TOTM for August, 2015 - "Field casualty care"

Assess and secure the scene. Stabilize the scene.


Last time this happened, I took care of diverting interstate traffic while the wife was administering first aid and keeping the pt calm (pt was upside down in the vehicle, strapped in and the vehicle was not in danger of igniting.) Car first aid kit helped her, while flares and warning triangles were my friend. I was also on the phone at the same time to get units responding...

We did get some ice from a passing motorist to help slow the bleeding from a head wound....

After the units arrived, the BIL got a call that we were going to be late picking him up from the airport

 

I'm assuming it is not in a SHTF scenario...don't panic... observe before you act... protect your self... Don't make the situation worse that it is... remember your ABC's Airway, Breathing, Circulation, Defibrillation (AED if available)...direct pressure on bleeding wounds... do a scan head to toe... treat the worst injuries first, If the injury is ugly protect it and the patient from passers bye... (Cover it)... Treat for shock...f it's a major burn cool it down physically clean sheets with sterile water... ACE bandages are worth their weight in gold .... Don't do anything more than you are trained to do... Make sure someone calls for help...

 

I might add, always carry 3 triangle bandages. Non sterile but useful for more things than you might think, including insulating an abraded stop light wire on a 1960 Royal Enfield.

 

I just did this, yesterday.
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It's an online training in TCCC. Powerpoint sort of thing with embedded videos. Good info, I picked up a couple of things and had others reinforced. There's a test at the end and if you pass, you can print out a certificate.

I was shown a very slick way to use a triangular bandage as a tourniquet.

 

I know this is slightly off topic but once you get them out of the field the injured will probably still need to be treated. Southern Prepper posted this video this week and it is a good set up. He talks about helping officials or still having officials available but I do think this is a great "field" type hospital or a triage. He has some good ideas.

 

BTW, the instructor acted in an unsafe manner in his presentation of how to use a tourniquet.
The use of the tourniquet was accurate as a non compression aided application. This phrase "compression aided application" can mean the use of a stick or any other safe lever device to tighten and maintain pressure.

I mention this because it is a more accurate way to control bleeding and the other plus is that it is bulky and lends itself to being observed in transit or while a patient is awaiting triage either at a injury scene or at a Hospital ER.

As demonstrated in the Video you will note that the patients shirt was left intact and the result was that the sleeve was lowered over the tourniquet. The danger is that the patient could become unconscious for any number of reasons and not be able to communicate the application of the tourniquet. If EMS was not aware of the tourniquet then the patient could loose the arm due to lack of blood flow.

The best way to insure that a patient is cared for is to cut off the sleeve of the shirt and have a tag attached to the patient noting date and time the tourniquet was applied.

Not trying to nit pick but understand some form of this event was a part of our EMT State Exam. Yup I know somebody is going to go home without their shirt sleeve, better that than a patient have their arm amputated later caused by a mistake at the accident scene.

Train like you have to work.

 

Planned Emergency use of a Drone.

TU Delft - Ambulance Drone - YouTube

 

Realize that THAT application was for times when you are under fire.
When you and the patient are in a safer place, more care can be taken.

 

Not the case, battle first aid or any first aid providers are taught using proven protocols. To do other wise will cause damage to the patient. Triage is always part of the process but within the training of the next step and those protocols.

Yet another reason to find a local EMS who will teach to the levels of what a person needs to know to protect the patient during their treatment and prevent unneeded damage. Yet another reason I carry Indelible Black Markers and a Space pen to write on a water proof paper or on the patients skin/forehead any aid given that is a concern of a Triage Group.

Even Hospitals have this problem. Forgotten But Not Gone: Tourniquets Left on Patients

 

I carry an STAT pack in my car and truck. If its just something minor it can wait for the pros.

 

Also know as an IPOK kit, Galls or Survuival supply
Individual Police Officer Trauma Kit (IPOK)
Price:$43.95

 

Also known as a blow out kit.

BE WARNED, most if not all of these kits have equipment that is date stamped and/or temperature sensitive.

For my self that is the reason my Blow Out kits come and go with me and nothing is left in the Bota or other vehicles. Sure you have to remember to gear up but in my case the enclosed vehicles internal temp can exceed 140 degrees and one of my kits came with an item that has a max sustained temp of 110.

Another reason I no longer buy some surplus gear, you never know how it was stored.

 

One of the things that had brought me to the place I exist in now started in the late seventies. As an early "survivalist" I wondered where would health care needs come from after the sphincter relaxed in our world. A pandemic or any major national disruption would hit our medical staff heavily. After fate took a hand in my future I entered a nursing program. And after thirty years, here we are! Still pondering that same question.

Now we have the internet and access to a tremendous wealth of information on all manor of subjects. All the responses so far have pertained to the first responder, and they are a valuable contribution, yet doesn't address that initial question of what to do and preppare for the longer term medical survivability of yourself, family, and group.

With the contributions of many talented Monkeys in other threads, we could have a solid solution for that initial question of mine. For those that depend on us, let us form a medical stratagy for after shtf..

So, to keep things on thread, here is the Army course on TCCC..
Medical - Tactical Combat Casualty Care | Survival Forums

 

Years ago, I was waiting to cross the street in downtown Honolulu. Lots of people, lots and lots of cars. The elderly lady standing next to me just collapsed and fell flat into the street with oncoming traffic. First step is to get out of harms way. So I grabbed the closest guy and told him to help me get her off the street. Dead weight is awkward and heavy.

Once we carried her off the road and out of traffic, I looked up and pointed to a guy with a cell phone and yelled, "YOU. Call 911." He was already on it.

Took a quick look at the woman. Fortunately, she was breathing so we tried to get her as comfortable as possible.

And fortunately, a cop pulled over and told me he saw everything and had called for an ambulance. Strange thing is everyone split the scene. It ended up being the cop, the woman and me. Poor lady fell flat on her face and we had to clear knocked out teeth out of her mouth.

I guess the main thing to me, is to be ready to act if needed. And the next thing to to be educated. I think our decisions are more important than our gear.

My last first aid and CPR certification update showed me what a small world we live in. The instructor was a retired fire chief and is a childhood friend, best friend to one of my good friends, who is also a retired fire chief. Such a small world.

 

More excellent downloads from @Dont.

Medical - Integumentary System | Survival Forums
Medical - Wound Care | Survival Forums

Great information resources.

 

Yeah the skin. Care source still has me itching and looking at my skin. I had no idea I could be such a hypochondriac. O.O. seriously great resources

Medical - Integumentary System | Survival Forums

Medical - Basic Medical Terminology | Survival Forums

 

Don't in addition to your basic (and beyond) medical care. What I think about is basic self care. Not just calories but micro nutrients as well. It's why I post herbal stuff. We were getting basic good nutrition long before packaged food so what happens when packages stuff runs out.

My basic premise is that the body is a great natural healer given the right building blocks.

So I look at what I can grow that will 1] give a body what it needs to stay healthy and 2] what can I grow that will aid healing

Agriculture - Disease Prevention In The Home Garden | Survival Forums

Alternative Medicine - Culpepers Herbal | Survival Forums

Alternative Medicine - Herbal Guide for Cold and Flu | Survival Forums

A while back some researchers in England discovered an old recipe from a viking or Saxon herbal that they found killed those nasty hospital bacteria that penicillin can't touch. I posted the recipe but can't find it atm