In Part 2 I will discuss the TC3 aspect of the class. Part 1 of the AAR can be found here.
The most important lesson about treating combat injuries is this:
The best medicine on the battlefield is fire superiority!
You don't treat anyone until the fight is over. You stop the enemy from shooting at you either by killing them, or forcing them to flee. When it is safe, then you can attend to the injured. If you have to move an injured person, you move them while continuing to engage the enemy, and if the injured person is able to do so, they should be engaging the enemy while being moved as well.
Without going into all the specific details of TC3 (Tactical Combat Casualty Care), I'll discuss the hands on portions we covered. You can download a copy of the US Army TC3 Handbook for all the nitty-gritty details. However, don't rely on this alone...without the proper hands on instruction, you won't understand the context and could end up doing more harm than good. Get trained first!
First Mosby went through everyone's IFAK to make sure they had the proper gear. Not everyone did. He had the list of required items listed on his blog. Make sure you have what's listed when you attend his class.
He showed us the HALO Chest seal for sucking chest wounds and discussed its purpose and proper use. During this portion, he also discussed the proper use and application of the 14 gauge ARS for Needle Decompression when treating a life-threatening tension pneumothorax.
The first thing to do for an injured person is to stop life-threatening hemorrhaging if tactically feasible. This is accomplished, in most cases, with your handy-dandy CAT tourniquet. Make sure you have the real deal and not the cheap ineffective knock-offs. You keep tightening it until the blood flow stops. Leave it on.
The class was instructed on the proper usage and application of the CAT. We were timed on getting one on ourselves as well as getting one on our partner. Untreated arterial bleeding will kill you in less than 3 minutes and you will lose consciousness in 60-90 seconds, so arterial bleeding must be stopped ASAP!
The proper use and application of gauze to stop bleeding from a gun shot wound and promote clotting was discussed. Students were taught how to properly dress a wound using an Israeli Battle Dressing. The debate on using Celox or Quick Clot impregnated gauze basically came down to preference. Even regular gauze works just as well if properly packed into a wound. One concern with using Celox is that it contains Chitosan, a shrimp shell derivative that could be fatal to someone with a shellfish allergy.
The importance of ABC (Airway, Breathing, Circulation) was discussed.
An effective airway must always be maintained. If the patient is unconscious or risks going unconscious, a Nasopharyngeal airway (NPA) insertion will be necessary. If this is not an option, due to severe maxillofacial damage, move on to a surgical cric. (this is beyond the scope of this AAR but was discussed in great detail)
A couple students volunteered to allow a NPA to be inserted in their nose.
I won't go into the details of how this was achieved because I'm not qualified to teach this and I'm not a doctor, nor do I play one on TV. But suffice to say, it was not a difficult procedure to execute properly although it was humorous at times.
As you can see in the illustration above, the purpose of the tube is to provide and artificial airway in the event that the natural airway becomes blocked.
Afterwards Mosby discussed the proper way to start an IV in the event of, or to prevent Hypovolemic shock and even allowed 2 students to actually attempt it on himself. What other instructor would ever do that?! The man is dedicated!
If you have an injured person that has a high probability of not surviving, even with medical treatment, don't treat them. Do what you can for pain but don't waste your finite resources on treating a dying man.
"It's called triage. It's is a mother fucker, and it sucks...but it's necessary."
- Mosby Maxim #35 -
Mosby recommended that we get the Special Operations Forces Medical Handbook along with a good human anatomy & physiology book.
In a SHTF scenario, you may have to rely on yourself for medical treatment. Get the books now and get familiarized with it. Practice conducting a surgical cric on a chicken neck. Practice suturing on a chicken breast. Shoot a roast and practice packing the hole with gauze and bandaging it.
Get medical training and Practice! Practice! Practice!
A good place to start would be to enroll in a CERT class near you.
The sooner you get trained, the sooner you'll be ready.