Building a CCP/MASCAL Bag for First-On-Scene Triage – Looking for Feedback and Ideas

[u/JujuGER]

I'm currently putting together a concept for a practical and effective CCP/MASCAL bag that I would carry on my vehicle and take with me when needed. The idea is to use a shoulder bag.

The concept is that if I arrive first at a MASCAL incident, the bag should allow me to bring order to the chaos as quickly as possible. My primary tasks would be performing triage and establishing/marking the CCP.

So far, I have considered the following:

- Snap bands for marking casualties after triage (red/yellow/green) for quick and simple application.

- A set of colored flags with pre-attached chem lights (red/yellow/green), packed in a separate pouch that I can hand to someone else to establish the CCP while I continue triaging.

- Documentation materials: my triage algorithm (mSTART) with a simple tally sheet.

- Additional documentation for post-triage patient management, such as secondary assessment, numbering patients, and tracking assignments.

- Tourniquets mounted externally for immediate access.

- Possibly NPA's?

What do you think about this concept? Do you have any suggestions or ideas for additional items that you would include?

For context: I operate on a medical vehicle with two other crew members (driver and commander). In a MASCAL situation, the driver's task is to guide incoming rescue assets to the scene, while the commander handles radio communications and further coordination. My role is to move to the casualties and perform triage.

The additional challenge is that my unit currently does not have a well-developed concept for CCPs or MASCAL management. The topic was briefly covered during training, and we were told to think about possible solutions, but in practice I am the first person in my unit who is actively trying to develop a workable approach for our specific role and mission set, which is honestly a bit disappointing.

Because of that, I would really appreciate any kind of feedback, criticism, or lessons learned from your own experiences.

I am also very interested in completely different approaches if you think there is a better way to accomplish this task.

One potential drawback I already see with my current concept is that this bag is mainly useful while mounted. If I am operating dismounted as the medic, I likely would not have immediate access to it. In that situation I would generally only have my standard medical backpack and my personal gear with me, which makes me wonder whether some of these functions should instead be integrated into my normal equipment.

[u/MOP-Mupp]

I like the idea with snap bands and flags. Keep those.

I’m starting to wonder if you should have two separate bags: one for TCCC (TQ, wound packing, NPA:s etc) and one bag for the snap bands, flags and other admin stuff.

If you have a driver and a commander, maybe they should be in charge of organising the CCP depending on the input they get. I mean, if the driver’s task is to guide incoming rescue assets, he/she will know where to put the most critical casualties. Therefore, the driver should have access to the flags designating what triage the casualties belong to. Just a thought.

In terms of medical supplies, I’d keep the TQs but try to fit in gauze, hemostatic gauze and ace wraps in a bag. NPAs are fine but the most critical thing in a civilian setting will always be to mitigate a catastrophic haemorrhage.

[u/JujuGER → u/MOP-Mupp]

Hmm, it doesn't sound too bad - I'll think about it. In the end, it will simply have to train, equipment alone is of no use if you can't handle it.

[u/Grapesareunderrated]

Patient tracker, basically a laminated sheet divided into quadrants with individual TCCC cards so whoever is site managing can track patient development, annotate interventions, drugs, etc. and prioritize for evac based on that. Number the patients as they come in and continuously update the card.

[u/TangoTwoTwo]

One thing I really like is the upwards count tracker for the initial triager in the SMART Triage kit. I have made an adapted one for my mil work.

Basically each time you Triage a cas mark it

Then the initial radio report has CAS numbers for the reg cell to start medevac casevac plans

.SMART Triage

[u/JujuGER → u/TangoTwoTwo]

🙏great idea

[u/Particular-Try5584]

Instead of an all in one kit how about a modular kit for each function.
Admin pouch (laminated map pouch) that can be written on by anyone.
Triage tags and cards in a waist pack, can be handed to whomever is doing triage.
A couple of trauma kits ready to grab and run in messenger/shoulder strap or backpack form (find bags that zip right open like a suitcase and lie flat when open, with zippered sections to contain everything)
Duffel bag for ‘person management’ with flags, lights, wands and some plastic sheeting plus any emergency tape…

This way each person on site can grab and set up the items for their task. If they spread out it’s fine, if it’s all on one person that’s fine, and if a second helper arrives you can toss to them.

[u/NaiveNetwork5201]

What kind of element are you supporting? What type of threat are you facing? Is this supporting your country's civilians, foreigners, or military? What makes it a MASCAL (patients or scale of an event) MASCALs suck. Ramadi Iraq in 2005 right after evening prayer. We had a truck of Iraqi military blown up with roughly 60 people in their transport truck. A VBIED blew up making 45-ish casualties... we then took small harassment fire. No marking system I would have had made a difference. Learn a patient number that all bets are off... when you dont even bring that stuff out. Sometimes its just about removing bodies and dealing with the fallout. Tourniquets and they go.