Miscellany: Notes from the D-Dey Response "Emergency Life Saver" class

It had nothing to do with the coronavirus pandemic/hysteria that's sweeping the globe, but I did take an emergency medical course from D-Dey Response Group, a veteran-owned and operated company that connects experienced instructors (basically all former military and/or fire rescue) with the general public. Here are some notes from the half-day trauma class:

Safety

Are you safe when treating the patient? You can't rescue anyone if you become another casualty, and there's a fine line between "hero" and "stupid." Protective measures can include anything from wearing gloves to taking cover.

Get Help

Call 9-1-1, or make sure someone is actually doing it.

The MARCH Algorithm

Massive Hemorrhage

You can black out from blood loss in as little as 30 seconds...maybe less.

Stopgap measures - use hands, knees to apply direct pressure to or above wound. Frees your hands up to return fire or open your medical kit.

Arterial bleeding - bright, red, spurting. But venous bleeding is life threatening, too. Internal bleeding can't really be dealt with out in the field.

The CAT Tourniquet: Apply high and tight, avoid joints. It's gonna hurt when applying.

To apply:

1) rip apart the packed tourniquet and tighten the loop around the limb
2) secure free end to the "C" holder
3) tighten windlass until the bleeding stops
4) run excess material through the "C" holder
5) TIME... and keep checking that it's tight

Self-application - manipulate it so that you pull inward toward your chest. Bulky clothes may interfere with the tourniquet, but water does not; works fine while diving.

Leg application - you will probably need to undo the loop, slip one end underneath the leg at the knee, then "saw" the tourniquet strap up. Works better than trying to slip the injured leg through a closed loop.

Junctional bleeding: armpits, shoulders, groin/pelvis, neck, etc.

Celox Rapid is recommended to pack the wound. Can also use Curlex, an ETD bandage, a cotton shirt, etc.

1) make a wad with the hemostatic dressing first
2) push it on the wound in the direction of the heart
3) keep pressure on it, thumb over thumb, and fill the void with material
4) should not feel sponge-y at the end, should be a tight wad...push on the dressing, and if blood oozes out, wrap more on it.

Technique for bandaging armpit or neck wound:

Airway and Respiration

Stopgap here is hand over chest.

Slap on a chest seal.

Don't take anything impaling out unless it's occluding airway.

Recovery position:

Circulation

(This step is where medical personnel start putting blood back into the body. For the average citizen, it's more of a chance to reassess and check for other wounds)

Are they pale, lightheaded, or cold? May be internal bleeding.

Hypothermia

Blood loss makes you cold, even in warm environment.

Keep a space blanket or other stuff in your kit for warming someone.

Treating a Patient under Stress

Auditory occlusion

Loss of fine motor skills

It's okay to take a breath