The shooting community likes to talk about itself as comprised of responsible citizens, and this is largely true. As shooters we have all undergone background checks, we have passed safety tests, we have met all the requirements and checks and balances put in place. As a highly selective group, we like to see ourselves as better prepared than the average citizen, in most aspects. By and large, we are, however one of these aspects largely overlooked is pre-hospital medical care and training.

In this day and age, responsible citizens are the true first responders to events and incidences, in which lives are potentially at stake. Fantasies of heroically responding to a mass shooting aside, we’ve all seen some kind of traumatic event, whether it is motor vehicle accidents, industrial equipment accidents, falls that result in broken bones sticking through the skin, children putting themselves through plate glass at high velocity, and so on, and so on. It behooves us to be better than the average Joe in the application of tactical medicine. Sadly, few of us are properly qualified, even in basic first aid. This is a critical missing link, and should be rectified at the first available opportunity.

Many shooters play Devils Advocate and ask if a trauma course for shooters is really necessary? Isn’t basic first aid good enough? Our sport involves inherent risks. The possibility of a high velocity bit of lead and copper punching through flesh rather than paper, is a reality that we should be prepared for. Basic first aid will not train you to the level at which you can respond to a major haemorrhage or penetrating chest wound. For anyone sitting behind their computer screen saying “but if you follow the four firearms safety rules you’ll hardly ever be at risk”: true, but anyone who says they have never had a negligent discharge, or have never been in the vicinity of one, is lying.

 

Tacmed Basic Trauma Course

Basic emergency medical training should be a skill in which as many shooters as possible are well versed. It should cover the spectrum of basic lifesaving skills, including gunshot and penetrating injuries. Tacmed Australia recognized this missing link, and is now offering courses for shooters and hunters in basic trauma management.

Tacmed’s basic trauma course covers the treatment of major haemorrhages, and penetrating chest injuries. The basic premise of the course is to prepare shooters and hunters to combat the two leading causes of death from gunshot and penetrating wounds: major blood loss, and tension pneumothorax. Major blood loss is pretty simple: you bleed out, go into shock, fall unconscious, and die. Tension pneumothorax is where a penetrating chest injury results in air from the atmosphere entering the chest cavity, and air pressure inside the chest cavity gradually increases as the trapped air cannot escape. This creates a great deal of pressure on the heart and lungs, and eventually, the heart will be unable to beat, and the patient will die.

Tension pneumothorax can be lethal if left unchecked. Chest seals either vented or unvented are the ideal pre-hospital tool to employ for basic trauma management.

So how quickly can you die from blood loss? Very quickly. Assuming the patient is an average male with normal haemoglobin concentration and a normal VO2 max (a measurement of the amount of oxygen the body is able to utilize in one minute) prior to being wounded, that the artery is severed, and that there is no compression on the severed artery, any major arterial bleed will result in death in 2-60 minutes. A life threatening reduction in blood pressure due to major haemorrhage will result in shock, which greatly reduces the body’s capacity to respond, and rapidly leads to unconsciousness. The average response time for paramedics in Australia is between 10-15min. In that amount of time, a person suffering from major arterial bleeding isn’t likely to survive, even if they are rushed to hospital via intensive care paramedics.

Here’s an example of a femoral artery bleed out:

*WARNING GRAPHIC*

The man is unconscious within 90 seconds, and in the absence of proper medical attention he will be dead shortly thereafter.

Here’s another one:

*WARNING GRAPHIC*

I can’t find the full length video anymore, but, in the full length video the victim is goes into shock in about 60 seconds, is conscious for around 2 minutes, falls unconscious within 3, and death follows shortly thereafter.

Tacmed’s basic trauma course arms shooters and hunters with the knowledge they need to save someone’s life, or their own life. Recognising when to use a tourniquet, how to use a tourniquet, and how to use a chest seal for penetrating thoracic injuries, is vital to tactical medicine. Students are taught how to burp a penetrating chest wound, in the event that tension pneumothorax occurs. Likewise, wound packing is a vital component to casualty care, and Tacmed covers the essentials of wound packing technique and execution. Most importantly, Tacmed gives students the opportunity to practice hands on applications of theoretical skills.

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Mick from Tacmed teaching students how to correctly apply a tourniquet to a dummy.

Despite my reservations about calling things “tactical”, tactical medicine is in fact tactical. It is the capability to use a skillset and tools beyond the basic parameters of their function, in austere environments, extracting maximum performance under duress. It is one of the most critical and noble life skills I can think of.

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Training in the proper use of chest seals.

And before you ask, no, a first aid kit won’t do the trick. No, a tampon is not suitable for packing a wound. A tampon can be used to stop small bleeds that occur in two places: the nose, and not the nose. It does not belong anywhere near a gunshot wound, or major trauma. The old standbys of gaffer tape, garbage bags, and a t-shirt, are less effective and don’t always work (try sticking gaffer tape to clammy, sweaty skin, and get it to hold properly, it won’t happen).

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Learning how to pack wounds and stem the blood flow.

At the end of the day, it’s a life skill that empowers you, in ways others can only dream of. One of the worst feelings in the world is to be at the scene of a traumatic event and not know what to do. As shooters we pride ourselves on being citizens of a higher calibre, and it behooves us to be exactly that. Get trained guys, I can’t stress this enough. Your life, the life of a loved one, and the life of a total stranger in need, is worth more than the $89.95 a Tacmed Immediate Trauma Kit will cost you. While you’re at it, check out Tacmed’s IFAKs and other kits.

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Man down! Simulating a multiple gunshot wound victim with arterial bleeding in both the arm and leg, and possible penetrating chest injury.

Mad kudos to Tacmed Australia for seeing a knowledge gap that needed to be filled. Get trained guys, and fix the missing link.

Stay sharp, stay safe.

JC