Tourniquet prep is a tool that I see missed from the professional level on down. Take a quick look at this 4 min video explaining the proper method to prepare your carry tourniquet for use in a critical stress environment.
The Bare Dynamics Cognitive Shooting Targets reviewed and demonstrated by "Shooting It With The Sarge"!
Shooting It With The Sarge
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A group of firearm fails that will make you consider carrying a trauma kit.
Prepared to take a life?
Prepare to save a life.
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One of my favorite high school era activities was weekend Paintball at a friend’s farm. It was good fun with good friends…most of the time. Keeping the games at my buddy’s place kept our costs down as opposed to registering at a field. Also, we didn’t have to worry about those pesky psi restrictions. We laughed at the paintball authority with cold discontent. Dammit, if we wanted the paintballs to break skin we should be allowed to do so! The flip side of this coin is we worked on the honor system. If you're hit, you’re out. Raise your hand and walk away so everyone knows you got smoked.
Inevitably arguments would come from the very nature of the game. Casualties would scorn the shooters: “You don’t have to shoot me a million times!” Shooters would bellow at their targets: ” I shot you, you’re out!!” It’s a typical and expected paintball mindset. If you're hit, you're out.
Here is the Problem… this paintball mindset will get you killed. Let me break this down Barney style…
Law Enforcement Officers (LEO’s) carrying OC (Oleo-resin Capsicum…because it’s fun to say) are required to endure the effects of the irritant. I would describe this as having your face sandblasted off while simultaneously barbecuing it with napalm, all while continuing to perform your duties. I was required to fight off a subject (Punching bag) and place them (real person) into proper handcuffed state while my face melted off. It showed your ability to endure and perform through the issue. This is a good example of training with a combat mindset. Its not the Paintball mentality of stepping down at the first hit. You embrace, you endure, you excel.
Often in training events which include gunfights, shootings etc. officers and bystanders are “shot”. It’s common to hear a ref, or supervisor say “You're dead dummy!" or "Dead people can’t talk”. You could argue the benefit to the LEO is to reinforce NOT to make this same mistake in the future. After all, a fatality is what we are all trying to avoid. It’s the highest form of defeat. You could even say this situation has some training value for the officers around the recently deceased… like how will they extract the casualty? Perhaps its decided that a shooter will have good shot placement and all wounds will result in immediate fatalities! I call ridiculous… this mindset is damaging and fatal. Here’s why…
Let’s transition in our minds to a real-world scenario. An officer at a traffic stop is ambushed and shot. Training kicks in and in their mind, they hear “Your dead dummy! Dead people can’t talk!” Sounds strange and counter intuitive… but consider the reinforced training paradigm. The officer is shot in the leg and bright red blood begins to pulse out of the wound. Training tells the officer their dead. It’s all they have done. It’s the fatality of the paintball mindset. These training evolution's should be done like the OC training. Embrace and endure. Stay in the fight. This is a combat mindset.
You will see me at Bare Dynamics often refer to the "Combat Mindset", and it all starts in training. Always train the way you fight because you will fight the way you train. Proper training should always include combat mindset considerations. This officer in our hypothetical should know the best medicine in hot environments is fire superiority. This officer should have practiced and known to utilize a tourniquet on the arterial leg bleed. But instead the training told him to freeze.
Not all gunshots are fatal, and those that are won’t always immediately kill you. Your mindset should push you to engage your target to end the threat. Your training should push you to know how to treat your own wounds. It can mean the difference between seconds and minuets, victory or defeat, life and death. You owe it to yourself and those who rely on you to assess your combat mindset. I challenge you all to perform a self-assessment. What is the status of your mindset? How does your training affect your mindset? How can you improve?
Bare Dynamics teaches preparedness. Preparedness is not status. It is a lifestyle. It's ingrained in all we do. Your mindset is no exception.
You may be wondering where all this "Stop the Bleed" stuff has come from. Likely you have or will have seen Stop The Bleed kits, hemorrhage control stations in public settings just like AED's. The American College of Surgeons got together with first responders, statisticians, the US Military and put their heads together. "Stop the Bleed" is their brain child!
In April 2013, just a few months after the active shooter disaster on December 14, 2012, at Sandy Hook Elementary School in Newtown, CT, the Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass Casualty and Active Shooter Events was convened by the American College of Surgeons (ACS) in collaboration with the medical community and representatives from the federal government, the National Security Council, the U.S. military, the Federal Bureau of Investigation, and governmental and nongovernmental emergency medical response organizations, among others. The committee was formed under the guidance and leadership of trauma surgeon Lenworth M. Jacobs, Jr., MD, MPH, FACS, vice president of academic affairs and chief academic officer at Hartford Hospital, and professor of surgery, University of Connecticut School of Medicine, to create a protocol for national policy to enhance survivability from active shooter and intentional mass casualty events. The committee’s recommendations are called the Hartford Consensus, and currently consist of four reports.
Hartford Consensus I–IV
Improving Survival from Active Shooter Events: The Hartford Consensus
June 1, 2013
Active Shooter and Intentional Mass-Casualty Events: The Hartford Consensus II
September 1, 2013
The Hartford Consensus III: Implementation of Bleeding Control
July 1, 2015
The Hartford Consensus IV: A Call for Increased National Resilience
March 1, 2016