball when a soldier’s injured head is subsequently wrapped with bandages.
“The eye shield is an addition, above and beyond what was in the IFAK II,” Stambersky said. “Eye shields are on the battlefield now in the MOLLE (Modular Lightweight Load-carrying Equipment) medic set and in the combat lifesaver bags. But now every soldier has one, to prevent further injury to the eye socket and to the eyeball.”
The addition of the eye shield came after the members of the Army ophthalmological community—eye doctors—recognized that something needed to be done in theater to give soldiers who administer first aid to their injured buddies the tools needed to prevent further, perhaps irreparable damage to eyes.
One such doctor is Dr. Robert Mazzoli, an ophthalmologist and retired Army colonel. He now serves as the director of education, training, simulation, and readiness at the Department of Defense’s Vision Center of Excellence. Mazzoli said the Army medical community had identified that eye injuries were not being treated with an eye shield, “which is the appropriate immediate treatment.” He added that they tracked why that was not happening, and found the eye shield was “not available where the injury was happening.”
“When we elevated that as a concern to the [U.S. Army Medical Department] Center and School, the logistics people and the Committee on Tactical Combat Casualty Care, they latched on to that,” Mazzoli said.
He added that the eye shields started making their way into various medical kits on the battlefield, and most recently they were included in the IFAK II.
Practice Makes Perfect
While Mazzoli said it’s a great move on the part of the Army to include eye protection in first aid kits, he noted it’s important too that training on how to use the new equipment is also provided, “We also have to make sure they know.”
One of the “good news” stories that has come out of the recent wars in Iraq and Afghanistan is the advancements in medicine and combat care, Mazzoli said. “It shows how we are doing things differently in this war than any previous war that we have fought, in that we are making rapid changes to not just how we are taking care of causalities, but to the stuff we are able to take care of casualties with—like the eye pro, like the tourniquets, and the development of new body armor systems,” he said.
Stambersky said the new IFAK II is designed to provide to soldiers only the most basic tools needed to save lives, at the place where injuries occur: “What the IFAK II gets at is life, limb, eye sight, immediate point of injury care—what needs to be done immediately to keep that soldier alive.”