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12/24/2018 6:47:54 PM EDT
I know, GD, but the medical training forum is slow.

TCCC guidelines lay out the contents of Combat Pill Packs, or as they're now officially called Combat Wound Medication Packs.

For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit. I'm not a cool guy or 0p3rat0r, just Joe Blow who does normal ass Joe Blow stuff. That said, what are your opinions on this? Forget about it? Make some up? It depends? Other thoughts?

Cliff notes for those unaware, a proper CWMP generally consists of-
  • Two painkillers, acetaminophen and meloxicam for mild to moderate pain. Fentanyl citrate or ketamine depending on scenario for severe pain.
  • An antibiotic, typically moxifloxacin.

I had something much longer and more intricate typed out but we'll see if this turns into an actual conversation or not before I post all that.
12/24/2018 6:50:11 PM EDT
[#1]
One drug issue containing antibiotics, morphine, vitamin pills, pep pills, sleeping pills, tranquilizer pills.
12/24/2018 6:52:29 PM EDT
[#2]
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
12/24/2018 6:56:17 PM EDT
[#3]
Quote History
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
View Quote
I don't. Like I said, I had a big thing typed up going over all that but I had the feeling someone was going to get all retarded over it so I just trimmed it down to what you see in the OP.

Antibiotics are entirely feasible to acquire (moxifloxacin isn't, but you can substitute) but again, someone was likely going to get retarded over it so I left that out.
12/24/2018 6:57:18 PM EDT
[#4]
Quote History
Quoted:
One drug issue containing antibiotics, morphine, vitamin pills, pep pills, sleeping pills, tranquilizer pills.
View Quote
A guy could have a pretty good time in Vegas with those.
12/24/2018 6:58:23 PM EDT
[#5]
throw in some viagra and you're all set.
12/24/2018 6:59:19 PM EDT
[#6]
why isnt moxifloxacin obtainable????
12/24/2018 6:59:42 PM EDT
[#7]
Absolutely pointless in an IFAK.

Put Tylenol and Ibuprofen in a boo boo kit not IFAK.  IFAK is for fix shit right now so I don't die.
12/24/2018 7:02:36 PM EDT
[#8]
Quoted:

For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit.
View Quote
if you have to take pain killers if you're by yourself you're probably not gonna make it.

I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief
12/24/2018 7:02:36 PM EDT
[#9]
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Quoted:
why isnt moxifloxacin obtainable????
View Quote
Prescription only, not available in "alternative forms".
12/24/2018 7:03:39 PM EDT
[#10]
For all our "regular guy" wounded situations it's better to not pop a bunch of pills and fish antibiotics before the EMTs get to you.

Don't overthink it.
12/24/2018 7:04:56 PM EDT
[#11]
Quote History
Quoted:
if you have to take pain killers if you're by yourself you're probably not gonna make it.

I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief
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Quoted:
Quoted:

For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit.
if you have to take pain killers if you're by yourself you're probably not gonna make it.

I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief
Already done.
12/24/2018 7:07:39 PM EDT
[#12]
I got a trauma kit in my truck  I also got a a separate first aid kit that I keep pills, band aids, over the counter meds, etc

I think it makes sense to have a bag that I would grab in an emergency situation versus needing to treat a minor cut, headache, rash, etc.

Both are about the size of an issue IFAK, just one is red and the other black.
12/24/2018 7:07:43 PM EDT
[#13]
Quote History
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
View Quote
Basic medication that comes in handy:
Ibuprofen (pain)
Acetaminophen (pain)
Benadryl (liquid too) (Allergic reaction)
325mg Aspirin. (Heart Attack)

Those 4 will cover most things you run into off the battlefield.
12/24/2018 7:09:31 PM EDT
[#14]
Quote History
Quoted:

if you have to take pain killers if you're by yourself you're probably not gonna make it.

I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief
View Quote
Maybe not heavy-duty opioids, but it's not unlikely to suffer a sprain or broken bone while out hiking. Anything to keep your mind off the pain will help you get back to your vehicle more quickly. A properly-equipped IFAK is useful for more than just bleeding or severe trauma.
12/24/2018 7:10:33 PM EDT
[#15]
If you're far off from help:

-OTC pain killers to dull your injury to assist in self rescue
-electrolyte solution to replenish your salts lost to exertion or blood loss
-antibiotic to get rolling on your inevitable infection associated with austere self aid

Dayquil caps are a good multi use item, you get some tylenol and also some added in stimulant to help keep you alert.
12/24/2018 7:10:41 PM EDT
[#16]
Quote History
Quoted:
For all our "regular guy" wounded situations it's better to not pop a bunch of pills and fish antibiotics before the EMTs get to you.

Don't overthink it.
View Quote
I overthink everything. That's how I roll.

Serious question, why? Is it a matter of possibly negative drug interactions if they try putting something in you and aren't aware of whatever you took? Overdose? Other?
12/24/2018 7:11:13 PM EDT
[#17]
Talk to your general practitioner, see what he will prescribe for your "disaster readiness medical kit"
he might have no problem prescribing you limited quantities, or he might think that you are nuts
12/24/2018 7:16:11 PM EDT
[#18]
Quote History
Quoted:
Maybe not heavy-duty opioids, but it's not unlikely to suffer a sprain or broken bone while out hiking. Anything to keep your mind off the pain will help you get back to your vehicle more quickly. A properly-equipped IFAK is useful for more than just bleeding or severe trauma.
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Quoted:
Quoted:

if you have to take pain killers if you're by yourself you're probably not gonna make it.

I would keep, lots of bandages and self applied blood management tools and the basic/OTC pain relief
Maybe not heavy-duty opioids, but it's not unlikely to suffer a sprain or broken bone while out hiking. Anything to keep your mind off the pain will help you get back to your vehicle more quickly. A properly-equipped IFAK is useful for more than just bleeding or severe trauma.
This is part of the possible scenarios of use. Rural area here and depending on where you go help can be 30+ minutes away easily. Sometimes hours and there's lots of cellphone dead zones. Having to make it out alone or in a small group is not an unlikely proposition in the event something goes wrong.
12/24/2018 7:19:38 PM EDT
[#19]
Quote History
Quoted:

I overthink everything. That's how I roll.

Serious question, why? Is it a matter of possibly negative drug interactions if they try putting something in you and aren't aware of whatever you took? Overdose? Other?
View Quote
They're pointless.  In the civilian world one dose of these really won't be of benefit.  Stop the bleed and stay alive.  You'll get pain killers if you're hemodynamically stable when the bus arrives and plenty of antibiotics and crap at the hospital.

ETA: you typed the above while I was typing.

IF you are looking at med kits to include sprains and breaks, anti inflammatory medications may be of help in a remote area.  More importantly will be items to assist in immobilization.
12/24/2018 7:21:12 PM EDT
[#20]
I remember pill packs being part of the old IFAK back in 05 06 but they went away for a long time. I didn’t know they were part of the most recent TC3 guidelines. I think it’s a good idea but you really do need a large dose of antibiotics and probably a good pain killer that’s doesn’t thin the blood.
12/24/2018 7:24:02 PM EDT
[#21]
Quote History
Quoted:
I remember pill packs being part of the old IFAK back in 05 06 but they went away for a long time. I didn't know they were part of the most recent TC3 guidelines. I think it's a good idea but you really do need a large dose of antibiotics and probably a good pain killer that's doesn't thin the blood.
View Quote
Why? Unless its going to be several days before you get to a hospital, taking some OTC fish abx isn't going to do you any good.
12/24/2018 7:25:47 PM EDT
[#22]
Quote History
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
View Quote
Trump banned that as well

For antibiotics.....local pet store and fish medicine.
12/24/2018 7:25:58 PM EDT
[#23]
Quote History
Quoted:
They're pointless.  In the civilian world one dose of these really won't be of benefit.  Stop the bleed and stay alive.  You'll get pain killers if you're hemodynamically stable when the bus arrives and plenty of antibiotics and crap at the hospital.
View Quote View All Quotes
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Quoted:
Quoted:

I overthink everything. That's how I roll.

Serious question, why? Is it a matter of possibly negative drug interactions if they try putting something in you and aren't aware of whatever you took? Overdose? Other?
They're pointless.  In the civilian world one dose of these really won't be of benefit.  Stop the bleed and stay alive.  You'll get pain killers if you're hemodynamically stable when the bus arrives and plenty of antibiotics and crap at the hospital.
What happens when "the bus" takes hours to arrive, or you have to arrive at the bus? Do you think everyone lives 100% of their lives in a metro area?
12/24/2018 7:27:59 PM EDT
[#24]
Quote History
Quoted:
edited

For antibiotics.....local pet store and fish medicine.
View Quote View All Quotes
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Quote History
Quoted:
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
edited

For antibiotics.....local pet store and fish medicine.
For real? Don't even suggest that. I'd appreciate you removing that as well.
12/24/2018 7:30:26 PM EDT
[#25]
I don't see the point.  I keep a IFAK with me for a major of shit type of moment. ( Chest Seals, Tourniquet, Combat Gauze, Israeli Bandage etc)    I have a large first aid kit at home and a few small ones for our vehicles.
Those are the ones for any pills IMO
12/24/2018 7:31:10 PM EDT
[#26]
Quote History
Quoted:

What happens when "the bus" takes hours to arrive, or you have to arrive at the bus? Do you think everyone lives 100% of their lives in a metro area?
View Quote
Do whatever you want man....... It's not like I know anything about medicine.  I mean we can make up scenarios all day.  What if you're paddling up stream in a canoe and your right front wheel falls off?

I would recommend lots of uppers and any other meds you think would be awesome.

I want my IFAK to be a keep me from being dead kit and maintain a second med/boo boo kit for everything else.  YMMV
12/24/2018 7:33:48 PM EDT
[#27]
Even if you could get ahold of it, I would not recommend antibiotics or Fentanyl for your usage.  Antibiotics are more of a fix for a longer term problem, and Fentanyl (like any opiate) has concerns with lowering respiration rate and blood pressure.  Both of these side effects are a Bad Thing when you are losing blood from a gun shot, stab wound, internal bleed, etc.
12/24/2018 7:45:27 PM EDT
[#28]
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Why? Unless its going to be several days before you get to a hospital, taking some OTC fish abx isn't going to do you any good.
View Quote
A few years ago I woke up with half my face swollen like a chipmunk. I went to an emergency dentist (an Army LTC), and he wouldn't even do anything but x-ray before I took chlorhexidine mouthwash, 4 500mg amoxicillin, a bunch of vitamin C and waited an hour or so.

If you're out in the middle of nowhere, might take a bunch of antibiotics to keep things in check until you can get help.
12/24/2018 7:48:42 PM EDT
[#29]
Quote History
Quoted:
Why? Unless its going to be several days before you get to a hospital, taking some OTC fish abx isn't going to do you any good.
View Quote View All Quotes
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Quote History
Quoted:
Quoted:
I remember pill packs being part of the old IFAK back in 05 06 but they went away for a long time. I didn't know they were part of the most recent TC3 guidelines. I think it's a good idea but you really do need a large dose of antibiotics and probably a good pain killer that's doesn't thin the blood.
Why? Unless its going to be several days before you get to a hospital, taking some OTC fish abx isn't going to do you any good.
Exactly.
12/24/2018 7:53:39 PM EDT
[#30]
With some Pervitin and Eukodal in your IFAK, you can conquer damn near all of Europe, let alone manage a simple GSW. They've been the go-to for nearly a century.
Attached File

Attached File

Safety tip: the D-IX tablets are convenient for dosing, but tend to make you a bit too jumpy for tasks requiring fine motor coordination.

The foregoing is not to be taken seriously. Serious answers have already been provided. This is GD, and we have a limit of 10 serious answers before commencing fuckery. This limit has already been met.
12/24/2018 8:01:50 PM EDT
[#31]
If you do this bad plan keep the Rx meds in original container addressed to you or you could be without gun rights pretty easily.
12/24/2018 8:04:22 PM EDT
[#32]
EMT-P/former corpsman...

As said above, just grab tylenol, Aspirin(81mg chewables) and Motrin for your snivel gear side of the kit, Aspirin, motrin and other NSAIDs reduce clotting ability so you don't want them for an emergent bleed issue(and why Mobic is in the pack)

Pill packs are predicated on being in an austere environment/far away from definitive care. Also meant for soldiers with and open wound, still able to fight and don’t need to/aren’t getting tended to by a higher echelon of care for some time.

You cited long distance time til help but any pill you swallow ain’t kicking in for 30-45 minutes or longer anyways. Any systemic bacterial issues aren’t kicking in for quite some time so one dose in your belly ain’t doing much at all.

So you tip your tractor into a manure puddle and end up with an open femur fracture? Pill pack? By the time you get to the hospital you’re gonna get whacked with all sorts of ABs.

Quoted:

What happens when "the bus" takes hours to arrive, or you have to arrive at the bus? Do you think everyone lives 100% of their lives in a metro area?
View Quote
That ain’t what/whom the pill pack is for.
12/24/2018 8:14:48 PM EDT
[#33]
Quote History
Quoted:
If you do this bad plan keep the Rx meds in original container addressed to you or you could be without gun rights pretty easily.
View Quote
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
12/24/2018 8:25:44 PM EDT
[#34]
Quote History
Quoted:
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
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Quoted:
Quoted:
If you do this bad plan keep the Rx meds in original container addressed to you or you could be without gun rights pretty easily.
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
You are over thinking it and dreaming up situations that will not happen.

Just hit up Cabelas, REI, etc for one of these.
12/24/2018 8:48:29 PM EDT
[#35]
Quote History
Quoted:
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
View Quote View All Quotes
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Quote History
Quoted:
Quoted:
If you do this bad plan keep the Rx meds in original container addressed to you or you could be without gun rights pretty easily.
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
Your original post beginning fentanyl citrate. Other than that nothing.
12/24/2018 8:50:44 PM EDT
[#36]
Quote History
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
View Quote
Hit up the local dealer?
12/24/2018 8:57:09 PM EDT
[#37]
Quote History
Quoted:
Your original post beginning fentanyl citrate. Other than that nothing.
View Quote View All Quotes
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Quote History
Quoted:
Quoted:
Quoted:
If you do this bad plan keep the Rx meds in original container addressed to you or you could be without gun rights pretty easily.
Where did I say I had or even wanted to acquire prescription meds? I'm under no illusion of doing such a thing.
Your original post beginning fentanyl citrate. Other than that nothing.
All I did was state the contents of a pill pack according to the TCCC guidelines to use as a jumping off point and explain to those not in the know what such a pill pack generally consists of.

Like I also said in the OP, I had something else typed up. It would have explained that I'm not retarded and am aware of obvious things like not being able to get controlled substances and discussed substitutions for them. I didn't post it or even finish typing everything I wanted to say because I had the strangest feeling someone would get their panties in a wad over it, which is why I'm loath to even mention stuff like this.

For the record here's most of the original OP:
That said TCCC guidelines call for the use of stuff I can't get except for acetaminophen. Specifically they call for the use of Tylenol 650mg 8 hour bilayer tablets, which are easily available. I was also considering Tylenol "Ultra Relief" tablets that have 500mg of acetaminophen and 65mg of caffeine. My thinking with those is that caffeine has been shown to give at least a small boost to painkiller effectiveness, plus if I'm in a situation that calls for popping one of these pill packs then I imagine a small boost from the caffeine wouldn't be unwelcome.

I can't really substitute meloxicam. Was considering using salicylamide as it's an NSAID and from my limited research doesn't seem to affect clotting like aspirin does. However, I can't find tablets that have just salicylamide, only the combo stuff that includes aspirin in the mix which is a no-go.

As regards antibiotics again I can't get what the TCCC guidelines call for, so a substitute would again be in order. Before I go further, I'm not here for your opinion on non-prescription access to antibiotics. I'm aware of the contention and arguments surrounding the issue.
12/24/2018 9:07:12 PM EDT
[#38]
Quote History
Quoted:

All I did was state the contents of a pill pack according to the TCCC guidelines to use as a jumping off point and explain to those not in the know what such a pill pack generally consists of.

Like I also said in the OP, I had something else typed up. It would have explained that I'm not retarded and am aware of obvious things like not being able to get controlled substances and discussed substitutions for them. I didn't post it or even finish typing everything I wanted to say because I had the strangest feeling someone would get their panties in a wad over it, which is why I'm loath to even mention stuff like this.

For the record here's most of the original OP:
View Quote
Meloxicam isn't that great, but does help with arthritic pain. The first dose really screwed up my gut.
12/24/2018 9:11:30 PM EDT
[#39]
Sweet jesus
12/24/2018 9:18:03 PM EDT
[#40]
Quote History
Quoted:
Joe Blow is getting Joe Blow meds. How do you plan on getting fentanyl, ketamine, or antibiotics?

Just get acetaminophen and ibuprofen.
View Quote
I printed out the TCCC guidelines and handed them to my Doc to look over and she gave them to me. Your millage may vary, it made sense in for my circumstances.
12/24/2018 9:19:07 PM EDT
[#41]
Quote History
Quoted:
One drug issue containing antibiotics, morphine, vitamin pills, pep pills, sleeping pills, tranquilizer pills.
View Quote
...does that include rubles and a prophylactuc?
12/24/2018 9:21:14 PM EDT
[#42]
As a civilian these are my must have meds—

Aspirin for MI/CVA
Dipenhydramine for allergies
Loperamide for diarrhea
12/24/2018 9:32:59 PM EDT
[#43]
You shouldn't use opiods for severe pain unless you're under the care of somebody who knows what they are doing and are going to be sent someplace with people who know even more.

The question is, what are you preparing for?  A first aid is for, well, first aid.  It's to stop the bleeding and keep you alive until you can get help.  What more do you need?  Guys in combat in remote places have different requirements from somebody in the states.
12/24/2018 9:41:38 PM EDT
[#44]
Mollys and Percs

There's your GD answer.  You're welcome.
12/24/2018 9:42:43 PM EDT
[#45]
Quote History
Quoted:
You shouldn't use opiods for severe pain unless you're under the care of somebody who knows what they are doing and are going to be sent someplace with people who know even more.

The question is, what are you preparing for?  A first aid is for, well, first aid.  It's to stop the bleeding and keep you alive until you can get help.  What more do you need?  Guys in combat in remote places have different requirements from somebody in the states.
View Quote
Can't tell some of these folks that they think because some medic in the middle of nowhere in a combat zone carries TXA fentanyl pops ketamine antibiotics ect ect they should have it too just because they read through TCCC or whatever medical book. Pain and infection is the last thing you need to worry about here in the states. ABCs.........
12/24/2018 9:55:06 PM EDT
[#46]
I'm not trying to be a dick here, but I'm going to be frank with you. If you don't have enough background or knowledge to form your own educated opinion on this, you really have no business self-medicating with serious drugs.
12/24/2018 10:05:24 PM EDT
[#47]
Quoted:
I know, GD, but the medical training forum is slow.

TCCC guidelines lay out the contents of Combat Pill Packs, or as they're now officially called Combat Wound Medication Packs.

For me this would be used for the one in a million chance I'm seriously injured while near any of my equipment, to include my car kit. I'm not a cool guy or 0p3rat0r, just Joe Blow who does normal ass Joe Blow stuff. That said, what are your opinions on this? Forget about it? Make some up? It depends? Other thoughts?

Cliff notes for those unaware, a proper CWMP generally consists of-
  • Two painkillers, acetaminophen and meloxicam for mild to moderate pain. Fentanyl citrate or ketamine depending on scenario for severe pain.
  • An antibiotic, typically moxifloxacin.

I had something much longer and more intricate typed out but we'll see if this turns into an actual conversation or not before I post all that.
View Quote
Meloxicam (or Mobic) may require up to two weeks to provide maximum relief of your pain and inflammation.  Not sure it's handy for a quick fix.  I'd stick with Ibuprofen.

For me, with all the joint inflammation, I've got a Meloxicam 'scrip, but I found that as far as effectiveness, speed of effect and duration I'd go


  1. Ibuprofen

  2. Naproxen/Aleve

  3. Acetaminophen

12/24/2018 10:06:30 PM EDT
[#48]
Quote History
Quoted:
I'm not trying to be a dick here, but I'm going to be frank with you. If you don't have enough background or knowledge to form your own educated opinion on this, you really have no business self-medicating with serious drugs.
View Quote
Truth NDC needles too!
12/24/2018 10:09:34 PM EDT
[#49]
I know most of the MDs in this thread don't move 10 ft from the bag of MT dew in their moms basement, but some us going hiking and climbing in remote areas hours away from a hospital. People like us already know what we need and prepare for it, suburban commandos like the OP don't need that information because they can get medical attention quickly.
12/24/2018 10:24:07 PM EDT
[#50]
"Please don't pump yourself full of drugs you don't fully understand for injuries you will not fully understand."

- your local EMTs

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