Categories
Medical

First aid

Yesterday at the blogshoot, we did a bit of training on gunshot wounds. Several people in attendance asked me to do a post on the contents of a first aid kit. Let me start by saying that the way paramedics can tell the new guy from the experienced medics is in the amount of gear they tote around. Medics, fishermen, and gun owners have a trap that they commonly fall into, and that is the tendency to buy tons of gimicky crap when it comes to equipment.

Remember that serious trauma is first and foremost a surgical emergency. Trauma patients don’t need a tricked out first aid kit- they need a trauma surgeon. All they need you to do in the field is keep them alive and prevent them from furthering their injury until they can get on the operating table. So with that in mind, I take a minimalist approach to trauma first aid equipment. Please see the end of this post for disclaimers and conflict notice.

First aid kits that are filled with bandaids, sting ease, and other supplies are not good for this sort of work. Sure, I have one of those in the car, but band aids are not going to do you any good with a serious injury. Likewise, don’t get one that has suture kits and everything else, because you aren’t gonna need that and will likely screw it up anyway. Remember: simple. minimal. Stay in your lane.

The basics:

A pair of trauma shears. Most often used for cutting off your victim’s clothes. Don’t bother with the ones that have built in carabiners, bottle openers, glass breakers, or any of that other nonsense. You will likely throw these out once they are soaked in blood, so don’t waste a lot of money on a tricked out pair.

A compressed space blanket. Trauma patients need to be kept warm. After you treat them, wrap them in one. I used to keep the back of my unit heated to 90 degrees for trauma patients. Since we can’t do that, a space blanket is a great way to help with that.

A couple ( 2 or 3) packs of gauze soaked with a clotting agent. QuikClot is best, any of the other commercial alternatives (Celox for example) are acceptable. Many doctors will trash talk QuikClot, but every time one has told me that, the only reasons they can give are anecdotal. The plural of anecdote is not data.

A quality tourniquet. I prefer the CAT. Try to get one with the NSN number printed on it, that way it is more likely to be MilSpec and not a Chinese knock off.

A nasopharyngeal airway with a pack of KY to aid insertion.

An Israeli combat bandage. I like these because they can also be used as an ACE bandage, or (in conjunction with a triangular bandage) to stabilize arm/shoulder injuries, and other uses. Use your imagination.

A Hyfin Chest seal.

A pair or three of exam gloves.

If you don’t want to assemble a kit piece by piece, this is a good one. I just throw out the cheap tourniquet, then add a CAT, a Hyfin kit, and that handles most of what you will need in an emergency.


I follow the CoTCCC (Committee on Tactical Combat Casualty Care) Guidelines (see below) very closely and have designed trauma kit around them. All of the trauma treatment training I conduct is based on those guidelines.

Tactical Combat Casualty Care (Pronounced “T-Triple C”) is a set of guidelines developed by USSOCOM (United States Special Operations Command) to properly train non-medics to deal with the preventable causes of death in the field. With that in mind, remember that the single most important piece of gear that you have is the knowledge that you carry in your head. Seek out and get some training. Do not attempt to do any of this or use any of this stuff without knowing what you are doing.

Supporting documentation from the National Association of EMTs:

Basic Management Plan for Care Under Fire

  1. Return fire and take cover.
  2. Direct or expect casualty to remain engaged as a combatant if
    appropriate.
  3. Direct casualty to move to cover and apply self-aid if able.
  4. Try to keep the casualty from sustaining additional wounds.
  5. Casualties should be extricated from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process.
  6. Airway management is generally best deferred until the Tactical Field
    Care phase.
  7. Stop life-threatening external hemorrhage if tactically feasible:
  • Direct casualty to control hemorrhage by self-aid if able.
  • Use a CoTCCC-recommended limb tourniquet for hemorrhage that is anatomically amenable to tourniquet use.
  • Apply the limb tourniquet over the clothing clearly proximal to the
    bleeding site(s). If the site of the life-threatening bleeding is not
    readily apparent, place the tourniquet “high and tight” (as proximal
    as possible) on the injured limb and move the casualty to cover.

Disclaimers and conflicts:

I have no financial conflicts to disclose, other than the fact that I do make money for training people in various aspects of trauma and medical care. I do not have a financial stake or interest in any of the products mentioned or linked in this post.

This post is not a substitute for training, knowledge, or does it imply that you should practice any of the techniques on this page without the necessary training, experience, and clinical judgement to apply these techniques. The writer assumes no responsibility for anyone who attempts to practice any of the actions on this page without first receiving training in the use or application of any of the procedures mentioned on this page.

Categories
Firearms Training

Blogshoot

This post is a plug for the upcoming blogshoot that is coming up this Saturday. I am going to do a “first aid for the shooting range” quicky class.

Be there. We had a good time at the last one.

This is the only post for today because I am doing some training for the maintenance of my medical license. Gotta get that done.

Categories
Firearms

Another gun free zone

A mass shooting at an American Legion Hall. All American Legion Halls are off limits to carry, per their National Charter.

Categories
Firearms Self Defense

NOLA shooting followup

More facts have come to light on the shooting that I posted about yesterday. The shooter was a 27 year old man who had a criminal history. The two victims who were killed were a store clerk, and what appears to be a female customer who was simply in the unfortunate position of being the backstop for the customers who were shooting at the killer.

The two who were wounded were the brother of the mass shooting criminal, and another customer of the store.

The shooter had a criminal record:

The family of the shooter claims that he dindo nuffin.

Categories
Firearms Self Defense

BREAKING: Gun store shooting

Early reporting says there are three dead and two injured. A man entered the gun outlet with a loaded, unholstered firearm. A clerk told him he should not have a loaded gun until he got inside the range. An argument ensued, and shots were fired. Two individuals were killed before he was engaged by other customers of the store, who were injured in the firefight. Other customers outside of the store also engaged the gunman, who was one of the three people who died in the firefight.

Categories
Self Defense

Happy ending

A man enters a day labor center with a machete and attacks the employees inside. One of the employees shoots his ass. Here are my thoughts:

  • Good for you in not hesitating.
  • Just remember to shoot until the threat is ended.
  • To the shooter: You either need a bigger gun or better aim. The next time, he might not flee after being shot once. Decapacitating the attacker is the surest way to stay alive.
  • Note that I don’t know the race/ethnicity of those involved. That doesn’t matter. Don’t attack people with machetes and you won’t get shot.
Categories
Self Defense

Too much TV

This guy went to a WalMart with a large knife and was threatening cops. When he refused to drop it, they shot him. He is suing the cops for excessive force.

The people in the comments are obviously not well versed in self defense law, demanding to know why police didn’t use a taser. Everyone thinks you should shoot the gun out of an assailant’s hand, shoo them in the leg, or should use a Taser, which is seen as a ‘magic weapon’ that will stop all assailants without hurting them. The odd part is that the lawyer suig the cops is Mark O’mara, who was part of the Zimmerman defense team.

If you are ever in a defense shooting, remember that these are the sorts of people who will be on your jury. It will be your lawyer’s job to educate them. It will be the prosecutor’s job to make sure the jury is too stupid to learn.

Categories
Firearms War on the Right

More demand = more $

In September of 2019, I was buying Anderson lowers for $49 each and using them to build sub-$300 ARs. Now Cheaper Than Dirt is selling those same stripped lowers for $300 each. Now let me say that I am smarter than that and won’t be buying one at that price. I don’t blame CTD for this price. After all, if you waited until now to buy an AR after seeing what the Democrats think about them, that is your own fault. Supply, demand.

My point here is this: Beto is no longer being considered for Biden’s “gun czar” position. I guess another Biden promise broken. The latest is that he is promising an EO on the subject soon.

I don’t think that a “buyback” will work, considering that I don’t think that people are buying $300 stripped lowers so that they can turn them in for $200.

Categories
Training

More Training

I added more military field manuals to the training page. There are now 40 of them on there. More to come. I have a couple of hundred more.

Categories
Firearms

This is my squad