Miscellany: Active Response Training - Knife Skills for CCW / Tactical First Aid and System Collapse Medicine class notes

I've been following Greg Ellifritz's insightful Active Response Training blog for years now, so when I heard that he was coming down to Florida for a weekend to teach some classes, I jumped at the chance to check it out. I was not disappointed.  Here are my rough notes from each class, unedited:

Day 1 - Knife Skills for CCW

Introduction and Knife Selection

West Side Story-style knife vs. knife combat is rare.

More common scenarios for using a knife in self-defense: (1) knife vs. unarmed but physically superior attacker, (2) knife vs. multiple unarmed attackers, (3) knife used for gun retention, (4) knife for rape defense, (5) knife for fighting in awkward close-range positions.

There's a wide range of students in class - including some total beginners.

Greg lectures a bit on knife selection - goes through fixed, folding, and automatic, along with demo of various locking mechanisms.

Greg's recommendation - carry a fixed-blade, non-serrated knife, that isn't too crazy big.

Targeting in this course is designed for blades around 3"-4" or smaller.

Greg hits on considerations of various carry methods and knife types, including discussions of common self-defense knives (Clinch Pick, TDI, Delica, etc.).

[I am using a Clinch Pick, a Kershaw/Emerson waved folding knife trainer in right pocket, a Blue Gun GLOCK 19, and a fixed blade trainer (left side)]

Grips, Openings, and Retention 

We practice getting a grip on the knife - practice forward, reverse. Need to be able to use all grips since you never know how you might draw the knife.

We practice openings - thumb, inertia, 2-hand

Knife retention position - in forward grip, brace on hip; in reverse, can use other side or center chest area.

If knife arm tied up: (1) switch hands, (2) cut attacker hand, (3) bring hip to knife then thrust

Knife Targeting

Blood stoppage targets - carotid, behind collarbone, armpit, past hip muscle/top of femoral, femoral, brachial

Biomechanical targets - muscles/tendons at lower arm/wrist, bicep/tricep, back of knee, Achilles, quadriceps/hamstring, fingers/eyes

Wound enhancement techniques - pressure cut, "filet cut," coring (twist the knife), "comma cut" (stab, twist, cut out), running (pump blade up and down)

Krav Maga-style chokes/grapples defended with knife

Special Topics

Concealed knife positions (reverse grip palming, crossed arms, knife in pocket, bag over knife)

Using a knife with a gun (Harries-style)

Knife to retain gun (grab enemy wrist or tie up with elbow trap, then cut with free hand)

Ways to sneak knife into NPE (hide it where they won't wand, ceramic/G10 knife, hide in cellphone case, use belt buckle, walk through as fast as possible)

Day 2 - Tactical First Aid and System Collapse Medicine

"Tactical" First Aid?

Focuses on gun/knife wounds, hostile conditions, limited training/equipment

Unpreventable deaths - severe head or torso trauma

Preventable deaths - extremity bleed, tension pneumothorax, airway

MARCH algorithm (we're skipping head injury/hypothermia)

Direct pressure is first - can clamp with hands, use CPR position, use knee on wound

Problems with direct pressure - self-application, strength/endurance needed, takes up hands, limits mobility

Most GSWs do not involve spinal injury, so usually safe to move patient

Equipment

Pressure Bandages

Wound Packing

Tourniquets

Hemostatic agent (note that you need multiple yards to pack even a moderate wound - 2" wound requires 3-4 feet of gauze)

Emergency TQ removal - after 2 hours, if no help coming, can try to remove slowly if wound is bandaged up. If it bleeds, reapply TQ and leave it. After 6 hours with TQ on, do not remove - dead cells in limb produce toxins that can kill.

Airway - chin lift/jaw thrust + recovery position + NPA if necessary

Chest seals - note even a "vented" seal only works 10% of the time on a sucking chest wound

Opiate OD - use Narcan, open airway

Longterm, Austere, and Wilderness

Wound care - need tons of H20 to irrigate wound

North American snakes - clean up wound, do not TQ, elevate, keep heart rate down, take a picture of the snake, get to antivenom ASAP

Antiseptic plants like yarrow and dandelion

Close wound or not? - closing speeds up healing and minimizes scar, not closing is better for deep punctures and really dirty wounds

Superglue, sutures, staples

"End of the world drug list" - animal antibiotics, etc.