AAR: Lone Star Medics - Medic 1 - Nov 8-9 - Fort Worth, TX
Company: Lone Star Medics - http://lonestarmedics.com/
Course Type: Field Medicine (non-tactical)
Date: 11/8/14 - 11/9/14
Location: Fort Worth, TX - Panther City Training Center
Course Description:
From the LSM website:
This is our most popular two-day course. This course is perfect for those with little to no previous first aid training. We will cover aggressive first aid for moderate to severe injuries/illnesses. Adult, child, infant CPR w/ AED (American Heart Assoc.) will be taught on the morning of the first day. Throughout class, each student will learn by minimal lectures, plenty of hands-on skills practice, and multiple scenarios involving role players. The students will participate in the skills training as individuals and as a team throughout both days. CareFlite will fly out a helicopter, real life missions and weather pending. Some of the subjects covered in this course:
Medical & Legal Issues
Body Substance Isolation; Use of Protective Barrier Devices
Basic Anatomy & Physiology
AHA CPR w/ AED
Patient Assessment
Penetrating & Blunt Trauma; GSW, Stabbings, Crush Injuries
Medical Emergencies; Stroke, Diabetic Emergencies, Siezures
Fractures & Sprains; Broken Bones
Burns; Thermal, Electrical, etc.
Environmental Emergencies
Animal/Insect bites
Heat & cold injuries
Dehydration & Prevention (Caleb’s favorite)
Shock; Management and Treatment
Tourniquets & Hemostatic Bandages; QuickClot, Celox
Movement of Patients (how, when & when not to)
LZ operations; CareFlite provides a helicopter
911 Communications
First Aid Kits & Equipment Selection
Instructors: The primary instructor was Caleb Causey, owner of Lone Star Medics. On day 2, we did have two additional instructors and some role players for our scenario-based training. Caleb has worked in medicine for 20 years, both as a civilian and in the military, and has spent much of that time as an instructor. One of the most obvious benefits of taking a LSM class is Caleb himself: he's clearly extraordinarily knowledgeable about field and tactical medicine, and he's able to communicate his knowledge to the layperson extremely effectively.
Equipment: All equipment was provided by LSM for training, though I did bring my IFAK from Tactical Medical Solutions (Thanks again for the group buy, Tom!) Caleb brought boxes and crates of medical supplies to the class, and one of the key benefits was getting to try everything out. It quickly became clear which products worked, which didn't, and what options are available. Caleb checked out my IFAK during a break, and made a few suggestions about arrangement and prep. I also will probably be picking up some chest seals and some hemostatic gauze to flesh out my IFAK, based on the class.
Class Makeup: Of the approximately 20 students, many were self-defense oriented, with a number of current/former law enforcement officers and military. We also had a doctor and an RN, both of whom were looking to pick up/verify knowledge about how to work with patients outside the hospital. We also had a family, many of whom participated regularly in hunting/hiking. Throughout the course, students were encouraged to jump in and comment/ask questions. While Medic 1 is not a tactical medicine course, many of the example scenarios we discussed in class were shooting/defensive oriented.
Course Description:
Training Day 1 started at 0800 with Caleb discussing his background and the purpose of the course. Students received an outline/brief notes on each of the topics we covered. We also did a class introduction: each student introduced himself/herself and gave the reason for attending the class. Personally, I was looking for a class that wasn't specifically "tactical." While running around and shooting at things is fun, I thought my time would be better spent learning about things that I'm more likely to see in the real world (ie. heart attacks and car accidents) and what to do about accidents/problems with firearms. My previous medical training was nearly non-existent; I've taken CPR a few times before, but didn't remember much of anything.
After the class was introduced, we jumped into our CPR training. The CPR material was from the AMA, with Caleb adding some additional advanced information as we went through everything. We discussed some very basic anatomy/physiology and normal heart/lung function, then talked about potential problems that can come up and the solutions. We took a short break, then discussed what to do when "Hey, look! There's a guy on the floor over there!"
One thing that Caleb preached throughout the class was scene safety. Your first priority as someone on-scene is to avoid becoming another casualty. This means that it's important to stop and evaluate when you encounter something out of the ordinary. Caleb encouraged students to stop and use a "viewfinder" with their hands - really a fence - to survey the scene before becoming involved. Traffic, electricity, fire, and chainsaw-wielding polar bears should all be accounted for prior to beginning medical care. We also discussed body/substance isolation; you really, really want gloves and a breathing mask when you perform CPR.
After our discussion on scene safety and some practice, we moved on to patient assessment. Is the patient alert? Does he/she respond to verbal stimuli? What about a sternum rub/painful stimuli? Should we be calling 911? (If you have to ask, then yes, you should be.) We discussed priorities of care - Circulation, Airway, and Breathing. Caleb explained the process for checking each item, then we practiced it. After discussing assessment, we moved on to discussing the actual mechanics of CPR chest compressions and rescue breathing. We also learned about AEDs (portable defibrillators) and their use. We then broke for lunch.
When we got back from lunch, we finished up our discussion of AEDs, then broke up into teams for scenarios. Groups of 4 had to move in, assess the scene and and bystanders, then proceed to giving CPR. My team did well, quickly getting an AED hooked up and starting CPR. We reviewed the actions of each team - don't forget scene safety! - and then moved on to other problems.
After finishing up CPR, we moved onto other problems. We discussed choking, and went over the procedure for the Heimlich maneuver. Afterwards, we went into assessing the patient for injuries using a "blood claw." Caleb demonstrated the process of checking a patient over for injuries, and gave us some real world examples of how difficult it can be to find injuries that are causing major problems. We use a "claw" method to check the patient for bleeding/broken bones. We broke into pairs and practiced on each other while Caleb reviewed.
After practicing our assessment techniques, we moved onto a discussion of tourniquets. Contrary to conventional wisdom, a tourniquet should be your go-to option for stopping moderate and severe bleeding. We talked about the types of commercial tourniquets on the market - Caleb likes the SOFT-T Wide and the CAT - and the rules for when/where they're appropriate. We discussed how to prep a tourniquet, which we later found out was very important to timely/one handed application. Having to open multiple layers of packaging when you or someone else is bleeding out is a huge waste of time. Caleb demonstrated proper application, and then we broke up to try it out on ourselves and partners. Caleb wanted us to be able to get one on in 12 seconds, and we had a contest to see who could get one on and placed properly the fastest.
After the TQ contest, class wrapped up for the day at 1700. Caleb offered to stick around and answer questions and check out people's IFAKs.
TD2 started at 0800 again with Caleb asking for questions from TD1.
Once the questions were complete, we moved on to a discussion of pressure dressings. We covered the uses and application of the Israeli-style and Olaes-style bandages, along with the value/uses of Z-pack extra gauze. The Olaes bandage is pretty awesome, and I was glad I had one in my IFAK. I should probably pick up a few Z-packs of gauze, though, just for my range bag.
After the bandages, we talked about hemostatic agents. We discussed the history of the product, what and when it should be used, and then looked at usage with combat gauze. Caleb showed us how it would be possible to pack a wound - definitely an advanced procedure! - and then we broke up to practice. I was able to get a bandage on very quickly using Caleb's tips. We also ran some additional TQ application practice. I definitely need to work on self-application one handed, because I had a hard-ish time quickly taking up the slack.
After the practice, we quickly discussed a number of other topics: things that are important, but probably aren't life threatening prior to EMS arrival. We talked about head trauma (don't move the patient, be careful) and impaled objects (don't remove it, build some stability around it), then moved on to burns. We discussed the various types of burns, along with what to do (and not do!) about them. We also touched on seizures (let them happen, nothing in mouth/don't try to hold the person down, get time/frequency, and try to cushion the head if possible)
We finished up burns, then moved on to broken bones. The important thing to do with any broken bone is to first resolve any bleeding/serious injury, then immobilize the limb. We discussed the use of triangle bandages to improvise a splint or sling and how to build up a bandage around a compound fracture.
Once we wrapped up with bones, we discussed shock: signs and treatment, along with the recovery position. Finally, just before lunch, we discussed eye injuries, and possible ways to improvise eye irrigation. One thing that was emphasized was how important patient contact is if there is an eye injury, because they can be scary.
After lunch, we discussed chest wounds. We reviewed basic lung anatomy, and then discussed the bad things that happen during a lung injury. To help mitigate these problems, we use a chest seal. Caleb showed us a number of commercial chest seals, and also touched on possible ways one could be improvised during an emergency. We also talked about the need to potentially "burp" a chest seal as pressure was applied to a lung, and looked at some examples of "self burping" chest seals. I'll be picking one of these up for my IFAK.
After chest wounds, we discussed nasopharyngeal airway tubes and decompression needles. We didn't go through usage, but Caleb mentioned that it might be a good idea to have one for someone ELSE trained to use one in your IFAK. In his words, "I can't improvise a needle."
Finally, we discussed EMT/Paramedic schooling and training times/costs, as several students were interested in getting some of the more advanced training.
With the classroom portion complete, Caleb brought in assistant instructors and role players to set up some training scenarios behind the classroom. We were split into teams of 4 people, and would arrive on-scene and be required to assist someone. This was by far the most helpful part of the class, since we were required to put all of the skills we learned into practice based on what we experienced. We also go to learn some drags/carry methods. It was invaluable to get some hands-on time in a simulated environment treating serious bleeding, broken bones, shock, stab wounds, and car accidents. Overall, my team did very well, and all of us found some things that we needed to focus on.
After the scenarios, we did a recap in the classroom. I certainly felt significantly more confident in my ability to make a difference in an emergency situation afterwards.
Finally, we discussed Careflight landing zone operations. Unfortunately, we weren't able to get the helicopter to come out to class - definitely disappointing - but we did learn about what it takes to set up a safe landing zone.
At 1645, we did an "in class" AAR, and talked about what we liked and didn't like about the course. Some students expressed a desire for a little more direction during the scenarios, but I actually enjoyed the free form environment: no one is going to tell me anything during an actual emergency.
My Take:
This is a great, great class. If you don't have medical training, go take some. It's significantly more likely that you come across someone having a heart attack or that has been in a car accident than you come across a squad of terrorists at the mall. It may not be as sexy as that carbine class, but it's probably more likely to save you or someone else's life. Caleb does a great job of keeping the material engaging, and not one PowerPoint slide was shown. This was excellent.
If you read my training log, you'll know that I had some difficulty when I originally planned to take the class a couple years ago. As a small business owner, it's really, really difficult for me to clear an entire weekend, and I wasn't sure that I was willing to risk giving LSM another shot. That said, Caleb definitely made good on things, and while he might make a shitty secretary, I can say without question that he's a good dude and a gifted instructor. In my business, I evaluate instructors daily and have to come up with interesting ways to present boring/dry material. Caleb made 16 hours of training fly by, and my only "complaint" is that I wish we had more time to do more of the hands on scenarios, which wasn't really possible with our class size. If the worst thing I can say about two days of training with someone is "I want more," they're doing something right.
The tl;dr
Highly recommended practical/useful training. Caleb is a great instructor, and the Medic 1 curriculum is excellent. Go now.
