What is a trauma class and why is it worth three hours of my time?
by Jim Irvine
It has been well over two years since we called for a trauma kit in every school building. At first only a few schools took the call seriously, but over the past year we have seen a steady increase in interest in both the supplies, and the training to use them. This year several districts have held trauma classes for staff.
The class we offer is a three hour class. It is a distilled class taking the highlights from TCCC ("T triple C"). TCCC stands for Tactical Combat Casualty Care. It was developed by the military to reduce battlefield deaths in the global war on terror. Units trained saw significant reductions in death and special ops units where every member is trained in TCCC have seen reductions never seen before in war.
TEMS (Tactical Emergency Medical Support) evolved along special operations law enforcement (SWAT) on the civilian side. It has identical objectives to TCCC.
The driving force behind TCCC/TEMS is that there is a delay between injury and advanced medical care. Help is simply not on scene when the injury happens and help is needed. Immediate care is needed to sustain life until a transfer to higher medical care can be accomplished. Just as an AED is used to preserve the life of a heart attack victim, trauma care preserves the live of a trauma victim until help arrives.
Class objectives are to train participants to treat preventable deaths. These include extremity hemorrhage (bleeding from arms/legs), junctional hemorrhage (bleeding from shoulder/pelvis), tension pneumothorax (collapsed lung) and airway obstruction.
Most bleeding, even gunshot wounds can be stopped with direct pressure. A problem arises when there are multiple injured and there is not enough time or hands to apply the pressure needed to stop bleeding. What is needed is a way to stop all bleeding quickly allowing the care giver to move on to other casualties. Any extremity injury with significant blood loss (generally pressurized/spurting or pooling) should be treated with a tourniquet.
Most of us learned a few things about tourniquets, which is unfortunately still be taught by uninformed trainers who have not updated their training. We learned that tourniquets are a tool of last resort, they are applied two inches above the injury (or above the joint), they should be loosened approximately every 20 minutes, and they will result in the loss of the limb. It turns out that EVERY one of those things are wrong!
The two tourniquets that have been battle tested and approved for our military are the CAT and the SOF-T tourniquets. There are other commercially available tourniquets, some likely very good, and some there are useless. Stick with the SOF-T or CAT and you will be good. Application is easy and can be done by a trained person in about 30 seconds, even on themselves.
Lacking commercial tourniquets, improvised tourniquets can be made using a non-stretchable cloth and a windlass. Though less comfortable for the patient, and more time consuming to apply, they will accomplish the objective of stopping the bleeding.
Any bleeding which direct pressure can stop can be treated with a compression bandage. The advantage is that a patient can be treated quickly and stabilized allowing the care giver to move on to other victims. These are perfect for wounds which are bleeding, but don’t require a tourniquet.
Chest wounds can result in a collapsed lung. Air inside the chest cavity, but outside the lung, can prevent the lung from properly inflating. As more air becomes trapped, less space is available for the lung. Left untreated this pressure can result in increased pressure on the lungs and heart causing breathing and heartbeat to become faster and shallower until death. This is a tension pneumothorax.
Using chest seals to prevent air from entering the chest cavity through holes prevents/delays the onset of tension pneumothorax. Many commercial options are available. AED pads also work well.
Blast and knife injuries can be devastating. Our class covers how to stuff wound cavities and the use of hemostatic agents.
In just a few hours participants will gain the knowledge and hands on training to prioritize treatment of multiple victims. They will know when, why and how to treat the trauma injuries most likely to result in death.
For more information on various commercial trauma kits or to scheduling a class for your school, church or business, contact Joe Eaton via email at [email protected] or visit us on the web at www.FasterSavesLives.org.
Jim Irvine is the Buckeye Firearms Foundation President, BFA PAC Chairman and recipient of the NRA-ILA's 2011 "Jay M. Littlefield Volunteer of the Year Award," the CCRKBA's 2012 "Gun Rights Defender of the Year Award," and the SAF's 2015 "Defender of Freedom Award."