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View Full Version : AAR: LMS Defense Defensive Medicine - Reed's Indoor Range, CA - Sept 15, 2007



pfaria
09-17-07, 13:57
Course: LMS Defense – Defensive Medicine
Date: September 15, 2007
Location: Reed’s Indoor Range, Santa Clara, CA
Instructor: John Chapman

The Defensive Medicine course was hosted at the Reed’s Indoor Range (http://www.reedsindoorrange.com/), located in Santa Clara, CA. Reed’s provided a very spacious lecture room for the course and the hands-on exercises.

We had a total of 6 students, with backgrounds ranging from experience in the military treating gunshot wounds to American Red Cross first aid training. Our instructor for the course was John Chapman.

The Defensive Medicine course curriculum and materials were designed by Dr. Keith Brown and the Global Operational Resources Group, Inc (http://www.gorgrp.com/). Dr. Brown specializes in remote and operational medicine, wilderness survival, rescue training and a host of other related services around the world. He is also well-known in the tactical community for his medical training.

The scope of this course is very specific: to teach you how to manage life-threatening bleeding, breathing, head and bone injuries until emergency medical services arrive. There are many other medical skills (splinting, IVs, etc) that would complement those in Defensive Medicine; however, due to the duration of the class, those skills need to be sought elsewhere. After taking this course, the student needs to seek out additional emergency medical training to complement those skills learned here.

The course was split into two main sections: lecture and hands-on.

John shared with us the importance of medical training and the criticality of having those skills when emergency services are still minutes out from arriving. In essence, we are all on our own until help arrives. EMS won’t enter a scene until the police have secured it. In the meantime, people are dying, possibly even yourself. You can increase those life-saving chances by having some medical skills.

As a general guideline, Defensive Medicine uses what it calls the “5 B’s” as a means to methodically approach the incident. The 5 B’s are (in order of priority):


Bullets – first priority is to finish the fight and then treat the wounded
Bleeding
Breathing
Brains – level of consciousness/is the person cognitive; brain injuries
Bones – stabilize to mitigate further or additional injury


It was noted many times that this is merely a guideline and each situation will require common sense in order to truly ascertain which action is the priority.

The students were paired up, in order to work with a partner. The purpose is to be able to quickly and correctly apply the medical items on ourselves (self-aid) but also understand how to do so on others (buddy-aid).

Each pair received a sealed blow-out kit to use in the class. Each kit contained the following items:

1. H-Bandage
2. Pair of gloves
3. Roll of gauze
4. Gauze pad
5. Roll of tape
6. NPA and lube
7. Glow-stick
8. SOF Tactical Tourniquet

As John delved into each of the B’s, he explained how to manage each type of trauma and how to apply the contents of the blow-out kit in order to mitigate the life-threatening injury(ies). In turn, we would use that information and practice on treating ourselves and then practicing on our buddy using the kit contents.

For example, during the bleeding lecture, John explained to us the different types of bleeding, location of the femoral and brachial arteries, etc and then how to treat traumatic bleeding by either applying direct pressure and/or stuffing the wound with the gauze and applying the H-bandage and/or applying the tourniquet. I used “and/or” only because the situation will dictate which technique to use first and in what combination or order.

Therefore, a patient who has a squirter from his femoral needs that tourniquet applied first due to the heavy blood loss, but a laceration on the arm (with no huge blood loss from the brachial) can probably get by with the pressure bandage and gauze stuffed into the deep wound. But if the blood loss continues from the arm, then the application of the tourniquet might be required. It depends on the situation.

The course also covered the use of hemostatic agents, the different types available, the level of training required to use them and the pros and cons of them in treating wounds. This was only a lecture and for the purposes of this course, we did not simulate the application of a hemostatic agent during our simulated treatments. Practicing with hemostatic agents is reserved for the advanced medical course offered by LMS Defense.

After lunch we began the hands-on portion. The morning session was theory and application, but now we were going to put our knowledge to use. In my opinion, this was the best part of the class, and worth the course fee. John created medical emergency scenarios for us to triage, identify signs and symptoms of trauma and then treat them as we deemed necessary. Throughout the exercises, we were given feedback, direction if needed and then our actions were critiqued.

I will not share the details of the hands-on section because I believe it would be an injustice to future students taking the course as they would be able to prepare themselves ahead of time. I will say that you will be stressed, and confused, and your heart will be pumping with adrenaline. This isn’t the type of class where you’ll be struggling to stay awake after eating your lunch.

Summary

My medical training background covers a semester course at a local community college where I received my Red Cross First Responder certificate. I noted that there was some overlap between that course and Defensive Medicine (NPAs, bleeding, etc); however, the difference is that the Defensive Medicine course specifically shows you how to use the blow-out kit items which are the medical tools that I will more than likely encounter at the range or during training or find on a buddy.

As I stated earlier, the afternoon session where we were put into scenarios and went hands-on was something that I had not experienced before. Truthfully, it sucked having to go through it, but it was an excellent learning tool in my opinion and totally worth it.

John and I spoke after class and I suggested that it might be useful to share photos of gunshot wounds, an amputated limb, severe blood loss from a femoral artery, etc. My reasoning is that it would allow the student to visualize these as he/she are going through the hands-on scenarios. It could also allow the student to mentally prepare him/herself ahead of time.

Time is of the essence and the immediate identification of the life-threatening injury and how to treat it will help sustain that person’s life until EMS arrives. If you’re not knowledgeable in this area and do not know how to use life-saving medical items in our blow-out kit, then seek out Defensive Medicine and learn. You owe it to yourself, to your buddies and your loved ones.

LMS Defense: http://www.lmsdefense.com/

Chappy.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_03.jpg


The contents of the blow-out kit.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_05.jpg


The fist is simulating an open wound and is helping in demonstrating how compact gauze material can be when stuffing the would channel.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_06.jpg


Chapman demonstrating to the class the application of the pressure bandage.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_07.jpg


The students were able to see what a blow-out kit and pouch looks like. The OSOE pouch served this purpose well. And I would like to add that having fingered this pouch first-hand, it is very nicely built (compared to my Blackhawk BOK pouch).
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_09.jpg


Students performing self-aid with the SOF tourniquet.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_11.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_13.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_15.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_16.jpg


Chapman observing and providing feedback on our techniques.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_19.jpg


Students performing buddy-aid with SOF tourniquets and pressure bandages.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_20.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_21.jpg


Headwounds.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_24.jpg


Chapman demonstrating the application of an NPA on students.
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_25.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_26.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_27.jpg
http://i22.photobucket.com/albums/b315/Gaijin_45/Training/DefensiveMedicine_28.jpg

Rmplstlskn
09-18-07, 12:07
Looks like good training!

I wish there were more "SHTF" medical courses out there to attend, rather than "wrap a towel on it and go to the hospital" type of First Aid classes. The last "combat wounds" class I took was back in the late 1990's when Bo Gritz did his SPIKE training tours and I was able to attend the EXCELLENT SPIKE MEDICAL class in central Florida. An old horse was first put down then quartered and multiple types of wounds (gunshot, arrow, cuts, explosive, etc...) were then inflicted on it for our lessons. I learned a lot that weekend... but one of my SF Medic buddies joked by saying, "Great! If I'm shot and out of it, I have to put my life in the hands of a "weekend MEDIC"..." Sadly, he was right. So I try to add MEDICAL training and equipment whenever I can... Over the last decade of this mentality I have put together quite a good setup for a civvy...

So many people learn to shoot and spend big money on ammo, gear and classes, but very, very few know how to handle a blow out or other "combat-type" injury... I guess most, including myself, hope we are the EXCEPTION and will emerge UNSCATHED from a conflict when it happens... but I recognize that this may not be the case and I try to be as well prepared, equipped and knowledgeable on EMERGENCY MEDICAL as possible. My worst fear would to be in a conflict and my wife, daughter or other family member was injured and I lacked the SIMPLE SKILLS and EQUIPMENT to save their life until the conflict subsided and I could get them to a hospital or have EMS arrive.

Plus, many still hold to OLD info that is now proven to be incorrect, such as "Use a tourniquet, lose the limb..." type of old-school fallacy.

Good for you taking this class!

Rmpl