These are my free "if it were me" suggestions:
Ditch the Shears and put that pocket-knife in a "pocket"
Remove the IFAK off the side and if you feel like you simply must carry it, mount it on the front/beside your mag pouches in a break-away med pouch from 5.11, condor or itstactical.
If your primary defense rifle is a AK variant, then ditch the shotgun shells. If a shotgun is a secondary defense weapon, then mount a shell side-saddle on its receiver. It is after all (a secondary)
Lots of patches make a space busy to the eye and takes away from your bloodtype patch. If you are trying to draw attn to your bloodtype patch, I would put the red cross side by side with it and get rid of all the other morale patches. I would probably have a bloodtype on a bracelet or boot tab- As your plate carrier will be tossed aside if someone has to work on you.
"I believe that the right of the citizen to keep and bear arms must not be infringed if liberty in America is to survive." - Ronald Reagan