Today I’m reviewing another DVD in the Personal Defense Network’s Personal Firearms Defense series. This time, it’s Caleb Causey teaching us how to deal with life threatening trauma!
Immediate Emergency Medicine
Presented by Caleb Causey and Rob Pincus
I’ve been pretty vocal over the last few years about the need for knowing how to treat life threatening trauma. I think it’s a good idea for anyone who carries a firearm for personal defense to know how to treat massive bleeding, and I consider it an absolute must for anyone who teaches shooting courses at any level.
To this end I’ve put my money where my mouth is and taken training classes in emergency medicine. You should too, but if you can’t this DVD will help you understand what you’ll need to do to respond to a traumatic injury. Of all the DVDs that the Personal Defense Network sent for review, this was one I most wanted to see!
Life threatening trauma, ultimately, means massive bleeding. There are all kinds of trauma which can kill, of course, but bleeding remains the one which is most immediately threatening and the only one which can be treated in the field; anything else requires a surgical suite and people who know how to use it.
This kind of trauma is often the result of a violent attack in which gunshot or knife wounds are sustained, but it can also happen under more mundane circumstances: the result, for instance, of an automobile wreck, a workplace accident, a child falling through a window, or even a slip onto a broadhead while bow hunting. Massive bleeding can occur anywhere, at any time, and knowing how to stop it is an important part of any emergency preparation.
I’ll go out on a limb and say that learning how to control massive bleeding, and carrying a kit to do so, may be more important than carrying a gun and knowing how to use it. Both have equal levels of consequence (death), but trauma is far more common (greater incidence.) That makes knowing how to treat it in the field a vital skill in the truest sense of the term.
This DVD features Caleb Causey of Lone Star Medics in Arlington, TX. Causey is a former Army medic with the 82nd Airborne and currently an EMT and SWAT team medic in Texas. He has significant experience dealing with trauma and is well qualified to teach others how to do so, which is what Lone Star Medics does!
Causey starts off by pointing out that an attack is likely to produce traumatic, life-threatening injuries, and that you have a responsibility to take care of yourself after the fight. He also points out that you’re not the only one who might sustain life threatening injuries during an incident; bystanders can be hurt as well, and in that case they’ll need your lifesaving attention.
He’s clear to point out that the context of use of these kinds of medical skills is very important. Military medical skills don’t always translate to civilian encounters, and the skills taught need to fit the circumstances under which they’ll be used. He’s careful to differentiate between what’s appropriate in a military context and which is appropriate in the kinds of traumatic incidents we’re likely to see. Those differences revolve around the how, why, and especially when to apply medical care!
Of course we all want to see what a real pro carries in his medical kit, and Causey shows several kits and their contents. He has some specific preferences in gear, and to me this was interesting as the instructors I’ve had voiced different preferences. I learned about some products which I didn’t know existed (like the OLAES Modular Dressing, which looks to be very useful) and got to see some which I’ve heard of but not used.
In making up your kit, Causey is clear that you need to focus on bleeding (making it stop) and breathing (keeping it going.) The gear you choose should focus on those two things, and as it happens you really don’t need a lot of stuff to do so. You do, however, need the knowledge to know how to use it!
He recommends, at a bare minimum, that you carry a tourniquet and some sort of chest seal (to keep the lungs working if they’ve been perforated.) Hemostatic gauze (fabric impregnated with an agent that causes even severe bleeding to clot) is very useful, as are regular gauze and pressure dressings, but the tourniquet and chest seal are the basis of any trauma kit.
Causey goes into some detail about the misconceptions regarding the use of the tourniquet, and if it’s been some years since you’ve had any first aid training you may be laboring under the misconception that tourniquets aren’t recommended any longer. Our military’s experience treating severe wounds in the various Middle East conflicts have produced not only better tourniquets, but a better understanding of their use and — most importantly — their limitations. The result has been a sea-change in the attitudes toward the tourniquet. For severe bleeding on an extremity, they are now the “go-to” choice in field treatment.
If you have the space, Causey recommends carrying a tourniquet, chest seal, some sort of pressure dressing (he’s a big fan of the aforementioned OLAES, which is his favored replacement for the commonly recommended Israeli dressing), a package of hemostatic gauze (he prefers the Quick Clot brand), a package of plain gauze, and a pair of trauma shears or a hooked fabric ripper.
Carrying this gear so that it’s immediately accessible is important, and he shows several varieties of carrying pouches ranging from a compact ankle rig to a fanny pack to a modular pouch that fits onto the back of a car’s headrest.
Whatever carrying method you prefer, he maintains that it has to do two things: first, allow you to access all of the contents using only one hand (in case you need to treat your own wounds); second, keep all materials contained even when open (so that the important contents don’t get scattered.) The latter is usually done with elastic retaining straps, so that you can even throw the kit to another person when it’s open and the gear won’t spill out.
Causey points out that your gear should be packed in order of most immediate need. The tourniquet, he points out, is usually the most urgently needed (and the first thing you apply) and it needs to be packed last — on top of the other gear — so that you can reach it first.
His firm belief is that you need to carry this gear regularly, just like you carry your defensive firearm, if it is to be of any use. It is emergency lifesaving equipment that does you no good if it’s at home or locked in the trunk of the car where you can’t reach it!
There’s much more in the gear discussion, but it’s the use of that gear which is really important. The section use starts with a sensible lesson on securing the scene — making sure that the threats have been neutralized — before you start treating any wounds. If you become a victim yourself because you rushed in before it was safe, or if you stop dealing with the threat at hand and he causes more casualties, you’ve failed. Make sure you’ve dealt with any threats, then transition into lifesaving mode and treat the injured.
He goes into great detail about patient assessment (showing a specific and systematic way to find and treat injuries) as well as showing how to properly apply a tourniquet — both to yourself and another party. (His explanation of one of the “whys” behind where to apply a tourniquet was significantly better than that of other instructors I’ve heard.) He even shows how to pack the tourniquet in your kit so that it takes up the least room yet is easy to apply one-handed.
After tourniquet use Causey jumps into the details of using pressure dressings and how to deal with chest injuries. He includes information on why chest wounds are dangerous and why the chest seal is so important. Chest wounds, he points out, often don’t bleed much and as a result many people don’t realize how dangerous they are. Do you know the symptoms of tension pneumothorax? He tells you and what to do about them.
One of the sections deals specifically with a wound that firearms instructors are most likely to see: a gunshot to the upper leg, as might happen during a reholstering accident. Tourniquets don’t always work for these, so he shows how to treat them using direct pressure and hemostatic gauze.
His presentation of packing a wound with the gauze is, again, more detailed than some of the instruction I’ve experienced and frankly cleared up some lingering questions I had. He also had a detailed explanation of where you can and cannot use that product; I would have paid for the DVD just for that information, as neither of my instructors mentioned any of it!
Causey finishes up with information on treating shock (including pointing out that bystanders without obvious injuries sometimes need to be treated for shock) and how to deal with 9-1-1 when making a medical call.
Like firearms training, in trauma care there is no substitute for hands-on education under a qualified instructor. That having been said, the Immediate Emergency Medicine DVD was detailed enough to serve as both an introductory course for those new to the topic and (especially) as a refresher for those who’ve already taken such a class. I learned quite a bit from it, and I’m not new to such information!
I’ll go further: of the DVDs I’ve seen from the Personal Defense Network, this is the first I’m calling a “must buy”. The information is important for everyone to know, it has wide application to everyone regardless of situation, and is presented clearly enough to be a primary source if necessary.
You can purchase the Immediate Emergency Medicine DVD from the I.C.E Store (I receive no compensation from your purchase.)
-=[ Grant Cunningham ]=-
Disclosure: This DVD was supplied by the Personal Defense Network for review. I am affiliated with PDN and its managing editor, Rob Pincus, as a contributor.