Trauma Medicine for the CCW Operator

[Sgt_R]

I just finished reading this book, available for order here:

Introduction

“First, do no harm.” This is considered the “First Rule of Medicine”. If you can help someone, please do so. However, the last thing you want to do is something that will actually harm the person. This fear of hurting someone often interferes with treatment, because the helper simply has never learned what to do in such a situation. They want to help, but innately understand that they do not want to harm accidentally. They are following the “First Rule of Medicine”, without even having learned it. Wouldn’t it be better if they learned how to help, instead? That is the goal of this book. Remove the fear, and replace it with training, skills and confidence.

The authors of this book brought a wide range of experience to this project. Dr. John Meade has been a board-certified Emergency Physician for over 20 years. He is an EMS medical director, an instructor of Tactical Medics for SWAT teams, and a reserve police officer on a SWAT team.

“Sua Sponte” is the nom de guerre of an active duty military Special Operations medic who cannot yet reveal his true name for operational reasons. He has extensive experience treating our military members overseas in adverse circumstances and environments. Between the two of them, they bring together a combination of civilian, military, law enforcement, hospital, and out-of-hospital perspectives.

Even though the authors work with and train highly skilled teams daily, this book is not written for those individuals. This book is directed toward the “Average Joe” who may have never even taken a first aid class, and certainly doesn’t consider himself to be a medically trained special operator. Instead, he is someone who realizes that, just as with his shooting skills, he needs to have skill to help save someone’s life, perhaps his own, in the aftermath of shooting or other traumatic event. We call that man the “CCW Operator”. He doesn’t have a team medic nearby. He must show the same self-reliance that got him through the initial incident.

It is the authors’ hope that the reader will take this book as only a starting point in learning to care for themselves or others. So please seek out and obtain some hands-on training to perfect your skills. Your life, or the life of a loved one, may depend upon it.

I could pick a few nits - it's small press, there are a few typo's in the text, it's not 100% politically correct, etc. etc. But I'm not going to, because the fact is that the content presented in this book is truly outstanding, warts & all.

I have 11 years of accumulated military SABC and civilian First Responder level training. I found something valuable on nearly every page, and had at least one "lightbulb" moment in every chapter. Simply put, the information presented in this book could save your life. I highly recommend it.

R

 

[Nushif]

I have come to really disdain this term "operator."

Ultimately to me being able to do render First Aid is a required skillset much like driving a car, knowing how to work an elevator,things like that. So I agree with it being a good thing to know for a CCW holder. I know I would most likely render aid, even for a person who I had to shoot at. Purely for moral and ethical reasons.

But man. I am not an Operator. And most of the SF types I've met in real life laugh at the term just as much as me.

 

[Loosedhorse]

Guys: this is not book stuff. Take a course in basic first aid and CPR. If you want more, great: consider a course in basic wilderness life support, or in basic trauma life support.

Remember the basic rule of trauma first aid: all bleeding stops eventually. Which way it stops can matter a whole lot.

 

[Bubba613]

I have come to really disdain this term "operator."

This.

 

[Fred Fuller]

It's a term of convenience, as far as I can tell. Search "motor vehicle operator" for example.

For me the word usually conjures up visions of Lily Tomlin in one of her signature roles (Ernestine, IIRC) on the old comedy show Laugh-In, but then I'm an oldephart...

And I agree, this stuff is best learned hands on. Red Cross First Aid is a good icebreaker, and from that you can go as far as you wish and can afford. The authors of the book in the OP teach a class for Suarez on the same subject, and though I haven't had it I'd imagine it could be worth while.

There are similar courses from other schools as well - see http://www.defense-training.com/gundoc.html for example.

 

[sidheshooter]

Always good to refresh your emergency aid skills.

+1 on the "sell more books" tacticool title. CCW "operator" is ludicrous.

overusing; 5-yard penalty...

 

[Sgt_R]

I have come to really disdain this term "operator."

I agree. As I said, I could pick a few nits, and that's one of them. If I'd been the editor or in any way contributed to the book, I'd have suggested "CCW Practicioner," or something similar, and I probably would have passed on the exclamation points.

There are some rough spots, but the information presented within is more than worth the price of admission.

Guys: this is not book stuff. Take a course in basic first aid and CPR.

Again, I agree. I think you'd be surprised how much the authors are able to get across in print, but ultimately, this stuff is better learned in a classroom environment.

However, as a refresher on tactical medicine for someone who has had the training, like myself, it is a valuable resource. I think it could be a useful introduction to the subject for an untrained individual as well.


I know Suarez is a polarizing character, and that the "tacti-cool" title and small press nature of the book are going to limit it's appeal. Which is a shame, because speaking as someone who has had hands on training in the material presented here (from some highly qualified instructors), I still learned quite a bit from this book. It's well worth the $25 cover price.

Disclaimer: I am in no way affiliated with SI, OST, or the author's. I won't see one red cent if you buy a copy. Check my post history - I'm hardly a shill for the company. But they have a good thing here, and I wanted to help get the word out.

R

 

[Nordeste]

Even to me, not a native English speaker, "operator" sounds more like the person who makes his living out of working with, say, a crane (with due respect), not whoever carries a handgun for self-defense.

Agree on the fact that these things are best learnt in a practical way, but, theory is better than nothing.

 

[Devonai]

Having been the victim of countless hours of "hip-pocket" aka "let's look busy" training, as well as more formal training, I can tell you that practicing scenarios with your buddy with the stuff you actually have available is far more valuable than reading a book.

 

[bigfatdave]

Guys: this is not book stuff. Take a course in basic first aid and CPR. If you want more, great: consider a course in basic wilderness life support, or in basic trauma life support.

Yep

And if this is going to come down to the old "do I give first aid to the threat I just shot" debate, anyone who has a rudimentary understanding of blood-borne pathogens (included in most FA training!) would answer "absolutely not".

Maybe if I was part of an elite protection force in one of america's retail facilities, I could convince my boss to get us this book for $25 (plus $9.99 shipping!?!?!) to put in out tactical response electric vehicles, or perhaps between my taped-on trauma plates.

Until then, I won't be carrying around a freaking assortment* of nasopharyngeal airways or the rest of a trauma kit everywhere I go, and I surely don't have a team of buddies to haul me out after a firefight. I might have my wife and/or a couple friends with me, and while they're all competent people, we are hardly a "fire team in hostile territory".

*(yes, you need an assortment, because everyone is a different size ... to determine the approximate patient size, compare tubes to the patient's pinky finger - at least that's what I've learned from real EMT instructors who run the training I have to go through 2-3 times a year for industrial first aid)

“Sua Sponte” is the nom de guerre of an active duty military Special Operations medic who cannot yet reveal his true name for operational reasons.

and that's a load of crap

 

[Sgt_R]

*(yes, you need an assortment, because everyone is a different size ... to determine the approximate patient size, compare tubes to the patient's pinky finger - at least that's what I've learned from real EMT instructors who run the training I have to go through 2-3 times a year for industrial first aid)

That may be optimal in an industrial/hospital setting, but that's not how it's done in the field. Every IFAK I've been issued has included a single nasal airway, and every SABC instructor I've had has taught the class how to measure and cut it to the correct length for each patient. Did they do it differently the last time you deployed to Iraq and/or Afghanistan?

Just out of curiosity, how many of the people saying this stuff is better learned in a classroom environment (I agree, but that's not the point) have actually had training in this kind of material (not basic first aid - the last time I took an American Red Cross basic first aid class they didn't cover gunshot wounds), or have any intention of getting this kind of training in the future?

R

 

[Shadow 7D]

I've known plenty of WELL trained people who just didn't have it under stress
and that's the part you AIN'T ever going to get out of a book
it's hands on skill,

what you just posted is like me saying I read Jerry Miculek's book and think I'm a speed shooter now. Ain't how that works, it takes training, it's labor intensive PHYSICAL skills, much like martial arts, you repeat it until you know it, and then keep going till you can do it in your sleep.

 

[Shadow 7D]

Me for one, wanna see my EMT-T certificate???
Wanna see my EFMB????
Wanna see my CMB???

been there done that call medivacs, dragged buddies off the dropzone and patched boo boos for 7 years

you, read a book?
gees, that'd make a rocket scientist since I like Niven, Asimov and Heinlein.

 

[Sgt_R]

you, read a book?

I guess you missed the part where I said I had 11 years of military SABC & civilian First Responder training, and I've deployed to combat zones with similar kit (thankfully I've never had to use it, but if you've BTDT, thank you for your service).

I never said that this book was a substitute for hands on training or experience. I said it was a useful supplement for that experience, or a useful introduction to the topic for an untrained individual.

Where, exactly, did I say that reading this book will make anyone a super secret squirrel high speed combat medic? I didn't.

Honestly, nevermind. Buy the book, or don't. Buy a different book, or don't. Carry a kit, or don't. Get hands on training, or don't. I'm done here.

R

 

[Shadow 7D]

I still have my old flip cards, SF handbook and a but load of reference books. They are REFERENCE, used mostly when I was training.
But really if you haven't done it, practiced it (like a rapid cricoidotomy - ala poppers or icepicks) or at least been trained on it (OS infusion, and no thank's I'll pass)

Reading a book is a good starting point to find out what you would like to GO ON TO LEARN, there is NO good substitute for hands on in the medical field, esp. trauma.

 

[Al Thompson]

Reading a book is a good starting point

I'd also suggest it's a good refresher.

Sgt_R. and I are in a howling wilderness of local training. I see exactly where he is coming from as we have zero close (with in two hours one way) places to get the training you suggest.

 

[Loosedhorse]

anyone who has a rudimentary understanding of blood-borne pathogens (included in most FA training!) would answer "absolutely not".

Speak for yourself, dave. I have more than rudimentary knowledge; and as you know, my answer is maybe. Your implications that there is only one answer for everyone, and that if someone doesn't agree it is because of ignorance, are false.

I understand there is only one right answer for you.

"operator" sounds more like the person who makes his living out of working with, say, a crane (with due respect), not whoever carries a handgun for self-defense.

My understanding is that the term grew out of "Delta", the elite Army SF guys. I am told that the members were not referred to as "soldiers," but because they were sent on "special operations" they were "operators."

If my etymology is off, I'd appreciate correction.

 

[Fred Fuller]

Folks, there's no reason for all the chest pounding. Someone's gonna hurt themselves.

Leave us dispense with that, please.

BTW, this is the only "please."

 

[Old Fuff]

I know nothing--- absolutely nothing!

So for that reason I may buy the book, and ignore words like "operator."

Because in the quest for knowledge you have to start somewhere.

Thank you Sgt_R, and please don't go away.

 

[Sgt_R]

Thank you Sgt_R, and please don't go away.

No worries, I'm not going to take my ball and go home.

I'm just done with this thread. I didn't start it to have an argument, just to get the word out. That's done, and I hope anyone who buys this book gets their $25 worth out of it. I know I did.

R

 

[Trunk Monkey]

There are a couple of points that this topic raises for me,

First, the paragraph about the SF operator whose name may not be mentioned reminds me of the line in the “Mall Ninja” stories about the assassin who was so skillful that “all of Viet Nam still trembles at his name” And for that reason alone, I’m out.

Second, rendering aid at all is a personal choice each of us has to make, it’s your life live it as you see fit. BBP issues aside, I choose not to render aid to a person I just deliberately shot because IMO it isn’t safe. Imagine this, God Forbid you are forced to shoot someone and as you rush forward to render aid he becomes combative again (remember he has no idea why you are approaching him) and you are forced to shoot again and every single witness tells the cops that you shot the guy down than ran up and finished him off at close range. They will bury you under the jail.

Third, training is critical but experience is a must as well. While I was in the army I was assigned to the medical company of a forward support battalion, all the medics were well trained but they spent most of their time in the motor pool. One day while they were in the aid station a soldier had a heart attack right in front of them. Every single one of them (including me) froze because our minds refused to believe what we were seeing. Even when I got a chance to work with the post EMTs I spent a good portion of my first month or so with them doing exactly as I was told to do.

Final thought, unless you are carrying an aid bag around in your car (if you are I gotta wonder why?) you are going to be very limited in the scope of what you can do anyway. God Forbid that you’re a Combat Lifesaver on post (do they even still have those?) and you try to start an I.V. on Academy Blvd because your ass is going to jail for practicing with out a license.

In the real world you’re kinda limited to ABCs; maintain the airway, control any bleeding, keep an eye on circulation, treat for shock, maintain spinal immobilization and wait for EMS.

I hope anyone who buys this book gets their $25 worth out of it. I know I did.

Then that's what really matters right?

 

[Al Thompson]

carrying an aid bag around in your car (if you are I gotta wonder why?)

Not an aid bag, but a blow out kit. Israeli Battle Dressings (IBD), Quick Clot, tourniquets and minor stuff. I shoot a fair amount and if someone does a Tex Grebner, I want to be able to stop the bleeding.

The Army does have Combat Life Savers, at least as of 2009. It's been expanded since the program started in 1985 or so.

Practice is important, but having a rudimentary knowledge beats having no knowledge at all.

 

[Loosedhorse]

Final thought, unless you are carrying an aid bag around in your car (if you are I gotta wonder why?)

What's the big wonder?

I agree with Al Thompson. If you mean by "aid bag" something a little more that a small first aid kit (also contains, for example, a large bandage that can be used as a tourniquet, a "sealing" (petrolatum) dressing, and something like Quik-Clot), what better place than in a car? Where are you more likely to see the type of trauma in which proper first-aid can literally be life-saving than on the roads? (Unless you're stationed in harm's way, of course.)

you are forced to shoot again and every single witness tells the cops that you shot the guy down than ran up and finished him off at close range. They will bury you under the jail.

You are correct that approaching a downed attacker has its tactical downsides.

Legally, witnesses can be informed (if you choose to approach) by your loud announcement to the attacker that you are approaching for the purpose of rendering aid, but you will shoot if the attack resumes. You can also directly say to witnesses, "Please stay back, he still has a weapon," which shows your concern for them as well as your knowledge that this is a highly hazardous situation.

As has already been discussed elsewhere, a decision NOT to render aid could also be devastating to your case in court.

(Mods: I know this thread isn't "about" rendering aid to an attacker, but I do think that if an opinion against that option may be given, and has an obvious counter, then that counter may also be given. I am not saying that such aid "should" be rendered.)

 

[Fred Fuller]

As near as I can tell, the point of the book was learning to render aid to self and friendlies.

Let's not drag this wounded thread off into the weeds of obfuscation and allow it to bleed out there, please...

 

[Trunk Monkey]

As near as I can tell, the point of the book was learning to render aid to self and friendlies.

Always a comendable goal.

If you mean by "aid bag" something a little more that a small first aid kit

I meant a U.S.G.I. aid bag, suture kit, Ringer's j tubes, C collars, the whole smash

As long as we're talking about friendlies, I still think getting some experience would greatly increase your effectiveness