Class:
Ditch medicine
Instructors: Hugh Coffee, Paul Gomez
Location:
NOLATAC Firearms Training, Metairie, LA
Dates: August 15-16
10 Students
Let me begin by saying that besides an eye-opening educational experience, we had a great time. Hugh and Paul did a great job of keeping the class entertained and motivated. I did a great job of keeping them fed.
Hugh Coffee’s true passion for the education of traumatic care is contagious. Paul is the “sensei” of tourniquets—WITHOUT A DOUBT. We ordered in Pizza Hut for lunch on day one, and we catered Raising Canes for day two. I think this will become the staple lunch plan for classes I host; it worked out well. ThosE who were not able to attend definitely missed out of lifesaving training. As someone who spends hours behind a firearm, I was definitely lacking in this area.
LUNCH DAY ONE
Given the time that most here spend on honing shooting and tactic, preparing for TEOTWAWKI, bug out bags, and things of this nature, I think there is a definite disconnect about the priority for basic trauma and medical care training beyond that of CPR. In real life, in southern Louisiana, we and our loved ones have a significantly higher chance of being involved in a medical emergency of a non-hostile nature, than ever being involved in a lethal force self-defense situation. Of course, we still train for the fateful occurrence, but the proper attention is not given to the more probable, but less “sexy” skills of administering aid in trauma cases, IE- gunshots, explosions, vehicle accidents, falls, blunt force due to impact weapons or fistic encounters. Point is, if you have not attended training of this nature, you have a serious and preventable fatal gap in your security plan.
On day one, we began with an overview of typical equipment used for traumatic injury care. We were actually able to touch and experiment with a plethora of tourniquet designs. Paul made a point of stressing how important using a tourniquet is when it is needed. Basically, when it is needed, it is the only thing that will work. We debunked a lot of myths and common misconceptions about tourniquet use and design. There were at least 15 different tourniquet designs for us to evaluate hands on and decide what would work best for our kits based on method of carry and intended applications. We looked at the evolution of tourniquet design and where we are today. For many of use, learning that in many cases, the tourniquet is the first resort rather than the last resort was especially eye-opening.
PAUL EMPTYING HIS "BAG-O-TOURNEYS"
After Paul’s Anthology of the tourniquet, we moved onto hemostatic agents. All three generations of Quickclot®, Celox®, Woundstat®, Combat gauze®, etc, were there for us to see, touch and examine. Probably the most eye-opening thing for everyone there was Hugh’s demonstration of the exothermic heat reaction of Generation 1 Quickclot® with water, or a very moist wound. I know that was especially revealing to me, as I had no idea and have some of that kind on hand in my kits. Hugh’s promise that these agents were not “magic pixie dust” was a little disappointing to some, but we got the message. LOL.
SOME OF THE DIFFERENT HEMOSTAT AGENTS WE WERE ABLE TO CHECK OUT
HUGH SHOWING US THE EXOTHERMIC HEAT PRODUCED BY OLD-STYLE QUICKCLOT. IF YOU LOOK CLOSE, YOU CAN SEE THE SMOKE.
At this point, many would agree that by lunch of Day One, we had already gotten our money’s worth, but we moved forward.
Day one concluded with lecture covering mechanisms of injury, patient evaluation, determining when we need to provide care under fire, or evac to a safer location. While the class was geared towards military, Hugh did a phenomenal job of transcending that and making it relevant to all. The class consisted on people from several backgrounds, none of which were LEO or .Gov. Only two people in the class had any type of previous limited medical training. There was also an emphasis on the preparedness mindset when choosing equipment and techniques for dealing with potential medical issues during “Katrina-Type” scenarios. Hugh showed us many field expedient ways to “MacGyver up” and get the job done in these types of environments and conditions. This included ways to do chest seals for “sucking chest wounds” or gunshots to the chest. We talked about what equipment and medicines you would want to have on hand for these types of events.
SOME OF HUGH'S MACGYVER SKILLS
NOLACOP TRYING TO DO A MAKESHIFT NECK COLLAR/EVAC FROM A BURNING CAR ON THATCHEVYMAN(SHOULD CHANGE HIS NAME TO THOSECHEVYMEN)
Day two began with Paul going over many of the components and advantages and disadvantages of commercially available IFAK kits(Individual First Aid Kits)out there. We talked about knowing what was in your kit, how to properly use your kit, and when certain tools were appropriate. We began to make decision on what specific gear would be best for our individual kits.
SOME OF THE DIFFERENT IFAK TYPE KITS COMMERCIALLY AVAILABLE
Then we got the kit Paul and Hugh set-up for us.
It was a great start on a kit, and after everyone handled the options available, it consisted of most of what was unanimously considered the best made and most practical gear.paul and Hugh made it clear that this was just a start and we had to tailor our kit to who and from what we wanted to protect. IE- women and children if it applied in your case.
1. (1)-RMT (Ratcheting Medical Tourniquet) Of which Paul is a member of the design team. The class felt this was the easiest to use, most secure and tightest, and it had an acceptable pack-ability in a personal or vehicle medical kit.
2. (1)- Olaes® Modular Bandage
3. (1)- Olaes® Modular Bandage (TRAINER)
4. (1)- Emergency Shears
5. (1)- Israeli Emergency bandages
THE PAUL AND HUGH STARTER KIT. WELL OVER 100.00 IN GEAR.
About the only thing missing was possibly a hemostatic agent. I think the class came to the conclusion that the Quickclot Combat gauze® was the best choice, followed by Celox® , and then Quickclot ACS®. Woundstat® was not an option due to reports from the US Army and the fact that they forbid their medics to use it due to particles traveling through the bloodstream and causing clots.
During Day Two, we continued to look at patient transport systems from traditional litters, the SKED®, and other portable systems. We all took turns trying them out on each other and discussed the ease of use vs. pack-ability issue with each one.
We worked different scenarios where we had to administer aide based off of limited information with the tools we had on hand. Everyone who wanted to, got hands on time with all of the gear and techniques.
The following texts were recommended reading by Paul and Hugh for continued education in this subject:
1. Emergency: This Book Will Save Your Life (Paperback) by Neil Struass
Amazon
2. Ditch Medicine: Advanced Field Procedures For Emergencies (Paperback) by Hugh Coffee
Amazon
3. PHTLS Basic and Advanced Pre-hospital Trauma Life Support: Military Version (Paperback)by National Association of Emergency Medical Technicians
Amazon
We are planning to have Hugh Coffee back at the end of the year for either another course like this, or possibly a 2.5-3 day course with a little more detail and more of an emphasis on medications, sutures, long-term care out-side the hospital, and more disaster preparedness type of info.
If you missed this class, you missed a lot. The course was highly informative and opened a lot of people’s eyes. We carry a gun everyday because we never know what may happen. It only makes sense that we carry the tools to mend ourselves or our family if a gun were to be used against us, or more probable, we were involved in a traumatic car accident, house fire, or some other natural disaster where medical help was not a 911 call away.
