Essential medical training?

[HowardCohodas]

Here we have classes to become Certified First Medical Responders. The class I attended was made up of 19 LEOs and me.

A trauma surgeon of my acquaintance told me that the key is maintaining breathing and stop blood loss. If you can get the person to him, he can deal with the rest. Except in unusual circumstances, doing anything else may not be advisable as you may do more harm than good.

Refreshers are useful. For example, when I took the class, the recommendation for both CPR and use of tourniquet was out sync with recommendations by the military and trauma community. You have to answer the test with the old teaching to get your certification, but you need to keep up with research.

[lwhazmat5]

Here we have classes to become Certified First Medical Responders. The class I attended was made up of 19 LEOs and me.

A trauma surgeon of my acquaintance told me that the key is maintaining breathing and stop blood loss. If you can get the person to him, he can deal with the rest. Except in unusual circumstances, doing anything else may not be advisable as you may do more harm than good.

Refreshers are useful. For example, when I took the class, the recommendation for both CPR and use of tourniquet was out sync with recommendations by the military and trauma community. You have to answer the test with the old teaching to get your certification, but you need to keep up with research.

Unfortunately where I come from most trauma surgeons from our level 1 facilities have no clue about pre-hospital emergency medicine. You hit the nail on the head with Airway, Breathing, & Circulation. However there is a lot more a seasoned medic with good street/field smarts can do to make that trauma surgeon have a lot better chance of successfully resuscitating a multi-systems trauma patient. No offense, but it sounds like your surgeon acquaintance is either brand new to medicine and green under the collar or has been around since the 60's and has refused to let his perspective evolve the way pre-hospital emergency care has.
Just my $0.02 though!

No offense, but your surgeon friend sounds as if he would want nothing else done besides what you listed, almost like flopping a patient on the bed fully clothed and have the most non-invasive clinical procedures performed in the pre-hospital setting.

[Gutshot John]

Take a 16 week Basic EMT class at your local community college. The class will cover all of the BASIC fundamentals of Shock/Trauma Resuscitation which is really what is important as far as taking care of GSWs, Stabbings. & etc. The hardest part of the course for the average student in learning the anatomy & physiology of the human body unless you have already taken an A&P class.

Good Luck

If you have an infinite amount of time, money and effort it's a great idea. To become effective with all that training you also need practical experience (i.e. work, volunteer etc.) which is not really feasible for most people here. You don't become "street-smart" without spending time on the street.

For something a bit more straightforward, essential and relevant to 99% of laypersons a first responder is probably a lot more appropriate. An EMT-B class goes well beyond "essential" given the needs stated by the OP and may be prohibitive. I recommend doing it if the person has the interest, but it shouldn't stop anyone from the very real and effective training you get in first responder class.

A first responder class is perfectly adequate and relevant to GSW treatment in the environment most here find themselves in.

Unfortunately where I come from most trauma surgeons from our level 1 facilities have no clue about pre-hospital emergency medicine.

Huh? Are you sure you don't want to qualify that a bit? I can't tell you how many trauma surgeons have ridden along in my rig, usually it's required for some length of time, most do it because they like to. Even still I'd be hard-pressed to dismiss four years of med school followed by 4-6 years of internship, residency and fellowships that most trauma surgeons at level 1 facilities have to go through just to get credentialed. That's hardly "brand new to medicine."

As a medic you're a short-term solution. The trauma surgeon is the long-term solution. Obviously a different emphasis but I'd still follow the doc's advice. That's why you have medical command.

[HowardCohodas]

No offense, but it sounds like your surgeon acquaintance is either brand new to medicine and green under the collar or has been around since the 60's and has refused to let his perspective evolve the way pre-hospital emergency care has.
Just my $0.02 though!

No offense taken.

Since I do not have his permission, I will not disclose his name, however he is ex military, a practicing physician and on the faculty of a well know institution.

My Mom was an RN, I have cousins and uncles who are doctors, and I have worked for a company that provides medical equipment and have worked jointly with groups including doctors and technicians. All of us feel that as much as we think we know, we know we have a lot to learn.

Bottom line... Even among professionals, opinions vary. So due diligence on all of our parts is a basic necessity.

[lwhazmat5]

I have taught all levels of EMS classes from FR to Paramedic. IMHO I feel that a FR Course is basically CPR & First Aid rammed down a student's throat in the shortest amount of time. The only REAL difference I can find between a FR Course & an EMT-Basic one is the EMT-B goes a lot more in depth in the studies of anatomy and physiology and lasts 16 weeks or 7 college credit hours versus FR witch I think carries only 3 credit hours in length.

My apologies to all of the ruffled feathers I may have caused.

[DrScooter]

Like greetings dude, been banned from LCP, liberal trouble maker! I'll try to avoid the politics. In Texas, SPI had the little trusty LCP for the drive. However, recently got a Predator and killing paper at the range easy out to the 100 yard limit (just like the LCP at 7 yards).

Basic, first aid, CPR and yes ABC's is what to know. Unless it's your job, EMS, Nurse or MD or even if you are, FIRST do no harm, in general basic support really helps. Make sure there is air, nothing stuck in throat pt able to breath or you must do it for him. Make sure he has a pulse, again if not you must do it for him, CPR. If he is bleeding, pressure try to stop the bleeding. In all cases, unless the S(has)HTF and there is no support activate the 911 system FIRST. In real life, when EMS shows up to the ER with a cardiac arrest and says no CPR until the rig arrived this person is toast, four minutes without a pulse and you are dead, probably much less. With CPR you have extended the time and chances of survival.

[mkmckinley]

Data from OEF-A and OIF has shown that stopping massive bleeding is the first priority for GSW and blast patients. They key is to stop the bad bleeding very fast and move on to airway right away. When I teach a TCCC class I use MARCH instead of ABC's:

Massive Hemorrhage (IE place a tourniquet or pack an arterial bleed)

Airway (can they move air in and out of their lungs?)

Respirations (are they breathing on their own or do you need to do it for them? Do they have a hemo/pneumothorax or hole in the chest wall? )

Circulation (shock, lower priority bleeders)

Hypothermia (pretty much every serious trauma patient can benefit from a blanket, even if it seems warm out. If you're not a little too warm the patient is too cold. The lower the body temp the lower the blood's ability to clot)

[TehLlama]

With a wife in medical school, I can attest to the importance of A&P knowledge, and the perishability of this knowledge.

I'm really seeing how inadequate our CLS training is - good thread.