How To Pack A 24 Hour Bag
A 24-hour bag is an assortment of medical gear and supplies that you carry with you during a short deployment, at the gun range, or any other activity you’re assigned to do (because you’re in the military, after all).
However, madness needs strategy when it comes to packing a 24-hour bag. Organized chaos is one way of looking at it. However, it has to make sense in your head for it to work. Organized chaos is the way you think things through and the people who work with you should know your approach and be used to seeing it.
For my part, I try to organize my 24-hour bag according to the order of treatment priority set out in the TCCC-M.A.R.C.H PAWS protocol.
I start with a bag that has an external snap closure. This is important as it gives you plenty of options to hang, pin down or secure the bag anywhere you like (one place you definitely shouldn’t hang the bag is outside of a vehicle – in case of enemy contact there is a chance that the bag stolen or shot at. If you come across an IED, there is also a risk that the bag and its contents will be damaged or blown to pieces by the explosion).
On the outside of my 24 Hour bag I carry the following items:
- tape
- scissors
- cable ties
- Soft pad
- CAT tourniquet
- rescue blankets
- Fast1TM (Intraosseous Infusion System)
- Quantum liquid warmer
Now let’s take a look inside the bag (well, maybe not quite literally, but let’s just look inside the bag instead).
I recommend organizing the equipment so that it is in the order in which you treat the wounded. To me that makes the most sense. But there is no rule that says you have to do it the same way.
However, if you follow my example and open your bag, the following equipment should immediately catch your eye:
- Combat Gauze
- CAT tourniquet
- Elastic bandages
- felt pens
- diagnostic lamp
- eye protection
- epi pen
- Container for storing sharp objects
- Chest Seals (2) each with an NCD
- stethoscope
- Pocket-sized resuscitation bag
- PEEP valve
- Cric Kit
- NPA with lubricant
- IVX kit
- trauma medication
- Arm slings or triangular scarves
- Abdominal dressing bandage with staples
- Plastic bag
Below this should be:
- paper or writing pad
- Accessories for a blood transfusion in the field
- Blue rubber gloves (to easily spot blood on your hands)
- Additional light
- wound cards
- Bubo gear
- Swiss Army knife
My tip: Consider using the newcomers from your unit by involving them in the preparation. For example, you could have them connect the NCDs to the occlusive dressings, attach loops of tape to your gear so you can grab and open it more easily, put labels on the inside compartments of your bag, and seal the items inside with bold capital letters label. These little tweaks will help you ensure optimal care while you’re under high stress.
Another great trick: Have your helpers attach Velcro to each piece of gear, as well as the inside and bottom of the bag. That way your gear inside the bag won’t fly around when kicked or thrown. Of course, this is slave labor for the newcomers to your unit, but consider the benefits too: at the end of the day, you get a neatly packed bag and they, in turn, learn all about its contents.
When you’re done packing, do some airbag exercises. After that, perform these exercises blindfolded (or at least with your eyes closed) – this will help you automate your moves so they come naturally to you and you don’t have to think about them when you’re in the heat of the moment.
You may get wounded yourself. If you’ve been hit and the junior/senior paramedic is too busy to attend to you at that moment, it’s your buddy who will grab your first aid kit and try to help you. OK, maybe everything he knows about Prolonged Field Care is from the old M*A*S*H* episodes, but luckily it’s all labeled in your bag and you’ve got all the vials and gear lined up just in case rotated for easy reading.
And if you’re really the bloke, you’ll create “cheat cards” for everything for your helpful pal to read and keep calm while he tries to save you from bleeding to death.
As I always say, proper preparation is 70% of success. You can’t be a perfect medic, but there’s always something you can improve upon. And something you can always improve on is preparing your gear more effectively.
HOW TO PACK A MASCAL BAG
A MASCAL bag is similar to a 24-hour bag, except that its contents are intended to care for more than just one or two wounded in the field. That is why MASCAL is an abbreviation for mass casualty, i.e. a mass incident of injuries.
Basically, a MASCAL bag is equivalent to 3 IFAKs in terms of what’s inside. By that I mean that the implements and accessories included don’t necessarily offer a lot of variety, but when it comes to quantity, feel free to stack up and even a little beyond.
Nevertheless, I try to keep the contents of my MASCAL bag as simple as possible. The reason for this is that with a large number of wounded people, they are first assigned and then treated according to the KISS method – this means that you only carry out life-saving measures.
On the outside of my MASCAL bag are:
- snap hook
- SAM Splint universal splints (2 or more)
- Improvised wooden splint
- Helicopter Rail (2 Bars)
- Triangular scarf or an arm sling
Inside is:
- bleeder kit
- CAT tourniquet
- Elastic bandages
- Cloth
- Cric Kit
- NPA with lubricant
- Combat Gauze
- emergency bandage
- Chest Seals (with NDC)
- Blizzard Survival Blankets
- Ready-Heat blanket
- rescue blankets
- paper (for triage)
- garbage bag
- gecko tape
- Hard/soft base
Check your equipment at regular intervals. Make sure everything is working and check that the equipment has not expired. If necessary, repair or replace the content.
And speaking of the expiration date. Make sure your skills don’t expire either. You don’t need a full education program or training to keep your skills and know-how up to date. Regular training should be enough. The main thing is that you are familiar with all the equipment and accessories and you know where things are in the bag.
Summary
If you want to carry out extended field care, you must be prepared accordingly with a 24-hour bag and/or a MASCAL bag, depending on whether you are treating one or several wounded.
You must have a 24-hour bag with you if you want to carry out minor procedures and the number of wounded is expected to be very small. Pack them according to the treatment protocols of TCCC-M.A.R.C.H. PAWS so you can access your gear in the order you treat the wounded.