Review: Combat Lifesaver Class – Jonathan (Opposing Force Leader)
Max adds: Jonathan is the leader of a our permanent OPFOR (opposing force i.e. enemy force) group. OPFOR attended this class for the lecture portion and also acted as both enemy and friendly forces for the three days.
Combat Lifesaver; Jonathan
I’m not new to the medical world; I’m an EMT myself and many people in my family are in the medical field in some form or fashion, so I interact with medicine quite often; however, battlefield care is an entirely different ballgame, so I was really looking forward to this class, and I was not disappointed. Most of the medical instruction I have gotten from tactical classes at other schools has been more or less limited to “put a tourniquet on it and call for the medic if you have one” but that is entirely insufficient. The truth of the matter is, most of us don’t have medics and unless your game plan involves some magical way to make sure no friendlies ever get shot, every person in a squad needs to have some real skill and experience keeping people alive in a hostile scenario. What’s funny is, even though I knew that mentally, I realized over the course of the weekend that I still thought of a lot of the basic skills as “medic” skills rather than “everyone” skills. “Everyone should be putting on tourniquets, but only medical personnel need to practice packing wounds, right?” Wrong. I appreciated this class a lot because it specifically did not focus on “medic skills” but rather on the skills that every single rifleman on a squad needed to know. To that end, every single person who trains with a rifle needs to take this class. Period, full stop, end of discussion.
The class was set up with Friday being a lecture day, with some skill stations to practice various elements of TCCC / MARCH. There weren’t any surprises, the whole protocol is pretty simple, but that does not mean that you can zone out for this portion; we got to watch the consequences of insufficient effort during Friday leading to significantly increased difficulty during the Sat/Sun “tactical portion.” More on that later. Suffice it to say, the motivation and effort you put in (or don’t) on the Friday portion will significantly affect the rest of the weekend. It’s no different than the other courses at MVT – zoning out or drilling halfheartedly on the square range portions of a HEAT 1 will cost you dearly during the tactical portion, and the same goes for CLS.
Saturday/Sunday were practical/field applications of the lecture portions, and though this class is focused on the medical side, “every class at MVT is a tactical class.” Max and Scott throttle the OpFor enough to where you can’t ignore the tactical side (you still need to post security, for instance) but the gunfight isn’t the primary focus. It also means the casualties develop naturally and unexpectedly as the result of enemy fire, rather than being arbitrary and assigned, which means that casualties are laying in weird places in the field rather than wearing jeans and a T-shirt on a grass lawn. You have to deal with inclines, with dragging casualties to cover before treating them, etc., and while that sounds pretty simple, very few of us have practiced that before, and it’s not nearly as straightforward as you’d think.
Mixed in with the tactical portion were more…”drills” I guess? For instance, there was a portion where students individually assessed and treated a patient under Max/Scott’s eye, kind of like a TC3 version of a jungle walk, where individual skill was put to the test instead of just being notional.
The combination of all of these elements is profound. It was striking to me how much “tactical medicine” is taught in a vacuum. I’ve been to several different classes from other schools, where you get taught a lot but you actually practice very little, and this class is different; you have to do it in practice. You actually have to put on a tourniquet; you don’t cinch it all the way down, but you have to actually put it on and snug it up. You have to actually bandage junctional wounds, which are not as straightforward to wrap as arm/leg wounds. You have to actually practice taking a casualty’s armor off and putting it back on, without aggravating his injuries, under fire, and then wrap him for hypothermia and carry him out. None of these are complicated, or even terribly hard, but to almost every one of us, they are unfamiliar and unpractice
Key takeaways:
1. Everyone needs to take this class, or equivalent. A “stop the bleed” is not even in the same ballpark – everyone needs practice rendering TC3 while in the context of a tactical scenario, because it’s a lot harder to do than you think.
2. Do as much physical practice as you can. Notional has to happen sometimes, but the more notional training you have, the less prepared you are. It shouldn’t surprise anyone that it’s harder to actually wrap/pack a “wound” than it is to just say “pack and wrap.” It’s easy to talk about taking a person’s gear off to treat him, it’s harder to actually do it. So, when you come take this class, physically do as much as possible. Which leads to the next point
3. Bring IFAK supplies with the intent to open and use them. Yes, it costs some money and yes, it’s a lot cheaper to do everything notionally, but I promise you, you don’t want the first time you open a pressure bandage to be when someone is actually bleeding, or even when you’re under Cadre’s discerning eye during individual assessment. It’s worth it to actually practice the skills you’re there to learn, and skimping the money for extra gauze/bandages/etc., is like showing to a HEAT 1 intending to do the whole thing dry fire. Bring extras to practice with, it’s worth it, and skimping on practice with the medical supplies you’re there to use is like stepping over a dollar to pick up a dime.
4. Don’t overlook the tactical element. Battlefield aid is rendered on a battlefield. You can practice classroom all you like but you can’t neglect the context that you’re training for. This class is not focused on the gunfight elements, but that doesn’t mean they can be disregarded; It’s still a gunfight and the enemy is still trying to kill you. It’s hard to manage both a fight and a casualty at the same time; that’s why you need practice managing both. I heard someone say that trying to do both was like patting the head while rubbing the belly; individually it’s pretty simple, it’s harder to do both at the same time than you might think, until you’ve practiced it. You’ll hear that “the best medicine on the battlefield is fire superiority” which is true, but part of that lessons is actually achieving fire superiority in order to be able to be able to render aid.
Final thoughts:
Max mentioned, and I agree, that one of the unique benefits of this class is not that it’s harder, it’s that it’s more realistic than others, and I agree. During SquadTac/CQB/Recon/etc., you take casualties but you generally leave them where they fall, and even if you extract them you don’t generally treat them, That makes sense for those classes – their focus is on other things. But any gunfight will involve casualties, and until you practice treating casualties in a tactical scenario you can’t expect to be able to do so in real life. I’m an EMT, I’m not new to emergency medicine, but this class was still pretty eye opening. Everyone who trains to cause gunshot wounds should learn how to treat them.