Gunshot Survival on the Street
Two deadly force incidents, two life-saving outcomes: A student at Virginia Tech is severely wounded during the terrible school shooting. As an Eagle Scout, he was trained to respond to emergencies, and he uses an electrical cord to fashion a tourniquet that saves his life.
An officer in the Midwest is shot in the leg by the offender he’s pursuing on foot. Both suffer arterial leg hits. The young student shot through the femoral artery is on his own, yet takes immediate life-preserving action. The wounded officer is aided by a partner who, as a military veteran of the ongoing wars, has been trained to immediately address combat injuries and carries a tourniquet that stems the blood loss and saves his partner’s life. Both men survive because of training mindset and access to simple tools.
These events serve as reminders that we do not choose the day and location of the fight, the number of offenders or the length and duration of the fight. The bottom line: You may be all the help that exists. You or others nearby will live or die based on if and how you’ve trained and prepared.
Faced with a situation in which armed offenders remain a threat, fire/EMS will not enter the scene. When requested, paramedics will stage and hold until given the all clear to move in. What happens when there’s no all clear and officers and citizens are wounded? Patrol officers must have the training and gear to save themselves and those around them when wounded or injured.
Knowing that we’re responsible for our own protection and care makes it obvious that every police officer must be trained and equipped to provide emergency medical care, including the ability to control bleeding, maintain an open airway, perform CPR and prevent shock.
In this article I focus on several ways you can control blood loss.
First, we must train. There are a number of training courses available to law enforcement, from the familiar Red Cross first-aid classes to the more job-specific information taught by our tactical emergency medical support (TEMS) doctors and paramedics. These classes focus on the basics of wound care and management. Airway and bleeding are the critical issues, and we must be able to keep the first going and stop the second as fast as possible under unstable or dangerous field conditions.
The training must be reality based. Several years ago we were instructed in the use of the Israeli Battle Dressing by our TEMS cadre. This is a pressure-wrap bandage easily applied to shut down serious bleeding wounds. Easy, that is, if you’ve done so many times under stress and real-world conditions.
Due to training time constraints, we worked with the bandage for less than an hour, with little stress to derail our efforts. It seemed so simple how long can it take?
Then came the day when I arrived at an auto wreck in which a bad head cut demanded that I make use of the bandage for real. I didn’t have protective gloves in a baggie taped to the bandage, and had none on me. As I tried to work in a very confined space, the rolled-up length of the bandage wrap fell out of my hand.
I surely did a less than credible job, but in this incident the paramedics arrived quickly and all was well. I relearned the lesson that actions and gear designed for emergency response must be trained for and practiced under simulated emergency conditions and repeated correctly on a regular basis.
Contrast that to recent courses we attended here in Illinois. We received training in greater depth from several highly qualified instructors, including Dr. Tony Barrera of Doc Gunn Inc. and SA Chuck Soltys of the DEA, and they required us to put in the time for realistic training. More recently we received training from Henk Iverson and Deputy Rob Briggs of Strike Tactical Solutions.
Iverson is a renowned combatives instructor who offers some of the most realistic and effective training I’ve experienced. Briggs is an experienced street deputy and paramedic with a large sheriff’s department north of Chicago. They set up training scenarios in which we had to rapidly move to an officer hit by gunfire, locate and stop the on-going deadly force threat with precision fire, then assess the wound and act.
The action included both stopping the bleeding and removing the officer. A large piece of meat with a gaping wound was inserted into a pair of pants to represent the wounded officer’s leg. Inside the “leg” was a line from an IV bag filled with a blood-type fluid. Briggs simulated an arterial hit by pushing on the bag. Seeing the fountain of blood pumping out of the wound was a visual we won’t forget.
But most importantly, through the training and gear we worked with, student officers stopped the bleeder and removed the officer, all the while maintaining scene security to protect against further attacks. If the downed officer was conscious and capable, he was enlisted into the area defense.Every officer must know and believe that being wounded does not equate to being out of the fight.
One key issue: We must learn how and when to move to a downed officer so we don’t become additional victims. A number of articles have addressed downed officer rescues, and one such recent article from Force Science News #109 by Dr. Matthew Sztajnkrycer, a SWAT TEMS doc, is well worth reading. (Find it here:www.forcesciencenews.com)
As police officers, we can carry only so much gear on our person. The rest gets left in the squad car or worse, the station, where it often can’t be reached in time and has little to no value in the fight. So, as trainer John Farnam says, carry what you must, because it will be a come-as-you-are fight.
The Pressure Bandage
In the Strike class, we were shown several key items every officer can put in a pocket for everyday, everywhere carry. Number 1: a pressure bandage. The first we used was the Israeli type. Other types have come out, and another we worked with is the OLAES Modular bandage from Tactical Medical Solutions (www.tacmedsolutions.com/07/products/product_detail.php?prod_id=3).
Available in both 4″ and 6″ types, this excellent product offers a wound pad that includes more than 3 feet of sterile gauze you can use to pack a wound, a pressure cup that sits directly over the wound for direct and focused pressure, and Velcro -type control strips to prevent the unraveling that happened to me. While bigger is better, the 4″ model is the one most likely to make it into your side pants pocket, (another reason BDU-type duty pants have value) or vest carrier.
When you purchase a pressure bandage, buy several extra for home and auto. We must be ready both on and off duty. Include two extra bandages for training purposes, and practice often. Take time to train your family members. Cost: less than $10.
Tourniquets have been a source of mystery and fear. In our early days, we were told the use of a tourniquet would mean the loss of the limb. While our docs caution that a ligature-type made from a boot lace may indeed severely damage the limb, they say the current models that are 1 inch or more wide greatly reduce or eliminate that danger. They also say a tourniquet can stay in place for several hours. The Midwest officer saved by his partner had just a few short minutes to live in the absence of the tourniquet carried by his knowing and ready partner.
An item that fits the pocket, the tourniquet is a must-have life saver. Tactical Medical Solutions offers its SOF Tactical model (SOFTT) designed by company founder Ross Johnson. Ross was a special-forces medic from one of our military’s most elite units who did multiple combat tours in the war zones he knows what works. Another model our Docs recommend is the Combat Application Tourniquet (www.combattourniquet.com).Cost: $35.
Insert two pair of surgical nitrile-type gloves into a plastic baggie and tape the bag to each pressure bandage. ITOA TEMS Dr. John Wipfler advises the following: “Nitrile gloves are more durable than latex rubber gloves, are very chemical-resistant, last longer than latex rubber gloves and are less likely to tear. They come in light-blue, green and black. The advantage of black is it’s harder to see in tactical settings, but the disadvantage is that any blood products/body fluids that get on them are difficult to see as well. It may be better to use a lighter color that can rapidly be scanned and discarded/replaced if blood is noted on them.”
Will you actually take the time to use the gloves in a true emergency? Maybe not, but again, better to have than not so that when you need gloves to keep blood and fluids off your hands, they will be there. Cost: a box of nitrile gloves runs less than $10.
A good pair of blunt-end medical shears taped to your bandage allows for cutting through the uniform or clothing to locate the wound. Using a knife to do so is another injury waiting to happen. Utility shears are inexpensive, and you can find them at the hardware store, Or, check with the local hospital ER. Cost: less than $5.
Designed to stop heavy bleeding by creating a clot, a number of wound/blood clotting agents are available in small packet form. Newer products also include gauze with the clotting agent impregnated for wound packing.
There is some debate about which products are best. As a non-medical practitioner, I’ve researched the issues and decided to carry a pack of Celox (www.celoxmedical.com). This product is developed from shrimp shells and is reported able to stop severe arterial bleeding in minutes when combined with direct pressure. It’s a very lightweight standby emergency item that takes up little space.
Make your own choice, but know that it’s worth the effort to carry one. Cost: $15 $30 depending on size.
I’ve outlined the basic few lifesaving items to keep with you at all times when on duty and close to hand all other times. You don’t need to be a skilled medical doctor or paramedic, but you must be skilled with these items and know when, where and how to make best use of them.
The items are readily available, as is the training. Cost for all items runs less than $100. There’s no excuse for not being prepared other than the refusal to do so.
Above all, each piece of gear and the training you undergo must prepare you for self-application. You may find yourself on your own.
For all officers working the dangerous streets, this is not a choice, it’s a mandate.
North American Resuce, Inc.
Defense Training International, Inc.
Strike Tactical Solution