Trauma Medicine for the CCW Operator

[Loosedhorse]

getting some experience

Which is why I recommended training over a book. "Getting experience" is difficult unless you are a medic/corpsman, EMT, paramedic, RN, PA, MD or DO; so the practical ability of most folks to follow a recommendation to "get some experience" is probably small.

 

[Fred Fuller]

The problem with carrying an A bag stuffed with gear you're not trained and qualified to use, is that you might be tempted to use it anyway.

However, I think there is something to be said for having useful gear on the scene on the off chance someone who has the training/qualifications to use it might show up, but without their own gear in hand.

Personally I quit carrying a full jump kit when my last EMT cert expired. A Plano 727 took up too much room in the truck hauling it around all the time, and keeping the contents in date was more than I wanted to deal with when I wasn't getting dispatched to handle calls.

More important than all the gear in the world is the skills to use what you have effectively. Skills will get you through times of no gear, better than gear will get you through times of no skills.

 

[Trunk Monkey]

More important than all the gear in the world is the skills to use what you have effectively. Skills will get you through times of no gear, better than gear will get you through times of no skills.

Truer words and all that.

There is one advantage to any manual if you absolutely have to you can have someone read the thing to you while you are acting.

Not ideal, but better than nothing

 

[Owen Sparks]

Having the equipment without training would be like having a guitar without knowing how to play it.

 

[bigfatdave]

and having it in the car would be even more useless if you walked somewhere

where should I stow this kit in my vehicle so it is always at hand when I'm on foot or if I take my motorcycle somewhere?

 

[Loosedhorse]

having a guitar without knowing how to play it.

Some "equipment" is very intuitive. You don't have to be Andrés Segovia to place and hold a pressure dressing, or to open a bag of Quik-Clot. If someone is talking about endotrachial intubations and intraosseous infusions--or playing Bach's "Chaconne", for that matter!--it ain't me.

Where should I stow this kit

The only thing impossible about such a kit...is making someone who doesn't want to keep one want to keep one.

 

[Sgt_R]

and having it in the car would be even more useless if you walked somewhere

where should I stow this kit in my vehicle so it is always at hand when I'm on foot or if I take my motorcycle somewhere?

I know I said I was done here lol, but...

This is why software is more important than hardware. I keep an IFAK in my truck, but I don't carry it with me if I'm on foot.

However, using a sharp knife, t-shirt, and key chain (3 things I always have with me), I could improvise a tourniquet, gauze, and pressure bandages, if I had to. And maybe add splints to that list, depending on what else might be at hand. Would any of it be as good as the real thing? No, but it would be better than doing nothing.

R

 

[Shadow 7D]

Here's a practical IDEA

if you want experience, training etc.

go join your local volunteer fire department
or Sheriff's posy/search and rescue
Ski Patrol
Red Cross etc.

there are PLENTY of civic agencies that will be happy to train you for some of your time.

 

[jeepnik]

You know, what I can't figure out is why a person operating a switchboard would need to carry concealed. One would think they could just open carry.

 

[Trunk Monkey]

if you want experience, training etc.

go join your local volunteer fire department
or Sheriff's posy/search and rescue
Ski Patrol
Red Cross etc.

there are PLENTY of civic agencies that will be happy to train you for some of your time.

God Forbid you might even help out the community

 

[Loosedhorse]

For those that have minimal access to volunteer fire departments, posses and auxilliary police units--and who are perhaps not quite ski patrol material, there are other options as well.

CERT and MRC, for example.

They will be able to provide training in first aid and CPR/AED, usually at no or nominal cost. But, again, experience is harder to come by.

 

[sidheshooter]

You don't have to be Andrés Segovia to place and hold a pressure dressing, or to open a bag of Quik-Clot. If someone is talking about endotrachial intubations and intraosseous infusions--or playing Bach's "Chaconne"...

You're an educated individual, Loosedhorse.

 

[Loosedhorse]

Well, I used to be. When I was 22 I knew everything. Now, every time I pick up a book (anyone else still know what a book is? My kids shoot me a puzzled look when I say "album") or talk to a guy who has his stuff stowed, it's a continuing introduction to what I didn't know that I didn't know.

Excuse the rant, please. I thank you for your kindness.

 

[Demitrios]

I was an EMT for a few years and the very first thing you should do is remain calm, you're no good if you're a bundle of nervce.
Next make sure the scene is safe, if you get hurt then the EMT's will have two victims.
Next, if you can, activate the emergency system and call 911 if you can, let the professionals do what they can, you do not want the responsibility of moving someone who just fell off a motorcycle because the slightest movement could render them paralyzed for life.
After that make sure you're wearing protection, nothing quite like giving someone CPR and getting AIDS or Hepatitis-B because you're being a good samaritan.
Get those down pat then you can start worrying about putting pressure on a wound, seating a cardiac patient upright or administering CPR to someone who's not breathing.

 

[Sgt_R]

I was an EMT for a few years and the very first thing you should do is remain calm, you're no good if you're a bundle of nervce.

Yes.

Next make sure the scene is safe, if you get hurt then the EMT's will have two victims.

Or, if the scene isn't safe, determine your level of acceptable risk. If a family member is strapped into the back seat of a burning SUV, I'm going in to get them. Safe? Not hardly. Acceptable risk? Damned straight.

Next, if you can, activate the emergency system and call 911 if you can, let the professionals do what they can, you do not want the responsibility of moving someone who just fell off a motorcycle because the slightest movement could render them paralyzed for life.

Yes and no. Call 911 at the earliest opportunity, yes. Don't move the victim? It depends. Using the burning SUV example: there's a chance that moving them will result in paralysis, but there's a certainty that not moving them will result in death. Movement seems preferable.

After that make sure you're wearing protection, nothing quite like giving someone CPR and getting AIDS or Hepatitis-B because you're being a good samaritan.

Yes and no. Would I work on a random stranger without suitable protection? Probably not. Family member with a known medical history? Absolutely.

Get those down pat then you can start worrying about putting pressure on a wound, seating a cardiac patient upright or administering CPR to someone who's not breathing.

The basics are a great place to start (the only place, really), but once you've got the basics down, the first thing you need to realize is that they don't always apply.*

R


*I don't mean you specifically - if you were an EMT then you know that better than I do

 

[Trunk Monkey]

Why should I take the word of Sgt. R. over a trained EMT who apparently has actually worked in the field?

 

[Sgt_R]

Why should I take the word of Sgt. R. over a trained EMT who apparently has actually worked in the field?

I'm sure Demitrios can speak for himself. If he disagrees with anything I've said, I expect he'll post his reasons.

R

Edit: if these "Heroic Bystanders" had blindly followed "the basics," then those 3 kids would be dead. The scene wasn't safe, they moved 3 accident victims, and they probably performed CPR on that dirty 4 year old without a barrier device. Oh, the horror!

 

[Loosedhorse]

Oh, the horror!

Exposing yourself to a blood-borne pathogen is a horror. So is letting a 4-year-old die when you could have saved him.

Decisions like this are called "life-and-death" for a reason.

 

[Sgt_R]

That's exactly my point. There is no "safe" scene, only degrees of safety and acceptable (or unacceptable) risk. Do you wade into that icy river? What if you can't swim? Do you move the kids away from the car? They might have spinal cord injuries from the crash, but is it better to let them drown? Do you perform CPR on that dying toddler? What might be the consequences if you do? What will be the consequences if you don't?

By the time things have gone that far wrong, there is very rarely a perfect solution - you're going to take a chance no matter what you do (even if you do nothing).

R

 

[Demitrios]

Sarge, you're examples of knowing someone is very poignant you're right, if someone is in a burning SUV that's about to explode and kill you or moving the victim promptly may paralyze them and it's a life or death situation that's your call to make. I personally would take the extra two seconds, drop to my stomach and see if I could see or smell leaking gas. You are right to think outside the box, I'm only giving scenarios from my point of view as a first responder.

However you ALWAYS call 911 first when someone is injured or experiencing and episode of some sort. Someone is having a heart attack? Call 911. A 9 year old kid had a siezure and fell down the stairs? 911. You need to do that immediately if there's a phone available, always.

Lastly any EMT will tell you that they're only as good as their training but can only be as effective as their equipment. I can't take a blood pressure accurately without a BP cuff or accurately check for pupil dilation with a flash light that's too powerful. Gauze, bandages, splints, those can be made from items that are in your surrounding area. But if someone is having a siezure, what do you do? I know some people who still believe sticking their fingers in someones mouth to keep them from swallowing their tongue is a good idea. You clear the immediate area (move tables, chairs, etc.) so they don't hurt themselves and roll the patient on their sides.

It's always a good thing that people want to help and you should always take action to do so, but keep in mind everything you do. Because you may not just be putting yourself in harms way, you could end up doing serious harm to the patient as well.

 

[Trunk Monkey]

I know some people who still believe sticking their fingers in someones mouth to keep them from swallowing their tongue is a good idea.

And you can tell the ones who have tried by the lack of fingers

 

[Al Thompson]

However you ALWAYS call 911 first when someone is injured or experiencing and episode of some sort. Someone is having a heart attack? Call 911. A 9 year old kid had a seizure and fell down the stairs? 911. You need to do that immediately if there's a phone available, always.

Excellent point. One thing to remember is that the address is the first thing you want to tell the person on the other end. If you don't have a physical address, nearest intersection. No intersection, road name or number and general location. I.E., "the wreck is on Highway 29 between Olar and Bamberg".

The address to the range I shoot at is on the back of my clip board. So if I catch one, hopefully who ever is with me can call it in.

 

[Demitrios]

Al, you bring up another good point, you want to watch your words as well. Not to nitpick but you should try and avoid stressful terminology. When you say, "The wreck is on. . ." you run the risk of further distressing the patient. I'm not saying you would do that but try keep your words as professional as possible, i.e. motor vehicle accident. Even an unconscious patient can be listening.

 

[XxBulletBendeRXx]

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.



Then that's what really matters right?

Good post.. Heeey Nooow.. If you just summed up the book. OR at the least That You have shared with us was a chapter or two (or a few portians of chapters the Top OP found relevent to the way he remembers and them), the OP Articulates ina way Such imo, a captive Way of writing, he has summed it up and saved me 35 Bucks.....

IMO good post Sir..