Tactical Medicine

Comment

Comment by Jen on December 26, 2008 at 7:55pm

We are a fairly new TEMS unit in our next of the woods. We currently carry two thigh pouches (one airway and one hemorrhage) as well as an M9 pack. The M9 is light and thin but packs well. We carry a lot of the usual items: israeli bandage, CAT, QuickClot bandage, etc. It has been a work in progress. We are now at the monthly trainings with the team which has been very good. We also attended a TEMS class recently which opened our eyes to the tactical enviornment. We will be taking a basic SWAT class in the spring. Good luck to your team Tim! If you need any info or would like pictures of our set up give me a holler!

Comment by Karen Wesley on December 18, 2008 at 5:05pm

Two things, Doug, it is the general protocol: if the scene isn't safe, LE goes in first. If SWAT is needed, they are called by LE. No sense in loss of EMS life. The old mentality was for EMS to charge in, now, we have to understand that we might have to wait in order to gain access to the sick or injured. LE officers first priority is going home at the end of the shift. EMS should model their behavior after that. It's just not a peaceful world anymore.
Secondly, Doug, Remember that SWAT medicine is not field casualty and care. There are rare circumstances that would have someone pinned down for the period that a tourniquet won't work over combat clotting agents. I am a proponent of these products, but we aren't doing field amputations out there. TEMS operators should have a risk assessment that includes evacuation plans with ALS, be it ground or air for those injured. This allows us to remain with the team, rather than pulling off the mission. As SOFMedic says, keep it simple. Commercial tourniquets are great, but two dowels and cravats work just fine.
My team medic equipment includes a vest, with dressings etc. But the two most valuable items I think we carry in the vest are tetracaine, and a nasal airway. Nothing fancy, we do have 2 tourniquets made by ARUK systems, and all our SWAT operators have one as well. Our medic bag is staged as others. It contains advanced airway and circulation equipment. Also included is a snivel kit containing OTC meds if the operators want to take them. Our kits were designed by a MD Medical Director who served in the ARMY as a Major and completed 3 overseas deployments in field hospital settings. So I know we don't have overkill, but can handle whatever situations we encounter. Best wishes with your team. Remember the warrior spirit and keep your operators in the game whenever you can.

Comment by Tim Zagorski on December 18, 2008 at 3:51pm

BJ,
I would love to have a list to go by and you can send it to me at ziggy@region2ems.com Thanks

Comment by Douglas Levitt on December 17, 2008 at 10:45pm

Just a quick question please, if all of you don’t mind.

I live in a rural county and we don’t have SWAT, but if we get a medical call and the dispatcher thinks “ it will endanger our lives, law enforcement will be dispatched and if we get their first, we are to stage and wait for them because in our department, our safety comes first. Once the office get’s the situation under control, we are allowed in.

For those of you who work in the big cities, do you have the same guidelines as we do?

I didn’t go out on the call, but we had a gunshot wound and I can just imagine.

So, when you are rolling to a call, do you prepare for the worse so that you can be ready?

Hope you don’t me coming to this group, but I am an EMT student/volunteer support person to our Fire Department and my hat goes off to you men and ladies for responding. I am new to this field

Comment by Scott on December 17, 2008 at 4:36pm

Thigh kits are good. Vests configured for the basics work well also. Large bags / rucks can carry all the other tactical field care gear, but are better staged, as Randy suggested. I always find a safe area or a cleared room to have it moved to if needed. There are bags made to fit into BDU pockets, but for that matter a ziplock or dry bag will work just fine for the most important gear. Also, SOFMedic has a good point with the commercialization of all the gear, but there are some, (read, a few) decent products that are quick to use without adding to the weight / cube issue. These are approved by the Special Operations Command medical shop for field use. Again, the Gucci Tactical Medical latest, and greatest gear may not be. So be sure of what you need, what actually works, and how you will deploy with it.

Comment by Jason on December 17, 2008 at 10:17am

I like the thigh kit, I keep a CAT tourniquet, a 50gram quick clot, 2 10g chest decompression needeles a chest seal and some smaller trauma dressings. Our department is only in the begining stage of starting a TEMS team with the police department...we have a long way to go.

Comment by Randy Goodale on December 17, 2008 at 4:20am

I tried to carry everything I needed in an emergency in the pockets of my BDU's. I carried a bag with more advanced gear, Iv's, ET tubes, BVM etc. That I would usually drop inside the front door of a residence, or in a safe room near the actual incident in a large building. My pockets held a large and a couple of the small trauma dressings, 1 Quick Clot bandage, ace bandages, a tourniquet, a oral and nasal airway, pocket mask, chest decompression kit, crash scissors and some type of chest seal. I found it too difficult to be tactical when carrying a large bag, and it was always close enough, for another team member could grab it if necessary. Randy

Comment by SOFMedic on December 16, 2008 at 8:53am

Beware of the pitfall of Tactical Medicine - commericalization. Widgets are nice, but remember the intent of the widgets. You can support your tac-teams on a "shoe-string" budget. Consider re-use of items such as gel-defib pads in lieu of ashermans, use kerlix & ace wraps in lieu of commerical "tactical dressings," and so on. Let's start a forum with "improvisational" items that can be used on missions....thoughts?

Comment by BJ Bryer on December 14, 2008 at 10:43am

Tim, You should also keep in mind that although you want to be prepared for everything you don't want to get to crazy and load yourself down to heavily. If you would like I can e-mail you a copy of the loadout list that we use on my team.

Comment by Scott on December 12, 2008 at 6:34pm

At the very least, Tim, make sure you include a good tourniquet, such as the Combat Application Tourniquet (all operators should carry one),Israeli Bandages, Hyfin (preferred) or Asherman Chest Seal, and tension decompression kit. Small rolls of kerlix or Tampax are good to have as well, for hemorrhage control since you cannot carry QuikClot or Celox.

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