Wow where to start... I'm not an expert, I am however currently deployed and I would like to think that my training is "current" (admittedly it is NOT extensive and my CLS cert is NOT current). First and foremost I am a helicopter crew chief/mechanic, my next assignment will be with a Forward Support Medevac Team and my wife is an ER nurse. AGAIN, please do your own research and don't take my word as gospel for any of this. If you need an aircraft fixed in the middle of nowhere I can probably be a great help but I feel sorry for anyone that would have to rely on my trauma skills to save them. In either event I'll do what I've been trained to.

Regarding tourniquets, if you even think they might be useful, use them. We are CURRENTLY trained to do so and a CAT (tourniquet) is by far the most easily accessed first aid tool on my flight vest, it is required as such. Everything else is tucked away in an otherwise inconvenient internal pocket. Current training is that a tourniquet can be left on for up to 8 hours before concern of losing a limb. I know this is highly contrary to what has been posted, that is why I am stating otherwise.

How important is it to stop bleeding? Even on a battlefield, with weapons designed to kill as effciently as possible, hemorrhaging still accounts for 80% of the deaths. You stop the bleeding you save lives.

Practically speaking, the types of tools you are going to have available as a cyclist are very limited assuming you brought any. When it comes to saving a life a cell phone is your best bet. Next, the ability to stop any serious bleeding is huge. Tourniquets do this. If you can keep a person from bleeding out long enough for the professionals to get there you have probably covered the majority of what could have killed the person, if the person dies it is unlikely that you have helped them with any of the other tools you would likely be carrying. For example, a space blanket might help prevent shock but blood loss will bring about shock that the blanket cannot stop.

Regarding Quickclot... it is an excellent tool. DO NOT USE IT AS A SUB FOR A TOURNIQUET and please DO NOT "THROW YOUR TOURNIQUETS OUT". Quickclot is an excellent alternative for wounds that cannot be addressed with a CAT... torso, neck, head. Quickclot would be an excellent addition to a CAT but different jobs require different tools. If you plan to carry Quickclot please read up on it and the precautions you should take with it. It is a fine powder that will render you useless if you get it in your eyes (it reacts with moisture, not specifically blood, and the crap can go airborne everywhere if you aren't conscious of the risk). QC must be applied to the point of bleeding. Not all bleeding is external and not all blood exits the body from the point in which it is leaving the vascular system (a tourniquet will will work if either of these probems is present in a limb). Medical staff will literally spend hours cleaning QC out of a serious wound as opposed to the seconds in which a tourniquet can be removed and further treatment can begin. You will not find QC in an ER. There are other precautions as well so don't consider this info as your education.

If this really is important to you please seek professional education and try to maintain it with some sense of on going training.

Helo mechanic out.

Thanks for posting.
My training is with the US Coast Guard and about 10 years out of date.
I am sure you would agree that a tourniquet is last in line after direct pressure, arterial pressure point elevating the wound ect.

I'm having a difficult time thinking of an item that could be more ponderable regarding its wisdom in a first aid kit. I assume you're talking about a little cut & suck kit. There's a good amount of legend behind their effectiveness but tons of analysis that indicates they are no good.

Any informed opinions on snake bite treatment?

I agree with Kookaburra1701 that the most important tool in an emergency is between your ears. Take a First Aid and CPR or First Responder course from a certified educational organization. I also agree that a few pair of nitrile or vinyl gloves and some basic wound care supplies are all that is needed for citizen first response. I too am a paramedic and the kit I carry contains gloves, a 10-pack of 4x4 gauze dressings, a roll of gauze bandage, a roll of Coban (stretch gauze that has been coated with a substance to make it stick to itself but still be removable/repositionable), a small roll of 1" athletic tape, a CPR micro shield, a small mylar space blanket, and a pair of bandage scissors. The entire kit fits in a small triangle bag.

- If you are going wilderness trekking where help could be hours away, you should consider a more comprehensive trauma kit, but this should be adequate for initial response to the majority of emergencies likely to be encountered by a cyclist. If you take a good citizen first aid, first response, or wilderness first response course you will be taught how to improvise what you can't carry in a reasonably sized kit. You can never carry everything you could possibly need so learn to prioritize.

- Direct pressure is the first line of bleeding control. Use some kind of reasonably clean dressing (a shirt or bandana will do in a pinch) or even just your gloved hand to put pressure over the bleeding wound. A first responder or wilderness medicine course will teach you about arterial pressure points, which are also useful for controlling bleeding on the arms or legs. Many bleeds can be controlled with a properly applied dressing and bandage. A tourniquet should not be used if bleeding control can be accomplished by one of the other means, but is viable when a patient has a severe bleed that cannot be controlled by other means, when there is severe bleeding from multiple sites, or when you need your hands for other priorities like keeping their airway open. You do need to learn to properly apply a tourniquet so again, a first aid course is a good idea.

- Snake bite kits are of dubious value. Take one of the courses mentioned previously to learn the currently accepted method of treating snake bites. Whatever you do, don't pull out your pen knife, cut Xs over the bite marks and try to suck out the poison. This is folklore that is best left to black and white Western movies. Honestly, your chances of being bitten by a snake while cycling, even offroad in the desert, are right up there with being struck by lightning or winning the lottery. Just watch where you put your feet and hands and if you see a snake, leave it alone, North American venomous species aren't aggressive but will strike if they feel threatened. Outside of the US there are some species that are actively aggressive, so know the snakes native to your area.

- Don't move a seriously injured person unless absolutely necessary to protect their safety or provide treatment. Again, a proper course will teach you the lowest risk methods of moving or positioning a person. Assure that the person can breathe adequately, immobilize any injured area including the neck or back (have them lie still and gently hold them in position), and control any serious bleeding. Contact 911 with your location and details of the incident and the victim's condition. Stay on the line unless the dispatcher tells you to hang up.

I'm guessing you've been out for 10 years then. Unfortunately the military has had a lot of "learning opportunities" since then. What you've stated is not incorrect and it will work assuming you know what you are doing (no different than anything else). It's my opinion that a lot of the changes are the result of people who didn't apply the older methods properly. For the average soldier it's been dumbed down, and I can appreciate that. However, the major parts of what you stated aren't what I have been taught in at least 4 years.

Same: elevating wounds is still a good idea.

Major differences: application of direct pressure and pressure points... I couldn't even tell you the details of pressure points. Obviously if it is a relatively minor wound you might escape w/o a tourniquet. The old method required an evaluation of the bleeding after 2 (I believe) steps were taken before applying a tourniquet and even then people were apprehensive about tourniquets due to the false belief that it would likely mean an amputation ...and people died as a result. Also under the old method, lets assume a tourniquet is required, during the first two steps the patient is still bleeding/dying. So if tourniquets do not automatically require amputations (you literally have hours) why even mess with the first to steps? Therefore we typically don't. You get jacked up around me and you are getting a tourniquet until someone that knows more can give you competent care. Part of the application process involves writing a "T" on the patients forehead and the time it was applied next to it. CAT's can be applied one handed to yourself if need be too. Also, since we aren't worried about amputation we don't sweat placing the tourniquet 2" above the wound. Now it goes as high as practical, one less detail I guess.

You might also be interested in knowing that IV fluids are no longer part of a CLS kit. I guess there effectiveness was questionable in the early stages of treatment and they were found to detract lesser trained people from performing higher priority care. Did I mention they dumbed everything down, lol?

I'd also like to add something that has already been mentioned... Protecting yourself, please have gloves too. A mask would be nice but not likely on a bicycle. We don't have them in military field kits but we also go through a crap load of regular health screenings so I feel relatively safe against anything serious.

Well they have dumbed down almost everything else. Why should first aid be any different.

Would you believe I have had a civilian on a boat on the radio that I had to talk out of applying a tourniquet
to an injured persons neck because they had a gash on their head?

There are some very stupid people out there.

This two minute video will teach you what you need to know for layperson CPR. For more in depth stuff, check out the AHA's youtube channel. Good stuff for non-medical persons on there.

Oh, Queen's "Another One Bites the Dust" also works, but people tend to get tetchy when you start humming it under your breath while performing chest compressions on a loved one, so I don't use it anymore.

Heh... maybe Nighttime in the Switching Yard

Speaking of quality CPR vids: Vinnie Jones needs a volunteer!

Too funny! If I had been drinking coffee it would have been sprayed on the monitor.

I hope the boy the OP found is OK... What luck he had that you where riding by and able to get medical attention to him.

This also got me thinking that I needed to restock my first-aid kit.

I usually carry mostly road-rash treatments... Disposable latex gloves, bandaids, non-adhesive gauze pads, a few antiseptic wipes, and waterproof tape. My job has me on-call 24-7 so I always have a cell-phone with me, which I think is the most important part if the injury is bad enough that the previously mentioned supplies are not enough to cover it and I can't limp or ride home.