MEDICAL
A Group Medical Bag Is Not
Five IFAKs Sewn Together
How should we equip a shared medical backpack for a four- or five-person team when everyone already carries an individual first aid kit and is trained to the TCCC CLS level?
A group medical bag is not five IFAKs sewn together.
How should we equip a shared medical backpack for a four- or five-person team when everyone already carries an individual first aid kit and is trained to the TCCC CLS level? I think the first step is to define the purpose of the bag.
During casualty care, the casualty's own IFAK should normally be used first. The group bag should then provide three additional capabilities: Redundancy when one wound requires more equipment than a single IFAK contains. The ability to manage multiple injuries or more than one casualty. Shared equipment that is too bulky to place in every individual kit.
Baseline Equipment for a Small Team
For a small team expected to support one or two seriously injured casualties until evacuation, a reasonable baseline might include:
Massive hemorrhage: 2–4 additional CoTCCC-recommended limb tourniquets, 4 hemostatic gauzes, 4–6 compressed or plain packing gauzes, 3–4 pressure dressings, one larger abdominal or trauma dressing.
Airway and respiration: Nasopharyngeal airways with lubricant, a compact bag-valve mask, two sets of vented chest seals, needle-decompression devices only when the personnel carrying them are trained and authorized to perform the procedure.
Hypothermia, injuries, and evacuation: Two effective hypothermia-prevention systems, one compact splint with several cravats, rigid eye shields, additional gloves, trauma shears, medical tape, markers, and casualty cards.
What Does Not Belong in the Group Bag
Medications should follow the unit's authorized protocol and should not be added simply because there is free space. The same principle applies to advanced equipment.
IV/IO access, TXA, blood products, advanced airways, or other medic-level interventions do not create additional capability when nobody in the group is trained and authorized to use them. In that situation, they mainly create weight, confusion, and false confidence.
Variables That Change the Quantities
The exact quantities should still change according to: expected evacuation time; mission and threat profile; likely injury patterns; distance to the nearest medic; whether the group moves on foot or by vehicle; and how many casualties the team realistically plans to support.
Organization Is Just as Important as Content
Critical hemorrhage-control equipment should be immediately accessible. Supplies should be divided into clearly marked MARCH modules, and every team member should know where they are located.
A perfectly equipped backpack understood by only one person becomes a single point of failure when that person is injured.
So perhaps the right question is not: "What should every group medical bag contain?" But: "What additional medical capability does this particular team need beyond its individual IFAKs?"
For CLS instructors and those who carry group medical bags: do you configure them primarily for one severely injured casualty, two casualties, or rapid resupply of individual IFAKs? And which supplies do teams usually carry too many of — while running out of something else?
TacMed USA Commentary
Paul Strauss MD — TacMed USA
The "I" in IFAK stands for Individual. An Individual First Aid Kit is designed to treat one person. An Active Shooter/Mass Casualty Incident is fundamentally different and requires a Mass Casualty Bag capable of treating multiple victims.
The word "mass" in mass casualty means there are not enough medical resources—personnel, equipment, or supplies—to immediately care for everyone who is injured. Those resources must be brought into the crisis site as quickly as possible.
Whenever operationally feasible, a Mass Casualty Bag should accompany the initial law enforcement response during the Stop the Killing phase or be brought in immediately once the threat has been controlled, contained, or has fled. Law enforcement should not wait for Fire/EMS to arrive before these lifesaving supplies enter the scene.
Every minute matters. Victims with severe extremity hemorrhage or major arterial bleeding may have only minutes to survive. Delaying the arrival of tourniquets and other hemorrhage-control equipment until Fire/EMS enters the scene can cost lives. Early access to a Mass Casualty Bag allows officers to begin lifesaving interventions immediately and significantly increases the number of victims who survive until they can receive definitive medical care.