Get a med kit if you don't already have one...

[RyanM]

Excellent job MSparks!

Just a FYI, but Dark Angel Medical is having a 20% off sale on all medical kits until December 1st. I have been wearing a Ryker Nylon Gear AFAK every time I go to the range or during a class with a larger kit always inside my car. I have been really focused on medical training recently and signing up for a Dark Angel Medical Class in 2019.

Coincidentally, I got an email from Dark Angel about 5 minutes after making my previous post. Going to order a Emergency Bleeding Control Kit: Compact as soon as I get home.

[OldRunner/CSAT Neighbor]

Excellent job MSparks!

Just a FYI, but Dark Angel Medical is having a 20% off sale on all medical kits until December 1st. I have been wearing a Ryker Nylon Gear AFAK every time I go to the range or during a class with a larger kit always inside my car. I have been really focused on medical training recently and signing up for a Dark Angel Medical Class in 2019.

MEGA props to MSparks, the Ryker gear AFAK is well done & you'll learn much from Kerry sim. to how I did back in 2014.

Needing to pick up a few items for family members, do you know the coupon code for the 20% off sale as I couldn't find it?

[LOBO]

No joy on the 20% off code for me either.

[Kram]

As per the email I received the code is .....

CYBERMON

It seems to work for me with the kit I placed in my cart.

CYBER MONDAY SALE:
Save 20% on ALL trauma kits!

Coupon Code: CYBERMON

Applies to Trauma Kits, Bleeding Control Kits, and Inserts Only. Trauma kits are available on a first come, first serve basis.

Sale ends on December 1, 2018!

[Totem Polar]

GREAT job, MSparks909. And very compelling AAR too, thanks for that.

[Hambo]

Msparks909, you did well.

FWIW my guess on the rifle is that he loaded a healthy charge of fast burning powder.

[Nephrology]

I happened to be retrieving some tools from my truck in the parking lot when the incident occurred. My buddy ran out to get his med kit from his truck and we both ran back to the gentleman to render aid. The other range patrons, range owner included, were in various states of disbelief. The gentleman was in a state of shock by this point and was bleeding pretty badly from what was left of his injured hand. I grabbed the tourniquet from my buddy and stuck it pretty high on the gentleman’s left arm (“Go High Or Die”) and cranked on it until the blood flow stopped and until the guy started complaining of how tight it was...adrenaline was really flowing by this point and my hands were pretty shakey as I worked to secure the tourniquet.

Strong work. One piece of info for the next time (hopefully there isn't one) - you don't have to go all the way up the extremity with the TQ. Going just proximal (i.e. just "above") the injury is what is currently advised.

Good on you for being prepared!

[UNM1136]

Strong work. One piece of info for the next time (hopefully there isn't one) - you don't have to go all the way up the extremity with the TQ. Going just proximal (i.e. just "above") the injury is what is currently advised.

Good on you for being prepared!

For most instances, yes. I just had to retrain the entire squad after skills update from a kinda affiliated EMT-IC. If you are providing care to yourself or another during or immediately after a gunfight, win the fight, if possible. Get off the X while winning the fight if possible. If not, then get the patient off the X, and TQ high and tight, over clothing, unless not feasable (winter clothing, etc). Sweeps, Rakes, pressure and pack. For me and my guys, if they are only going to remember one method, I prefer it to be along the lines of TECC. That said, for non "tactical" patient care expose, 1.5-2 inches proximal to the wound, pack and pressure bandage while awaiting transport. I have a level one trauma center literally minutes away in my jurisdiction, (IIRC you are VERY familiar with the facility and people), and AFR's EMT-Ps are TQing everything high and tight... I have yet to see one make it to the OR..The ED staff get them off in the Trauma Bay as a general rule.

MSparks, you done good.

Just picking nits, my friend Nephrology, not slighting you, your training, or experience.

pat

[TGS]

currently advised.

High and tight is also currently advised.

Just depends on what organization you're asking.

[ST911]

@nephrology needs no medical education from me, but for the benefit of those listening...

High-or-die is a 99% solution that requires remembering only one thing. Limiting judgemental and conditional tasks is critical for lay rescuers with minimal training and experience. If the limb is bleeding and DP isn't working, shut it off. Other rescuers can reevaluate the work and make changes as indicated.

Application proximal to the wound also works and can be a better plan. However, it requires the lay rescuer to consider distance and potential involvement of joints. Already in the last few posts we've seen two different distance measures that will be assessed visually in the heat of the moment. Application proximal to the wound may also involve combinations of less tissue, more bone, smaller circumference with resulting effects on control. As many lay rescuers will be using field expedient TQs, this matters more.

I have experimented with umpteen drill sets and recommendations for teaching TQs across diverse populations, and been astounded by the axles some get wrapped around. Easy-buttons rule, especially for lay rescuers and the minimally trained.

In my earlier post, I didn't mention high-or-die specifically but I touch on the decision making process and what the best way looks like for me and mine.

Get the first TQ on and get the best effect you can. Then, get your field clear and apply any additional TQs you need in more optimal fashion. Depending on your needs/wounds, you can then clear the first TQ (some will disagree), or convert to dressing if indicated and situation appropriate (more training/experience helpful).