1. MOUNT THE KIT TO YOUR LOADOUT: Identify a section of PALS webbing on your plate carrier, medic bag, or backpack. Thread the kit's straps through the webbing in an alternating pattern between the gear webbing and the pouch webbing, then engage the snap closures to lock the pouch firmly in place.
2. CONDUCT PRE-DEPLOYMENT INSPECTION: Confirm all instruments are present: two straight hemostats, one curved hemostat, one scissors, one tweezers, one needle probe, one number 3 scalpel handle, two scalpel blades, one suture set, one suture holder, and one penlight. Verify that two alcohol wipes and two BZK antiseptic wipes are present, sealed, and unexpired, and test the penlight for battery function and sufficient brightness.
3. ASSESS THE WOUND: Determine whether the injury requires intervention within the capability of this kit, such as a deep laceration, embedded foreign object, or active bleeding requiring hemorrhage control. Do not proceed with an intervention that exceeds your demonstrated level of medical training.
4. PREP THE AREA: Clean the skin around the wound margins using the BZK antiseptic wipes to reduce contamination risk before any instrument contacts the wound. Reserve alcohol wipes for instrument cleaning, not for direct wound-adjacent skin contact.
5. ILLUMINATE AND INSPECT: Use the penlight to inspect the wound cavity, assess depth, and identify bleeders or embedded debris, particularly in low-light or dark field conditions. Use the penlight simultaneously with the tweezers or needle probe when exploring deep cavities.
6. CONTROL BLEEDING: Apply the straight or curved hemostat perpendicular to any identified bleeding vessel and lock the ratchet to maintain pressure. Use the curved hemostat when accessing bleeders in deeper or awkward wound tracks where straight jaw access is not possible.
7. REMOVE DEBRIS: Use the tweezers and needle probe to carefully locate and extract embedded foreign objects or wound debris. Maintain penlight illumination throughout this step to confirm complete removal.
8. INTERVENE AS TRAINED: If your training authorizes it, use the number 3 scalpel handle with a blade to make a controlled incision for drainage or wound access. Use scissors to debride devitalized tissue as appropriate, keeping the blades clean and away from bone.
9. CLOSE THE WOUND: Use the suture holder as a needle driver to pass the suture needle through the wound tissue on both sides of the laceration. Tie off each suture with a square knot to close the wound, reduce infection risk, and promote healing.
10. DRESS THE WOUND: Once the surgical procedure is complete, dress the wound appropriately using materials from your primary trauma kit. Ensure the dressing is secure before moving the casualty or resuming operations.
11. RESTORE KIT READINESS: Immediately clean all instruments with alcohol wipes to remove blood and biological debris, then re-sterilize by boiling for a minimum of ten minutes or by applying a high-level disinfectant solution. Dry all instruments completely before storage to prevent corrosion, restock all single-use consumables without deferral, inspect all components for new damage or wear, and confirm MOLLE/PALS attachment and snap closures are secure before returning the kit to your loadout.
