What Is an IFAK?
  
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IFAK is an acronym for "Individual First Aid Kit" or "Improved First Aid Kit".
What is an IFAK?
With close to 20 years of experience in designing and assembling first aid kits, we will attempt to explain an IFAK in common terms. We have worked with military and law enforcement clients working in a multitude of environments with different requirements and different requested load outs.
For those who served in the military in the 1980's and 1990's, the only soldier-worn first aid item was the trau-medic bandage. In a major leap forward at the commencement of the Global War on Terror, the military developed the Individual First Aid Kit (IFAK). In an effort to put life-saving items on the wounded person at the scene of the injury, they looked at deadliest wounds, and the frequency. Military Special Operations Doctors looked at injuries that were potentially deadly if not treated on the battlefield. The traditional EMS first aid acronym ABC (Airway, Breathing, Circulation) was changed to MAR (Massive Hemorrhage, Airway, Respirations) reflecting the priority of injuries that need to be treated.
“The IFAK increases individual soldier capabilities to provide Self-Aid/Buddy-Aid and provides interventions for two leading causes of death on the battlefield, severe hemorrhage and inadequate airway. These capabilities increase soldier survivability during dispersed operations.” - USAMMA
The number one preventable cause of death is massive hemorrhage. Three items inserted to address this are typically found in all quality IFAKs we have seen.
- The tourniquet - a robust and durable strap with tightening windlass buckle and locking device to stop the flow of blood to a wounded appendage.
- The pressure dressing - combining a blood absorbing bandage with an elastic ACE-type wrap bandage and a plastic pressure tensioning device to allow you to apply a dressing and apply pressure.
- The hemostatic agent - a substance now impregnated in gauze that when placed on a ruptured artery promotes blood to clot, diminishing or stopping the flow of blood.
The next preventable cause of death is an inadequate airway. A nasopharyngeal airway kit is frequently inserted made up of a #28 French nasopharyngeal and a water soluble lubricant for insertion. All military kits have this, and most law enforcement kits have an NPA, but some LE kits leave it out.
The third most common item in IFAKs seals a sucking chest wound. The chest seal, sometimes issued in pairs is a sterile plastic sheet with sticky adhesive.
Supporting items commonly inserted are shears for cutting clothing to expose the wound area, rubber gloves for sterile handling, medical directions card and tape.
All of these items should be placed in an easily (one handed) opened pouch with slots to organize for logical access. The pouch should be one that can be mounted on the vest, belt or thigh, and be easily accessed. Frequently tourniquets are placed in a carrier mounted on the user's chest for quickest access, and sometimes two are carried. If the kit will be left in a vehicle and mounted when the situation dictates, then it needs to be marked with an easily identifiable red cross or subdued cross. It is helpful to have troop mounted IFAK pouches marked with “IFAK” or a red cross to help a rescuer identify your kit.
Other items we have been asked to insert in IFAK kits:
- Medications packet
- z fold gauze and medical tape
- 14 gauge catheter for needle chest decompression, which requires advance training.
- Iodine / betadine swabs
- CPR Face Shield
The basic load is frequently the model issued to regular troops and patrol officers, while the larger more comprehensive IFAK reflects the Special Operations load out we have seen issued to those with more extensive training. All IFAK training should follow Tactical Combat Casualty Care (TCCC) guidelines (for military and law enforcement). Or the TECC (Tactical Emergency Casualty Care) for civilians. For more information on these guidelines reference the NAEMT website: http://www.naemt.org/
HOW DO YOU USE AN IFAK?
Using an IFAK requires medical knowledge, basic skills and the decision to use it. It serves as the minimum necessary medical assistance to save a life. Almost 85% of preventable combat deaths are from bleeding out, and about 10% are from a collapsed lung. Knowing how to handle these two situations and having the right IFAK can have a substantial impact. You should definitely seek instruction from a competent trainer and practice with your IFAK. In serious trauma, every second counts.
   
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