Equipment Considerations: Level 2

As mentioned in an earlier post regarding Level 1 kit, you must pack your medical gear to reflect the mission requirements and constraints. Here are some considerations when packing your Level 2 gear:

1) Pack supplements to Level 1. For instance, medics may need more bandages and tourniquets.

2) Pack for Tactical Filed Care phase of treatment. In this phase, you may need:

    A. Drugs (e.g., Toradol) and associated items (e.g., syringes, heplocks)
    B. Splinting material
    C. Evacuation Platforms (e.g., poleless litters or a Foxtrot Litter)
    D. Fluids
    E. Needle Thoracostomy items
    F. Hypothermia Prevention
    G. Casualty Equipment Bag
    H. Casualty Documentation

3) An aid-bag for the above items. Err on the side of too small, as carrying a “tick” on your back might be more of a burden than an asset, depending on the mission. That is your call.

The above serves as a framework. We will cover Level 3 in the next post.

13 replies
  1. Nukefaith
    Nukefaith says:

    Do you consider a C-collar splinting material? What would you recommend to store a c-collar? Would you further say to use a c-collar for casevac and/or medevac?



  2. just saying
    just saying says:

    I would think c-collars would go here,but storage is a big problem for me as well.It seems the way to go is 1or 2 adjustable collars but they cant really be folded(breakage) and the only 2piece collars aren’t adjustable. looking forward to some insight about this.

  3. admin
    admin says:

    It is mission dependent. If, for example, you are fast-roping in, then it might be advisable to pack a c-collar. If, however, you are assaulting an objective on trucks, then it ought to be packed in your level 3 gear, with you rigid stretcher.

    Thanks for the comments and please keep them coming.

  4. kaja
    kaja says:

    For c-collar- try nexsplint/x-collar. It’s adjustable and 2piece- helped me a lot with organizing my kit.

    Hope it helps….

  5. Froto
    Froto says:

    Most level II type packs come with a hydration-bladder sleeve sewn into them somewhere. I’ve been able to slide a universal sized adjustable collar (with the chin unbuttoned) in there on many occaisions. It’s a tight squeeze, but you should be able to do it and still fit in a hydration-bladder.

  6. Cdn_Medic
    Cdn_Medic says:

    What good is a C-Collar if you don’t have a backboard?

    Asking the question is giving the answer. The is no place for C-Collar in 2nd line.

    Backboard and C-Collar are for 3rd line and 3rd line only.

  7. TacMedic338
    TacMedic338 says:

    Agree that carrying a C-collar is mission specific. low incidence of c-spine injury generally (unless mission includes some rappel/high angle component). I can usually put a c-collar around the interior of my small level II bag as support. C-collar useful for C-spine support when advanced airway in place and patient being moved over terrain. If i need to pack light. the collar is out.

  8. starlight_cdn
    starlight_cdn says:

    Depending on the size of your team, some of this kit can be spread around ie IV Fluids, hemorrhage control, pill packs. With team members carrying robust IFAKs combined with Lvl 3 vehicle kits and follow-on forces, I carried minimal ‘software’ and concentrated on ‘hardware’. I used my advanced trained team members (CLS/TCCC) for hemorrhage control and splinting. I would managed the event and perform advanced interventions.

    If your task is kicking in doors and making friends in a team environment, the op calls for a smaller bag like the TacMedSol RAID loaded as your Lvl 2. You may need more mags ‘n frags than med gear.

    If you are tasked to support company or combat team level ops, pack heavy. Carry lots o’ batteries for your radio so you can call on armored ambs or helo assets. CTOMS 2nd Line with both Modules would be a good gear choice.

    If your are running convoys, you got vehicle kits to draw on, your route has been booked with Ops and assets are on standby. The TacMedSol RAID or the CTOMS 2nd Line Primary Module only would be appropriate.

    Mission drives the gear. Tactical situation drives the level of medicine. There is no such thing as a standard loadout.

  9. just sayin
    just sayin says:

    I understand thomas and cdn feeling that a c-collar is useless without a spine board,but i have to disagree.I have used c-collars with a Sked-stretcher and they would work just as well with a foxtrot(not complete spinal immobilization but better than letting the head dangle).Then you also have the fact that c- collars are used in ambulatory patients quite often(sure they may be 200 dollar aspen collars but the concept is the same).Now i can’t see letting someone walk around with a c-collar on ,but if I have the choice between c-collar and nothing, when the MOI is there ,it ain’t much of a choice.

  10. Geodkyt
    Geodkyt says:

    Yes, casualty documentation should be in the Level 2.

    But each Level 1 IFAK should ALSO have the basic documentation stuff with them. Each troops should have in his IFAK: a cas card, writing instrument (I prefer a mini-Sharpie — the downside of rotating stock every few months to avoid drying beats the various downsides of pencils, grease pencils, or ballpoint pens), and a couple of SAFETY PINS to tag the patient with wrappers of anything besides an external-only bandage. . . that way, critical documentation is attached to the patient for higher echelon docs.

    I think the safety pins and Sharpie in the IFAK are key, and probably more important than a cas card or the Level 2 documentation — if you are the receiving surgical unit and receive a patient with no legible documentation and a garbeled verbal, but his TK has a clearly written time on it and there are 2x hemostatic agent wrappers (ESPECIALLY if it’s anything granular) and a chest seal wrapper, you’ve at least got a solid clue as to what you’re treating. (For one, you know you have at least two injuries to treat — one in the chest and one in an extremity.)

    Just this will give you the overwhelming majority of documentation the patient needs when evacuated.

  11. starlight_cdn
    starlight_cdn says:

    I went even further on my last gig, in regards to Cas tags. The casualty card patient ID info, PM Hx, Current Rx and Allergies/NKDA were all filled out and attached to a laundry bag for cas effects which was store in a uniform spot by all the troops. That way I would chart the current injuries & tmts quickly and efficiently, plus I had a casualty effects bag already labeled…

    I still carried some Cas Docs in my Second Line for LN, ANSF and other cas not using the above SOP.

    This was not my idea, I adopted it after ‘meeting’ with some smart guys in Suffield.


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