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Author Topic: Emergency Tips, Emergency Medicine, Trauma Care, and First Aid  (Read 47429 times)
Crafty_Dog
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« Reply #50 on: June 08, 2009, 07:46:01 AM »

Haven't had a chance to check it out properly yet, but it seems promising.  Any comments?

http://www.wikihow.com/Do-Basic-First-Aid
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MHouston
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« Reply #51 on: June 09, 2009, 11:25:31 AM »

Just to throw another light on things. EMT students are scared into only using a tourniquet as an absolute last resort, I feel, because of the legal ramification. If a person loses a limb were direct pressure would have been effective, you have a messy law suit on your hands. So we are told to use very sparingly. Also we are told NEVER to release the tourniquet due to the fear of "Tourniquet  Shock". Where built up latic acid can effect the heart and kidneys resulting in possible death.

Kaju Dog knows what he is talking about and really understands the WIN approach (What is Important Now). Listen to his advice and get the person help ASAP. If you don't know what you are doing the longer your screwing around the less time that person has.
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MHouston
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« Reply #52 on: June 09, 2009, 12:49:13 PM »

Here is a question I would like help on.

What should a layperson have in their emergency kit? Being in martial arts are there other things that most kits don't have that would be beneficial to have on hand?
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Crafty_Dog
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« Reply #53 on: June 09, 2009, 01:24:30 PM »

Items for knife and gun wounds.  I also have some burn gel (think car crash). 

Also, I think in terms of what can go wrong here in LA.   An accident shutting down a freeway trapping me or my family for hours.  An earthquake, a terrorist event, etc.   So I have some cheapie bright ponchos to keep the kids visible at night.  Some Zone bars. Chem lights.  A strong flashlight.  A back up hand generated flashlight.  Some basic tools.  Large roll of duct tape.  Some high strength rope.  A folding shovel.  A siphon.  Jumper cables.
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Crafty_Dog
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« Reply #54 on: June 24, 2009, 02:29:50 PM »

Putting aside the politics of this footage, for those of us, e.g. me, who are cherry to these things, there is some footage here of a fresh gunshot wound.  Note the failure to adress the exit wound.

VERY GRAPHIC, not suitable for office environments, viewing by children, etc.

http://www.youtube.com/watch?v=JykkvYbNsk0
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maija
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« Reply #55 on: June 24, 2009, 03:46:25 PM »

This was forwarded to me only a few days ago - any thoughts?

The Jump Kit, by Skyrat

Inside the trunk of my vehicle is a near duplicate of the “jump kit” or “Green Bag” used in my days with the Detroit Fire Department's Emergency Medical Service Division. When I come across a roadside collision before the local medics, everything I need to start patient care is in the green canvas bag I sling over my shoulder. The supplies in my personal vehicle are very much like those I carried in my street medic days, and reflect a strong basic life support/trauma bias.

Basic life support includes those interventions that do not go past the skin, and generally do not require physician direction to implement. Advanced life support, on the other hand, includes therapies that do go past the skin, and include medications, intravenous fluids (IVs), electrical counter shock, and airway intubation.

I do not include intravenous fluids or medications in my green bag for a couple of reasons. First, these items have a limited storage life under the best of conditions, and the rear of a passenger vehicle in Northern Michigan is not calculated to prolong it. Second, the statutes under which paramedics practice here in Michigan requires systematic physician supervision of advanced patient care. Fundamentally, that means that if you are not functioning within an established paramedic system, you are out of bounds should you perform advanced procedures on the street. Third, advanced patient care procedures are occasions of peril even in the hospital, let alone in the rear of an ambulance. This is so, even within a system of continuing education, continuous quality assessment, supervision, and the backup of both your partner, and the physician and clinical staff on the other end of the telephone or radio. Soloing at the roadside provides neither you nor your patient with these safeguards.

Firearms owners are likely acquainted with the “gun shop commando”, classically braying about the bogus “shoot 'em and drag 'em inside” philosophy of home violence management. Likewise, you might consider the existence of the “parlor paramedic”, who seems to reason something like, ”wait until the Schumer hits the fan, and I'll come out of the closet, birthin' babies and saving lives!”

In order to entertain this fantasy, you will need the tools of the trade. Medications are not without risks, do not keep forever, and are expensive. Additionally, there is the issue of convincing a physician that he or she ought to prescribe for you and that you can differentiate your Barneyfrank (ass) from a hole in the ground. If the expense is no problem for you because you have money to burn, please see me after class! If you think that the utility of your medication stash outweighs the other concerns, please contemplate these points: 1) In the absence of a catastrophe the likes of which America has never seen, it is both illegal and immoral to withhold professional medical care required by an ill or injured person. 2) During Schumeresque times, it is unlikely that the infrastructure will be in service which allows the delivery of complex, highly skilled care to those in need. Particularly, you will not have access to that infrastructure, and (if you have your head screwed on straight) you will have no desire to perform skills you are not trained to do, in the midst of a disaster, upon your vulnerable, hurting and injured loved ones.

By way of example, I have 30 yeas of EMS and nursing experience (in ICU, CCU, and ER), as well as licensure as a Physician's Assistant. I have used Dopamine, along with other invasive therapies, innumerable times to support the blood pressure of critically ill or injured patients. Dopamine has potent effects upon the heart, among other systems, and these effects are monitored by a cardiac monitor. I found a Zoll Automatic Cardiac Defibrillator, after a brief internet search, for $3,000, which appears after a casual review to allow monitoring. The question, however, is whether you can make sense of the tracing the monitor displays, identify adverse changes in cardiac rhythm, and respond appropriately. Additionally, do you know the adverse effects Dopamine may have, and how they must be managed? If not, you have no business trifling with it. I have done all these things for years in my Nursing practice, and I do not have Dopamine in my personal stores. You need to assume the risks you both understand and are comfortable with. I am reluctant to assume this risk for myself and my family.

My bias toward trauma derives from the fact that the stabilization and management of the medical patient, in contrast to the trauma patient, calls for assessments and interventions that I generally do not find appropriate outside of the hospital or advanced life support ambulance. Determining the source of the patient's distress will identify what treatment is required. While there are a few medical conditions that are responsive to basic life support interventions, I am not about to pretend that a few thousand words will equip you to make such judgments. Find an American Red Cross first aid class and master it. Better yet, become an EMT.

Just the other day, I came upon a rollover as my girlfriend and I were en route to attend some family function. There were half-a-dozen civilians clustered about, and things seemed well in hand. The first firefighter arrived shortly after me, and I deferred to him. Offering him wound care supplies, I was surprised to discover I could not find any gloves in my kit! Returning home, I undertook an inventory. Here is the result of that tally, and some discussion of my view of why each item belongs in my kit.

Training comes first. There is a story told of the early days of the Israeli state, when the emergency response planners had the budget required to train their personnel to stabilize and transport spine injured patients, or buy the splints (called backboards), but not both. The story relates that the planners elected to train their personnel, and subsequently noted a spine injured kibbutznik transported to the hospital by his comrades, secured effectively to an entire barn door.

I place a priority on training for several reasons. First, neither vermin nor adverse storage conditions have ever ruined training and rendered it unusable. Secondly, “they can have my training when they can pry it from my cold, dead mind”. Third, I have never ever (in my disorganized life) failed to pack my training. Fourth, there is nothing that will be displaced from my supplies in order to make room for my training. Fifth, in contrast to supplies, ability improves with use, and becomes more abundant when you share it with others.

Begin with CPR training. Three or four hours of your time will equip you with the skill that may save a life in the here-and-now. You will gain an introduction to patient assessment, and learn some of he fundamentals of first aid, and whatever dilemma confronts you, your response cannot fail to be more effective with some training to guide you. Effectiveness saves lives.

Look into local outlets for first aid training. The American Red Cross, the National Safety Council, your local community college, as well as perhaps others offer credible training which may serve as an introduction to further studies. The justification for the further expenditure of additional hours may be found in the preceding paragraph. Additionally, if you are more acquainted with what the medical conversation is about, the health care decisions made with regard to yourself and your family will be less mysterious to you, and better informed decisions tend to be better decisions. The better your health, the better your chances of coming out the other side of Schumer times intact, and therefore the better chance of bringing your family with you, likewise unscathed.

Consider EMT schooling. You will learn more emergency care skills (a good thing), and an introduction to elementary anatomy and pathophysiology (how things go wrong in illness and injury). Such education gives you the opportunity to be a more informed participant in your health care decisions, and that is itself a good thing, as well.

SELECTING YOUR CASE
It really doesn't matte what sort of container you employ for your emergency supplies, so long as it meets your particular needs for security, identification, accessibility, protection and convenience.

Some fire departments use plastic “totes” to organize supplies required for specific types of calls. For example, haz-mat supplies are packed inside specific totes, and the top secured with a cable tie or some such device. An inventory is attached to the top (sealed in plastic) to identify what is inside, as well as out dates of time sensitive components. When properly closed, such bins are drip and dust resistant, resist crushing or jumbling of the contents, and can be convenient to carry when not overfilled. On the other hand, they will not conveniently fit beneath a vehicle seat, may be unwieldy to retrieve and place into action, and may get buried beneath other stuff in a trunk or truck box.

Others of my acquaintance use ammo cans, or plastic fishing tackle boxes. These are generally more convenient to shlep about (unless your tastes run along the lines of a 20 mm ammo can) and are more drip/dust/duh! resistant than the tubs mentioned above. On the other hand, they may overturn with disappointing ease, spilling your supplies into whatever noxious fluid is abundant on your particular scene.

I use a green canvas musette type bag. It is not water resistant, is not neatly compartmentalized, and does not have an IR glint Star of Life embroidered upon it. On the other hand, I know how my stuff inside is organized, it is convenient to sling over my shoulder when the scene requires that I do so, and the local military surplus store will sell me another for $10-20 when that becomes needful. It will fit beneath a van seat, or in a tub in my trunk, and I can work out of it when I have it slung.

IN THE TOP, OR IN AN OUTSIDE POCKET
Items that I am likely to require promptly are either in the outside pocket or immediately inside the top flap of the bag. These are things that I do not want to be fumbling for as I approach a scene. I will not list what might be considered “everyday carry” items like pocket knife, flashlight(s), CS spray, sidearm, and a cell phone. While these tools help keep the rescuer from becoming a victim of an ambush laid for a 'Good Samaritan” , particularly when employed in concert with a Condition Orange mindset. (I did mention I started out in Detroit, didn't I?) These items do not seem to me to be rescue/first aid/emergency medical tools.

First up is several pairs of gloves. (well, now, anyhow!) I am allergic to latex, so I have nitrile gloves. Current practice is to wear gloves anytime you might reasonably anticipate exposure to blood or other bodily fluids: tears, urine, stool, saliva, gastric contents, or any other moist, body-origin material you might imagine (and perhaps a few you might not!). I have so thoroughly incorporated this into my life that I get uneasy caring for my own children (or, at my advanced age, grandchildren!) without gloving first. These are in a zip-lock bag, safety pinned (now!) just inside the top flap of my green bag.

The upside to all this is that scrupulous gloving and thorough hand washing have so far proven highly effective at preventing the spread of the most common blood-borne infections. Diseases spread via airborne droplets (for example, Legionnaires disease), of course, require additional precautions. Others are spread by organisms coming to rest upon environmental surfaces and then accessing a vulnerable host (just like you and I are vulnerable hosts to “the common cold”) by means of unconsciously touching our faces after touching a contaminated surface. For myself, after 30 plus years of patient contact the worst I have brought home has been an occasional upper respiratory infection due to my conscientiously applying the glove/hand wash/hands away from my face regimen.

The next item I'll feel a burning need to have in my hands is a bag-valve-mask (BVM). This is a manually operated ventilation tool. It is employed by sealing the mask over the unbreathing patient's face, squeezing the self inflating bag, and thereby forcing air into your patient's lungs. Repeat at a rate of approximately 12-20 times a minute. Advantage: no kissing strangers, required for mouth-to-mouth resuscitation. You are able to maintain situational awareness of such things as evolving environmental hazards (like leaking gasoline), or indicators of your patient's improving condition (...he said, thinking positively!). On the downside, using a BVM is difficult in untutored hands. It is easier (compared to mouth-to-mouth) to force air into the patient's stomach, which will elicit vomiting. Aside from the aesthetic issues this presents, vomiting in a profoundly unconscious patient (such as one so unconscious as to have stopped breathing) presents the opportunity for aspiration into the lungs of that which has been vomited, which may be deadly.

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maija
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« Reply #56 on: June 24, 2009, 03:47:01 PM »

Part 2 -

Training in use of a BVM will be part of the EMT class I mentioned earlier. I'll wait here while you go find out when your local community college or rescue squad will be having their next class. Plan on being a part of that class. You will be making your community, and thereby your family, safer.

You can buy your own, and Gall's will ding your for around $15 for a disposable model. In the hospital, we use these once and discard them. You might choose to meticulously clean yours and re-use it. Your local rescue squad or ambulance may shop locally, and you might want to do likewise. Ya know, if you were to volunteer with your local rescue squad, you might be able to obtain things like this at your agency's cost. All this on top of the good karma from helping to provide a necessary community service. And,, besides, becoming known to the locals (police included) as one of “the good guys”. Your phone book likely will provide the contact information you require. I'll still be here when you get back.

One of the adjuncts to using a BVM is called an oral airway. Oral airways come in sizes, which may be selected according to the size of the patient. Their purpose is to hold the flaccid tongue of a profoundly unconscious patient forward, so that it does not sag against the rear of the throat and thereby block the passage of air into and out of the lungs. The problem it may trigger is, should your patient be other than profoundly unconscious, he or she will vomit. Among other disasters this may cause, the enzymes from the stomach, designed to digest proteins, will (unsurprisingly) begin to digest the proteins found in the delicate tissues of the air sacs (alveoli) of the lungs, with effects you are likely to be able to imagine on your own. Very Bad Thing. [JWR Adds: Plastic airways usually come in sets of six sizes, and usually color-coded these days, available for less than $5 per set on eBay. Buy a couple of sets. Someday you may be very glad that you did!]

Another way to fail when employing an oral airway is to bunch up the patient's tongue in the rear of the throat. This blocks air flow, strangling your patient. This device must be restricted to only profoundly unconscious patients, and only if you are schooled in its use. You can buy them individually, or in sets. Before shipping, they go for around $5.00/set. You might elect to buy them one at a time, but at $5 a pop, they aren't a particularly major investment.

When I'm confronted by an actively bleeding patient, I reach for a Carlyle dressing. Mine are the old style The Carlyle iteration includes muslin (cloth) ties to secure as any other tied bandage. The 21st century version is called an Israeli Dressing, and is available from various sources. (see my shopping list/spreadsheet for representative sources) It consists of a sterile dressing incorporating an elastic bandage to secure the dressing to the wound. Should you shop gun shows or surplus stores for your equipment, be wary of old dressings. They present potential issues of failed sterility as well as mustiness or mildew occasioned by improper storage or imperfect packaging. The contemporary Israeli Battle Dressings are available from Cheaper Than Dirt or from Gall's for $9.00 or $10.00 each.

Another wound care product is QuikClot . This is a mineral product, bound to a dressing, which enhances clotting, and thereby slows and limits blood loss in the bleeding patient (common in trauma, surprisingly enough!) One article (QuikClot Use in Trauma for Hemorrhage Control: Case Series of 103 Documented Uses. Journal of Trauma-Injury Infection & Critical Care. 64(4):1093-1099, April 2008.) reflected the occurrence of burns in several patients, but the manufacturer's web site reports that changes in packaging and delivery system have addressed this issue.

An alternative you might consider is Celox. It appears perhaps to be a reasonable alternative to QuikClot. It is derived from shrimp shells, although it seems to not produce allergic reactions in folks otherwise allergic to seafood. I have no personal experience with either product, but the reports are interesting. This goes on my “further research” list!

The preceding items are to be found in the outside pocket or very top of my jump kit. I don't want to be searching for them when I feel the need for them Right Freaking Now. Beneath the don't-wanna-wait-for-them items, I have supplies of somewhat lesser immediacy. These allow me to assess the situation in greater detail, or address issues that may come to light that are of less time sensitivity.

Triangular Bandages are useful for slings of injured arms, or may be folded into narrow strips and then used as a means to secure splints or dressings (as “cravat bandages”). If we were to consider them as a backpacker might, they may be used as expedient dust masks, bandannas, head coverings, or washcloths. I buy muslin by the yard at Wal-Mart, and cut it from one corner to the other, forming (surprise!) 2 triangles approximately a yard on a side. I keep 6 to 8 in my kit.

Bandage shears are the most obvious of the prehospital medic's tools. You can go with Lister style bandage scissors, often found as “nurse's scissors”, or the plastic and steel “super shears”. Prices range from $4.00 and up. Frequently employed to trim dressings to the proper size, cut away clothing from wounds, and to cut bandages.

Did you ever notice that a tongue blade/tongue depressor is almost exactly the width of a finger? And just a bit longer than your Mark 1, Mod 0 finger? Exactly like it were designed to be a finger splint, isn't it? In addition, should you tape three of them together one on top of the other, you have a dandy tool for tightening that “Spanish windlass” you are going to learn about, when your EMT class teaches you how to apply and improvise a traction splint for a fractured femur (thighbone). Finally, if you are unhappy at the thought of wiggling somebody's fractured femur (broken thighbone) so you may place ties (cravats: remember them?) for a splint, tongue blades are thin, stiff, and very helpful at limiting the wiggling as you place ties beneath the broken bone of your choice. I keep a handful handy.

You can pay a couple of bucks for them at the corner pharmacy, or you might be able to talk your way into several for free, like when you are volunteering at some public service event with your local volunteer fire department, emergency medical service, or amateur radio club.

Stethoscope/Blood Pressure Cuff. A stethoscope allows you to hear the sounds made as air moves into and out of the lungs, and note changes from normal. These changes might occur because your patient has a collapsed lung, or has pneumonia, or heart failure. When you get that far into your EMT class (hint, hint), you will learn how to evaluate these changes, and what sort of treatment decisions you ought to consider when you notice them. In addition, you will learn how to measure, and interpret, your patient's blood pressure.

I am certain you will know somebody who will go out and get the cardiology deluxe stethoscope, with the multi disc cd player, mag wheels, and gold trim. Do not join them in this folly. Spend $10-40 at the same place the local student nurses get their stethoscopes, and spend the difference on your spouse, whose enthusiastic support you will require, anyhow. If you can show your spouse how your expenditure of family money and time on supplies, education, and volunteering promote values that you both agree upon, the both of you will thereby make your family more crisis resistant. If your family is more crisis resistant, then you are not only NOT a drag on community emergency services during an emergency, you all might even be an affirmative community asset during bad times. That cannot fail to be a Good Thing when you get to explain yourself to The Jewish Carpenter. Me, I'm going to require all the help I can get. I'm volunteering!

Adhesive tape (1 inch, 2 inch) secures dressings, holds loose ends of bandages, and provides a single use notepad (tear off a length, tape it to your thigh, and jot notes. You will not lay it down somewhere to be forgotten). If you listen to some friendly and knowledgeable athletic trainer, you can learn how to use it to support sprained ankles or knees if the preferred treatment (rest, ice, elevation) is not possible. Before you employ these tricks, bear in mind that physicians frequently cannot differentiate a sprain from a fracture, even after an x-ray. In my view, except under the most dire possible circumstances, walking on a fractured (or sprained) extremity is a Very Bad Thing. Two rolls each are at hand when I open my green bag.

I keep 12 to 15 Gauze pad, sterile, 4x4 in my kit. I employ them as eye pads, padding beneath splints, or as (oddly enough) dressing for wounds. Occasionally I encounter a wound bleeding so enthusiastically that a couple of gauze pads will be overwhelmed. Fortunately, I haven't come across such a wound off duty, but in the hospital we use a “boat” of sterile gauze. This is a plastic tray of ten sponges in one pack. The tray also may be used as a clean basin for wound irrigation/cleansing solution. In the hospital we use sterile saline, you may elect to use the water from your retort pouch, or fresh from the bottle as you purchased it for storage. I would certainly give it some thought.

If you happen to be the purchasing agent for your entire survival community, ambulance service, or the entire Boy Scout Council, you might find the case price from Galls to be a useful bit of information. 1200 sterile 4x4 pads for $89.99 works out to around 7.5 cents each.

Triple padding/ABD padding, sterile, 5x9 inch. These multiple layer absorbent dressings are designed for wounds producing a lot of drainage of either blood or other fluid. They are my first choice for a bulky dressing or splint padding. I keep 6 in my kit. The frugally minded may note that “sanitary napkins” are designed to absorb drainage, are “medically aseptic”, and are available nearly everywhere.

And, on a related note, tampons from the “feminine hygiene” shelf at your local store are also constructed to absorb fluids, and contain them. Should you confront a penetrating wound, “tamponading” a wound is a widely known concept among inhabitants of the medical world. Packing such a wound with a tampon using sterile technique might prove to be life saving, and provide hemorrhage control options not otherwise available. (http://snopes.com/military/tampon.asp)

Roller Gauze, 4 inch is typically used to secure a dressing (see Gauze Sponge, above) to the wound. I pack 6 in my kit, and they have “found careers” as bandages to secure dressings, securing splints when I run out of triangular bandages, and upon occasion as packing/dressings for vigorously bleeding wounds. In fact, when one is employed as the dressing, and another as the bandage, I can not only dress the wound, but also (since the bulky roll provides a pressure point) apply direct pressure to the bleeding site. This provides an alternative to the Carlyle or Israeli Dressing, cited above

Vaseline Gauze (sterile, 3x9 inch) is intended to seal wounds penetrating the chest, in order to prevent collapse of your patient's lung(s). When you seal the defect in the chest wall, your patient will not draw in air through the wound when s/he inhales, and thereby not fill the space between the lung and the chest wall (the pleural space) with air. When you can avoid this, inhaling draws in air through the mouth, trachea and bronchi, and that inflates your lungs, and we think that is a good thing. Myself, I pitch the gauze and tape three sides of the foil package, sterile side towards the wound, forming a flutter valve sort of effect. In this way I allow excess pressure in the pleural space to vent to atmosphere (stopping further lung collapse, I hope), and seal the hole when the pressure inside the chest is less than atmospheric pressure (like when the patient inhales). The only way left to equalize that pressure is by inflating the lungs, already described with approval above.

The other use for Vaseline gauze is when my lips or hands are dry, in which case I use the Vaseline to remedy that little problem.

We all can think of uses for the common elastic bandage, 4 inch and 2 inch. Two inch is useful for sprains of your wrist or thumb, and the 4 inch is used for an ankle twist/sprain. In addition, I can use them to secure a splint (there is that rule of threes, seen in other posts on this blog, again!), as the “swathe” part of a sling-and-swathe to immobilize an injured shoulder, or as part of a pressure bandage over a dressed wound that does not want to stop bleeding.

Large Bulb Syringe (for which you can substitute a turkey baster) functions as an expedient means of removing fluids from the airway of someone who is not managing to do so effectively on their own. It will not work nearly as well as a battery powered or pump action suction, such as you might find on your local rescue squad rig, but it won't cost you $50-$60 (for the manually pumped version) either. Second best is superior to nothing.

Mylar “Space blankets” protect you or your patient from the hypothermia-inducing effects of the wind, slowing heat loss. Generally colored bright orange on one side and silver on the other, there are signaling opportunities as well. In a pinch, you can improvise shelter from one or two. Amazon sells the "Space Brand" blanket inexpensively. Equip your jump kits, and each member of your family with one or two.

Any accident so severe as to convince suspicious old me (alumnus of Detroit's EMS) to stop and offer assistance will not be fixed with a couple of Adhesive Bandages (aka “Band Aids”). I have six in my jump kit, two entire boxes at home (and parceled out among my camper, car, and household kits).

I keep a couple of Ice Packs around, as assorted adventures may bring on modest orthopedic injuries. Ice is helpful for strains, sprains, or overuse of an over aged joint (...not that I would know anything, firsthand, about that...). Choices include “instant cold packs”, or that old picnicker's standby, a zip lock bag full of ice from the cooler.

Either option has drawbacks. I do not generally drive about with a cooler of ice at hand, although when camping I am likely to do so. Instant cold packs are kind of fragile, and you might find, when you go to place one in service, that you have a leaking mess on your hands. On the other hand, they are more likely to be there when you want one.

The foregoing lists the contents of my “jump kit”. I keep one kit in my vehicle, and another at home. In addition, there are Subordinate Kits, kept in camper, car and home, for lesser sorts of occasions. I have customized each by adding more dressings, triangular bandages, roller gauze, and gloves. In addition, I improved over the baseline “Wally World” $15 first aid kit, by adding zip lock bags of various household medications. I labeled each bag with the name of the med, the out date of that particular bottle, directions for use, and date of packing. I made my selections by inspecting my own medicine cabinet, and pondering which meds I had wished I had kept handy the last time I was out camping, for example. Most everything commonly needed is therefore in the Camper Kit, Car Kit, or House Kit.

The jump kits are reserved for “Holy Fertilizer!” sorts of events. They are not mere “boo-boo boxes”. Reserved in this way, I will not find myself hunting (and swearing) in crisis, as I need this or that widget, which some child (or adult) has used, and not restocked.

LONGER TERM CONSIDERATIONS
Some of us might contemplate longer term medical preparations. For those, I recommend Dr. Jane Orient's article. Once I get beyond the 20 year old pricing, the are only a couple of improvements I could suggest. One is in the arena of recently developed antibiotics (as in quinolones). Even in that light, it seems to me to be a very good basis for developing a longer term medical kit (and training plan) for your particular circumstances.

Another substitution I would make, is to delete surgical masks, and substitute NIOSH N-95 masks. I found a carton of MSA Safety Works No. 10005403, Pack of 20 Harmful Dust Respirator Model 10005043 for $18.97/each carton at Home Depot. You may find similar products locally.

Additionally, I would add loratidine (you may recognize the brand of Claritin) as a non-sedating antihistamine. (Personally, I would prefer my personnel pulling OP duty to be non-sedated.) I'd also add the most frugal of the following : ranitidine, famotidine, cimetidine, in lots of 1,000 tabs, as a superior stomach acid blocking medication, to supplement the antacid Dr. Orient suggested over 20 years ago. As the “big gun” for acid stomach problems or GERD, I'd lay in a supply of Prilosec OTC. This class of stomach medication is the yardstick against which all others are presently measured.

If you are planning establishing a longer term medical cache, it is imperative that you do so only in concert with a physician, or other personnel licensed to prescribe. The guidance you will receive will help you avoid causing more illness than you relieve. Medications are a double bitted axe, and may cut on the upstroke as well as on the downstroke. Be aware.
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It will seem difficult at first, but everything is difficult at first.
Miyamoto Musashi.
Crafty_Dog
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« Reply #57 on: June 30, 2009, 11:35:46 PM »

One of our DBMA Assn members posted the following on the DBMAA forum and I thought to ask the knowledgeable players here for feedback.

TAC
CD
====================================


Woof,
 I just recently heard about this device invented by a Navy Seal Team Doc, called the Asherman Chest Seal. This is a dressing for a sucking chest wound that has a oneway tube. A box of ten will set you back $150 www.greatmedicalsupplies.com
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Kaju Dog
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organ donor


« Reply #58 on: July 02, 2009, 07:49:14 PM »

One of our DBMA Assn members posted the following on the DBMAA forum and I thought to ask the knowledgeable players here for feedback.

TAC
CD
====================================


Woof,
 I just recently heard about this device invented by a Navy Seal Team Doc, called the Asherman Chest Seal. This is a dressing for a sucking chest wound that has a oneway tube. A box of ten will set you back $150 www.greatmedicalsupplies.com


WOOF! 

Guro Crafty,

You should have a couple of these in the pack I gave you  wink   afro

PS

They are great!  I have had the unfortunate need to use them on more than a few Wounded Warriors while I was in Iraq.  The main thing to remember is to wipe the area as dry as possible before sticking it on.  And always check for an Exit wound!  They can be used for both entry and exit wounds.

Before the ACS came about, we would use a piece of plastic and tape on 3 sides to allow for burping the trapped air from the chest cavity.   

On a similar note you can also use a needle to decompress the chest, cut a finger off of a surgical glove and put the needle through the finger tip, add a bit of vasaline or surgi lube/KY whateva inside the finger sleeve as to not allow air in while still allowing air to escape.

This will buy you some time but should only be performed by a trained professional!

I'll be happy to share this at the next adventure as time permits.

If C-Sleavy Dog is up for it?   cheesy
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« Reply #59 on: July 03, 2009, 01:17:21 AM »

That pack you gave me is one of the most awesome presents any one has ever given me.

I do confess to being a bit intimidated by it though embarassed cheesy

I need flight time with it , , ,
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« Reply #60 on: July 13, 2009, 04:46:16 PM »

From a post on the WT forum:

============================================

The Latest Special Operations Forces Medical Handbook



Jim,
Among the books listed by the recent "favorite books" survey respondents was the US Army Special Forces Medical Handbook (ST31-91B). This book is obsolete and has been supplanted by the Special Operations Forces Medical Handbook.

The best summaries as to why the one is obsolete I've found are:
“That manual is a relic of sentimental and historical interest only, advocating treatments that, if used by today’s medics, would result in disciplinary measures,” wrote Dr. Warner Anderson, a U.S. Army Colonel (ret.) and former associate dean of the Special Warfare Medical Group.
“The manual you reference is of great historical importance in illustrating the advances made in SOF medicine in the past 25 years. But it no more reflects current SOF practice than a 25 year-old Merck Manual reflects current Family Practice. In 2007, it is merely a curiosity.”

“Readers who use some of the tips and remedies could potentially cause harm to themselves or their patients.”


JWR Adds: The new manual is a massive 680 pages. Here is the table of contents:
PART 1: OPERATIONAL ISSUES
PART 2: CLINICAL PROCESS
PART 3: GENERAL SYMPTOMS
PART 4: ORGAN SYSTEMS
Cardiac/Circulatory
Blood
Respiratory
Endocrine
Neurologic
Skin
Gastrointestinal
Genitourinary
PART 5: SPECIALTY AREAS
Podiatry
Dentistry
Sexually Transmitted Diseases
Zoonotic Diseases Chart
Infectious Diseases
Preventive Medicine
Veterinary Medicine
Nutritional Deficiencies
Toxicology
Mental Health
Anesthesia
PART 6: OPERATIONAL ENVIRONMENTS
Dive Medicine
Aerospace Medicine
High Altitude Illnesses
Cold Illnesses and Injuries
Heat-Related Illnesses
Chemical
Biological
Radiation
PART 7: TRAUMA
Trauma Assessment
Human and Animal Bites
Shock
Burns, Blast, Lightning, & Electrical Injuries
Non-Lethal Weapons Injuries
PART 8: PROCEDURES
Basic Medical Skills
Lab Procedures
APPENDICES
Thanks, - Frankie

JWR Replies: Thanks for mentioning the new manual! I have updated both the survey results post and the SurvivalBlog Bookshelf page, accordingly. OBTW, I have had difficulty finding an original copy of the new manual at a reasonable price. The copies that are presently listed on Amazon are "secondary market", at grossly inflated prices. But the good news is that the GPO also publishes a paperback edition for $59. I would prefer the military 9.7" x 6.4" edition that is three-hole punched (and hence will lay flat when open--making it a better "working" reference), but the GPO paperback edition should suffice. There are also electronic editions available for PDAs and Windows for $73, and for Palm PDAs for $60. The Special Forces.com online store sells a smaller 7.5" x 4.75" format edition (a bit harder to read), but they do sell it in combination with a CD-ROM.



www.survivalblog.com
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« Reply #61 on: July 23, 2009, 02:35:07 AM »

Woof,
 I carry a tube of super glue in my kit for those times when getting stitched up at the hospital might be days away. It works pretty good on straight line cuts but don't try it on anything really deep or jagged, just bandage it up as best you can and get help to come to you. Remember only you are responsible for you so don't try this at home kids. grin
                           P.C.
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« Reply #62 on: July 30, 2009, 06:55:52 AM »



http://lomalindahealth.org/medical-center/our-services/emergency/programs-and-divisions/venom-er/about-us/index.html
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« Reply #63 on: August 08, 2009, 12:55:18 PM »

Doomed pigs used to teach first aid
Marines practice on wounded animals in war simulation
By Kristina Davis
UNION-TRIBUNE STAFF WRITER
2:00 a.m. August 8, 2009

As the blood began to surge from a femoral artery, Lance Cpl. Chad Pham dug his hand into the gaping wound to stanch the flow.

Fellow Marines were doing the same all around him, trying desperately to keep their pig patients from bleeding out and dying on stretchers in the dusty clearing of a Valley Center avocado grove.

Working as though the pigs were comrades who had just taken a blast from a roadside bomb, the members of Camp Pendleton's 1st ANGLICO unit realized a tourniquet would do no good on this kind of wound, inflicted by a scalpel. Instead, they packed the holes with gauze and leaned hard on the arteries.

“This was a guy that was standing next to you five minutes ago,” an instructor barked. “Make it work!”

As the training progressed, the sounds of battle blared through a loudspeaker and the pigs were shot with 12-gauge shotguns and rounds from a 7.62mm rifle, causing more grotesque injuries.

Though it has received little publicity, the training has become standard on numerous U.S. military bases and off-site locations across the country during the eighth year of war in the Middle East. It is intended to prepare front-line troops and corpsmen for the gore and pressure they will encounter treating wounds on the battlefield.

Military officials and Marines who have received the “live tissue” training maintain that nothing else could prepare them as well for battle.

“We believe very firmly that this training saves lives,” said Cmdr. Bryan Schumacher, 1st Marine Division surgeon at Camp Pendleton.

“You have to truly know how to put a tourniquet on so it stops the blood flow . . . but then you have to be able to do it when you're scared to death. You have to be able to do it when you're afraid for your own life, when you're worried about your buddy, when you're worried about your own performance because it's not a simulation anymore. It's real.”

The training also has sparked a nationwide debate, with critics who question the need to maim and kill animals when other training methods are available.

'The quick and the dead'

The pigs, which are connected to IV tubes delivering anesthesia, feel no pain, said officials with Deployment Medicine International, a private Gig Harbor, Wash.-based company founded by a trauma doctor that conducts some of the training. The pigs are euthanized when it is completed.

About 1,370 Marines and Navy corpsmen from the 1st Marine Expeditionary Force, based at Camp Pendleton, are scheduled to go through the training this year under a $1 million contract with DMI, which declined to reveal how many contracts it has or total dollar figures. Another company also has government contracts worth millions for similar courses. The training attracted attention last month after neighbors complained about noise at the Valley Center grove, owned by Escondido police Officer David Bishop.

For the first time, three reporters were permitted to observe and participate in the DMI instruction this week.

The first three days of Marine training were in classrooms at Camp Pendleton, and the fourth day was at the 17-acre grove and used pigs. Giving the full names of instructors was not allowed, nor were photographs of any exercises involving pigs.

Twenty Navy doctors were also trained using both pigs and high-tech mannequin simulators that bleed and breathe like humans.

One of the first things the Marines learned is that other than instantaneous death, massive hemorrhaging kills more troops than anything else on the battlefield, and it happens quickly. By the end of the week, they had rapidly applied tourniquets on their own limbs and on others' at least 50 times.

“In this business, there's the quick and the dead,” a DMI instructor yelled during a 30-second drill. “Half your body fluids are on the ground now!”

On the final day, training focused on the unconscious pigs, which had blood gushing from wounds and their bowels spilling out.

“One of the benefits of live tissue is watching the faucet get turned off,” a trainer told the troops.

Navy corpsman Richard Cheek said his first exposure to massive bleeding was during live-tissue training in 2006 in San Diego County.

“It was shocking to see,” Cheek said. “It shows exactly what an injury does to an actual body.”

He left for Iraq the following March, he said, and the skills he learned while practicing on pigs came back to him when he responded to a car crash.

“There were lots of injuries, and I had to do an airway (tube),” Cheek said. “I had practiced a lot on pigs. It's not an easy procedure, but once I made the decision to do it, I was really confident in doing it.”

The Marines' emotional connection to the pigs was evident as they struggled to keep their patients alive – a psychological effect that can't be gained from simulators, training proponents say.

One pig, which they'd named General Dude, was brought back to life twice before it succumbed.

The pigs used in Valley Center are obtained from various research-grade vendors in the state and later disposed of at a rendering plant in San Bernardino County. The pigs weigh 140 to 200 pounds, about the weight of a typical Marine.

Other alternatives?

Despite the wholehearted support by the military, some question the usefulness and morality of the training.

“We think live-tissue training for soldiers, medics and physicians and other first responders is not necessary in order to provide the best training to prepare these folks to go into war zones and prepare them for trauma they'll see,” said Dr. John J. Pippin, a Dallas cardiologist with Physicians Committee for Responsible Medicine, a nonprofit health organization.

Such critics argue that high-tech human simulators can provide similar training for combat. For medics, corpsmen and military physicians, Pippin said, training should focus on working in civilian trauma centers.

Most civilian medical schools in the United States have stopped using animals, Pippin said.

“We feel that if there ever was a role for (live-tissue training) – and perhaps there was before these other methods were available – we feel that time has certainly passed,” he said.

Earlier this year, People for the Ethical Treatment of Animals sent a letter to the Obama administration asking it to ban the practice. Also, 15 members of Congress, including Rep. Bob Filner, D-San Diego, signed a letter sent last month to the U.S. Army surgeon general and the secretary of the Army voicing their disapproval.

But Navy doctors who were trained this week using both simulators and live pigs said that while the simulator was good, it wasn't the same as a living subject.

“One thing is you have to actually keep the patient alive. It's a very artificial feeling otherwise,” Lt. Matt Andres said.

Kristina Davis: (619) 542-4591; kristina.davis@uniontrib.com

Kristina Davis: (619) 542-4591;





Find this article at:
http://www3.signonsandiego.com...county&zIndex=146179
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Kaju Dog
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« Reply #64 on: August 08, 2009, 03:51:52 PM »

So the PIG's out of the bag...   

I have had this training OEMS "Operational Emergency Training Skills" and it was by far the BEST TRAINING I have ever received as a Navy Corpsman.  Without this course, I can honestly say that some of America's Sons would not be alive today.

The old saying was, "The First Rule of Pig Lab - Don't talk about Pig Lab".

If they shut down this training, Lives will be lost.  GAURANTEED

 angry

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« Reply #65 on: August 08, 2009, 04:21:08 PM »

I was taking a rifle class several months back, during the breaks we were showing each other our blowout kits. A couple of the gents who let drop they were in class to get tune ups before proceeding overseas had some very interesting things to say about dealing with gunshot wounds, but kept pulling up short when quizzed about where they obtained their training. I surmise now they went through something like what's described above.
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« Reply #66 on: August 09, 2009, 12:03:54 AM »

Kaju:

We have been in conversations with someone about providing blow out kits for us to offer here and today we forwarded to you what they sent to us for your evaluation.  Please let me know when it arrives.

TAC,
CD
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« Reply #67 on: August 09, 2009, 12:11:23 PM »

Kaju:

We have been in conversations with someone about providing blow out kits for us to offer here and today we forwarded to you what they sent to us for your evaluation.  Please let me know when it arrives.

TAC,
CD

 cool  Will do Sir.

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« Reply #68 on: August 10, 2009, 09:38:23 PM »

Crafty,

I received the package today.  I will email you my report in a couple days. 

I have visited the web site and looked over the inventory lists.

Q:  Is it ok for me to open a couple items to get a closer look?  Everything is still in its packaging for now.

Respectfully,
Dean KD "Doc"
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« Reply #69 on: August 11, 2009, 03:51:37 PM »

PLEASE do whatever you want to evaluate the kits AND make whatever suggestions that occur to you.  These kits will be bearing our logo and you are our resident "go to" man for all of this.
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« Reply #70 on: August 16, 2009, 11:38:00 AM »

Woof,

Guro Crafty... You've got mail.   smiley

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« Reply #71 on: August 18, 2009, 12:34:23 PM »

Guro Crafty,

Just curious if you received my email?  I can resend it if you need me to.  Plus, I will be shipping the package back to you soon.   wink
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« Reply #72 on: August 18, 2009, 03:34:20 PM »

Yes, I did; I've just been waiting for a convenient moment to call.

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« Reply #73 on: August 18, 2009, 03:34:56 PM »

 cool
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« Reply #74 on: September 02, 2009, 10:20:50 AM »


http://www.youtube.com/watch?v=TjBW7oHVTgU
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« Reply #75 on: September 10, 2009, 09:14:33 PM »

WOOF,

Crafty - "You've got mail"
 wink
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G M
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« Reply #76 on: September 13, 2009, 04:06:02 PM »

Course outline: http://www.thebackup.com/pdfs/classes/TLS.pdf

http://www.thebackup.com/Tactical-Lifesaver-P52.aspx

The primary goal of the Tactical Lifesaver course is to improve the survivability of accidental and non-accidental life-threatening injuries encountered by law enforcement and corrections officers, with a secondary goal of decreasing liability for the officer's department. The course is not designed to turn officers into medics, but rather teach the time-critical skills that may permit survival long enough for victims to obtain definitive medical care.
___________________________________________________________________________________________

I recently completed the above "digital based" class. For me, it was worth the 50.00 and time invested. If you are an EMT, Paragod or TEMS, this would probably be a waste of time and money.

If you aren't someone with advanced medical training, then this is something I'd recommend to go along with your basic First Aid/CPR training, no matter if you are a LEO or armed citizen.
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Tony Torre
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« Reply #77 on: October 30, 2009, 03:38:21 PM »

Here's a cool article.

http://www.raems.com/altwound.html

Tony Torre
Miami Arnis Group
www.miamiarnisgroup.com
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« Reply #78 on: November 08, 2009, 03:33:49 PM »

Any lessons from the jihadi attack on Fort Hood?
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« Reply #79 on: November 08, 2009, 04:07:04 PM »

1. Shoot the haji into the ground ASAP.

2. Combat lifesaver "Platinum 5 minutes" can mean the difference between life and death.
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« Reply #80 on: November 08, 2009, 04:14:43 PM »

Here in Fayetteville  wink the local newspaper reported an account of one soldier who bravely assisted a wounded buddy in getting out and THEN WENT BACK IN TO SEE WHO ELSE HE COULD HELP ESCAPE.  Apparently he literally ran into the Jihadi's back  shocked shocked shocked and went skittering back out in a hail of bullets!!!    For his ability to act and think of his comrades in arms welfare at the risk of his own, the man is a hero.  To bad he didn't have a knife and some basic sentry neutralization training.

However, I was think more of the subject matter of the thread -- care to remind us about the Platinum 5 Minutes?
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G M
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« Reply #81 on: November 08, 2009, 04:45:57 PM »

There is the "golden hour" of getting emergency medical treatment for trauma victims. Those who get treated in that hour have much improved odds of survival. The "platinum 5 minutes" is that initial response in the first 5 minutes of trauma that can be that factor that allows someone to survive into the golden hour.

One need not be a EMT or Paramedic to do what is needed in the first 5. Stopping/controlling blood loss can, and should be done by anyone.

Bottom line, it's about keeping the blood inside so it continues to supply oxygen to the organs/tissues of the victim until EMS arrives.

IMHO, everyone should have this and the concept of triage drilled into them.
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Kaju Dog
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« Reply #82 on: November 08, 2009, 10:48:21 PM »

I've been out and about today and just caugh wind of Guro Crafty's post.  I dont have time right now but look forward to reading your posts and following up with my .2C's soon for what it's worth.  Good replies by all so far, lets dig into this a bit deaper. 

Until tomorrow,
Goodnight
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« Reply #83 on: November 09, 2009, 05:00:13 PM »

Subject: Fort Hood Account from JAG officer onsite

What happened.

Since I don't know when I'll sleep (it's 4 am now) I'll write what happened (the abbreviated version. the long one is already part of the investigation with more to come. I'll not write about any part of the investigation that I've learned about since inevitably my JAG brothers and sisters are deeply involved in the investigation).

Don't assume that most of the current media accounts are very accurate. They're not. They'll improve with time. Only those of us who were there really know what went down. But as they collate our statements they'll get it right.

I did my SRP last week (Soldier Readiness Processing) but you're supposed to come back a week later to have them look at the smallpox vaccination site (it's this big itchy growth on your shoulder). I am probably alive because I pulled a ---------- and entered the wrong building first (the main SRP building).

The Medical SRP building is off to the side. Realizing my mistake I left the main building and walked down the sidewalk to the medical SRP building. As I'm walking up to it the gunshots start. Slow and methodical. But continuous.

Two ambulatory wounded came out. Then two soldiers dragging a third who was covered in blood. Hearing the shots but not seeing the shooter, along with a couple other soldiers I stood in the street and yelled at everyone who came running that it was clear but to "RUN!" I kept motioning people fast.

About 6-10 minutes later (the shooting continuous), two cops ran up. one male, one female. we pointed in the direction of the shots. they headed that way (the medical SRP building was about 50 meters away). then a lot more gunfire. A couple minutes later a balding man in ACU's came around the building carrying a pistol and holding it tactically.

He started shooting at us and we all dived back to the cars behind us. I don't think he hit the couple other guys who were there. I did see the bullet holes later in the cars. First I went behind a tire and
then looked under the body of the car. I've been trained how to respond to gunfire...but with my own weapon. To have no weapon I don't know how to explain what that felt like. I hadn't run away and stayed because I had thought about the consequences or anything like that. I wasn't thinking anything through.

Please understand, there was no intention. I was just staying there because I didn't think about running. It never occur red to me that he might shoot me. Until he started shooting in my direction and I realized I was unarmed.

Then the female cop comes around the corner. He shoots her. (according to the news account she got a round into him. I believe it, I just didn't see it. he didn't go down.) She goes down. He starts reloading. He's fiddling with his mags. Weirdly he hasn't dropped the one that was in his weapon. He's holding the fresh one and the old one (you do that on the range when time is not of the essence but in combat you would just let the old mag go).

I see the male cop around the left corner of the building. (I'm about 15-20 meters from the shooter.) I yell at the cop, "He's reloading, he's reloading. Shoot him! Shoot him!) You have to understand, everything was quiet at this point. The cop appears to hear me and comes around the corner and shoots the shooter. He goes down. The cop kicks his weapon further away. I sprint up to the downed female cop. Another captain (I think he was with me behind the cars) comes up as well. She's bleeding profusely out of her thigh. We take our belts off and tourniquet her just like we've been trained (I hope we did it right...we didn't have any CLS (combat lifesaver) bags with their awesome tourniquets on us, so we worked with what we had).

(Hmmm, , , not quite like initial reports , , ,)

Meanwhile, in the most bizarre moment of the day, a photographer was standing over us taking pictures. I suppose I'll be seeing those tomorrow. Then a soldier came up and identified himself as a medic.
I then realized her weapon was lying there unsecured (and on "fire"). I stood over it and when I saw a cop yelled for him to come over and secure her weapon (I would have done so but I was worried someone would mistake me for a bad guy).

I then went over to the shooter. He was unconscious. A Lt Colonel was there and had secured his primary weapon for the time being. He also had a revolver. I couldn't believe he was one of ours. I didn't want to believe it. Then I saw his name and rank and realized this wasn't just some specialist with mental issues. At this point there was a guy there from CID and I asked him if he knew he was the shooter and had him secured. He said he did.

I then went over the slaughter house. - the medical SRP building. No human should ever have to see what that looked like. and I won't tell you. Just believe me. Please. There was nothing to be done there.

Someone then said there was someone critically wounded around the corner. I ran around (while seeing this floor to ceiling window that someone had jumped through movie style) and saw a large African-American soldier lying on his back with two or three soldiers attending.

I ran up and identified two entrance wounds on the right side of his stomach, one exit wound on the left side and one head wound. He was not bleeding externally from the stomach wounds (though almost certainly internally) but was bleeding from the head wound. A soldier was using a shirt to try and stop the head bleeding. He was conscious so I began talking to him to keep him so. He was 42, from North Carolina, he was named something Jr., his son was named something III and he had a daughter as well. His children lived with him. He was divorced. I told him the blubber on his stomach saved his life. He smiled.

A young soldier in civvies showed up and identified himself as a combat medic. We debated whether to put him on the back of a pickup truck. A doctor (well, an audiologist) showed up and said you can't move him, he has a head wound. we finally sat tight.

I went back to the slaughterhouse. they weren't letting anyone in there. Not even medics. finally, after about 45 minutes had elapsed some cop showed up in tactical vests. someone said the TBI building was unsecured. They headed into there. All of a sudden a couple more shots were fired.

People shouted there was a second shooter. a half hour later the SWAT showed up. There was no second shooter. That had been an impetuous cop apparently. but that confused things for a while.

Meanwhile I went back to the shooter. the female cop had been taken away. a medic was pumping plasma into the shooter. I'm not proud of this but I went up to her and said "this is the shooter, is there anyone else who needs attention...do them first". She indicated everyone else living was attended to. I still hadn't seen any EMTs or ambulances.

I had so much blood on me that people kept asking me if I was ok. But that was all other people's blood. eventually (an hour and a half to two hours after the shootings) they started landing choppers. they took out the big Africa American guy and the shooter. I guess the ambulatory wounded were all at the SRP building. Everyone else in my area was dead.

I suppose the emergency responders were told there were multiple shooters. I heard that was the delay with the choppers (they were all civilian helicopters). they needed a secure LZ. but other than the initial cops who did everything right, I didnt' see a lot of them for a while.

I did see many a soldier rush out to help their fellows/sisters. there was one female soldier, I dont' know her name or rank but I would recognize her anywhere, who was everywhere helping people. a couple people, mainly civilians, were hysterical, but only a couple. one civilian freaked out when I tried to comfort her when she saw my uniform. I guess she had seen the shooter up close.

A lot of soldiers were rushing out to help even when we thought there was another gunman out there. this Army is not broken no matter what the pundits say. Not the Army I saw.

Then they kept me for a long time to come. oh, and perhaps the most surreal thing, at 1500 (the end of the workday on Thursdays) when the bugle sounded we all came to attention and saluted the flag. In the middle of it all.

This is what I saw. it can't have been real. But this is my small corner of what happened.
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« Reply #84 on: November 30, 2009, 10:41:48 AM »

 Immersion Hypothermia Skills that can save a life

--------------------------------------------------------------------------------
Hypothermia and Immersion Hypothermia are both killers. Most cases of hypothermia happen in the outdoors in 50 degree F weather and are preventable- dress properly (no cotton!), stay hydrated, and do something about it when you get wet or begin losing dexterity such as build a fire & shelter, get back to the vehicle, or into the sleeping bag. A good hypothermia recipe is to have a cup of hot chocolate with a tablespoon of butter and I always carry this solution in a thermos when on the winter trail.

Keep in mind that the statistics bear out that the classic "survivor" lost in the wilds each year is injured and hypothermic.

Immersion Hypothermia is a real killer and you only have a limited amount of time on your hands. The best info comes from this U of Toronto Professor who has studied it the most and is on YouTube. Pass this vid around to those who spend time playing ice hockey, ice-fishing, or traveling the wilds in winter. It can be a lifesaver to know- http://www.youtube.com/watch?v=ysnKtuUTt8k

Another test I do with my students on winter survival courses is to have them place their hands (minus gloves) in the snow for a count of 60 seconds. After this, they must get a fire going using their matches, lighter, or spark rod. With a loss of dexterity, the spark-rod wins out as it involves gross-motor movement compared to the lighter and matches. Try this test of your gear in the backyard next snowfall and see how the gear holds up when the hands are numb.

Cottonballs smeared with vaseline and used for tinder is the other half of the picture in successfully starting a fire when the forest is buried in snow and your hands are numb.

Tony
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« Reply #85 on: November 30, 2009, 10:11:27 PM »

That is an excellent post for those of us up north. Thanks!
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« Reply #86 on: December 01, 2009, 05:07:31 AM »

The "less cold" temperatures can cause Hypothermia too.  The 600 range down into the 50's allow the slow loss of heat.  Uncomfortably Cool weather is when we started having the hypothermia show up when I was in the service.  Ignoring discomforts can allow some things to sneak up on you.
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« Reply #87 on: March 12, 2010, 01:48:27 PM »


http://www.youtube.com/watch?v=E5huVSebZpM
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« Reply #88 on: March 12, 2010, 09:34:56 PM »


WOW!  "Dont check for a pulse" @1:22  Huh  WTFO! 

PLEASE CHECK FOR  A PULSE BOTH AT THE NECK AND THE WRIST.

I  cannot remember if I covered this in the DLO3 or not.   FFT?
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« Reply #89 on: March 12, 2010, 09:45:20 PM »

That caught my curiousity, but I figured "It's the Mayo Clinic , , ," 

Kaju, are you saying something bad would happen if this technique were administered in the presence of a pulse?
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Rarick
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« Reply #90 on: March 13, 2010, 05:24:02 AM »

Immersion Hypothermia Skills that can save a life

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Hypothermia and Immersion Hypothermia are both killers. Most cases of hypothermia happen in the outdoors in 50 degree F weather and are preventable- dress properly (no cotton!), stay hydrated, and do something about it when you get wet or begin losing dexterity such as build a fire & shelter, get back to the vehicle, or into the sleeping bag. A good hypothermia recipe is to have a cup of hot chocolate with a tablespoon of butter and I always carry this solution in a thermos when on the winter trail.

Keep in mind that the statistics bear out that the classic "survivor" lost in the wilds each year is injured and hypothermic.

Immersion Hypothermia is a real killer and you only have a limited amount of time on your hands. The best info comes from this U of Toronto Professor who has studied it the most and is on YouTube. Pass this vid around to those who spend time playing ice hockey, ice-fishing, or traveling the wilds in winter. It can be a lifesaver to know- http://www.youtube.com/watch?v=ysnKtuUTt8k

Another test I do with my students on winter survival courses is to have them place their hands (minus gloves) in the snow for a count of 60 seconds. After this, they must get a fire going using their matches, lighter, or spark rod. With a loss of dexterity, the spark-rod wins out as it involves gross-motor movement compared to the lighter and matches. Try this test of your gear in the backyard next snowfall and see how the gear holds up when the hands are numb.

Cottonballs smeared with vaseline and used for tinder is the other half of the picture in successfully starting a fire when the forest is buried in snow and your hands are numb.

Tony
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Tony Nester
Ancient Pathways Survival School
http://www.apathways.com

When I was in the service the "creeping cold" was the usual case of hypothermia.  Temperatures between 60 and 50 degrees where the cold kind of crept in while people were occupied with other things. Same thing with heat casualties at the 80-90 degree marks (hot but not too hot or cold but not too cold).  We constantly were looking for guys "blowing their hands to keep warm" that did not have sweatshirts or sweaters on- if your hands are that cold and you do not have an extra layer...........  One of the other things- when we were doing things that precluded an extra layer like running and it was "middle cold" was wear a watch cap/beannie.   "when your hands/feet are cold, put on a cap" was a saying I learned long before the service, and it works.
« Last Edit: March 13, 2010, 06:46:01 AM by Rarick » Logged
Crafty_Dog
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« Reply #91 on: April 07, 2010, 04:36:13 PM »



This is an unbelievable story. The video  is incredible. This  story is about  PVT Channing  Moss, who  was impaled by a live RPG during a Taliban  ambush  while on patrol.  Army protocol says that  medevac  choppers are never to carry anyone with a  live round in   him.  Even though they feared it could explode,  the  flight crew ignored the protocol and flew him to the  nearest aid  station. Again, protocol said that in  such a  case the patient is to be put in  sandbagged area  away from the  surgical unit, given a shot of  morphine and left  to wait  (and die) until others are treated. Again,  the medical  team ignored the protocol. Here's a   seven-minute video put together by the Military Times,  which  includes actual footage of the surgery,  where Dr. John  Oh, a  Korean immigrant who became a naturalized citizen  and went  to West Point,  removed the live round with the help  of  volunteers and a member of the EOD (explosive  ordinance disposal)  team.
 
 
Click  link  below:
 
 
http://www.militarytimes.com/multimedia/video/rpg_surgery/
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maija
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« Reply #92 on: April 07, 2010, 06:45:10 PM »

Wow  shocked cool
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It will seem difficult at first, but everything is difficult at first.
Miyamoto Musashi.
Rarick
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« Reply #93 on: April 09, 2010, 08:33:03 AM »

Question:

Los Angeles is a city likely to go into heavy gridlock in the event of Islamofascist attack.  If the attack is a dirty bomb, what are the realistic options for the citizen at home or caught in the mother of all gridlock on some LA freeway.  Picture a woman with children in a van.  What is she to do?  I've heard iodine potassium (IIRC) tablets protect the thyroid gland.  Is there some sort of mask that lessens inhalation of nasties into lungs?  Will a child wear these?  What else?

TIA,
CD

A dirty radiological bomb is about dust, get a dust mask that filters out the smallest particles.  Gas masks are good filters, the cartridges have chemicals to neutralize chemicals, but the filter properties is what you are looking for in a dirty bomb setup.  Paint respirators would work too- even with the paint cartridges.
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Crafty_Dog
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« Reply #94 on: April 09, 2010, 08:42:52 AM »

Thank you, good tips.
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Rarick
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« Reply #95 on: April 10, 2010, 04:32:20 AM »

It is just something I see a lot of, buying the medical masks at pricex3, when it does the same job as a box of a dozen (b85?) masks at the same price.   also using a Clevis to link and hold a couple of chains together when a couple of regular "A" class hardware bolts throught the links with doubled washers will do the same thing at a lot less cost.

I remember decontamination spray kits we had in the service that had the same exact manufacturer and inner workings as a flower mister we found down the road at the home and garden/ nursery (this was just as Reagan was starting to update things).  Yes it was commercial and heavy duty, but the service was paying triple the price, all that for some green paint and plain boxes........  (yet another reason why a lot of "off the civilian shelf" style procurement has started happening)
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bluesbassist
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« Reply #96 on: April 19, 2010, 01:48:55 AM »

Hi all. Great thread! I just finished EMT school and passed the NREMT-Basic exam. Looking forward to getting out there and learning how to actually "do the job."
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G M
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« Reply #97 on: April 19, 2010, 03:14:24 AM »

Hi all. Great thread! I just finished EMT school and passed the NREMT-Basic exam. Looking forward to getting out there and learning how to actually "do the job."

Good for you for stepping up to do this job. It's a sacred thing to run towards what others run from to save lives.
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Crafty_Dog
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« Reply #98 on: April 19, 2010, 06:22:21 PM »

Amen.
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Crafty_Dog
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« Reply #99 on: September 28, 2010, 03:57:23 PM »

http://www.foxnews.com/scitech/2010/09/23/emergency-remove-bra/?test=latestnews
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