CTOMS 1st Line, a blast from the past.

This is a review of a discontinued CTOMS pouch. Though CTOMs still has a few of these excellent Treatment Kits for sale on their website. The 1st Line was integrated into a layered approach to combat trauma during my second deployment to Afghanistan. On this deployment, I was part of a small team embedded with the Afghan National Police to provide training, liaison and combat power to their Police Sub-Stations, patrols and operations. This was a few years ago, so some of the medical kit in the pouch is outdated. Always check the current recommendations by the CoTCCC or CCCWG before any deployment.

CTOMS 1stLine saw extensive service
by both Medics and TCCC

First, the 1st Line is not an IFAK or Individual First Aid Kit. It is intended as a Tactical Field Care bubble Treatment Kit, designed for the primary team medic. So, the 1st Line is larger than an IFAK because of the requirement for advanced interventions.  It is not removable like an IFAK. A Treatment Kit remains attached to the First Responders/Medics rig. A TFC Bubble is not intended for sustained medical treatment. Rapid tactical movement and evacuation to a properly secured Casualty Collection Point happens once the threat is dealt with. In combat, anything that goes on the ground will stay on the ground. A medic without a Treatment Kit on their rig is now a rifleman. As a TFC Bubble is for stopgap lifesaving interventions during an active engagement while under cover, a medic should not be employing or accessing their second line medical kit.

CTOMS 1stLine saw extensive service 
by both Medics and TCCC

My first impression upon receiving the 1st Line was on the high quality of construction.  The zippers are proper Milspec coil zippers. Made with coated 1000 denier cordura, sewing on the product was excellent and reinforced at load points. I was also, struck with the size of the pouch...it is huge. This was both a pro and con. It will take both experience and discipline not to load too many med supplies. The layout of the pouch was very sensible supporting TCCC principles with an external glove pocket and 3 external tourniquet pouches fit either the C-A-T or the SOF-T TQs. As we all know during Care Under Fire, the only medical care applied is a TQ and return fire. No need to open my pouch while actively engaged. 

MARS System setup during pre-deployment training.
 With this system, you can adapt your panel
according to experience, situation and available kit.

I like the MARS system, as a medical operator can customize the load for maximum efficiency or medical priority. For example, the top portion of my loadout was hemorrhage controls.  Behind the modular panels are large pockets to accommodate hemostatic dressings, and cas tags. The bottom portion of my loadout was Airway and Breathing with the large pockets behind the MARS System filled with ASCs, Chest Seals or large Tegaderms, Trauma Shears and triage tags. The MARS System is a standard feature on many CTOMS products and has gone through three generations of evolution.

Other features of the 1st Line include Quick Close Velcro Tab. When working on a cas and the tactical situation changed, I was able displace in a rapid military manner without the flap panel flopping around littering the battlefield with much needed kit.  Loop Velcro panel on the glove pouch intended for for attaching Medical Cross or MEDIC; mine sported an IR Flag for IFF on deployment. The 1st Line mounted to  any MOLLE/PALS platform with two large MALICE Clip consuming four channels of real estate.

1st Line on Modular Panel by CTOMS

The 1st Line came with a CTOMS Modular Panel.  This platform provides 8 columns of PALS/MOLLE to facilitate the medical pouch and a pistol holster so both are worn on the dominant side. This allows the pouch to sit near the front of the leg allowing for a smaller profile than side worn and easier access to the contents when treating a casualty in a kneeling position. If worn with a pistol holster, the holster is then worn to the rear of the pouch and on the side of the leg.

It is well made and of rugged materials like all products from CTOMS. Personally, I do not like sub loads. They are cumbersome and restrict movement in tight areas like exiting vehicles. I used this setup while doing some light range practice. It did not interfere with presentation time with my sidearm but did affect my gait. I did not deploy with it in this configuration. Some people like subloads, I do not.

Note the CAT TQ held in place with elastics.
It had to be replaced every few months
due to wear 'n tear and UV damage.

This pouch served me well during my eight months as a LN combat advisor. Upon return from my second deployment, I gave the pouch a thorough wash (removing the eight months of dust and blood) and a quick Nikiwax treatment.  It looks like the day I unwrapped the parcel. For the time period, this pouch was revolutionary. Even to this day, there are few true rig mounted Treatment Kits available. CTOMs still has a few of these excellent Treatment Kits for sale on their website.

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Take Care Out There