AAR Idaho Combat Lifesaver
BLUF: If you are not an experienced combat medic, you need to take this course. You are more likely to be a hero by saving someone’s life than you are taking someone’s life and this course is a hands-on fundamentals course on how to deal with traumatic injury. Specifically gunshot wounds, but applicable to car accidents et. al.
WHO: The class consisted of students with no prior medical experience and also included two ER physicians, respiratory therapist, nurses.
Me: Registered Nurse since 1994 currently working on an MSN to become a Nurse Practitioner. While I did critical care and worked in an ER some for 2 years right out of school, the last time I did any trauma training was when I went to Army Medical Department Officer’s Basic in 2012 when I commissioned.
WHAT: A 1 day course consisting of classroom instruction on the Army’s Tactical Combat Casualty Care protocols and a hands-on, scenario based practical application. Nobody was actually shot, we took turn practicing our scenarios on our buddy. Most of time was spent practicing the MARCH protocol.
Hypothermia (and by extension head).
Time was also spent discussing care under fire, tactical field care and as an addendum care after TFC.
So, to sum it up MARCH addresses the 3 preventable causes of death on the battlefield: Massive hemorrhage, tension pneumothorax and airway obstruction. All of these are addressable by a minimally trained person using the contents of a standard IFAK. During the Care Under Fire stage, the only thing that is addressed is massive hemorrhage using a tourniquet either by self care or buddy care. Once you are no longer receiving fire then you have time to go through the entire MARCH protocol which also includes packing extremity wounds, sealing sucking chest wounds, releasing tension pneumothorax with a needle/angiocath and maintaining the airway.
What I particularly liked about this was the hands on practice. This gave us the opportunity to practice perishable skills like tourniquet application, head to toe assessment and getting items out of the IFAK.
WHERE: An undisclosed location in the vicinity of Midvale, ID. Not a lot of hotels in the area, but we stayed at Mundo Hot Springs hostel (Bring your own bed linen). It consisted of 2 bunk beds, a rollaway and a claw foot bathtub plumbed with hot spring water.
WHY: I have already explained the reason why I attended, the real question you need to be asking your self is why someone with my experience (including 15+ tactical training classes) would interrupt a cross country vacation, drive 10 hrs from Colorado to attend a 1 day class and then in turn drive 12 hrs back to Cody, WY? And I had even had a preview of this class in the Rifleman Challenge. It’s not because I am a Max groupie, it’s because it is good training and I take every opportunity I have to get training.
Max stated in his class that this class is his least offered class because there is just no demand for it. This I fail to understand. If you carry a gun, train with guns and plan to defend yourself you should be training on how to deal with getting shot. It’s not just gunshots either. This training is applicable to many traumatic events such as chainsaw accidents, car accidents and mass casualty events. Think Boston Marathon bombing. If you know the principles of MARCH and are confident in your ability to use them, you realize that you don’t necessarily need the equipment (although it is best to have them) because you are surrounded by field expedient TQs and chest seals.
Some takeaways from the class.
- Have an IFAK.
- Know how to use the contents of your IFAK. Buy 2-3 and learn through practice how to use the contents. Max has a list of items that need to go into an IFAK. Max and I discussed the possibility of having a Team Coyote approved IFAK, but it may take some time to work out the details. In the meantime, the contents on the list should be purchasable through Chinook Medical or other sites.
- Everyone on your team needs an IFAK and it needs to be standardized located in the same place.
- The contents of the IFAK are for use on YOU and not anyone else. You may not know how to use the 14 gauge needle to decompress the pneumothorax, but it is for use on you and someone on your team may know how.
- The IFAK is for traumatic injury only and should not be mixed in with Tylenol and boo boo supplies.
- Tech is always changing and improving. The SOFTT-W Generation 4 tourniquet is a vast improvement over the CAT tourniquet and I will be buying some.