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MDS
12-29-2012, 01:04 AM
I was checking into the range a couple of days ago, when a woman shot herself. (http://blogs.miaminewtimes.com/riptide/2012/12/key_west_principal_commits_sui.php) Some dudes came out into the store area yelling about a gsw. Several folks started dialing 911. I unzipped my BOK compartment and took the contents into the range area. I'll skip the detailed visuals, but it did not look promising. There were two people kneeling with her, who seemed to know about as much as I did - i.e., not much. I had nothing additional to offer except the stuff from my BOK. One of the dudes kneeling had his hand on the chest wound, I gave him the Olaes bandage. A cop arrived, an off-duty paramedic started to help, too. I got out of the way, the bus showed up and took her away. The debriefing and paperwork ensued. The off-duty paramedic told me later that the bandage almost made the difference. I guess that's something.

For a while, it looked like this might have been an accident - the gsw was in the chest, and there was some ill-advised malfunction clearance happening right before the gsw. The woman left a note for her family, though, so this is being ruled a suicide. That makes me feel a lot better, for some reason.

I've signed up for the first BLS class I could attend in my area, and will sign my wife up for one soon after. I'll look for additional training after that - I'm especially interested in the WFR cert, it seems like a good combo of prevention, trauma from mild to serious, and outdoor-relevant skills, without a bunch of EMT stuff that I won't be able to use. I'll reconsider my BOK, maybe add some simple gauze as well as the Olaes.

I've been getting sloppy with my range trips - heading out not quite early enough, so that the place isn't as empty as I like. I'm reasonably comfortable, for example, at the NRA range when it's full, because while the RSO's aren't perfect, they're at least somewhat vigilant. There's no public range I know of within an hour of me that allows holster and rapid fire, and is also RSO'd in any meaningful way. My AO has a, ah, "higher than average yahoo saturation level." I'll be more careful about the timing of my range trips in the future.

........

Don't really know what I'm offering here with this post. Hey, guys, listen up: guns and gun ranges can be dangerous! I guess, if you guys can think of any other useful lessons from this, I'd love to hear them.

CCT125US
12-29-2012, 01:26 AM
I always request an end slot so that I only have one direction to watch. Does not always work out though. I also ask for the rifle range with the thought process being it takes more movement and therefore is more visible to manuever a rifle out of the shooters box.

dbateman
12-29-2012, 05:27 AM
Rough day.

Good work on going to the aid of others.

SeriousStudent
12-29-2012, 01:30 PM
Many moons ago, I used to drive a big white bus, and then ride in a big orange choppa.

Something along the lines of a military 9-line card would be a good idea, along with printed instructions on how to treat a gunshot wound. The reason I say this is, what happens when some booger-eater shoots you, the most skilled care provider? Want to stir angst and concern in the platoon? Shoot the medic first.

Wilderness First Responder, after a simple first aid class, is a personal favorite of mine. My reasoning is that they are very good at teach improvisation. Knowledge trumps gear every time. People will flail about, looking for precisely the correct piece of gauze, when there is a perfectly good fresh kitchen towel within arm's reach. WFR and WEMT teaches you what to do with what you have.

Good on you, having a kit and helping out. That's a great thing in today's society.

I'm shooting at a new range now, which is out in the boonies. If someone occupies the same space-time coordinates as a bullet, it's going to be an hour helo ride to a Level 1 trauma center. My gear reflects this. If this fits you as well, don't forget signalling gear and GPS coordinates of the range. I want to be able to get the pilot's attention, as well as provide info on wires, wind speed and direction.

You may want to look into local CERT training, or any volunteer or reserve EMS work. Those folks can be very helping in regards to training and potential gear choices.

Again, thanks for stepping up.

Chuck Haggard
12-29-2012, 02:05 PM
I've never had to treat a GSW off duty, but I have had to treat people at the scene of several MVAs during the course of a road trip, including one that had a squirting artery involved.

David Armstrong
12-29-2012, 04:04 PM
For those in some smaller/more rural communiites the locals will provide free EMT training in exchange for a commitment to work the ambulance for s certain amount of time. A good chance to get some good training and experience at little cost and learn a trade while helping your community.

MDS
12-29-2012, 08:57 PM
Something along the lines of a military 9-line card would be a good idea, along with printed instructions on how to treat a gunshot wound.

Good idea! I'll figure something out and post what I come up with here.


Wilderness First Responder, after a simple first aid class, is a personal favorite of mine. My reasoning is that they are very good at teach improvisation. Knowledge trumps gear every time.

Cool, that was my impression, I'm glad to have it verified, even if only on the Internet. ;) The worst part of this was feeling like an ASS for not having gotten on at least my BLS this year - it's such an easy thing and if my most recent BLS wasn't 20 years ago I might have been able to help more. Totally in sync with the bolded above.


You may want to look into local CERT training, or any volunteer or reserve EMS work. Those folks can be very helping in regards to training and potential gear choices.


For those in some smaller/more rural communiites the locals will provide free EMT training in exchange for a commitment to work the ambulance

Absolutely. I'm planning on moving to CO this year, I'm hoping for some volunteer firefighting opportunities.

Thanks for the ideas!

ETA: FWIW, she was taken to a respected level 1 trauma center a mile away.

Cookie Monster
12-29-2012, 10:03 PM
Getting training is always a good thing.

I've had my Wilderness EMT certification for going on a decade now and I've keep it current. I never understood gunshot/massive trauma and what to do and how to do it well until I took a dedicated two day class dealing with that stuff. The collective understanding of what to do has also advanced a lot in the last 10 years.

Good job stepping up and helping and also not getting in the way.

The thread is a good reminder to keep the skills and materials close at hand.

Prayers and healing to the woman and her family, good reminder to be checking up with the people we love.

Cookie Monster

JMorse
12-29-2012, 11:11 PM
I spent roughly 7 years as a volunteer EMT, donating literally thousands of hours per year doing so. By far the most rewarding thing I've ever done. I wish I was still in an area that used volunteers, as I'd still be doing it.

Edit: I should go on to say the catalyst for my starting was coming up to an auto accident and having zero clue what to do. I felt so ineffectual, and never wanted to be that way again.

SeriousStudent
12-30-2012, 12:32 AM
The best way to learn to treat gunshot wounds is to treat lots of gunshot wounds. I was (fortunate enough to be?) assigned to a crew in an area that was rife with unlicensed pharmacists. That amount of cash attracts attention, and bullets, and knives.

If you do get on with a volunteer crew, they may let you do observation in an ER, or do ride-alongs. Check with your local law enforcement agencies, they may also have a ride-along program.

If you have an opportunity to chat with some of the Army medics or Navy corpsman that have experience in Iraq and/or Afghanistan, they may also help you. Or they may not, some people change paths, and leave things in the past. Tis' understandable when they do.

Cookie Monster is absolutely correct about the major strides made in the last ten years. When I was a paramedic, they had just taken away our leeches, and started this new stuff called "gauze". Clotting agents and TQ's are two major changes, that you have likely seen in your BOK. Ten years ago? No way.

Zhurdan
12-30-2012, 03:08 AM
I spent roughly 7 years as a volunteer EMT, donating literally thousands of hours per year doing so. By far the most rewarding thing I've ever done. I wish I was still in an area that used volunteers, as I'd still be doing it.

Edit: I should go on to say the catalyst for my starting was coming up to an auto accident and having zero clue what to do. I felt so ineffectual, and never wanted to be that way again.

Used to drive for work a lot and drove up on two different accidents where people died. Unfortunately, all I could do was essentially hold their heads and watch them pass away. All I can think is that I gave them some sort of comfort while they passed. It has steeled me to get more training though, so I guess it's a win/win in that regard.

It is something that haunts my dreams to this day. Being there and NOT knowing what to do in the most basic of manners. Haunting.

I knew a bit, but these people were DOA essentially. There wasn't anything I could really do. There was so much blood. The one lady probably shouldn't have even been conscious with as much of her face that was missing but I held her there, and she seemed at peace. God bless those that deal with this on a daily basis, as I don't want to have to deal with it ever again!

peterb
12-30-2012, 07:21 AM
Used to drive for work a lot and drove up on two different accidents where people died. Unfortunately, all I could do was essentially hold their heads and watch them pass away. All I can think is that I gave them some sort of comfort while they passed. It has steeled me to get more training though, so I guess it's a win/win in that regard.

It is something that haunts my dreams to this day. Being there and NOT knowing what to do in the most basic of manners. Haunting.

I knew a bit, but these people were DOA essentially. There wasn't anything I could really do. There was so much blood. The one lady probably shouldn't have even been conscious with as much of her face that was missing but I held her there, and she seemed at peace. God bless those that deal with this on a daily basis, as I don't want to have to deal with it ever again!

You did well. Being alone and scared and hurt is miserable. If just being there and being calm was all you knew to do, it was a hell of a lot better than doing nothing.

http://ambulancedriverfiles.com/2012/12/17/for-newtown-volunteer-ambulance-corps/

First aid skills are important, but so is the human side of patient care, and it's a lot harder to teach.

SeriousStudent
12-30-2012, 04:17 PM
......

First aid skills are important, but so is the human side of patient care, and it's a lot harder to teach.

Amen. It's also one of the first things to go. And then you should go, as well.

Not turning this into a sob story or anything. But it is like a lot of career paths. It's something you are cut out for, or you are not. No dishonor or hard feelings if you aren't.

I think medical skills are just one of those things that everyone needs, to a varying degree. If you spend a lot of time in harms way, or performing higher-risk activities, it's good plan to know how to deal with the red squirty stuff. It just baffles me how many people think they are set for self defense, but have no ideas about threat avoidance. Or what to do when the threat becomes reality, and parts are no longer working as designed. There's a ton to learn, always more to learn.

ST911
12-30-2012, 07:04 PM
Critical life-saving skills needn't be complicated. Early simple BLS saves lives. Keeping air going in and out and blood circulating around and around are huge. Machines and meds are great, and sometimes you really need that OR fast, but I've seen too many die at the roadside or in living rooms that would have had a fighting chance if someone knew something simple.

MGW
12-31-2012, 09:40 AM
I'm sorry you had to go through that. I'm definitely a lot less skilled than others on this board so I probably can't add much to the conversation. There was a similar incident in our area this past year where a male rented a gun at an indoor range, bought a box of ammo, and did the deed when he stepped into his booth. I wasn't there only got the information second hand.

I've been through Red Cross first aid and CPR (I believe they call it level I?) multiple times and really it's a joke. The best training I've been through is Army combat life saver. The strange difference between the two is current CPR is really only teaching chest compressions and direct pressure for bleeding. CLS doesn't teach any CPR skills and they teach you to put a tourniquet on anything possible if there is blood loss involved.

The big three things in CLS now are stop the bleeding (tourniquet or direct pressure if the wound is in a place where you can't use a tourniquet), establish an airway (chin and head tilt or nasal pharyngoscopy (sp?) (hose up the nose), and needle chest decompression if a lung has been punctured. These three things don't sound like much but over 10 years of combat these three injuries have been the biggest cause of possible preventable deaths and they are three things that almost anyone can learn how to do. The other big skills taught of course is how to get help headed your way and how to move someone that's been injured.

Everyone is issued a personal first aid kit with items to perform those three things too. I think a civilian first aid kit would have a very solid base if it had those three items too. I think the needle chest decompression kit would probably be a lower priority and maybe someone else can chime in on that for me. When I was doing convoy security we made everyone carried at least one extra tourniquet. Having multiple people ready to punch out a nine line card and radio the information in was key too. I think the civilian version of a nine line would be

1. your name
2. your location
3. type of injury(ies)
4. number of people injured

Then you stay on the phone with the dispatcher and let them tell you what else they need. If you have enough people you'll also want someone to meet the ambulance and direct them to where they are needed.

To be effective with first aid you need to be ready to take over a scene if there isn't someone else qualified running things. In my experience when something bad happens there are lots of people standing around and not many people actually doing anything. Time will be the biggest factor in saving someone most of the time. Someone needs to call 911 immediately. Preferably someone that isn't performing first aid.


The biggest thing to remember is the goal of first aid is to keep the patient alive until more skilled and better equipped help gets there.

vaspence
12-31-2012, 10:49 PM
Sorry you had to witness what you did, but give yourself a huge pat on the back for being prepared and acting.

WFR is a great choice! I started there and moved to WEMT but WFR is a great place if you don't plan on riding the bus. I'm hoping I'll have the time to take the WFR course again when I recert.

I also took an additional two day GSW course. (If you are attending the Tactical Conference, Doc K is who I took the class from and he is a very good instructor). The only thing I'd offer up is to take the WFR from a reputable company (SOLO, WMI, WMA) to insure a good instructor. Moving to Colorado you shouldn't have any trouble catching up with a WMI course. The WFR will be a great tool for the toolbox out there with your little guys, etc. Even if you get your front country EMT the WFR offers up a lot of skills that you just don't get in a course that is designed around having a stocked bus.

MDS
01-01-2013, 01:08 PM
I never understood gunshot/massive trauma and what to do and how to do it well until I took a dedicated two day class dealing with that stuff.

Do you remember where you took that particular class? I've been looking, at it seems like they only have that as part of EMT programs in colleges around here...?


I should go on to say the catalyst for my starting was coming up to an auto accident and having zero clue what to do. I felt so ineffectual, and never wanted to be that way again.

Yeah, I can certainly see how one could fall into the whole trauma care thing. The more I read about it, the more interesting it is - lots of technical details combined with lots of judgment required to make life-and-death decisions under pressure. The highs and lows must both be pretty intense...

MDS
01-01-2013, 01:08 PM
If you are attending the Tactical Conference, Doc K is who I took the class from and he is a very good instructor.

Thanks for the tip! I haven't quite had the motivation to make it to the con, but this might put me over the edge...