Practical/Tactical Medicine: Understanding Blood Types

Quick question: Do you know your blood type?

How about your spouse and your kids blood type?

Do you know if you could donate blood to them if it was an emergency?

Knowing how to stop traumatic bleeding along with understanding blood types and donor compatibility is one of the most important medical skill sets for the martial civilian.

I urge all of you to take a hard look at your medical skill-sets. In particular, TCCC  in treating gunshot and knife wounds using anti-coagulants and/or tourniquets.

What about your trauma kits? Are they stocked and up to date?

Do you carry on your person or in your vehicle a Personal Trauma Kit (PTK)?

These are all good questions better asked NOW than LATER!

“Fortune favors the prepared mind.” – Louis Pasteur

 

Stay Alert, Stay Armed and Stay Dangerous!

 

Field Review: The E3 Solutions “PTK 1.0”

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My good friend Mark E., who has contributed some excellent narrative frequently to the blog, has started a new CO business venture:  E3 Solutions. His first product, the “PTK” or Personal Pocket Trauma Kit is what I will be reviewing today.

Having a viable trauma kit (not first aid/boo-boo kit..we are talking about shit to save your life not make your “owwie” feel better) around and readily available is an essential for every CO IMO. I tell all my students, if you are going to carry a firearm for self-defense, have a fully stocked trauma kit handy and know how to use it. Even if you don’t carry a weapon for self-defense, having the ability to stop serious bleeding if you are wounded, say in a car accident or maybe out hunting or hiking, could be a literal life saver for you or any unlucky soul you might come across. For this reason, I advise having a trauma kit handy in several locations, not just one..i.e your home, your vehicle, your gun range kit and of course, on your person, when you can.

For all the benefits a trauma kit offers, the one con is that for the most part, due to the quantity of materials and weight involved, they are often designed to be carried anywhere but on your person. Sure, you see them all the time on soldiers in the field in a MOLLE pack or on a belt, but for a civilian to strap on the same gear or pack would be a bit disconcerting to some I am sure, not to mention very conspicuous. But what if a civilian could have an “abbreviated” version of that trauma kit that could fit inconspicuously in a pants cargo pocket? That way, when it was needed, no more running to the backpack or vehicle, it’s right there to use! Enter the “Necessity is the Mother of Invention” PTK 1.0.

Now before I get into the specifics of the kit itself, I would be amiss to not tell you to first learn how to use one properly. Sure, the general directions sound easy enough on a pack of Quick-Clot, but I assure you, when blood is gushing out of a vein or artery and pain and adrenaline have combined into a nasty little cocktail of near hysteria and utter despair, those same directions might as well be Mandarin Chinese. I am not saying you need an EMT Certification to use a PTK, but you DO NEED to know the basics of Trauma Medicine with an emphasis on stopping Arterial Bleeding, both by Coagulant (Quick-clot or Celox) and Tourniquet, not to mention the ever so important skill of reducing and treating Shock, which has killed more people than bullets ever dreamed of. I highly suggest you seek Professional, Hands-On Training for this skill set, as a book can only go so far. Check out Texas’ own Lone Star Medics. These guys are the real deal and offer Real-World Applicable medical trauma training for the armed civilian.

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OK, so on to the kit inventory. First off, is the Quick-clot 25gr 1st response Clotting Sponge. Pretty simple piece of kit: take the sponge and apply it to the wound with a lot of pressure to start stopping the bleeding. This is much simpler, easier to use and more streamlined for individual use than the Celox granules IMHO. Next up is what I would call your “Auxiliary” or “Backup” option if the bleeding cannot be stopped with the sponge alone; a SWAT-T Tourniquet/Pressure Dressing. There is an excellent You-Tube link on E3 Solutions for this piece of kit, I highly suggest watching it. Also in the kit is a 2 pack of 12 ply 4×4  Gauze Pads (to cover the wound), a pair of well made Red 5.5″ EMS Shears (to cut clothing, bandages, etc.) an XL Pair of Nitrile Gloves (to protect yourself against blood borne pathogens) and to keep everything in one place, a handy cardboard stabilizer, and all of this housed in a sturdy, re-closeable, poly storage bag.

Since I promised Mark an actual “field review” of his kit with critiques, I intend to fulfill my promise. I will tell you though, since I am always honest with my readers, on my last “outing” in the field, I or none of my associates experienced any life threatening, traumatic injuries that required the use of the PTK (Thank God!) I had to improvise as far as using the kit on an injury (Similar to pre-deployment work-up training, we designated a random operator as a casualty, “Single gun shot wound to upper thigh” would be yelled, for example. At that point, the team goes into action.  I also must apologize for not having any good photos, due to the nature (and location) of my last outing, no cameras or even  smartphones, were allowed in the AO.

I will approach this critique, to make things simpler for the reader,  in a Pro/Con type commentary. The reader needs to be reminded, (as I had to remind myself often) is this is a BARE BONES Trauma/Blowout Kit. It was designed to stop major, arterial bleeding from a traumatic injury such as knife or gunshot wound. It was not designed to address every traumatic injury you may come across (broken bones, neck injuries, etc.) Having said that, there are a few things the kit still needs to make it a viable kit IMHO.

Pro’s

  • Kit fits and rides well in a cargo pocket, little shifting
  • Due to stabilizer, Kit is easy to access, all packages can be torn open with one hand and teeth.
  • Shears are sharp and very functional, cut through denim and canvas very easily.
  • SWAT-T Tourniquet very easy to self-deploy for self-treatment, can be done with one hand (with some practice).

Con’s

  • Since shock is ALWAYS an issue with any traumatic injury, an inexpensive, compact, foldable, mylar blanket needs to be added to the kit.
  • A small roll of duct tape needs to be added, since in a pinch, the wound will need to be wrapped and the patient transported. This also gives the operator more options to self-treat and get mobile to an ER.
  • Replace the gauze pads with an Israeli Dressing. This would be much more universal in application.

In Summary, the PTK 1.0 is an excellent Blow-Out/Trauma Kit to have on your person. Get yours today and check one more thing off your “Oh Shit, I wish I had that”!! inventory list.

Stay Prepared, Stay Armed and Stay Dangerous!

The CO “Blowout” Kit

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For the CO to be prepared to survive in the battlefield we call everyday life, he must be ready to administer life saving first aid quickly and at any time, either to himself or others. To meet that need, the CO needs to have one or more “Blowout” Kits prepared. Simply put, a “Blowout” kit is a bare bones trauma pack. It primarily addresses the “B” of the “A-B-C’s” of Trauma First Aid:  Airway, BLEEDING and Circulation.

A typical Blow-Out Kit will include:

  • Quick-Clot or Celox
  • Rolled Gauze
  • (2) 4″ Emergency Battle Dressings 
  • C-A-T Tourniquet
  • Combat Medic Shears
  • Duct Tape
  • Nitrile Gloves

One of the first fundamentals of “life saving” is to STOP or SLOW Bleeding. The first and best choice(s) are applying pressure or applying a tourniquet (especially if it is an arterial bleed). If this does not work or the wound is in a awkward location or position (pelvis, groin, armpit, neck etc.) the only other option for the CO is to apply a coagulant agent such as Quick-Clot or Celox. A word about each of these “formulations”.  If you browse through Amazon, you will find that Quick-Clot can be bought in 2 forms: Granule and Sponge. The granule form is simply the kind you pour directly in the wound while the sponge form is a clotting sponge impregnated with the solution and an X-Ray strip you stuff directly in the wound. Keep in mind however, that medical attention needs to be sought ASAP after applying QC as the clot and damage will have to be repaired poste haste by medical pro’s.  Celox is a granule forumlation only and is made of chitosan, a natural polysaccharide (polymer made of sugars) and has been shown to be broken down to basic sugars (glucosamine & n-acetyl glucosamine) by lysozyme, one of the body’s normal enzymes. Celox™ (unlike QC) does NOT use non degrading procoagulant minerals or nano particles such as kaolin, smectite or zeolite, which will remain in the body indefinitely unless completely removed.

For the CO to be adequately prepared for medical emergencies, it is not enough just to have the knowledge, you must also have the forward thinking to STAGE the Blowout kit(s) in the MOST LIKELY places you might need them, BEFORE you need them!

Some examples are:

  • GO-Bag
  • Range Bag or Training Bag
  • Vehicle(s) (or VBOB)
  • Work
  • Hunting Bag
  • Deer Stand/Duck Blind

Of course the most ideal location is ON YOUR PERSON, but unless we are on the range or in the field it might look a bit awkward and “Officer Tackleberry” of us to carry one around. Unless of course you design one specifically designed for discreet, individual carry in a cargo pocket like my friend Mark E. did… see his “PTK 1.0” HERE.  

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Above are pictures of Mark’s “PTK 2.0”, which includes an upgraded handy dandy pocket for the shears which keeps it from tipping over in your cargo pocket.

OK, so now we have our Blowout kit built and adequately deployed, now what? Well, the only thing remaining is to actually get some REALISTIC MEDICAL TRAUMA TRAINING

For the CO to be adequately prepared for REAL-WORLD, REALISTIC scenarios (gunshot and knife wounds, traumatic injuries from a car crash, etc.) You cant expect to be prepared by Reading the Survivalist Boards (forums) or watching that series of You-Tube Vids by some so called “medical expert”. Even that $20 First Aid class at your local YMCA just will not cut it. As in buying quality trash bags, this is one item in your toolbox it PAYS not to skimp on!

For those of you in Texas, check out Caleb Causey and his team of pro’s at Lone Star Medics. Caleb and his team bring over a century of experience to the table dealing with real-world medical emergencies in the field. They are a great bunch of guys and the real deal.

For stocking up on quality med supplies and trauma gear, check out Chinook Medical Gear. If you want to build a complete GO-BAG or MED-KIT on the cheap (Plus find some other really cool stuff) check out County-Comm.

Stay Alert, Stay Armed and as always, STAY DANGEROUS!

Do you Mothball your Medical Training?


 

Often Medical training is one of the most overlooked areas in the Civilian Operator’s toolbox…it is more than having a boo boo bag or that tacti-cool Trauma Pack, as in all things, it comes down to KNOWING. KNOWLEDGE combined with QUICK RESPONSE can save lives.

Personalizing your kit and training to your specific household’s medical needs is a good place to start. Jot down any specific needs you have..for instance, Allergies, Diabetic Supplies or Heart Medicines. Speaking of allergies,  Anaphylactic issues need to be addressed and prepared for as a priority, when dealing with small children this can be a real killer.

Having Quickclot and Celox in your kit is a MUST, but ask yourself, if the poo hit the oscillator, would I know how to use it? Whether using the granules or the combat gauze, knowing how to “pack” a severe gunshot or knife wound is training you really need. The Military top tier units use pigs to practice on due to the similarity in anatomical makeup.

Also, most people carry WAAAY too much stuff in a trauma kit..understand that in an emergency, you want to be able to have this gear at hand quickly and not have to be sorting thru stuff.

Here is what I recommend to make it as KISS as possible:

1. HSGI Blowout Pouch

2. Combat Med Shears

3. C-A-T Tourniquet

4. Quickclot or  Celox Trauma Pack 

5. Roll of Quickclot Combat Gauze

6. (2) 4″ Israeli Bandages

7. Pair of Surgical gloves

(An addition you can make if you wish is a Halo or Bolin chest seal for sucking chest wounds)

 

 

 

The HSGI Blowout Pouch is the most field practical pouch I have ever used..it will store all of the above easily and won’t take up alot of room, giving you more space for ammo.

That brings us to my final point. In Military TCCC (Tactical Combat Casualty Care) training, the very first response the instructors tell their students is required when a man gets hit is not to put pressure on the wound or to check their breathing, but FIRE SUPERIORITY. Maintaining a steady base of fire on your enemy will allow the movement needed to get the wounded man out of the kill box and into a space where he can be treated.

Understand, when a man goes down, either being killed or just wounded, you cannot push the pause or reset button..the enemy will not stop to allow you to treat your man; if anything he will try and exploit your subtraction in man (and fire) power.

The dynamics of operating in small units and caring for wounded under fire is not just a Military, LE or Private Security principle; it is a Civilian Operator principle. WHAT IF it is you and your family when the crap goes down? You and your friends? You and a group of total strangers in a mall? The variables are endless, but the reality is stark.

 

 

 

Build your Trauma Kit and Start your Medical Training NOW. There is nothing too complicated about this..I am not talking about doing field surgery here. You can easily get  Paramedic or First Responder materials on the web, enough at least to get the basics of Trauma Medicine:

1. Stop Bleeding (coagulants/pressure/tourniquet)

2. Maintain Airway (clear throat of obstruction)

3. Reduce Shock  (keep warm)

Understand the underlying principle of TRAUMA medicine is SPEED. The faster you can do these things and the faster you can get the man to proper medical attention, the better their chances of living.

Stay Dangerous.

 

 

 

Where are you PTK??

(By Contributing Author Mark Edwards)

A few days before the tragic Batman Movie Massacre in Colorado, I found myself without my Pocket Trauma Kit (PTK).  In my daily travels, I find my brain dwelling on tasks at hand, and then at stop lights, sometimes wondering what I forgot to bring along.  On a recent Thursday, it was my PTK.

Some background might be in order.  A few years back, I took a course in Tactical Combat Casualty Care, or TCCC, as it is known for short.  Since that course, I immediately re-evaluated what I carry with me in my vehicle, my workbag, what I have at home, fighting bag and/or pockets.  I’ll focus on the pockets today.

So you might have had the revelation that “if you can make holes” with lead projectiles or sharp pointy things, perhaps it might be a good idea to have a way to plug some holes?  Put another way; to give yourself a chance to stop your own traumatic bleeding or that of a loved one.  Gun shot wounds (GSW’s) are bad and knife wounds can be even worse.  I have my normal trauma kit in a back pack in my vehicle trunk, and another at home.  But, hey, if you need to stop bleeding, RIGHT NOW, where you stand or sit, what are you going to do?

So back to the PTK.  Why have it at all?  It’s another thing to manage, right?  I’m a fan of the Keep It Simple Stupid or (KISS) approach. But when I checked my cargo pants pocket that day it hit me:  “If I get in a car wreck and puncture an artery, or catch a bullet through the wall of a movie theatre, I may not be able to get to my car trunk.”  The scenarios are, of course, endless, but imagine this one:  you catch a bullet while at a stop light because of some gang activity.  At that point, plugging a hole may be more important to your survival than firing back.  Let’s assume it is…so, time is of the essence.  Again, getting to the car trunk still might not be feasible, so carry on your person is the most viable option.

A few more assumptions…you establish and agree that a PTK is good for your world.  And you know enough about basic combat medicine to stop or reduce arterial bleeding to put a few common medical supplies to use.  And let’s assume that you practice accessing said items with either hand, and while seated, flat on your back, or standing.  Good, now what to put in your PTK?

Every possible version of contents could differ depending on what you do, your climate, work environment and type of clothing/dress.  You will find endless reference material on YouTube for both large and small trauma kits, some pocket-sizes and some not.  But I keep mine simple.  I have long since removed boo-boo type stuff (band-aids, anti-bacterial goop, alcohol prep pad) after the TCCC studies.  Keep in mind, the following two features that were important for me:  light weight and thin enough to carry at all times, and with just stuff to patch a GSW or stab wound or other puncture wound.

Here is a starting point:

  • 1 ea Medical Shears
  • 1 pair of Latex or Rubber Gloves
  • 1 or 2 non-stick pads with adhesive tabs
  • 1 clotting sponge (Celox, Quik-Clot, etc)

Where on your person to carry it?  My default is a front pocket of cargo pants or cargo shorts.  An alternate spot is a jacket/coat pocket, work bag or computer bag.  Between the arm rests or console of your vehicle is another.  These are locations I use every week, depending on what I’m wearing and what I’m doing for work tasks or personal pursuits.  See what works for you.

Next there is the consideration of what container to use so that your PTK is not constantly getting folded, bent, or otherwise wearing out the medical supply packaging, or poking through your pocket.  This is no small matter.  For simplicity, and availability, I use a common zip-top, one quart, food storage bag.  The upside is it’s water-tight and sweat-proof.  The downside is that you have to replace it once a month, if it is your every day carry PTK, because it will still wear down in the corners.

The key item to manage is the Medical Shears.  If you don’t craft a small, folded paperboard sheath, you’ll have a hole in the bag in a week or two.  Sure there are MOLLE solutions, and EMT pocket organizers you can buy (and don’t rule those out), but I’m talking about something you could put together and maintain with little expense and fit with the “thin and light approach.”  The bonus of the zip-top baggie, is that it will settle on a curvature to match your clothing and legs (assuming cargo pocket carry).  This helps it “print” less to avoid prying eyes, if you happen to care about such matters.

A ballpark cost estimate is $27.  Approximately $21 for the Quik-Clot, $3.30 for the shears, $.50 for each 3×4” pad, $1 for the gloves (individually wrapped) and $.20 for the baggie.  It’s time for this Texan to go make another one!