Make Ready with TacMed Solutions: Concealed Carry Medical
Presented by Dan Stout, training manager for Tactical Medical Solutions
https://www.makeready.tv/en/watch/tutorial/details/make-ready-with-tacmed-solutions-concealed-carry-medical/5676
Reviewed by Gila Hayes
When I need to do mindless tasks, it’s easier to stick with the job if there’s a video or audio lecture playing to teach me a thing or two. Streaming video is great in those circumstances, with the opportunity to be exposed to new material, benefit from reminders of past instruction and get motivated to go to training. I’m picky about instructor qualifications and while it can be amusing to watch a wanna-be make a fool of himself or herself, really, best use of time requires that before committing time, I need to know that the presenter is competent to teach the material.
Panteao Productions’ Make Ready TV has presenters with the chops to teach the topics under consideration with authority. Recently, I watched their Concealed Carry Medical program, and think it is well worth discussing in our review column. At the time, I wondered if I’d subscribed and forgotten about it, because the content streamed with no paywall to work through. Later, when I complimented Panteao head Fernando Coelho on a well-done program, he explained that he is switching to advertising-supported programming. That’s a huge change, and Network members should bookmark https://www.makeready.tv/ for video instruction. Let’s run up the viewer numbers and let those advertisers know we appreciate these lectures and demonstrations.
Life comes with many risks, requiring many responses, of which the need for deadly force comprises only a tiny fraction. The self-defense training community supports that premise and has done an admirable job of adding emergency medical and first aid to class offerings. The video I watched was a great refresher.
After introducing himself and his experience, instructor Dan Stout comments that although retired, he carries emergency response supplies with him everywhere. His law enforcement and military training in emergency medical treatment is useful both in public and at home. Even in communities where emergency medical services are nearby, medics have to wait for police to clear the scene before starting to work. The time lost waiting can cost lives. Likewise, a shooting range accident or a serious injury during outdoor recreation can kill before emergency medical teams can reach the victim. Acknowledging that this video compresses into an hour a subject on which he could teach a week long course, Stout’s intent, he explains, is to give an overview of practical solutions. Don’t mistake the video for training, he warns. He can only describe and illustrate the basics which he hopes will motivate the viewer to get formal training.
Stout cites the 1999 Columbine school shooting as the wake-up call that made him look beyond his duties as a Gainesville police officer and train to become an EMT and become his SWAT team’s medic. Columbine emphasized the necessity of immediate care as soon as the threat is neutralized, but before ambulances arrive.
Stout translates military terminology used and often parroted in training, commenting that tactical combat casualty care would, for the private citizen, mean tactical emergency casualty care. Accurate terminology for private citizens recognizes that the private citizen operates without being able to call for back up teams, as police or military units could. As a result, he says, our response to a medical emergency is, “What can we do, with what we have, right here and now?”
Immediately rendering medical aid may not be the most effective ways to keep people alive, he continues, noting that hazards like gunshots or natural disaster not only endanger the first responder but also everyone else present. The greater danger must be addressed first. Make sure, he emphasizes, that it is safe to stop and help the fallen. He later gives a good briefing on awareness, avoidance, and remaining alert to risks even while deciding what you can do to help others who have been hurt.
When triage is taught, numerous acronyms are used. For example, A-B-C can teach to prioritize assuring that the victim’s airway is clear, and that they’re breathing, and have blood circulating. Those priorities may be taught in different orders, Stout acknowledges, but he thinks that may not make a lot of difference, so long as all the acronyms make sure we don’t forget something. His guiding principle which he hopes to imprint on his viewers is, “We are in a ‘find it, and fix it’ mode.”
You need to determine the cause of injury, he continues. Next, assessing severity of injury and the victim’s level of alertness gives not only an indication of their condition, but also directs the haste with which that person requires treatment over, perhaps, another victim or moving them to a less dangerous location. Stout identifies four categories, starting with fully alert. Less alert might find the victim capable of speech – “verbal,” he terms it, but adds that at this stage, a person’s communications are less clear than in the first. In the condition termed “painful,” the victim isn’t communicating verbally, but is responsive to minor pain you create to assess their condition. At the fourth and lowest level, the victim is unresponsive, does not react to the rescuer’s attempts to get their attention verbally or by creating minor pain. “If they’re drifting into unresponsiveness, you better do something now,” he adds.
The right attitude is all-important in find it and fix it mode, Stout teaches. When reacting to an emergency, the urge is to go too fast, and that is dangerous. You need to “slow your roll,” he emphasizes, and take time to be a medical detective to determine what put the victim on the ground. Look for deformity, a bump or abrasion; an open injury from gunshot, a puncture from a stab or other injury that opened the flesh; look for tenderness or swelling that might lead you to discover a fractured bone.
Having found the cause, offer help “to the best of your abilities,” he continues, “with what you have, where you’re at, and how you’ve been trained.” Stout teaches that the minimum load out carried on body is a tourniquet, “the #1 thing we have to have,” and a hemostatic agent for places a tourniquet won’t work. Those supplies need to be carried on-body, he explains, “It’s got to be on me in order for it to make a difference.” In his waist-pack, Stout also carries gloves and other supplies. Although retired, he equips his cars with a bigger kit to allow him to use his higher level of training, and it includes chest seals, tape, bandages, and more. He carries trauma shears, leading him to discuss the risks of a pocketknife pressed into service to cut clothing away from an injury.
Stout’s long segment on tourniquets is a great refresher. First, Stout emphasizes, tourniquets are safe. He debunks the old belief that amputation may be required if you cut off circulation to stop bleeding. Next, he urges, practice applying TQs on oneself and on others, but practice realistically, adding that no one who’s injured an arm will stick it out straight away from their body or the end of the limb may be trapped, and you may not be able to slip the TQ over the hand or foot. He demonstrates solutions, explains why to apply tourniquet pressure “high and tight,” shows how to wind the windlass if you have trouble gripping it, and a variety of other tricks of the trade to make applying a tourniquet smooth and speedy. There’s a lot more in this segment that makes the time spent watching the video well worthwhile.
Stout demonstrates use of various hemostatic dressings for bleeding that can’t be stopped by tourniquets. He gives a little history, harking back to the granular clotting agent once poured into wounds and the gauze that’s now infused with the clotting agent. He demonstrates rolling the tip of the hemostatic gauze into a little ball, packing that into the wound, then maintaining pressure while aggressively packing in sections of the rest of the gauze until the wound is tightly filled, all the while consistently maintaining firm pressure, so bleeding doesn’t start again.
Did it work? If blood is still flowing, you’ll have to tear it all out, pack it in again, and keep the pressure on. He warns that if the victim is conscious, they may pull away from the pain of packing; a second person may be needed to control them.
He shows packing in the gauze firmly, maintaining pressure with the heels of both hands, then wrapping bandages to maintain compression. If blood is no longer seeping beneath your hands after three minutes of pressure, you can wrap it tightly with a compression bandage, he teaches. He gives a shout out for the Olaes® Modular Bandage to keep compression on a packed wound.
In addition to discussing and demonstrating stopping bleeding, Stout shows stabilizing spinal injuries, preventing shock, includes a good chapter on CPR, demonstrates practical ways to move victims out of danger and to evacuation areas and a lot more. More than once, his explanation was so much clearer than previous instruction I’d received that I thought, “Ah, ha! That is what the instructor meant.” Still, Stout repeats that he doesn’t intend for the video to serve as training. It is a reminder of the need to stay current on our training. I found the presentation very useful and hope our members will take advantage of this resource, as well as other videos at Make Ready TV.