Fact #1- If you’re planning on taking up arms, plan on getting hurt.
Fact #2- Statistically speaking, 10% of those injured will die from injuries sustained. Nothing you will do can change this. These casualties will be dead usually from first contact.
Fact #3- Of the 90% who don’t die, without a tiered response plan by trained and seasoned pros, many of them will die also.
Fact #4- In this era of government sponsored public endangerment, most public places are now an asymmetric battlefield.
Now that may not fit into your 3%er Rambo paradigm, but its the truth. So if you haven’t been a) networking, b) networking with the right people and c) training, you might just want to get on that. We are going to deal with how to stock a realistic personal kit that will actually save lives and won’t kill you or your patient in the process of using it. Simplicity is the watchword here.
Not long after I got out of the Army I was contacted by a local milita-type, who was a little too eager to show off his field kit seeking approval. What he called an ‘IFAK’ was stuffed to the gills with all sorts of crap that couldn’t be accessed when needed and was otherwise generally erroneous even if he could. This individual had no other training aside from a long out-of-date CPR course, which is to say, none at all. I tell you this story to illustrate a painful reality for many; not only is there little to no concept of what defines individual trauma response, but there’s even less of a concept of how to implement a basic treatment plan. From here we will address what goes in a real Individual First Aid Kit (IFAK), how you implement it into your kit, and guidelines for use.
Keep It Simple, Stupid
The IFAK is not for treating others. It’s for others treating you. It is not for treating minor booboos and earaches, it’s for trauma that follows a strict definition based on the MARCH acronym, which we’ll talk about in a bit. The contents of the IFAK must be standardized across the board. We do this so that we know what’s in them, what each of those components do, and so that the next echelon of care can get a visual idea of the wounds by what items have been used. The IFAK is an immediate response to trauma in order to increase wound survival, hence it is very simply constructed and organized. This simplicity, like all things, is key to effectiveness under duress.
MARCH is the acronym to follow for treating trauma in order to save lives. CLS, or the Combat Lifesaver Course the Army teaches everyone in the Infantry (and probably everyone else too) is very outdated, or at least was according to the last doctrine I saw before I got out. The medics emphasized Responsiveness, Breathing, Bleeding, Fractures, Bruising/Contusions (as a sign of internal injury), and Head trauma, followed by treating for shock (which was very vaguely defined). The problem is that following that paradigm first takes too long and second is not placed in the order of what will kill you the fastest. MARCH is more logical and is as follows:
- Massive Bleeding: While you won’t bleed out quite as fast as what’s commonly thought Arterial wounds, while they do gush for the first bit, are marked by very bright red blood will clot faster and re-route themselves. I’ve actually seen arterial blood clot to itself on asphalt in a street. Venal wounds which are dark blood take much longer to clot but bleed slower. Despite this, blood loss is the fastest killer, especially when dealing with blast injuries. The primary item that belongs in your IFAK is a tourniquet. You should have one in the kit and two more on your your person. There are two types of tourniquets you should consider. I know there’s a bunch of other ones that I’m sure work just dandy, but these two I’ve used and it saved the respective lives of those casualties. Don’t ask me about the other tourniquets.
The first tourniquet is the Combat Application Tourniquet, or CAT for short. It’s a long strap of velcro with a plastic windlass for tension. Because it’s plastic, it works just fine for arms but I don’t trust it on legs. Muscles sometimes spasm uncontrollably from blood loss or shock, and plastic doesn’t give me a warm and fuzzy. That being said, the CAT is the fastest and simplest for self-aid, AKA putting it on yourself, so it’s likely the first one to be used.
The second design is the Special Operations Forces-Tourniquet, AKA SOF-T. It’s a little more complicated, being a thick strap of nylon with a screw down strap tension and metal windlass. This is the one you use on legs(ideally) because once it goes on it will not come off by accident. A note on using tourniquets- they do NOT go, as erroneously taught in Army CLS, two fingers above or below joints. They are placed on single bone structures as close to the top of the limb as possible (to use the single bone as a compression point) to immediately stop any bleeding. Conventional wisdom used to teach that everything below the tourniquet would get amputated, and this is 100% false. Arteries love to roll and move, and slip in between double bone structures of lower limbs.The higher you go, the better the tourniquet works, meaning as close as possible to armpits and crotches. Roger?
The second item to go in your kit also addresses bleeding. The Compression Bandage,seen above, sometimes also known as an Israeli Bandage, is the most versatile bandage on the market and allows for a high level of compression second only to a tourniquet. In addition to stopping the bleeding, it also covers wounds, can be used as a stabilizer for fractures, and be made into a sling if need be. These three items alone, if you have nothing else, are a huge step to saving lives.
- Airway: The second fastest killer is blocked airways, common in blast injuries and other facial trauma. There’s two steps to address this- lifting the chin of a casualty in the supine position (on their back) while clearing the lower airway (throat). Next you’ll insert a nasopharyngeal airway, or NPA for short. It’s a small green or blue rubber tube that goes up the nasal cavity and and into the throat, creating a clear artificial airway from an otherwise damaged path. (Yes, it sucks. BAD. Every CLS trained Infantryman knows, because they all had to do it. If you’re prone to fighting, like I am, and have a deviated septum from a broken nose they suck that much worse. They universally suck so bad, that I had a SGM that loved to give them to soldiers who fell out of formation runs and ceremonies. He kept it in his pocket and made that soldier’s NCO put it him in as a sweet reminder to not do that again.) This being said, an NPA needs to be in your kit. It WILL save a life.
With these two areas addressed we’ve increased the odds of a casualty surviving many times over. Even if you forget the rest, a casualty stands a good chance of survival with the appropriate follow-on care. An additional note on hemostatic agents (such as Celox and Quik-Clot) because I know someone is going to ask- I don’t recommend using them unless you’ve been trained on their use by a professional. I have, and I don’t tell you carry them individually without training. Do they work? Yes, and quite well. But there’s a caveat. First, the untrained go for them primarily whenever they see blood. Wrong. That should be the tourniquet. Second, Celox is made of shrimp shell, so if your casualty is allergic to shellfish, guess what- you just killed him. Third, and this has to do more with Celox than the others (when used improperly) it can break off and cause an internal blood clot killing your patient sometime down the road. It is only used as a LAST RESORT in places a tourniquet cannot otherwise go, such as groins or necks. Last, higher echelon care now must take it off, causing more problems. So in short, use the tourniquet. Its simple. It will do what it’s supposed to, and let those with more training take it from there.
- Respiration: This is where CPR comes in. Get them breathing.
- Circulation: We’re looking for swollen limbs, which indicate internal trauma. You’ll want the follow on medical aid to know about this, but there’s little you can do as a primary responder.
- Head Trauma (H1): For head trauma, like circulation, you’ll want to make a note of it, then cover any open wounds to the head to prevent possible encephalitis. Further, upon recognition of head injuries, prevent the casualty from moving around. I’ve been that guy (catastrophic IED, I was in the turret nearly completely exposed) as well as treated that guy and he’s gonna say and do some strange things. Keep them as calm as possible if they’re awake.
- Hypothermia (H2): The injured get cold FAST. It’s something we don’t think about, but open trauma causes the body to lose heat at an expedited rate which will kill an otherwise stable casualty very quick. The easiest way to address this is with a simple space blanket, available pretty much anywhere that has a sporting goods section.
So as a recap, our new acronym for treating casualties is MARCH- Massive bleeding, Airway, Respiration, Circulation, and Head Trauma/Hypothermia.
But wait- you didn’t talk about abdominal injuries- gunshots, sucking chest wounds, etc? No, I didn’t. The reason why is that there’s not that much without extensive training you can do for this type of injury. You can pack it with gauze (or a tampon) to keep it from getting worse, but the best thing to do is close it with a safety pin. You should not consider a needle decompression for a sucking chest wound if you have little medical training either. Doing so incorrectly or overestimating your skill can cause many more problems than it solves, possibly killing your casualty. Understand? Extremity wounds are the ones you can treat the easiest and also kill the fastest if untreated. So focus on what you can do (unless you’re trained in advanced medicine by an accredited institution) and leave the rest to people who know what they’re doing. I also didn’t reference pushing fluids- that’s left to those with training for not only administering fluids but for monitoring the patient for shock possibly induced by those fluids.
Your IFAK is built along this paradigm, stocked with a CAT and SOF-T Tourniquet, a Compression Bandage, a NPA, medical tape (to better secure the tourniquet and NPA- make sure it’s 3M and not the cheap crap), space blanket and a safety pin. It’s not expensive, the equipment is available on Amazon and should be on the hip (or accessible in a standard place) of every person on your patrol. Ideally it should be on your belt and not your kit (because your kit might come off of you, your IFAK is Line 1) and in the same position on each person, so they can each be accessed without searching for it.
Since apparently everywhere is a potential battlefield in this era of government sponsored public endangerment, these basic techniques will be likely be needed in the near future. Act accordingly.
63 thoughts on “Contact Medicine”
Reblogged this on The Defensive Training Group and commented:
Wisdom…real world. And it’s free. Take advantage!!
Reblogged this on Thoughtfully Prepping and commented:
Simple knowledge well presented.
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Reblogged this on Starvin Larry.
I believe this is the best post I’ve ever seen regarding the IFAK and basic trauma treatment.
Too many guys want to use quick clot for what are in reality minor wounds.
I’m far from an expert-but my sister is an RN and worked a level I trauma center E.R. in Cleveland Ohio for 9 years.
That’s who I go over first aid/trauma care with at least twice a year.
Bonus is nurses always have pockets full of useful stuff- and after a hard shift they forget it’s in their pockets and bring it home. Keeps me in stuff like 4×4 gauze,Dermabond,sutures,medical tape,saline flush syringes-(great for wound irrigation)-ABD pads,chloroprep wipes,betadine wipes,individual packets of bacitracin and neosporin,steri-strips,Xeroform,Kurlix gauze rolls…
That’s what I can remember at the moment-over the years I got tons of supplies like that.
My sister and one of her fellow trauma nurses are our “medics” during any emergency situation.
That’s quite a compliment Brother, and believe me, it’s deeply appreciated.
Having an RN in the family is a HUGE blessing. I’m fortunate enough to have several, including an MD who’s a wife of a close friend. I was blessed myself with having the opportunity to attend some very advanced trauma medicine courses while I was in, which paid huge dividends even today.
I *might* be giving a quick rundown on this, this weekend, somewhere. I posted it for the folks who will be in attendance, but also in a sort-of response to a couple other recent ‘medical’ posts that amounted to ‘hey, buy stuff!’ vs. ‘hey, average Joe, this is reality.’ I’ve even met a few ‘preppers’ who are very dangerously under the impression they can perform serious medical procedures and buy the kit for it (skipping the training, of course). Its far easier to make friends with some medically experienced folks.
Since we have hit a boiling point which seems to be getting worse with a non-response from the government, it’s time folks lose the fantasy and start getting grounded.
Looking forward to this weekend. I’ll be the guy setting up a mobile phone system.
Reblogged this on The Tactical Hermit and commented:
Outstanding Info Here. Read x3, then send to 5 friends to read.
Was attending a winter combat course at Max’s, there was a Doctor there who is the fellow who redefined the casualty trauma care under fire standards. It was snowing all weekend, temps in the high twenties. Doc is a really gracious and kind dude. Volunteered to give us all a down and dirty afternoon course on the things we would have to know to tend to ourselves under fire. Extremity wounds, chest injuries, how to get a collapsed lung re-inflated, what type of and how to occlusive dressings for each situation, staunching exanguation for deep body wounds, great stuff. Expedient methods and materials and how to use them. And it Was down and dirty. I was amazed how basic the techniques have been condensed to the prime essentials of saving your life. And the one really neat thing I had not an inkling of prior, is most of it is designed so you as the wounded do, and must tend, to your wounds yourself, because if somebody is helping you it’s one less fighter fighting and shooting. The idea is for everyone to survive, so put that tourniquet on and get back in the fight if possible. Which in small infantry citizen combat, makes lots of sense. You don’t have medivac, no mash unit or front line aid station, probably not even a real trained medic. And not much in the way of replacements either.
Doc used me as the tourniquet dummy, I pulled out my CAT and the Doc proceeded to demonstrate on my upper thigh, right up to my groin far up as it would fit, he cranked down on that puppy and the plastic windlass snapped clean off in the cold before it was all the way tight. Mmmm? A class mate had a SOFT-T. we used that worked sweet.
When I got home I ordered up the SOFT-T’s, and took each out of the package, wrapped a big old strip of knife sheath leather around my thigh, put on the SOFT-T and cranked those puppies down for all they where worth. All of them passed without any damage or problems. Did the same with the CAT’s I had, and another broke. Threw them in the trash tell you what.
You guys might have different results, I might have bought some from a defective lot or something. Might take my advice and give them a shakedown run before you got to use them for real.
Imagine your bleeding like a stuck pig behind cover, it hurts like nothing in your life, rounds are chewing up the ground above your ass, and you get your tourniquet out, everything is slippery with blood, hands shaking like a junky, and your scared shitless, and your tourniquet breaks. That’s not a bad day, that is a legendary bad day. If you live.
What was the Doc’s name that ‘re-defined’ TC3.
Actually, just give me his rank when he retired. Should be easy to remember, yes?
He’s a civillian Doctor far as I remember from talking with him, likes to run combat drills with a suppressed SOCOM M1-A1. We were really blessed Doc gave us that class in that environment. It was priceless to me.
Dr. James Berry if I remember right.
Not the same guy I know.
Jim just wrote a nice little booklet, he didn’t redefine anything. He’s an anesthesiologist. But I agree, Doug, it was a good overview and priceless when the CAT broke. I bought the Sof-t afterwards as well.
He wasn’t running suppressed, BTW. His BOOM was pretty noticeable 😉
This is a great overview about the nitty gritty people need to know. Sporty times approacheth.
The CAT shouldn’t be dismissed- it’s a hell of a lot faster to put on and simpler to put on single handedly or alone.
Just don’t put it on legs.
Been a few years since the course Doc Berry gave. Had to think for a spell to remember everything he talked about, but the one thing he and a group of people got together to do, which stood out in my mind as a common sense approach, was to streamline and standardize trauma treatment down to the bare essentials. He talked about that within the emergency first aid community there where a lot of ether outmoded or conflicting standards. Like order of priority of injuries, taking care severe hemorrhaging first no matter what else was going on, that they sought to eliminate the time rating for how long a tourniquet was to be kept tight, get away from the synthetic coagulants because of the thermobaric heat issues and wound deriding/cleanliness, advocating for use compression and cotton gauze plugs, Israeli combat dressings, I’m sure I’m not telling you anything here. But for a chivy like me, it was fantastic stuff. I don’t know of anybody other than John Mosby back then who was out in the actual field instructing on this stuff. John was pretty much teaching the same basics, but from a dirt crawling operator verses a doctor direction.
I know one thing for absolute, You got to know this stuff. There is no substitute. It’s your only way your gonna survive a survivable combat injury. Without it your dead meat. Guaranteed dirt nap without it.
And the people in this trauma community have put tremendous effort into making it simple, learnable and practical.
Doc gave us combat trauma care handbooks he and his team wrote, they are 3 pages long.
Lots of folks are. There’s a few wilderness medics I know that do as well.
I am this weekend for a group.
The aluminum windlass makes the SOFTT-W > the CAT. It also packs up a hell of a lot better.
Unless you’re rigging it in a upper arm pocket for quick-draw as we all did (and do) this is true.
The SOF-T is best used on legs and CAT on arms.
Good write up. I went through a few combat lifesavers courses and I am always interested in reading the different perspectives on the subject. Things have changed a lot even in the nearly ten years since I last attended one. A good book I came across awhile back that ties in perfectly with this post, and would be a sort of “further reading” is “Beating the Reaper”. (http://www.onesourcetactical.com/beatingthereapervol1-traumamedicinefortheccwoperator.aspx)
It’s a quick read with lot’s of pictures that helps train for situations just like the Boston bombing or any other random, violent, mass casualty event that you might come across, from a more tradecraft (as opposed to tactical) perspective. Definitely something to brush up on with the holiday shopping season coming up.
The guy that wrote that knows some of the same folks I do.
Sua Sponte’s a good dude.
Suarez, not so much.
I figured as much. Not to go off on a tangent, but he has written some other good stuff as well. His Guerilla Sniper II, that’s also put out at one source tactical, is another. Just the chapters on mission planning alone would be required reading if I had my druthers.
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Known (rescuedoc) Kieth that long???
Good, informative, important essay. One of the best.
get a hold of EMT/ Pre-hospital care text books. it is an on going read here in my house. I can tell you this, know and doing are two different things. know and doing it at 3am is a different thing. get your self involved in as volunteer fire fighter/EMT. Get out there and do it.
While that’s ok, those books are supplements to the training given in courses.
Without the training to provide the base, they’re not really helpful.
First: your assessment is IMO grossly optimistic. In any “irregular warfare” the “irregular” fighters have two choices if wounded. Surrender to the government forces that control the medical treatment centers. OR. Stay in the field and be treated by “friendly forces”. Staying in the field will result in a death rate greater than 25%. Second: No level of first aid training: NO MATTER HOW ADVANCED. Will save severely wounded that cannot be evacuated to a professional “chain of care”. IMO. The death rate among wounded “irregulars” in a civil war, will be comparable to that seen in the American civil war (1861-1865) . Everything else is fantasy. I AM a trained medic. My wife is an APRN. Without hospital level support we could offer the same care you would have received in a field hospital at the first battle of bull run. Nothing more.
Ok…citing battlefield statistics of the American Civil War and the contemporary conflicts are dissimilar.
Second, having been in substantial combat across three deployments and being fortunate to attend a couple of very advanced trauma response courses (DMI’s DMOC and OEMS courses including live tissue training) I will state that the need for competent IFAKs in personal kit and more importantly regular training in their use is critical. Treatment beyond the primary phase is tantamount to survival, and can be attained. AQI had sympathetic hospitals in every city, as do many, many more examples in Syria and Ukraine.
Aukai Collins gives a rather visceral description of trauma care he received in Chechnya from outside aid in Azerbaijan. So yeah, like I already stated, networking with the RIGHT people is pretty important.
Also- I’m not a fatalist, and don’t like fatalistic attitudes.
ncscout, I was an instructor at DMI. Congrats on making it through both DMOC and OEMS. We had some great classes. Im in central NC, where are you located ?
I’m in central NC as well.
I was in the classes you guys did in Hawaii in 08.
Im about one hour north of Fayettnam. We need to link up and see if we can help each other. Im on unseen as Dave. I bet we know some of the same people.
Cool, we probably do.
Timely post bro….
One never knows these days when a traumatic injury will happen to oneself, or a bystander and being able to provide aid is critical…
That said, training is key, and here is a good place to start for those looking to go beyond basic red cross classes:
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There is some pretty damn bad information in there too. A tampon for an abdominal wound or a sucking chest wound? No one uses tampons for any type of TCCC. Do your own research. Long story short they fall apart, do nothing to stop a serious bleed, and cause a management nightmare for follow on surgeons trying to avoid an infection. If tampons are in your IFAK, go get some training. The author is way out of his lane here.
First, thank you for reading.
Second, I did NOT and would not advocate using a tampon for a sucking chest wound. In fact, I said a primary responder’s best bet if no gauze was available is to simply use a safety pin to secure the wound. Read what I wrote for yourself, again:
“But wait- you didn’t talk about abdominal injuries- gunshots, sucking chest wounds, etc? No, I didn’t. The reason why is that there’s not that much without extensive training you can do for this type of injury. You can pack it with gauze (or a tampon) to keep it from getting worse, but the best thing to do is close it with a safety pin. You should not consider a needle decompression for a sucking chest wound if you have little medical training either. Doing so incorrectly or overestimating your skill can cause many more problems than it solves, possibly killing your casualty. Understand?”
This material is written for those with ZERO medical training, repeatedly citing the need for those with advanced training, starting with the third line under the title pic.
If you still take issue with the material, feel free to email me.
Hey brother, thank you for this. As already stated above, this is the easiest to “get” trauma/IFAK article I have read. I will be getting the stuff together ASAP. -55six
Thanks and I’m glad- come see it live.
Is there any reason to choose the wide version of the SOF-T over the regular one?
Wide version? I’m only familiar with the standard one. The wide one I suppose covers more area.
The standard SOF-T works just fine unless the person wearing it is morbidly obese.
Regular here: http://www.chinookmed.com/cgi-bin/item/05149/s-tourniquets/%2DSOFT%2DTourniquet%2D%28SOFTT%29
Wide here: http://www.chinookmed.com/cgi-bin/item/05189/s-tourniquets/%2DSOFTT%2DW%2DTourniquet
They don’t seem to get into the why’s and wherefors…
The wide version they have eliminates the screw down bezel that the strap threads through.
I’ll pick one up, looks like a nice piece of kit.
I hope so – just ordered 4 of ’em. 🙂
Try them out- run a few drills trying to put them on yourself quickly. If they’re made to the same standard as the normal SOF-T, they’re outlast all of us.
Reading this post is like a refresher course. Good stuff. You can’t learn these things enough. Or enough times.
Thanks for putting this together NCScout.
You’re very welcome.I’m glad y’all are getting something out of it.
Definitely. You got eat this stuff with a spoon. It is one of those things that only count if you learn them first hand by doing. Part of staying left of bang, right? No substitutes.
Off topic interesting:
Surrendering to the gov’t to get hospital care?
Might as well take your chances in the field.
Post-SHTF you’re dead anyway if they get their hands on you.
And probably a slow painful death too.
I don’t know what sort of zombie fetish you envision, but down in reality, many guerrilla fights are happening right now in a few corners of the world. Observe a couple. Matter of fact, look up the Doctors of the Peshmerga in a video link I posted from Vice a while back. There was a whole big section on volunteer Doctors from Europe struggling to build a hospital.
Among guerrillas and others in the underground, the fight to control hospitals and attract sympathetic medical staff is paramount.
Anyone with real experience in counterinsurgencies knows this. Keep your Red Dawn bullshit to yourself.
Every time any post is made on anything medically related, I appreciate how medical professionals all seem to suddenly appear, riding magnificently on their white steeds throwing us ignorant deplorable condescending stares and assuring us we cannot possibly understand their dark magic. Here’s an idea for all of you wannabe Jonas Salks that pop up every time someone happens to offer ANYTHING related to medicine. Pony up and come up with a constructive way to alleviate the obvious knowledge gap within the community or kindly shut your collective pie holes. ‘But…but be wrong about sumptin!’ The obvious answer here is to not be an asshole and send the guy an email where it can be hashed out or a correction made. The railing in the comments tells me a) you’re a special snowflake with a serious ego problem and damn near debilitating self-image issues or b) you’re too mentally indigent or lazy to figure out how to find and/or type an email (precluding any real medical contributions you have to make and relegating you to the idiot savant/circus freak category). Sorry, NC, the stupid meter got pegged and I’m over the sniping that really boils down to SJW behavior rather than an exchange of ideas.
It’s fine Brother- although I at least make a facade of diplomacy 😉
The way I see it, negatives fall into two distinct categories- 1) Never-has-beens who live in fantasy land and 2) people who do know a bit, but don’t quite comprehend the frame of reference. If one knew where the material presented was learned, I highly doubt they’d hold that opinion.
One serious problem is that writing a post about Self Aid/Buddy Aid in the trauma department is tough to do without live instruction. I addressed this by simply eliminating things NOT to do, and focusing on what can.
On the whole sucking chest wound thing, sure I can tell you to put on an asherman chest seal over the entrance wound in the upper chest and make an occlusive cover from the plastic wrapper on the exit, but without being there in person, I can’t convey how to do it correctly, so I don’t convey it all. Second, an Asherman doesn’t even go in an IFAK anyway- it’s too big and takes too much time to administer when the untrained need to focus on hemorrhaging and airway. Tension Pneumothorax (aka ‘sucking’ chest wound/ deflation of the lungs) won’t kill as fast as bleeding. Ask me how I know.
Anyway, yeah…tangent…and tampons stop bleeding in small entry holes without ‘falling apart’ too…they do in women everyday. Gauze is far better, but in a pinch they work too. Don’t take my word for it; ask any other veteran of some of the rougher areas of Iraq.
Silly nitpicking is not bruising any ego here- the info is there, they use it or not. But the information came from a course taught by the very best that most of the readers (and most legitimate medical staff too) will never experience and used (and continues to be used) where reality was quite real.
You know because you have been there and done that AND because me and Col. Hagmann taught you the science behind it ncscout.
Its bad enough training active duty and you always have one student who wants to play “stump the instructor” instead of focusing on what is being taught. Training civilians in TCCC is exponentially worse for many reasons.
So pardon us Jesse for voicing frustration as we try to give our time and knowledge to the patriot community, knowledge that may one day save your or a loved ones life.
You’re exactly right, but Jesse was speaking about another guy who decided to deride the information contained here. While I don’t know that individual’s level of expertise, I’d rather take the high road than cut him off at the knees.
Mr. James is well aware of those frustrations though in other areas aside from TC3.
I read all 3 points regarding the use of hemostatic agents loud and clear – within that context my question is regarding point #2 –
“Second, Celox is made of shrimp shell, so if your casualty is allergic to shellfish, guess what- you just killed him.”
Celox put out this statement in their FAQs:
“Do people with shellfish allergies have allergic reaction to Celox as a result of the chitosan?
There have been no known or suspected allergic reactions as a result of using Celox since its launch in 2006. The chitosan has been extensively tested on individuals with suspected and confirmed shellfish allergy, none of the test subjects demonstrated any dermal sensitivity when tested against the chitosan material.”
I have done some searching, haven’t found too much (scholarly), is there anything you can expound upon here or point us toward more information regarding celox allergic reaction?
Thanks for the post.
Yes, I’ll expound upon it.
The MD running the course I attended when this was addressed said not to do it, for the reason I stated. By his position and experience in trauma medicine, I take his word for it.
NCScout, thanks for another solid post. Your contributions to the knowledge base are greatly appreciated.
Question to the floor: Recommendations on solid TC3 training in the deep south?
I greatly appreciate your compliments.
As for TC3 in the South, there’s a guy who was advertising in the Appalachian Messenger with a wilderness medicine class. I don’t know him other than his ad, but he’s supporting us. IIRC, he’s a former military medic too.
I’ve always been leery of the Celox for the same reason. That’s why I run the QuickClot Combat Gauze in my personal kit. When I voiced my concerns to our medical director, he dismissed them with the same boilerplate response from the manufacturer. Is there anything to it? I can’t say that there is, but why risk it?
The wide SOFTT causes less pain to the extremity under compression. It simply spreads the pressure over a greater surface area. When the Army was testing tourniquets in the early days of TC3 doctrine-writing, pain level during application was one of the criteria that was assessed, along with actual efficacy in controlling hemorrhage, ease of use, and several other categories that escape me right now. The CAT and the SOFTT both performed well overall.
Our current protocol calls for the application of 2 CATs to the lower extremities if one doesn’t stop the bleeding. Thus the need, as you pointed out, for multiple tourniquets per patient.
As a cautionary note, the secondary market is also tainted with Chinese knockoffs of the CAT, some of which are very close copies. The main giveaway on these seems to be a very flimsy, overly flexible windlass. If you can significantly bend the plastic rod, it’s an airsoft prop, and it will fail if you attempt to use it on a casualty. North American Rescue has a very detailed article on their website explaining how to identify the genuine article.
Great blog, and rock-solid info on the basics of managing the most preventable causes of death on the battlefield…wherever that battlefield may be. Thanks for what you do.
Thanks for the clarification on that- I had not seen the wide SOF-T, but I’ll have to pick up a couple and get up to speed on them.
Thanks for your input and compliments, it’s greatly appreciated!
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