AAR Immediate Action Medical by Tactical Response

Same course... www.m4carbine.net/showthread.php?t=393


Name of Course: Immediate Action Medical
Training Org: Tactical Response in conjunction with GRMS, Ltd.
Location: Arcadia, CA
Lead Instructor: Doug Kimbell
Assistant Instructor: John Chapman
Date: August 12 &13, 2006
Weather Conditions: 85 degrees, but, we were indoors mostly.



Date Day One
After a brief introduction of everyone, Doug Kimbell, aka Docgizmo, launched right into the concept of tactical medicine. A scenario was set before us: a vehicle with four operators is hit, the driver is DOA, the front passenger is dazed and confused, the operator in the rear left seat has traumatic amputation of both lower legs, the operator in the right rear has facial trauma... so, whom do you treat first. This scenario set the tone for the rest of weekend’s class... and it got all of us to think of the following: We have a 15 minute window of opportunity to treat a trauma patient from the time the injury happened to, well, for lack of a better term, it’s too late and they expire. I am not talking about stubbing ones toe or cutting yourself with a piece of paper. I am meaning femoral artery, arterial in general, trauma, thoracic trauma, facial trauma.

The contents of the Ventilated Operator Kit (http://www.tacticalresponsegear.com/...3959c6a3310bb7) offered by Tactical Response Gear was reviewed in great detail. Each item of the kit was taken out and explained in detail what its purpose/purposes were... NOTE: Just the fact that you have bought the kit, doesn’t mean that you will know how to use this kit, or, any kit for that matter. It was great to listen too the instructor talk in detail the uses of each of items in the kit. Frankly speaking, I leaned allot in this segment of the class and I thought I knew how to use this kit upside down and inside out.

Docgizmo then when into the use and application of tourniquets.
Q: When do you use them?
A: To stop arterial bleeding, place them 3-4” above the wound site. If the wounds are in the lower part of the extremities, put the tourniquet above the elbow/knee.

Q: How long can you leave a tourniquet in place?
A: A long time... for hours.

Q: From the time arterial bleeding starts, how much time do you have to put on a tourniquet?
A: You have a 3 minute window to get it on and stop the arterial bleeding.

We went over the application of the “H” Dressing. It is not meant to be used as a tourniquet but it can be used if needed.

Docgizmo then threw out the possibility of each police patrol officer having a VOK in each door panel in their patrol cars or on their person, figured it would save quite a few officers, and others, lives every year.

The NPA, or Nasopharyngeal Airway, AKA...nose trumpet... I have never had one applied to me... and frankly, next time, I hope I am out when they do. Kidding, it was not that bad... just...foreign and new. We all learned the technique to apply the NPA which was different than what I imagined it was. You can either use the lubricant or, you can use spittle, or...another fluid to act as a lubricant. A vital piece of medical kit that everyone needs to have with them.

The VOK comes with two safety pins. The uses for these items are endless. But, they are also very useful, if necessary, for pinning the tongue to the lower lip to keep it from obstructing the airway. Harsh, yes, but... consider the alternative.

Duct Tape, the VOK comes with 100” of silver duct tape... that is 8.33 feet of tape! Man, the uses are endless... we could almost build a space shuttle with that much tape.

Decompression needle, used to relieve tension pneumothorax caused by a plethora of trauma. Complex subject, not going to go into the how’s and why’s here. Get training yourself.

We covered a few other items that are included in the VOK.

One of the items we covered that is not in the VOK is the Asherman Chest Seal... I have felt that this is a good piece of kit; however, I learned that this Chest Seal can possibly not work if it’s stored improperly and if it becomes creased. Very important to know.

Covered the 5 B’s:
1. Bombs: The rescuers personal safety. You do no good to anyone if you get hurt/killed by whatever on the approach to the patient.
2. Bleeding: Find and stop the bleeding.
3. Breathing: Now that the bleeding is stopped, insure the breathing is uninterrupted.
4. Brains: What is the level of consciousness of the patient? Alert? Able to answer questions or...
5. Body: Look, access, the patient using a systemized assessment.

Covered AVPU
A: Alert
V: Voice
P: Pain
U: Unresponsive

Assessment is on-going... continually check patient.

Day Two
Today the course covered more theoretical and practical aspects of tactical medicine and patient treatment.

Note: When applicable, put the patient to work with you... have them help if they can. This can often take their mind off what has happened to them.

Covered the use of Hemorrhage Controls...i.e., hemostatic agents, Quikclot, Hemcon, Traumadex... and a new over the counter one... QR Powder.

Mass Casualty: use the 5 B’s to evaluate, treat, and evacuate.

What is shock? Covered how to identify it, treat it, how to prevent it.

Camelback enema for treatment of dehydration... you don’t want to experience it... but, it will work, I am sure...Say, does anyone want to buy a slightly used Camelback?


Recommendations:
This class needs to be 3 days long. Two days is too short... in my humble option.

Closing Observations:
This is a terrific class, well worth the time and expense to attend. Explained, clarified and dispelled allot of what I already knew, thought I knew and didn’t know. I feel it’s a must for any and everyone.