What Should Be in Your IFAK? A Comprehensive Checklist for Emergency Preparedness

You’re first on scene. There’s blood on the pavement, the patient is panicking, and the clock is already beating you. In that moment, an IFAK isn’t a “nice-to-have”—it’s the difference between a controllable problem and a preventable death.

Important: Carrying an IFAK without quality training is like carrying a firearm without knowing the rules of engagement. This checklist assumes you’ve been trained to treat penetrating trauma and life-threatening bleeding. Also, real trauma gear isn’t bargain-bin cheap. If you see tourniquets or hemostatics priced far below market value, assume counterfeit or expired until proven otherwise and buy from credible sources.

If you want a ready-to-roll option instead of piecing everything together, start here: Stocked Kits.

Table of Contents

• Build Your IFAK Around M.A.R.C.H.
• M: Massive Hemorrhage (Stop the Bleed Fast)
• A: Airway (Keep It Open)
• R: Respirations (Seal the Chest)
• C/H: Circulation + Hypothermia/Head Injury (Prevent the Spiral)
• Bonus Items That Complete the Kit
• Common IFAK Mistakes (and What to Avoid)
• Bottom Line
• Get the Right IFAK Setup

Build Your IFAK Around M.A.R.C.H.

The most practical way to build a real-world IFAK is to follow the M.A.R.C.H. algorithm commonly used in tactical medicine:

• M – Massive Hemorrhage
• A – Airway
• R – Respirations
• C – Circulation
• H – Hypothermia/Head Injuries

This isn’t about stuffing pouches with “cool stuff.” It’s about solving the problems that kill people first—at the point of injury—using proven, evidence-based tools.

M: Massive Hemorrhage (Stop the Bleed Fast)

If your IFAK isn’t built around bleeding control, it’s not an IFAK—it’s a first aid pouch. Massive hemorrhage is where preventable death lives, and your gear needs to reflect that.

1) Tourniquet (CoTCCC-Recommended)

Every serious IFAK starts with a CoTCCC-approved tourniquet. In many environments, two is smarter than one.

• CAT Gen-7 (North American Rescue): widely issued, widely trained, excellent one-handed application, and a long record of success in military and civilian use. For most users, this is the “standard.”
• SOF Tactical Tourniquet-Wide (SOFTT-W) (TacMed Solutions, Gen-4): known for ruggedness and proven performance across military and law enforcement.

Pro-tip: Buy one tourniquet specifically as a trainer. Repeated training reps can wear out staged tourniquets you’re counting on for real-world use.

2) Pressure Bandage (For Wounds That Don’t Need a TQ)

Not every bleed is a tourniquet problem. You still need the ability to apply firm, sustained pressure and secure it.

Carry an elastic pressure bandage or a vacuum-sealed emergency trauma dressing—something designed to handle tension. Avoid relying on “generic stretch gauze” as your primary pressure tool.

Solid option: Mini Responder 4" ETD (North American Rescue).

3) Wound Packing Gauze (Junctional Bleeds = Priority)

Junctional bleeding (groin, axilla, neck) can be catastrophic—and you can’t tourniquet it. That makes wound packing non-negotiable.

Hemostatic gauze options (trusted, field-proven):

• QuikClot Combat Gauze (Z-Medica): a widely trusted hemostatic gauze designed to help stop bleeding rapidly when packed correctly and held under pressure.
• Celox Rapid (Combat Medical): another proven performer in the hemostatic category.

One study showed Combat Gauze holding a slight performance advantage. Reference: NIH PubMed (31441025).

Don’t skip standard gauze: Hemostatics are great, but standard S-rolled wound packing gauze (ex: North American Rescue) is also effective with proper technique—and costs far less. Whether you choose hemostatic, standard, or (best) both, make wound packing gauze a priority item.

Reality check: Tampons don’t belong in a trauma kit. They’re not designed for wound packing, they don’t conform well to irregular wound cavities, and they don’t solve the problem the way purpose-built gauze does.

4) Trauma Shears (Wound Access Matters)

You can’t treat what you can’t see. Clothing, gear, and PPE get in the way—fast. Trauma shears let you expose the wound quickly so you can identify what you’re dealing with and treat appropriately.

Cheap shears can work, but premium options make the job easier under stress:

• Leatherman Raptor
• ER LIFE ONE SHEAR
• XShear

A: Airway (Keep It Open)

After bleeding is addressed, airway issues can end the fight quickly. In an IFAK, the most common airway adjunct is the Nasal Pharyngeal Airway (NPA).

• Most common adult size: 28F (common carry choice for many users)
• Trusted option: Rusch Latex-Free Robertazzi NPA
• Convenient option: Pre-lubricated NPA (Combat Medical)

Safety note: NPAs are not a “slam it in” device. Use them only within your training and protocol.

R: Respirations (Seal the Chest)

Penetrating trauma to the torso can create open pneumothorax problems—fast. Your IFAK should include vented chest seals as your baseline solution.

Carry two chest seals: one for an entry wound and one for a potential exit wound.

• HyFin Vent Chest Seal (North American Rescue)
• SAM Medical Chest Seal

Needle decompression: A commercial-grade chest decompression needle (or two) may be appropriate only if your training, licensing, and protocols support it. For those who fall into that category, options include the ARS or SPEAR from North American Rescue.

C/H: Circulation + Hypothermia/Head Injury (Prevent the Spiral)

In an IFAK-sized footprint, your options for circulation and hypothermia management are limited—but not meaningless.

If space allows, add a rescue Mylar blanket to help retain body heat after trauma. Don’t overestimate it: data on effectiveness is limited, and you should plan on other warming strategies when possible. Still, preventing heat loss is a simple step that can help keep a trauma patient from sliding into a worse state.

Bonus Items That Complete the Kit

These are small, high-value additions that many people overlook—but they pay dividends when it’s real.

• Nitrile gloves – protect yourself and reduce cross-contamination
• Fine point marker – most commonly used for tourniquet time
• CPR face shield – compact barrier protection

Need a place to stage and carry trauma gear beyond a pocket-sized IFAK? Browse Trauma Bags and build a scalable setup for your vehicle, range, or duty rig.

Common IFAK Mistakes (and What to Avoid)

• Buying “too good to be true” tourniquets/hemostatics: Counterfeits and expired items are real problems. Use reputable sources and avoid mystery listings.
• Stuffing gimmicks instead of solutions: Your kit should reflect M.A.R.C.H.—not social media trends.
• Carrying gear you haven’t trained with: Under stress, you default to reps. If you can’t deploy it fast, it doesn’t belong.
• Not carrying enough of the essentials: One tourniquet and no packing gauze is a common failure point. Build for real injuries, not convenience.

To fill gaps or restock the right way, start with purpose-built essentials from our Medical Supplies collection.

Bottom Line

A solid IFAK isn’t defined by how much you can cram into a pouch—it’s defined by whether it can reliably solve the most common causes of preventable death at the point of injury. Build around M.A.R.C.H., prioritize CoTCCC-recommended bleeding control, carry two vented chest seals, and add only what you’re trained to use.

Get trained, buy real gear, and stage it so you can access it fast with either hand. When the moment hits, you won’t rise to the occasion—you’ll fall to your level of preparation.

Get the Right IFAK Setup

Ready to build or upgrade your kit? Start with a professionally curated option or stock up on the essentials:

• Shop Stocked IFAKs & Ready Kits
• Shop IFAK Kits & Pouches
• Shop Trauma Medical Supplies