Thought to share on trauma medicine

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wm
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Thought to share on trauma medicine

Post by wm »

I've been reading after action accounts of the shooting in California last week & comparing it to other shootings and it occurs to me as much as we (both sides) tend to focus on firearms and what could have been done before the shooting (often a discussion that boils down to control …… guns, thought, custody, medication, mental health confinement, etc) we over look the immediate need of treating the wounded.

In the case of the shooting in Saugus High School, many accounts talk about the fact that off duty officers were dropping off their children and immediately headed towards the sounds of gunfire. They were obviously too late to stop the shooting or even prevent the suicide of the shooter but what they did do was render first aid and likely saved a couple of the shooting victims.

I have determined (and am writing up a proposal for the place I work) to include emergency trauma treatment in our future training. Not just CPR/AED/Choking but also issues like treating wounds. This does not simply apply to gunshots. Car accidents, industrial accidents, even slip and falls can result in life threatening injuries. And we as a community of shooters have to recognize that our hobby has a element of danger to it. From the newbie on the line who does not understand trigger or muzzle discipline to the ricochet or bounce back from the back stop to even the KA-BOOM we see pictures of regularly.

It might be worthwhile for each of us to consider reaching out to our employers or civic groups about offering classes. If nothing else it might be fun to watch a politician on one hand say there is insufficient need for such classes and then turn around and say we need to confiscate or ban firearms.

Like the old Boy Scout motto …… Be Prepared!

Wm
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jeepnik
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Re: Thought to share on trauma medicine

Post by jeepnik »

Decades ago Red Cross taught first aid. Most firemen, cops & ambulance attendants were required to have Red Cross certification. It was basic but the equipment available was also basic.

Things started to improve. FD’s began to have Paramedics. Local schools started to offer training as EMT’s and certification became more difficult. At the same time the equipment got better. What folks in the field could do, with & without doctor or RN approval expanded. A lot of folks survived injuries that would have been fatal just a few short years earlier.

It was during this infancy of field trauma treatment that I got involved. Now the military and civilian worlds had different rules. The Navy had medics (these guys were are and always will be top notch. Army medics specialized in trauma medicine in the worst of conditions. The Air Force had PJ’s, the best trained field medics anywhere. But there were darned few of them.

So some of us firemen went out on our own and took the training. But there was no organized system each base winged it. Our rescue trucks were worn out and outdated. So we filled 1/2 ton pickups with whatever the base hospital would let us use. Then squeeze three guy onto the bench seat.

Somebody paid attention. Before long we had new rescue trucks. The tools and equipment made a quantum leap. And it started to become more organized and uniform throughout the service. But as it did more restrictions on what could be done in the field were enforced. It became as restrictive as the civilian world in many ways.

So where is this going. Back to the Red Cross. During this transition the Red Cross developed a more intensive course. Called Advanced First Aid it tried to fill the gap for first responders that didn’t have EMT training available locally. It involves treatment of some pretty serious trauma. Available equipment was still restricted but it was much better than earlier training.

As EMT’s became more prevalent first aid training became less complete. There isn’t much more than basic first aid available in most schools, industrial or business settings available. Folks rely on first responders. Yet in many places and some situations paramedics are as rapidly available as would be desired.

What’s needed it a return to the advanced first aid concept and readily available trauma kits for folks to use. If you heard about the young girl that ran into the band room you know the teacher’s first aid kit was good for only cuts and scrapes. Some of today’s trauma dressings have clotting capabilities that we’d have loved way back in those early days.

Sadly it will never happen. The ever present threat of litigation will stop any organization and most members of those same organizations from ever doing more than putting a bandaid on a boo boo.
Last edited by jeepnik on Sun Nov 17, 2019 2:10 pm, edited 1 time in total.
Jeepnik AKA "Old Eyes"
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AJMD429
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Re: Thought to share on trauma medicine

Post by AJMD429 »

Both of you make really good points. I see some of the outdoor blogs and other firearm and hunting related things on the internet where they will talk about bug out bags and other things.

Some of them talk about Advanced first aid kits or trauma kits, but most of the ones I've seen seem to be more advertisements for a specific brand of gear than anyting.

It would be good for all of us to have the basic stuff needed (kit as well as training) for major penetrating wound or other immediately life-threatening injuries.

I remember coming upon an automobile accident where several of us got out to see if we could help anyone, and of course the other people in my vehicle knew I was a physician, so expected I must be able to work some sort of miracles for the accident victims. Physicians know the anatomy that is pertinent, and usually have common sense, and won't panic about blood and guts, but they are way less helpful than a trained medic, unless they have specific trauma experience or work in an emergency room. Even there the scenario is so different because in an emergency room you just speak out the things you need and want to happen and someone else does them, plus every imaginable piece of equipment is handy.

In short, I think eveyone would benefit from training and have if nothing else some tourniquet, clotting-gauze, gloves, and an airway in their car or workplace.

We had a guy who happened to pull his car into our lot when it quit running and somehow his battery exploded throwing sufuric acid all over his face; quick thinking on the part of the receptionist, who has worked in a factory and got training there for chemical accidents, probably saved his vision. You never know when bad stuff is going to happen...!
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piller
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Re: Thought to share on trauma medicine

Post by piller »

I agree. At one of our stores, about a week ago we had a young child go into a febrile seizure. Amazingly, there was a Pediatric Nurse in line who took charge. I got called to come up front from the Pharmacy to come and help. On the way I grabbed all the instant cold packs off of the shelf. I got there and popped 4 of the instant cold packs, and the Nurse held them on the kid. When the seizure ended, the kid was confused and crying. The Mom was very distraught. The Store Manager had already called 911. I had grabbed one of those instant read temple thermometers off the shelf on my way up front. The kid's fever was at 103.2 when I first checked. With the Nurse and the Mom holding the cold packs on, the fever was down to 99.7 by the time the Paramedics arrived. The Nurse was holding cold packs on the neck and stomach, and the Mom had them on top of the head and between the shoulder blades. Without the Nurse there in her scrubs, the several customers tossing out advice might have made the situation worse. I would have held the cold packs against the kid if the Nurse had not already been there. The Paramedics took the cold packs with them. It seems we did what was best based on what was available. Grand Mal seizures are scary to see at any time, but when it is a toddler it is even worse. We claimed the cold packs and the thermometer as damaged. I felt as if my training was totally inadequate.
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Re: Thought to share on trauma medicine

Post by piller »

I do keep gauze, rolled gauze, tape, self adhesive tape, and black pepper in the bathroom towel cabinet at all times. For those who have never been on Coumadin/warfarin, black pepper clots wounds instantly and does not burn. It will even cause blood to clot when you are on a blood thinner. I learned about the pepper causing bleeding to stop back in the Army.
D. Brian Casady
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jeepnik
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Re: Thought to share on trauma medicine

Post by jeepnik »

The comments on commercial kits is dead on. The best kit is one you put together based on your experience and training. Mine wouldn't suit someone with less expensive and training. No I’m not being an elitist. It’s just that some things used wrong can do more harm than good.

One thing I’ve seen are kits that are obtained stuffed in the trunk and forgotten. The components have a shelf life. I’d still rather have outdated supplies than none.

The problem with obtaining and maintaining a good kit is cost. In the service I taught Advanced Red Cross First Aid. At the end of the course the students were given very complete kits in line with their training. As
Things expired or were used they could drop by the firehouse for fresh supplies. Uncle had deep pockets and we never heard a complaint about this setup. Such a deal in the civilian world would have politicians wringing their hands over the costs cutting into their perks.

Schools used to teach first aid. I know of none that do so today. Potential litigation rears its ugly head again. As in so many things people tend to rely on the “government” to take care of them rather than have any self sufficiency.
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fordwannabe
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Re: Thought to share on trauma medicine

Post by fordwannabe »

I am an RN by training though I don’t do bedside nursing anymore. I put together my version of a first aid kit for both vehicles using fishing bags. It is a smallish multippcketed affair that has removable trays inside with adaptive compartments for lures or other tackle. I numbered the trays and each tray has a purpose. Burns, wounds, broken bones /sprains ect. In my birthday in February each year I go through the kits for updating and changing out expired leaked, damaged items and use my Birthday money to replace stuff. Those kits have come in handi on more than one occasion and I take it to all the gun club activities as a supplement to the one in the clubhouse. Good stuff to know and have with you anytime.
a Pennsylvanian who has been accused of clinging to my religion and my guns......Good assessment skills.
Rusty
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Re: Thought to share on trauma medicine

Post by Rusty »

IIRC in some of the news coverage of the recent Ca. shooting they were talking about trauma kits that they used on the scene. Some of the kits used were used to pack gauze into woulds and the contents were exhausted, they had to go look for more kits which took time.It sounded like the kits were kept on hand by the school.
I always wondered if something like the black pepper mentioned or Quick Clot is used on a wound does it cause problems for doctors once the patient gets to the medical facility?
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piller
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Re: Thought to share on trauma medicine

Post by piller »

Probably not. Once the scab/clot is rinsed and scraped off it will bleed again. It is a fix best for temporary or shallow injury use. Shallow injuries may heal without any more being done than just pepper being sprinkled on. Injuries that go deeper than a couple of layers of skin, or into the fat or muscle should be looked at by a Doctor to determine where to place the stitches. I have no trouble stopping the bleeding on a cut or wound, but you shouldn't think that my treatment is sufficient. First aid is temporary for a serious injury. I have been through Red Cross training to stop bleeding and to give CPR. Anyone who thinks that is enough to fix a serious injury is probably going to think that any firearm will stop a charging elephant.
D. Brian Casady
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Advanced is being able to do the basics while your leg is on fire---Bill Jeans
Don't ever take a fence down until you know why it was put up---Robert Frost
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Tycer
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Re: Thought to share on trauma medicine

Post by Tycer »

Taking a TC3 course is near the top of my bucket list.
Kind regards,
Tycer
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