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!

 

Civilian Operator 101: Trauma Care in Active Shooter Scenarios

By Hammerhead

 

I highly suggest you guys routinely visit sites like The Journal of Trauma and Acute Care Surgery  for applicable medical/trauma care articles like this one.

I first found out about this site Through Greg Ellifritz’ Active Response Training Weekend Knowledge Dump, which I highly suggest you guys peruse each Friday.

The acronym T.H.R.E.A.T is used to describe the course of action LEO’s, First Responders and Armed Civilians need to follow when responding to Triage and Trauma Care in these situations. For those of you familiar with the Military TCCC (Tactical Combat Casualty Care) you will recognize these principles immediately.

In reality, only the first two and MAYBE the Third step in this acronym are going to apply to the Armed Civilian, the rest will fall in the LEO’s and First Responders Wheel House.

 

T = THREAT SUPPRESSION

If the bad guy (or guys) are still a viable threat, they need to be dealt with before any serious triage and medical attention can be given. Bottom line if you get hit, what is the point? Now you have two wounded people out of the fight.

The term SUPPRESSION is used here, with the ideal there will be a TEAM present to deal with the threat..in other words a couple of people lay down SUPPRESSING FIRE on the bad guy while another person triages and treats the casualty or casualties. This type of thinking is endemic to Military and Law Enforcement Trauma training, but I think for our purposes here, where we are talking about a situation with the Individual ARMED Civilian, the world NEUTRALIZE is much more REALISTIC term since we can NEVER depend on a TEAM being present to help us. It is up to you, the INDIVIDUAL to survive this day, therefore you need to KILL the Threat before moving on to medical assistance.

As CR Williams states in his new book Gunfighting and Thoughts About Doing Violence, Volume 4 The choices you will be presented with in situations like this will NEVER be good ones, but regardless of WHO is down, the PRINCIPLE remains the same: DEAL WITH THE THREAT!!

• Team Mate Down? YES. Threat Still Active? YES.   DEAL WITH THE THREAT!
• Family Member Down? YES. Threat Still Active? YES. DEAL WITH THE THREAT!
• 10 Year Old Child Down and Crying for Help? YES. Threat Still Active? YES. DEAL WITH THE THREAT!

H = Hemorrhage Control

This is where carrying and knowing how to use a PTK (Personal Trauma Kit) is going to come in Really essential. If you don’t have one, creating a make-shift pressure bandage (ripped shirt/pants/etc.) and applying steady direct Pressure to the gunshot wound will suffice. The PTK I carry has both a Hemostatic Agent and a SWAT-T (Stretch/Wrap/Tuck Tourniquet) inside them.

Having the training to know how to use each item for each type of injury is MANDATORY , so before you go out and spend $100 on the latest and greatest Blowout Kit, budget the money for some good Trauma Med Training too! In an article I did four years ago Do You Mothball Your Medical Training? I cover this extremely important subject in a bit more detail.

R & E = Rapid Extraction To Safety

Although technically this does not fall into the Civilian’s area of responsibility, as with any fluid scenario, you are going to have thing fast on your feet and ACT. If you have the opportunity to help a wounded person to safety without endangering yourself or others, by all means, but typically this is not going to fall to you.

A = Assessment by Medical Providers

N/A

T = Transport to Definitive Care

N/A

Stay Alert, Stay Armed and 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!