Issue link: https://let.epubxp.com/i/237213
FIRE A R M S TAC T I C S according to Dr. Gerold. Now the focus was on hemorrhage control, where training at this level should focus on immediate care. Hemorrhage control (specifically, controlling an exsanguinating extremity hemorrhage where a tourniquet or direct pressure would save a patient), according to Dr. Gerold, can be addressed with only a moderate level of sophistication. If you think about it, there are several competing events in emergency operations. This was obvious to me was when I had a victim of a gunshot wound. I wanted to help the patient, but I also needed the evidence left by the suspect, which would not be as important to a medical professional working on him. Although the suspect had fled, witnesses indicated he lived there. We had to consider maintaining a protective perimeter in order to prevent further crimes, while rendering aid until we could get medical professionals in. Having an officer with advanced training would have helped. If an officer can communicate with the next echelon of care, having common medical nomenclature will improve things for the patient. I told Dr. Gerold I had heard the attitude about tourniquet use has changed: Was the tourniquet "in"? Dr. Gerold says that originally, the context of tourniquet use was use as a last resort. That is, at one point it was assumed a patient with an applied tourniquet would lose that limb. The military actually reintroduced the tourniquet. Dr. Gerold says if the patient was transported to a hospital in a reasonable amount of time, the tourniquet was not about limb losing, but life saving. In previous conflicts like World War II, patients might not have gotten a timely evac depending on the tactical situation. Technology made the battlefield more mobile and new medical doctrine, like attached 68W (medics) and embedded CLS (Combat Life Savers-nonmedic soldiers with training that goes beyond buddy aid) have strengthened the chain of evacuation. Current wars 28 Law Enforcement Technology The combined training staff of Hammer Stryke and NorCal MedTac teaches students to perform shoot/rescue drills on the Safety First Shooting Association range. This particular drill included slicing the pie, contact/cover and controlling the environment so the "patient" could be stabilized. have proven that the applied tourniquet can work in law enforcement. Various other technology improvements have changed the priorities of emergency care. We talked about the "ABC" protocol, which is Airway, Breathing and Circulation. This was how everyone learning mass education of CPR was trained. The truth is, the highest priority should be to keep the patient from losing too much blood in a very short time. Ballistic panel technology made the most likely avenue of blood loss through the limbs, hence the tourniquet. I asked Dr. Gerold, "What can small agencies can do now when it comes to emergency care?" His reply: It comes down to money and time. Medical training competes with officer safety January 2014 www.officer.com training. The question boils down to how much training can be allotted to life saving procedures. Obviously, the more sophisticated the training sessions, the greater the time block. As a minimum, officers should be equipped with a tourniquet and a pressure dressing, not in the car, but on the patrol belt. A kit in the car does nothing if the officer is bleeding on the other side of a building. The IFAK (Individual First Aid Kit) should be on the officer's person for self or the life of someone else. Last month, LET reviewed the LEMK-PO from Chinook Medical Gear Inc. I recommend this type of kit. Gerold said a culture change is necessary in how we look at lifesaving care. That is, every citizen should have basic medical survival care training. Other countries do it and we should, too. Also the current "911 approach" is somewhat of a disappointment. Vendors are selling kits with extensive