Defense Trauma Preparedness: You be the Judge Kerry Davis July 16, 2013 Join the Conversation “….but, medical training isn’t cool…” That is a line many of us heard numerous times. However, recent events have shown us the importance of being proactive rather than being reactive not just in self defense but in the ability to address a traumatic injury. We have also seen the extreme dangers in which complacency and lack of situational awareness can place us. Whether it be a natural disaster, a motor vehicle accident or a terrorist event, we can try to mitigate those risks as much as possible. Unfortunately sometimes things far beyond our control will happen, and it’s during those times that being adequately equipped, trained and prepared will pay off many times over. Gear Up Buying the equipment and obtaining the training in order to be better prepared takes time, money and desire, especially in tough economic times. You will need to budget for it as best you can, remembering you may need to stage first aid/trauma gear or blow-out kits in more than one location. Cut corners in other areas in order to stick a little aside to get things that you know you may need on that ‘rainy day.' Don’t take shortcuts and try to bargain basement gear, tactical or medical, on just so you can get it quicker (or less expensively). Buy it right and buy it once. Your life or the life of a friend or loved one may depend on the quality of gear which you chose and you don’t want to tempt Mr. Murphy when the fecal matter hits the rotating-oscillating device. Buying a solid, well thought out med kit with proven components is the first step in the right direction. Learning how to utilize the med kit is another step we need to take to make ourselves more of an asset rather than a liability. Train Up There are many different specialties in which we can receive training. All of them can increase our ability to be self-sufficient or of use to others during an exigent event. Basic emergency medical skills training should absolutely be considered one of the cornerstones of being self-sufficient. Just as we build on the fundamentals of shooting, we should build on the fundamentals of medical skills. Having the ability to understand the body’s various processes and what makes us more effective machines is a huge advantagge as we can focus on more holistic approaches to our well-being. By being proactive, situationally aware and threat conscious in our daily activity we may be able to avoid injury or trauma. Nothing is guaranteed, however, and should something horrible befall us, our friends or loved ones, we need to be prepared to react instinctively and effectively to respond, just as we must respond with a firearm to a threat. What gives us that edge? Training and repetition. How many of you look around a restaurant when you walk in and see where the exits are and scan the crowd? How many of you like to be seated with your back to a wall with a clear view of all the entrances and exits? Why are you doing so? Because self-preservation hinges on situational awareness. It may also rely on your ability to act under extreme stressors under the worst possible conditions. To that end, how many of you have self-applied a tourniquet to your upper thigh in the dark, seated in your car, with a seatbelt on? Have you considered a situation that might force you to do that? Have you ever noticed just how thin door panels are, or witness how easily they’re punctured by bullets on the range? Have you known anyone who was trapped in a vehicle after a crash (or overseas in an IED hit) while bleeding? You should consider such eventualities and practice them for the same reason you should do a once-over when entering a room: self-preservation. Plan for the worst case scenario and hope that it never comes to pass. Let's consider redundancy and staging. Two is one and one is none, neither is any good if you do not have access to it. A spare magazine with your concealed carry piece is peace of mind and insurance, but you cannot reload if it is in the door of your car and you've gone inside to pay for fuel. So too is it fair to say that neither a second med kit (or even a third or fourth med kit) is ‘too much'. There’s really no such thing. Let’s say you come upon a multiple motor vehicle collision with multiple victims. Is one kit going to hack it? If you carry more than one kit or have more than one kit, where will you stage or carry them? One on your person and one in your backpack, plate carrier, man purse or Indiana Jones satchel? Again, always think of the worst case scenario, i.e. “What if I get separated from my backpack or European Shoulder Bag?”, or “Will I have at least one kit, on my person, to fix myself in case I’m injured?” Many kits are small and light enough to carry one on your person and stow one in each door panel of a car, the center console or the glove compartment. On a motorcycle, consider keeping one in the saddlebags or panniers. On a bicycle, stage one in a little bag under the seat. On horseback; in the saddlebags. On an ATV or UTV; bungee cord it to a cargo net or rack. At home, many folks talk about ‘strategically' placing firearms so that they’re readily accessible should something bad happen. In a similar fashion, I advocate a personal trauma kit on each level of the house (or in different wings of the house, depending on a layout) and preparedness drills that have each member of the family who could possibly be called upon to operate the kit trained in it’s use. Stress inoculation is just as important with medical gear as it is with fighting gear, and which one do you think you might be more likely forced to use? It can happen when you're out doing some recreational riding. It may not be a duty-related event; in fact, with most of this readership it won't. Training each family member in the use of the kit is where they will each play a role in each other’s well-being. Our family is a team and each team member has a specific role for emergencies, whether it be a fire drill, tornado drill or yes, even a home invasion drill. Each of these emergencies could require the utilization of the med kit, under a time limit, during different times of day to get the blood flowing and get some repetitions in under stress. Obtain practice components and have scenarios where your family members have to activate their roles and render aid to another family member or a guest, or more than one family member or guest. This will help with with critical thinking skills, problem solving and triage. Does your teenager know how to apply HALO seals or a CAT tourniquet? Does everyone in your family know how fast someone can bleed out? [SEE BELOW] Can they exploit their environment in the event of an emergency? This isn't just important if you keep a gun in the house or are thinking preparation for an intruder. It may be nothing more than a slip when someone is carving brisket before a family get-together. Remember, do not practice with your ‘real' kit but have identical components that you can use for training. Give your family members the chance to learn kinesthetically. Have them put on a two minute presentation to the rest of the family (or neighbors) on how to use a particular piece of kit, the situations it could be utilized in and what could also be used as a field-expedient replacement. After the scenario, have a ‘hot wash' or debrief so that everyone can talk about what went well, what they learned and what they can do better. Make it so that they look forward to it. A little friendly competition or sibling rivalry can be a good motivator, too. They’ll be having so much fun that they won’t even realize that they’re building long-term potentiation and learning. There are many parallels between the gun and the med kit. The more you train with either, the better you will understand your own limitations and as a result, you will strive to push past those limitations and understand the processes better, which, in turn, make you a better performer. That performance, with either skillset, can mean the difference between life or death. If you lack the medical training component, get that box checked off. You can pass on the skills that you learn to your family and friends and make it ‘cool'. Whether you do it or not, my friends, is entirely up to you, but the last time I checked, watching helplessly as you or a friend or loved one bleed out ain’t too cool, either. You be the judge. Stay safe. Kerry Davis SIMPLICITY UNDER STRESS Editor's Note: This is the first in what will hopefully be an ongoing series about wound management/trauma care. I first met Kerry “Pocket Doc” Davis about a year and a half ago, and I've always quoted his ‘Missing Link‘ and ‘Train Like You Bleed‘ rants when I instruct, regardless of the course. Let us know what you think, and if there is anything you'd like to see him address. I also suggest following them for their frequent medical emergency ‘pop quizzes'. David Reeder About the author: Kerry Davis is a a former flight medic and paramedic in the USAF before going to work in the civilian sector as a critical care RN in an emergency room. He teaches courses on his own, via Dark Angel Medical (which he runs with his wife Lynn) as well as the Sig Sauer Academy. They are the designers of the D.A.R.K. and Pocket D.A.R.K. medical kit (the former being selected as one of the “Best of SHOT” winners in 2012). Davis believes in addition to being prepared for everyday life eventualities such as motor vehicle accidents and hunting mishaps, shooters should be prepared to fight like they bleed. Though he is justifiably proud of the Dark Angel Medical proprietary medical kits, he will be the first one to preach preparation of any kind. “Roll your own if you need to,” Kerry says. “Buy our kit, by another kit, put a kit together, but have one and know how to use it.” You can learn more about Dark Angel Medical on line or via their Facebook page. See video below as a graphic demonstration of just how quickly someone becomes unable to render self-aid or take action while suffering an arterial bleed. WARNING: GRAPHIC. 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