The Essentials: How to Build a Mass Casualty Trauma Kit

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A few years ago, I had the opportunity to work as a security consultant for organizations looking to be proactive for active shooter incident (ASI) or mass casualty events. It was a great experience that I thoroughly enjoyed since I was able to use hard learned skills I acquired from the military.

One of my focuses when working with a new client, was asking them to show me what medical gear they had on hand to treat any injuries. Usually what I found was pretty dismal.

After a lot of rummaging around, they would drag out an old sun faded EMT bag with most of the important things missing, or bring out a small plastic kit half full of Band-Aids and Motrin packets.

This is unacceptable of course and you probably agree since you’re reading this article. You not only need the right gear to save the lives of your employees and customers, but all medical gear has a shelf life and even if you have the right things on hand, it might fall apart on you when needed most.

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I recommend checking the expiration dates of every item in the trauma kit at least once a year and replacing any items past expiration.

Before we get into the meat of this article, let me take a moment to encourage you to get some medical training. All the gear in the world is useless if you don’t have the education how to use it.

Mountain Man Medical has a free Emergency Trauma Response online course that will get you started off right. These short easy to watch videos teach you how to use the items in your kit and are a great way to change up the quarterly company training time. Plus, it’s a benefit your employees can take home with them to their own families.

Mountain Man Medical already has a Mass Casualty Trauma Kit with the items I think are most essential. It’s far more cost effective to buy all the items at once from us since we get bulk discounts, but perhaps you want to put together the kit yourself. If so, I’ve got some thoughts on what you should prioritize.

Here’s what I recommend you stock in your trauma kits for getting the best possible outcome from a catastrophe:

The Mountain Man Medical Mass Casualty Trauma Kit


Bleeding is the most important thing to prepare for and while you might be confident you’re ready to go because you bought a bunch of TQs off amazon, you might not be. Some commercial trauma kits purchase their tourniquets from disreputable vendors selling fake tourniquets at a steep discount to the originals. Some of these companies simply don’t know better, and others are just looking to cut corners and save a few bucks.

Either way, you MUST look through your trauma kit and ensure every TQ is a legitimate North American Rescue Combat Application Tourniquet (CAT). If they aren’t legit, you need get real TQs or you’ll be frustrated that the people you are trying to save keep bleeding to death.

If you find you have a surplus of fake tourniquets, don’t worry. Just take a sharpie and write the word “FAKE” across the time tab so it doesn’t get confused with an actual life saving device. Now you can use it as a trainer to learn how to apply a tourniquet without having to use up your precious real ones.

Pressure Dressings

Bleeding control redundancy is a great idea. Having a way to treat multiple types of wounds is essential since you can’t anticipate what might happen. Pressure dressings like the Israeli style or the OLAES are great to have in your kit for treating junctional wounds and other open bleeding injuries.

Blood Clotting Gauze

Hemostatic agents, like QuikClot and ChitoGauze are essential for packing junctional wounds which can’t be controlled with tourniquets. This is a common wound you might see in an active shooter incident (ASI), so if you’re preparing for that, I recommend stocking extras.

Chest Seals

If you’re preparing for an ASI, chest seals might be just as, or more important than tourniquets. This might seem counter intuitive, but I have a good reason why this is the case. Read this article I wrote for Concealed if you’d like to learn more:

Active Shooter Medicine: Are Tourniquets as Important as Everyone Thinks?


Keeping yourself and other first responders safe is important when dealing with people you don’t know. Having a few extras on hand is a good idea so you can pass them out to helpers or change them out when needed.

Trauma Shears

Exposing the wound is important for understanding the wound you’re attempting to treat. If you’re working blind, you probably won’t make the right call. Cut the casualties out of their clothing so you know what you’re dealing with.

Survival Blanket

Casualties suffering from massive hemorrhaging are at a great risk for hypothermia. Blood loss can cause the core body temperature to drop far below normal levels, and this can cause greater harm if not anticipated and will decrease your casualty’s chances of making it out alive.

Survival blankets give you a quick, easy, and effective way to ensure the casualty doesn’t expire from being too cold, even in the middle of a summer heat wave.

Ok, That’s Great, But How Many Kits Do I Need?

Every organization has different needs, so this isn’t a perfect answer, but I suggest getting enough trauma gear to treat the following:

  • 20-50 People: 1 Kit
  • 51-100 People: 2 Kits
  • 101-200 People: 4 Kits
  • 200+ People: 6 Kits
  • Add 1 more kit for every 100 people

You also want to think about the proximity of your trauma kits. If you need to run a quarter mile to where your trauma kit is and back again, the victim might already be dead. Or, if you’re the one injured, you don’t want to be limping too far to the nearest kit. I recommend at least 1 kit per 5,000-10,000 sq ft, so response is quick.

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