Individual first aid kit (IFAK)

Educational use only

This page provides general educational information for emergency preparedness scenarios when professional medical care is unavailable. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider. Use this information at your own risk.

Three minutes. That is the outer limit for survival from arterial hemorrhage before irreversible shock begins. Your IFAK is the kit that works within those three minutes — on your belt, reachable with one hand, organized so you deploy the right item first without thinking. The military developed the IFAK concept from hard lessons in Iraq and Afghanistan, where most preventable combat deaths were from extremity bleeding that could have been stopped by the casualty or the person next to them. Those lessons translate directly to civilian preparedness.

Educational use only

This page describes IFAK assembly and use for emergency preparedness education. Trauma interventions require hands-on training. Read this page to understand the system, then attend a Stop the Bleed course, a Tactical Combat Casualty Care (TCCC) course, or a Wilderness First Responder program to build the muscle memory these procedures demand. See medical training for course options.

What an IFAK is — and is not

An IFAK (Individual First Aid Kit) is a personal, immediately accessible trauma kit sized for one casualty's immediate needs. It is designed to stop the three preventable causes of death in tactical medicine — massive hemorrhage, airway obstruction, and tension pneumothorax — in the first three to five minutes before more skilled help arrives.

An IFAK is not: - A first aid kit for cuts and headaches - A duplicate of your home medical kit - A pharmacy - An all-day care kit

The scope boundary matters. Adding aspirin, antacids, and bandages to your IFAK adds bulk without adding life-saving capability. Every non-critical item you add is space and weight taken from items that save lives.

The scope distinction by kit layer:

Kit	Purpose	Location	Duration of care
IFAK	Immediate trauma response	On your person	0–10 minutes
Patrol/vehicle med bag	Extended trauma and secondary assessment	Vehicle, pack, or bag	10–60 minutes
Home medical kit	Broad household care, prolonged care	Fixed location	Days to weeks

The MARCH protocol

Your IFAK contents are organized around the Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia (MARCH) algorithm — the Tactical Combat Casualty Care (TCCC) priority sequence:

M — Massive hemorrhage: Stop life-threatening bleeding first. Tourniquet for extremities; hemostatic gauze pack for junctional wounds.
A — Airway: Open and maintain the airway. NPA for unconscious or semi-conscious casualties.
R — Respiration: Seal open chest wounds. Decompress tension pneumothorax.
C — Circulation: Continue hemorrhage control; recognize and treat shock.
H — Hypothermia/Head injury: Preserve core temperature; protect the head.

Your IFAK directly addresses M, A, and R. C and H are primarily addressed by the larger patrol bag and extended care protocols. Build your IFAK around MARCH, not around what fits in the pouch.

Core IFAK components

[DIAGRAM: IFAK pouch layout showing component placement from top to bottom — tourniquet exterior, then gloves, hemostatic gauze, chest seals, NPA with lube, pressure bandage, marker]

Combat Application Tourniquet (CAT Gen 7)

What it is: A windlass-style tourniquet approved by the Committee on Tactical Combat Casualty Care (CoTCCC). The CAT Gen 7 has a reinforced windlass rod and a buckle with auto-lock.

What it treats: Life-threatening extremity hemorrhage. Indicated when direct pressure fails, when blood is spurting, when the wound is too large or anatomically awkward for manual pressure, or when the casualty must self-treat.

How to carry it: Mount on the outside of the pouch with the pull tab oriented upward. This allows one-handed deployment by reaching across the body. The tourniquet should be accessible from either hand without visual confirmation. Pre-routed "ready to throw" configuration (loop fully open, velcro loose, windlass upright) saves critical seconds.

Specs: 37.5-inch (95 cm) circumferential strap; recommended for limb circumferences up to 30 inches (76 cm). Apply 2–3 inches (5–7.5 cm) above the wound, tighten until hemorrhage stops or becomes minimal, rotate windlass until taut and lock, note the time of application in writing.

The time documentation rule: Write the tourniquet application time on the windlass lock tab, on the tourniquet itself, or on the casualty's forehead with the marker. "TK 14:23" written on the forehead is readable at handoff even if the tourniquet is cut away. This is a named step, not an optional note — receiving medical personnel need this time.

Improvised tourniquet as last resort

A properly applied CAT tourniquet at 1.5 inches (3.8 cm) wide generates controlled occlusion pressure. Improvised tourniquets narrower than 1.5 inches — shoe laces, paracord, belts with thin edges — cause severe localized tissue damage before achieving occlusion and frequently fail to stop arterial bleeding entirely. Carry the real device. See improvised alternatives for the clinical evidence on improvised tourniquet limitations.

Hemostatic gauze (kaolin-impregnated)

What it is: Gauze impregnated with kaolin clay, which activates clotting Factor XII and concentrates the clotting cascade at the wound. QuikClot Combat Gauze is the CoTCCC-recommended product. The previous generation used zeolite (exothermic, generated heat — no longer used).

What it treats: Wounds in "junctional" zones — the groin, axilla (armpit), and neck — where a tourniquet cannot be applied. Also used for high-volume wounds too large for simple pressure dressing.

How to use: Pack the gauze directly into the wound cavity with your fingers, applying firm continuous pressure. Fill the wound channel, not just the surface. Hold pressure for 3 full minutes by the clock. Do not lift the gauze to inspect — checking breaks the forming clot. If bleeding soaks through, add more gauze on top and continue pressure.

How to carry it: One 3-inch (7.5 cm) Z-fold roll, sealed in original packaging. Keep inside the pouch, not in an exterior pocket exposed to moisture.

Vented chest seals

What they are: Adhesive occlusive dressings for open chest wounds (sucking chest wounds). Vented seals have a one-way flutter valve that allows air to escape the pleural space on exhalation but prevents air from entering on inhalation. Vented is preferred over non-vented — non-vented seals carry a risk of converting an open pneumothorax into a tension pneumothorax by trapping air.

What they treat: Penetrating chest wounds (stabbing, gunshot). An open chest wound allows air to enter the pleural space with each breath, collapsing the lung. Sealing the wound restores the negative pressure needed for effective breathing.

How to use: 1. Expose the wound completely. Wipe blood and debris from the skin — most seals require a dry surface for adhesion. 2. Apply the seal over the wound, centered, pressing firmly from the center outward to eliminate air pockets. 3. Apply a second seal if there is an exit wound. All holes in the chest wall require coverage. 4. Monitor: if the casualty's condition deteriorates after sealing (increasing respiratory distress, tracheal deviation, distended neck veins), suspect tension pneumothorax. This requires needle decompression — a procedure beyond basic IFAK scope requiring the patrol bag and training.

How to carry: Two seals minimum — one for entry, one for potential exit wound. Hyfin Vent or HyFin Vent Compact are the most commonly carried civilian options. Store flat to preserve adhesive.

The vented vs. non-vented distinction:

Type	Mechanism	Preferred for	Risk
Vented (flutter valve)	Allows air out, blocks air in	All penetrating chest wounds	Low — safest default
Non-vented (occlusive only)	Seals completely	Improvised field use only	Can create tension pneumothorax if air accumulates

Nasopharyngeal airway (NPA) with lubricant

What it is: A soft rubber or silicone tube inserted through the nostril and advanced into the posterior pharynx, providing a patent airway in casualties with altered level of consciousness.

What it treats: Airway obstruction in semi-conscious or unconscious casualties who still have a gag reflex (an oral airway is contraindicated in patients with a gag reflex; the NPA works where an OPA does not). Common causes: facial trauma, altered consciousness from blood loss, head injury.

Sizing guide:

Patient	NPA size
Average adult female	28 Fr (6.5 mm internal diameter)
Average adult male	28–32 Fr (6.5–8.0 mm ID)
Large adult male	32–34 Fr (8.0–8.5 mm ID)
Adolescent (12–16 years)	22–26 Fr

French (Fr) size equals 3× the outer diameter in millimeters. A 28 Fr airway is approximately 9.3 mm outer diameter. When in doubt, size down — a slightly smaller NPA functions; one that is too large damages the nasal passage. Ideal NPA length correlates with height, not sex.

How to use: Apply water-based lubricant to the outside of the tube. Insert with the bevel facing the nasal septum (midline). Advance with gentle, steady pressure. If you feel significant resistance, stop and try the other nostril. The airway is correctly seated when the flanged end rests against the nostril and breathing sounds are audible through the tube.

Contraindications: Suspected basilar skull fracture (Battle's sign — bruising behind the ear; raccoon eyes — periorbital bruising; clear fluid from nose or ears). In these cases, jaw thrust without an NPA is the correct airway maneuver.

How to carry: Pre-lubricate the tube, place it in a small sealed bag with the lubricant packet, and store inside the pouch. The ready-to-use configuration saves seconds in a real airway emergency.

Pressure bandage

What it is: An elastic bandage with an integrated pressure bar (Israeli-style, also called "Emergency Bandage"). The bar allows the bandage to change direction and apply targeted mechanical pressure to a wound.

What it treats: Secondary wound coverage after hemostatic gauze packing; wounds not requiring tourniquet; post-tourniquet wound coverage during transport.

Size: 4-inch (10 cm) is the standard all-purpose IFAK size. A 6-inch (15 cm) bandage fits in the patrol bag for larger wounds.

Nitrile gloves

Carry two pairs. Put on gloves before touching any wound — this protects the casualty from environmental contamination and protects you from bloodborne pathogens. Nitrile over latex: latex sensitivity is common; nitrile is chemically resistant and more puncture-resistant for field use.

Permanent marker

Write tourniquet time. Write the patient's allergies if known during casualty card documentation. Write "T" or the time on the forehead. The marker is not optional — it is a documentation tool in a medical emergency.

Positioning and access

The best IFAK in the world fails if you cannot reach it under stress.

Primary rules: - Must be accessible with the non-dominant hand (your strong hand may be managing direct pressure on a wound) - Must be reachable while seated, in a vehicle, and lying prone - Must be visually identifiable by another person — use a distinctive color or clear labeling - Standardize the position so others can find it on you without asking

Common carry positions:

Position	Pros	Cons
Belt line (appendix or 3–4 o'clock)	Fast access, works seated	Uncomfortable for extended wear
Drop-leg platform	Clear of belt gear, highly visible	Slower to a full sprint; can shift
Plate carrier (front or side)	Logical with body armor	Only useful when wearing armor
Backpack shoulder strap	Visible and accessible	Requires carrying a pack

Vehicle staging: A vehicle IFAK should be mounted visibly within reach of the driver seat without moving. A visor clip, door pocket, or center console mount all work. Do not bury it in the trunk.

Household staging: Every household member should know the location of every IFAK in the house. The standardized layout means any family member can operate someone else's kit without instructions.

Monthly inspection checklist

Trauma supplies degrade. Chest seal adhesives dry out. Tourniquet plastic cracks in vehicle heat. Inspect monthly.

Tourniquet: windlass rotates smoothly; velcro adheres fully; no cracks in windlass rod; strap threading intact
Hemostatic gauze: packaging sealed; no moisture damage; within expiration date
Chest seals: packaging intact; adhesive not brittle or dried (fold test — does the liner peel cleanly?); within expiration date
NPA: tube flexible and not stiff; lubricant present; correct size confirmed
Pressure bandage: packaging intact; elastic band not dried out
Gloves: no holes; not brittle; size correct for user
Marker: cap on; ink flows
Pouch condition: zippers/closures function; no cracking or separation at seams

Record the inspection date and your initials on a strip of tape inside the pouch lid. A kit with no inspection record has not been inspected.

Field note

Vehicle heat kills chest seal adhesives faster than anything else. A car parked in summer sun can reach 160°F (71°C) — far above the 104°F (40°C) storage maximum for most medical adhesives. If you carry a vehicle IFAK, rotate the chest seals every six months regardless of the expiration date printed on the package. The expiration date assumes controlled storage, not a hot dashboard.

IFAK vs. the next tier up

Your IFAK handles immediate response — the first five minutes. The patrol medical bag or range bag handles the next tier: secondary assessment, IV access, extended hemorrhage control, splinting, medication administration.

What belongs in the patrol bag but not the IFAK: - 14-gauge needle for tension pneumothorax decompression (both 2nd ICS midclavicular and 4th–5th ICS anterior axillary landmarks are CoTCCC-endorsed; the lateral site is preferred in patients with heavy musculature or obesity due to shorter effective depth) - Cervical collar - SAM splints - Oral glucose - Suture kit or stapler - Advanced airway (supraglottic airway device) - Hypothermia prevention (space blanket)

Do not migrate these items into your IFAK to feel more prepared. An overloaded IFAK becomes a sorting problem under stress. See home-kit.md for the full Tier 2 and Tier 3 supply lists.

Training that activates the kit

Carrying an IFAK without training is like carrying a fire extinguisher without knowing how to pull the pin. The equipment has no value until you can deploy it under stress, with cold hands, in bad light.

Minimum training to carry an IFAK: Stop the Bleed (2 hours, free, nationwide). This course covers tourniquet application, wound packing, and pressure dressing.

Recommended training to carry a full IFAK with NPA and chest seals: TCCC or Tactical First Responder course (16–32 hours). This covers the MARCH algorithm, airway management, chest seal application, and casualty packaging.

How to practice: Run monthly timed drills. Set a timer. Deploy the tourniquet on yourself, on your non-dominant arm, in under 30 seconds. Do this seated, lying down, and in low light.

Debrief: was the tourniquet above the wound? Was the windlass locked? Was the time marked?

Cross-reference: bleeding control, chest trauma, medical training.