This is a great, little kit. It's ideal for critical response for self, family, or an operational environment. I have traditionally kept small kits like this in conjunction with something akin to an Altoids tin of boo boo gear and self-made packets of various oral medications. There's not a negative to this kit as I see it. You could add a NPA if you wanted and possibly even an OPA although I haven't. A decompression needle would fit well. I'm not sure you could put decent shears inside it. You'd be hard pressed to fit an emergency blanket. This is by design a "mini" FAK so it's not meant to hold everything. The only "drawback," although this doesn't obviate the quality, is that the small mass of the kit with the packed volume makes for a rather dense item. The pouch ends up being a bit firm (more so than I imagined) so you'll have to be judicious in where you locate it. Nonetheless, this is a great kit for a bag, a belt, a vest, etc. It's readily removable so you can relocate it for your mission of the day whether it be a trip to the zoo, the corporate office, a remote hike, or an environment that goes bang. It's also inexpensive enough to merely buy one for every location you'd like to have it. I really like the pouch and am considering buying an empty pouch from the manufacturer for a completely different purpose.