It’s all Frank’s fault. Yes, it’s Frank’s fault that I am sitting against a mail box with a simulated gunshot wound.
When I attended a Defense Training International rifle class, Frank Sharpe of Fortress Defense Consultants introduced me to the well thought out Israeli Battle Dressing, which got me to start thinking about being prepared to provide trauma care. Being a firearms instructor, this just seemed prudent, in case one of my students got injured.
Recently, in the wake of the Westgate mall shooting in Nairobi, the U.S. Navy shooting in Washington DC, the Boston Marathon bombing, as well as other active shooter scenarios, Frank made several online posts that made a serious point: in this type of situation the police will cordon off the area and not let anyone enter until it is safe to do so. This includes health care first responders like EMTs.
There will be no one coming to treat you or any of the other victims’ injuries until the situation is contained. That could be 45 minutes, an hour, or more. How long can you survive while you are bleeding heavily?
Beyond active shooter events, there are other situations where medical care could be delayed. Medical personnel talk about the ‘golden hour’. If an injured person can make it to the hospital within an hour of their injury, they have a very good chance to survive. The survival rate drops rapidly after that first hour.
In an active shooter situation, it could very well be that your golden hour gets used up while the police search the area and make sure there are no more threats. Add to this the confusion of multiple injuries, limited first responders and ambulances, and just how long will it be from the time of your initial injury to when you first receive care? How long before you get to the hospital?
Given that there are a number of situations where medical care is delayed, you should prepare to take care of yourself, your loved ones, and other people around you. If you are reading this article, there is a very good chance you are a gun owner and likely also have a permit to carry a concealed weapon. Good! You are already taking proactive steps to ensure your safety and security. I believe those proactive steps should also consist of being able to provide trauma care. This might be self aid, or aid for others.
What am I talking about when I say ‘trauma care’? I’m considering serious, potentially life threatening injuries, that if not treated quickly could result in death or crippling injury. A gunshot wound, an injury from an explosion such as the Boston Marathon, or trauma sustained in an accident.
What should you do to prepare to provide trauma care? First, as with all things, knowledge is more important than equipment. Get some training. I’m certain that there is Red Cross certified training available in your area. Take it. Beyond the basic first aid and CPR, I strongly recommend their ‘Wilderness First Aid’ class.
While the Red Cross is a good starting point, you can certainly take your training further. A number of organizations offer varying levels of trauma care specific to dangerous environments. As with all training, this can run from short one day classes that combine shooting with trauma care, to multi-day classes that go well beyond the basics.
The second part of the trauma care equation is equipment. There are several pieces of gear that are important to have on you as you are out and about. The three most important items are a tourniquet, a clotting agent, and an Israeli Battle Dressing (IBD). Those 3 things will enable to you to control severe bleeding, giving the patient the time they need to get to higher level care.
Tourniquets are credited with saving more lives in our overseas wars than any other piece of first aid equipment. A serious wound to an arm or leg can result in death in just a matter of minutes. The immediate application of a tourniquet can extend that time to hours. A good tourniquet is compact, easy to carry and apply.
To prevent additional injury, the band on a tourniquet should be at least 1.5” wide; this will reduce the potential for damaging tissue. My two favorites are the CAT (Combat Application Tourniquet) and the SOF-T W.
Clotting agents are products that are put directly on wounds to rapidly stop bleeding. QuikClot is probably the best known but Celox is also popular. Clotting agents come in several configurations mainly, loose granules and gauze impregnated with the clotting agent.
A bandage will be required to cover the wound, keeping dirt out and the clotting agent in. Some bandages have the ability to provide direct pressure to the wound. The best of the bunch is the Israeli Battle Dressing (IBD or Izzy for short). They come in 4” and 6” versions, and consist of a sterile pad, an elastic bandage, a pressure bar and a closure bar. The closure bar can also be used as a windless to turn the IBD into a tourniquet if needed.
For any number of reasons you might be presented with a serious, life threatening injury to yourself or others. Medical care may not be immediately available and if left untreated the injury could result in death in a matter of minutes. Being able to provide trauma care is fairly easy to learn, and the equipment you need is easy to carry with you all the time.
Train up, gear up, and remember, chance favors the prepared!
Disciplina Renumenor Fidelis
Peter Burlingame is a nationally recognized instructor in the dynamic use of firearms. In addition to running his own school, The Self Defense Initiative, based on St Thomas, in the Virgin Islands, he also volunteers his services providing instructor development classes for the International Association of Firearms Instructors and the International Law Enforcement Educators and Trainers Association. You may contact him at via email.