For a warrior lying wounded on the battlefield, there is no greater sight than that of a combat medic kneeling over him, treating his wounds. The combat medic’s main weapon in the battle to save his wounded comrade’s life is the trauma medical kit.

From such primitive beginnings such as in World War I when an individual warrior might carry a simple cotton drawstring bag containing some bandages and dressings, today’s trauma medical kit contains an impressive variety of emergency medical care items in a relatively small container. Over the years trauma kits, originally known as medic kits or medic bags, have evolved and reached a certain degree of specialization. Today when a special operations team goes on a mission, it takes with it up to four kits – two on each individual, a third carried by the medic, and, if the mission calls for vehicle transport, a fourth contained in one of the vehicles.

The most basic kit is the one that is part of the warrior’s SERE – Survival, Evasion, Resistance and Escape – individual survival kit. As the name suggests, this compact kit is designed for survival in a hostile environment. As such it has the minimum medical items because it must also contain communications and environment survival equipment. Next is the individual trauma kit. This kit contains enough supplies and equipment so that the warrior, provided he’s not incapacitated, can treat himself. The third kit is the medic’s team trauma kit. This is a backpack that ideally contains enough supplies to treat everyone in the team. The fourth kit, in the vehicle, is a mass casualty kit used to replenish items the medic’s had to use from his kit. Occasionally, there’s a fifth kit. This goes by such names as drop kit and kick-out bundle. It’s a trauma kit packed by the medic at the base and is brought in by helicopter when specifically requested during a medevac. It gets its name from the fact that it is dropped or kicked out of the helicopter during the initial overflight of the pickup location.

As for what’s in a kit, some items, such as field dressings and bandages, and scalpels and scissors, would be recognized by a medic from any era. Other items, such as devices designed to keep airway passages open, are more recent. Additional equipment includes tourniquets, pain medications, and heat reflective blankets. Depending on the type of kit (individual or team), they also include catheters, chest seals, intravenous fluid bags, infection control medication, and latex gloves, amongst other items.

When a mission is assigned, the medic immediately begins assembling his trauma kit. While one might think that the kits are customized to be mission-specific, that’s not really the case. Mark L. Donald, a retired SEAL lieutenant warrior-medic who was awarded the Navy Cross for action in Afghanistan, said, “Kits are mission-specific for environment.” Land-based direct-action, surveillance, reconnaissance, or force protection patrols in which a team either marches or drives to a location and then returns “are generally the same” and require little or no changes. Amphibious and airborne operations present different challenges, particularly when it comes to waterproof and pressurized packaging.

Donald noted that the equipment and supplies used today are all high quality. But, given the fact that the same equipment might be carried on operations over dry land, in high altitude, and in water, he said, “We need to figure out a way for the kit to be preserved going from one environment to another. Simply vacuum sealing isn’t the answer. Simply carrying it in nylon isn’t the answer either.” He added, “We also need to learn how to make these things smaller. The kits are made based on the functionality of the item. But the functionality of the item doesn’t necessarily equate to what’s practical.”

Yet, as important as these medical supplies are, recalling his experience of helping wounded and saving lives in the middle of combat, Donald said, “It’s not about the kits. . . . It’s about the training. It’s about understanding the pathophysiology of what is happening in the body and knowing how to improvise things. . . . Eventually you’re going to run out of equipment, or you’re going to be caught in a situation without having any.” Donald added that if the medic or corpsman has studied to the point of learning and understanding what works and what doesn’t and why, and then follows up that knowledge with repeated rehearsing and training, that medic or corpsman “can overcome any obstacle.”