A Combat Lifesaver (CLS) bag is a medical kit carried by trained military personnel who aren’t medics but serve as the bridge between basic self-aid and professional medical care on the battlefield. The standard CLS bag contains roughly 18 categories of supplies, organized around controlling bleeding, maintaining an airway, treating chest injuries, and preventing shock. The exact contents can vary slightly by branch of service and mission, but the core items are standardized across the U.S. military under Tactical Combat Casualty Care (TCCC) guidelines.
Bleeding Control Supplies
The largest portion of a CLS bag is dedicated to stopping hemorrhage, which is the leading cause of preventable death in combat. The centerpiece is the CAT (Combat Application Tourniquet), a windlass-style tourniquet used to cut off blood flow to a severely bleeding limb. CLS personnel are trained not only to apply tourniquets but also to reassess and replace them if needed, a skill recently added to the combat lifesaver skillset.
For wounds that can’t be tourniqueted, like injuries to the neck, groin, or abdomen, the bag includes Combat Gauze. This is a hemostatic dressing, meaning it’s treated with an agent that accelerates clotting when packed directly into a wound. Backing that up are H&H Compression Gauze, standard 4×4 gauze pads, and an “H” bandage (a versatile pressure dressing sometimes called an Israeli bandage). A Big Cinch abdominal dressing handles large torso wounds that smaller bandages can’t cover. Triangular bandages round out the bleeding control section, useful as slings, pressure wraps, or improvised tourniquets in a pinch.
Airway Management Tools
The CLS bag carries nasopharyngeal airways (NPAs) in two sizes: 22 French and 26 French. These are flexible rubber tubes inserted through the nostril to keep an unconscious casualty’s airway open when the tongue or swelling might otherwise block it. Having two sizes lets the lifesaver choose based on the casualty’s build. NPAs are one of the key items that separate a CLS bag from more basic kits, since standard first aid kits typically don’t include airway devices.
Chest Injury Equipment
Penetrating chest wounds are a particular threat in combat because they can cause a collapsed lung. The CLS bag addresses this with two items. A Bolin Chest Seal is an adhesive patch placed over a chest wound to prevent air from entering the chest cavity. If air does become trapped and pressure builds (a condition called tension pneumothorax), the bag includes a needle decompression kit, essentially a large-gauge needle inserted into the chest wall to release the trapped air and allow the lung to re-expand. This is one of the more advanced procedures a combat lifesaver performs.
Splinting and Stabilization
A SAM Splint is included for stabilizing suspected fractures. It’s a thin, flexible sheet of aluminum covered in foam that can be shaped to fit almost any limb or joint. Rolled into a C-curve it becomes rigid enough to immobilize a broken forearm; folded differently it can support an ankle or finger. Its versatility and light weight make it a staple of field medicine kits.
Hypothermia Prevention Gear
At the CLS level and above, kits typically include hypothermia prevention equipment. This can range from simple reflective blankets (passive warming) to full hypothermia prevention kits that provide active heat. Keeping a casualty warm is a critical part of shock management, since blood loss drops body temperature rapidly and hypothermia makes it harder for blood to clot, creating a dangerous cycle.
General Utility Items
The remaining items are support tools that make everything else work:
- Trauma shears: Heavy-duty scissors designed to cut through clothing, boots, and gear to expose wounds quickly.
- Strap cutter: A small hook-blade tool for slicing through seatbelts, body armor straps, or other equipment without risking the casualty’s skin.
- Medical tape: Used to secure dressings, splints, and chest seals.
- Gloves: Nitrile or latex gloves for infection control.
- Alcohol pads: For cleaning skin around wound sites or prepping areas for needle decompression.
- Water-Jel burn dressing: A gel-soaked dressing for cooling and covering burns.
How a CLS Bag Differs From an IFAK
Every service member carries an Individual First Aid Kit (IFAK), which holds a basic tourniquet, wound packing gauze, a chest seal, and an NPA. The CLS bag is significantly more comprehensive. It carries multiples of key items (since a lifesaver treats other people, not just themselves), adds the needle decompression kit, includes splinting materials, and contains hypothermia prevention gear. The IFAK is designed for one person to treat their own injuries long enough to survive. The CLS bag is designed for a trained responder to treat multiple casualties across a wider range of injuries until a medic or evacuation arrives.
Contents can shift based on branch of service, unit mission, and the most current TCCC guidelines, which are updated regularly. The January 2024 guidelines represent the current standard of care. If you’re packing or inspecting a CLS bag, check with your unit’s medical officer for the most current required load list, as items and quantities are periodically revised.