IFAK Basics

Every modern IFAK is built around Tactical Combat Casualty Care (TCCC). The framework stacks by threat: the order is MARCH — Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia. If you build a kit without MARCH in mind, you end up with a first-aid kit, not an IFAK.

Civilian or duty, the order matters. A victim with a bleeding femoral artery does not need a Band-Aid. Your IFAK needs to answer the biggest lethal problems first.

Tourniquet, hemostatic gauze, and pressure dressing. Period.

Tourniquet: one genuine CAT Gen 7 or SOF-T Wide, mounted on the carrier or belt where either hand can reach it. Counterfeit tourniquets are everywhere on Amazon — verify the source. A counterfeit CAT fails at 40% the load of a real one and kills people.

Hemostatic gauze: Combat Gauze (ChitoSAM or QuikClot) in a vacuum pouch. You use this for wounds a tourniquet cannot reach — neck, groin, axillae. Plain gauze works too but hemostatic gauze clots faster in a high-flow bleed.

Pressure dressing: an Israeli bandage or OLAES. Wraps a wound under tension to stop moderate bleeding and hold gauze in place. Much faster than tape-and-gauze improvisation.

Nasopharyngeal airway (NPA), 28Fr for adults, with a packet of surgilube. Opens an unconscious airway without requiring an ET tube or training you do not have.

Vented chest seals, two of them (one exit, one entry). Hyfin or HALO are the mainstream options. A sucking chest wound from a GSW or stab becomes a tension pneumothorax without a seal. Two seals because the bullet probably went through.

Decompression needle (14ga, 3.25 inch) is a provider-level tool. Do not carry it unless you have current training. If you are not a paramedic or military medic, leave this off.

Trauma shears and nitrile gloves. You cut the clothing off to find and treat the wound. Bare hands in blood is how you catch hepatitis.

Mylar emergency blanket. Hypothermia onset is within minutes in any casualty with major blood loss, even in summer. Wrap them.

Sharpie: write time of tourniquet application directly on the victim's forehead or exposed skin. EMS crews need it. Also write the time on the tourniquet itself.

Band-Aids, aspirin, sting relief, and moleskin. None of those belong in an IFAK. An IFAK is for trauma, not a boo-boo kit. If you want those, carry a separate small booboo bag.

Quikclot granular (the original version). Causes exothermic burns. Use gauze-impregnated hemostatic instead.

Knockoff tourniquets. Already said. Worth repeating. A fake CAT is worse than no tourniquet because you will believe it is working when it is not.

Mount the tourniquet outside the IFAK pouch, on the carrier shoulder strap or belt, accessible with either hand. The whole point of an accessible TQ is that it works with one hand while your other hand is busy doing first aid on yourself.

IFAK pouch goes on the belt or carrier where you can reach it with the non-dominant hand. Tear-away designs let a teammate pull it off you and use your kit on you. Never use your kit to treat someone else unless you have a second — then you have nothing.