On Sunday, we had the opportunity to take the Tactical First Aid and “System Collapse” Medicine course put on by Greg Ellifritz of Active Response Training. Greg was in the area putting on two classes hosted by FPF Training. The day before, Greg taught his Extreme Close Quarters Gunfighting course out on the range. We weren't able to do that class, but after experiencing Greg's teaching, it's on my list of things to do now. Greg is a 19-year veteran police officer, including 13 years as the full time tactical training officer for his agency. He has a hobby of third-world travel, and as such has developed extensive knowledge on surviving outside a "civilized" medical system.
Greg starts the class by going over how the tactical first aid taught in this class differs from the "standard" Red Cross or EMT first aid procedures. Those are highly valuable skills too, but for different situations. Think about the typical issues seen by our EMT and paramedic squads; car accidents, falls, and illnesses are probably the most common things seen. Treatment in these cases typically involves stabilizing the patient until he can be transported to a hospital. For shooters on the range, wilderness hikers, or for warriors on the battlefield, there may be no hospital nearby. There could be multiple injured persons, or gunshot victims needing treatment while the bullets are still flying. In these situations, the injury is most likely to revolve around blood loss, the circulation system, and respiration. In addition, this course covers survival during a short or long term break down of our medical system. Imagine your local hospital filled with pandemic victims. Are you willing to go to the hospital when you slice your hand open in the kitchen? Will doctors and EMTs report to work when people start dying of widespread disease? It's not hard to imagine scenarios where one might have to deal with a serious injury of a family member, or oneself, without the benefit of the local EMT responder and emergency room.
We spent a lot of time going over how to stop massive blood loss. Starting out with Israeli bandages, and other compression bandages, we learned the differences, along with how and when to use them. More importantly, we practiced applying various types of compression bandages to others and to ourselves. (It's not so easy to properly apply a pressure bandage on your own strong-side arm.)
We also covered tourniquets in depth. There's a lot of misunderstanding, and downright outdated and incorrect information regarding the proper use, safety and effectiveness of tourniquets. Much of what we know now comes from experiences in Vietnam and the Middle East conflicts. Once the pariah of emergency medicine, studies have shown that significant numbers of lives could had been saved in Vietnam by the proper application, rather than avoidance of tourniquets. After covering some of the main types of tourniquets available today, including C-A-T, SOF-T, and TK-4, we practiced their use. And again, we practiced both on partners and on ourselves. It wasn't the most pleasurable experience, but it's important to know how to apply these life-saving tools quickly and properly. We also covered the use of hemostatic agents such as Quikclot and Celox, including how to use them to transition from extended-term tourniquet use.
After lunch we moved on to respiration issues, including basic airway clearing procedures, as well as more advanced topics. Clearing a throat obstruction with an emergency cricothyroidotomy was covered. Chest cavity wounds and treating the "sucking chest wound" or tension pneumothorax was discussed next. We also covered how to relieve the pressure on the lungs by "burping" the wound or doing a needle decompression. Greg emphasized that these procedures are considered medical procedures, with related moral and legal complications, and should be considered only in emergency situations.
Moving on to circulation, we covered wound treatment including proper cleansing and disinfecting. Emphasis was placed on the difference between a quick rinse in the kitchen sink before heading to the local doc-in-a-box for treatment, and thoroughly cleansing and closing the wound in the home or field. We learned basic suturing, which we practiced on chicken thighs. Stapling and other (preferred) alternatives for closing wounds were also covered.
The final portion of the class was devoted to drugs, both over the counter and prescription. We talked about what medicines should be included in a emergency medical kit. We discussed alternatives for common drugs, as well as benefits and drawbacks. Greg also shared his experiences on how to legally obtain the discussed medicines, including prescription drugs, to prepare for travel or a collapse situation.
As a shooter, I am often at the range by myself. In the event of a serious injury, I may very well be the first responder, or the only responder. Even without the threat of a zombie apocalypse, this is important information to know and I feel better equipped after this class. Greg constantly challenged us to think about alternatives to the treatments and supplies we covered. We talked about how many of the first aid supplies, and even the packaging they come in could be multi-purposed. In fact, improvisation was a constant theme throughout the day. (Which reminds me I need to add duct tape to my kit.) After all, this is also a collapse medicine course. There are a few adjustments to be made to the contents of my range bag and my car med kit, and those fixes will be done very soon.
Greg is an excellent and highly qualified instructor. The material is presented in an interesting and engaging manner. The class was never boring, despite the heavy subject matter. There were several students in our class who were taking the course for the second time, there's so much information in the class, it's hard to retain it all at once. After the class we were given a CD with over 150 medical references as well as documents summarizing the class material. I've not even had a chance to go through that material.
As with other course reviews I've done, I've only given very high-level information here. There was much, much more information shared than is covered in this post. I'm not qualified to explain the material in detail, and it would be unfair to both Greg and the reader. Take this course if you can. For local readers, FPF Training will be hosting this and other classes from Greg next year. If you can't learn from Greg, get the training from another qualified instructor. In a tactical or collapse medicine situation, this is the stuff you need to know.