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9/25/2016 3:11 PM
 
.  TAK, does there really need to be a Glock analogy attached to everything?  Geez! 

 

Yes.  Sort of like the Glock to a German farm wife, they both work their azzes off and folks understand the analogy.
 
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9/25/2016 3:33 PM
 
Take-a-knee wrote:
.  TAK, does there really need to be a Glock analogy attached to everything?  Geez! 

 

Yes.  Sort of like the Glock to a German farm wife, they both work their azzes off and folks understand the analogy.

Yeah....but...okay...we all get it....you love Glocks.  


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9/25/2016 3:36 PM
 
I once knew a dude in college that absolutely loved fat chicks. Not only loved 'em but preferred 'em. And he spent countless hours trying to justify his freak to the rest of us. Why he did so, I don't really know. But I suspect his constant chatter came from a sense of nervousness or perhaps a sense of self disgust.

No matter.
 
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9/25/2016 5:07 PM
 
El Mac wrote:
I once knew a dude in college that absolutely loved fat chicks. Not only loved 'em but preferred 'em. And he spent countless hours trying to justify his freak to the rest of us. Why he did so, I don't really know.

 

So that means all SOCOM assets are now "freaks"?  They've ALL gone to the "dark side".  Tier One first, then SF CIF companies, now finally NSW and MARSOC, the latter after two less than satisfactory dances with the 1911.

 

 

 
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9/25/2016 5:51 PM
 
TAK, I was talking about fat chicks and an old college buddy. Settle down Beavis. Get off your TRX, step away from the mirror, take off your flag patch cap and stow away your MC tank top and check out the following:

Hey, this may come as a total shock to you. So, be prepared....I'll take it easy on you....ready? Here we go now! As for SOCOM, Tier 1 Anybody, SF CIF, NSW, MARSOC, GSG Super 9, Spetsnaz, FBI, DEA, Mayberry RFD PD, or anybody else that you want to throw into the mix - pay attention here: I do not care what they carry. At all. All I have to concern myself with is me, my family, my gear. And my gear works. Period. Glock failed me in Afghanistan. Period. Get that through your thick skull and thin skin.

Don't you have some Lost in Space reruns to watch?


 
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9/25/2016 5:56 PM
 

Here we go again with this nonsense.  Look...it's still Free America (at least for the moment).  If you want to run a Glock...knock yourself out and have fun with it.  If another guy wants to like the 1911 best, then that's just fine as well.  If yet another guy likes a Ruger or S&W semi-auto, or a wheel gun, or a....you get the picture.  Pick one and run it as well as you can.  Best pistol in the world?  The one you have with you when you need it, that does what you need it to do.  There.  Now everybody can quit beating that poor old horse.

Plus...now this thread can actually be put back on its intended track...Backcountry FAKs....which have absolutely zero to do with any kind of firearm.  So...we don't need Glock, 1911, or even 40 watt range plasma rifle analogies to describe pieces of medical kit, right?


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9/25/2016 5:58 PM
 
Thank you Ken.
 
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9/25/2016 6:14 PM
 
Sorry TAK. I may have come across a bit harsh. Probably did. But brother, I get real tired of the purple dildo reactions. And if you have moved in the circles you claim to move in, you know exactly what I'm talking about.
 
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9/25/2016 6:38 PM
 

To bring the conversation back to the originally scheduled program...we've been fine with the NATO particularly on upper extremities when two full wraps can be used, thus negating the pinching issue to a large extent.  That said, there is a learning curve with the NATO...but that is true with any of them.  We've been successful doing one-handed application of the SWAT-T by capturing the initial tail with the mouth for an upper extremity.  I don't consider it to be the end-all be-all and never stated that.  However, it is a viable means and certainly beats improvising one.  

It is probably worth re-stating that the intent of this thread is items one might include in a Backcountry IFAK.  Unless things really go sideways in this country, full-on combat conditions won't be experienced by anybody here, which is actually a good thing.  Now, the potential does indeed exist that a GSW might possibly be encountered, or some other penetrating trauma with arterial involvement...so, by and large, any decent TQ will work, as long as proper training is possessed.


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9/25/2016 6:43 PM
 
Starting with GoKartz"s list on the first page and reading thru the rest of this thread, I can only add training. I am a retired AEMT in Montana with lots of ambulance runs in the past. But with all the training I had I will say the NOLS Wilderness Training was the most useful. I'm proud of my Wilderness EMT badge.

I practice and am a member with the local SAR. My personal pack includes a larger FAK then most. Backed up by the rescue sled Kit.

I addition I also carry an Epi-pen, Sam Splint roll, Sam Splint large flat splint, and a 3 inch wide cloth roll and speri-strips.

Items I don't have (because of training) Quit-clot and a Tourniquet. My training has always been no Tourniquet. The wars we are in have advanced these new methods of treating trauma, but I have no training. My EMT friends are now getting this training.

When I recertify my Wilderness EMT license this next summer, I'm sure we will train on this.

 
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9/25/2016 6:55 PM
 

100% agree, Boy Wonder.  The employment of TQs in trauma protocols has really become standard.  Like you, I was also originally trained to stay away from them...but the things we've learned about them over the last decade + has really flipped a lot of the old standards on their head.  Now...proper wound packing and dressing is still critical, and I'm sure you know that will often handle a great deal of bleeding.  The principals of direct pressure, elevation, pressure dressing, pressure points still have a big role.  Definitely jump onto whatever training you can.  I think one thing that gets addressed at the Wilderness EMT courses that might not get covered at others is the factors involving downgrading a TQ at some point, if possible...because sometimes it might be days before the injured person can be transported to a definitive care facility.


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9/25/2016 7:16 PM
 
El Mac wrote:
Sorry TAK. I may have come across a bit harsh. Probably did. But brother, I get real tired of the purple dildo reactions. And if you have moved in the circles you claim to move in, you know exactly what I'm talking about.

 

Thin skin still quite intact.  "Harsh" is typical team room fodder.  As for my "circles", nothing too impressive, 4yr Infantry with a stint as a Airborne Dept blackhat (twr branch), then 17yr USAR/NG SF, 18B and 18D.  I worked in Iraq as a contractor (Cochise) when I retired.  Liking and discussing HPG gear on the Kifaru board got me banned there, Scot will probably ban me from here for liking Glocks.  So be it.   But back to tourniquets....

I will assuredly try that SWAT-T "in the mouth" thing tommorrow.  As for CAT windlasses breaking, the only ones I've seen break were ragged from training use, or we TRIED to break them on a manequin.  Not saying they don't break.

 When I teach hem- control, I always ask how tight do you apply a tourniquet?  The answer is invariably "as tight as you can", which is dead wrong.  6ft+ guys with 500# deadlifts, amped up from contact, applying them needlessly tight, broke a lot of them.

 
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9/25/2016 7:25 PM
 
alpendrms wrote:

100% agree, Boy Wonder.  The employment of TQs in trauma protocols has really become standard.  Like you, I was also originally trained to stay away from them...but the things we've learned about them over the last decade + has really flipped a lot of the old standards on their head.

 I attended a Flight Paramedic course several years ago and a local crew (pilot, RN, paramedic) landed to show us their rig.  The had ONE CAT, still in the wrapper.  We gave them several.  None of their jump bags had them.

 When did you hang out at the gas station?  Boss Hog believed in tourniquets, but they emphasized wound packing because that is always the best way if you can get hem con that way. 

 
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9/26/2016 1:25 AM
 
Just recently attended a NOLS/WMI WFR course, and was a WEMT-B via NOLS/WMI 10 years ago (lapsed)...in between I was a medic in the French military.

TQ are very lightly addressed in the "official" curriculum, and mostly ad-hoc/improvised TQ's. The reasoning was explained that statistically, extremity massive bleeding in the backcountry is rare, as compared with TCCC. TQ have one job, and does it very well but it is relatively less likely to be needed in the wilderness environment vs other medical equipment. In short, it is a topic that has been discussed and debated and for now there is no impetus to change the curriculum.

Personally, I carry pretty much what all y'all carry in the backcountry...a pretty standard Mk Uno military IFAK, minus the NPA. CAT and SOFTT-W (both) if I have the space, one on the 1st Line. Add 1-2x SAM splints and some ACE bandages and I'm usually GTG.

In the front country, I carry a SWAT due to its lower profile when I'm without a bag/murse/backpack.
 
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9/26/2016 3:39 AM
 
Take-a-knee wrote:

I will assuredly try that SWAT-T "in the mouth" thing tommorrow.  As for CAT windlasses breaking, the only ones I've seen break were ragged from training use, or we TRIED to break them on a manequin.  Not saying they don't break.

 When I teach hem- control, I always ask how tight do you apply a tourniquet?  The answer is invariably "as tight as you can", which is dead wrong.  6ft+ guys with 500# deadlifts, amped up from contact, applying them needlessly tight, broke a lot of them.

The "teeth grab" works pretty well...just start with enough exposed tail.  Some guys have even captured it underneath their chin until the SWAT-T grabs onto itself.

When I saw them break, neither time involved big mongo-types reefing on them.  Both involved soldiers who were freaked out & trying to get bleeds under control.


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9/26/2016 3:43 AM
 
Take-a-knee wrote:

 When did you hang out at the gas station?  Boss Hog believed in tourniquets, but they emphasized wound packing because that is always the best way if you can get hem con that way. 

87-88.  Our TQs still consisted of stacked tongue depressors taped together, with a cravat back then.  The focus was control via aggressive wound packing, pressure points, pressure dressings, and elevation.


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1/9/2017 9:31 AM
 
As has been said here before, but I feel I must repeat LOUDLY (as a former Surgical Tech that saw the end results of LOTS of badly executed, poorly thought out, trauma treatment in the field)

GET TRAINED!

Know the difference between when a large laceration to the leg needs a tourniquet rather than a maxi pad and some duct tape. Hey...guess what. The guy with the unneeded tourniquet lost toes on that leg. The man who put the maxi pad and duct tape on HIMSELF and walked out 4 miles, irrigation and sutures and was discharged that night.

And who prey tell put the tourniquet on the 23-year-old kid who didn't need it? Hate to say it, but it was his ex-military buddies. Of course, they were not medics. (As I recall one of them was a pilot.) Was it a gruesome looking wound that was probably scary as shit to see? Yep. Would have 15 minutes of direct pressure or some Clox worked on it. Yep. Too many folk carry tourniquets without ever being trained. Hell, I watched a guy READ THE DIRECTIONS on his tourniquet while he was considering putting it on his kid. Fortunately, we talked him into .....you got it...maxi pads and duct tape. Hey...most women have one or two in their bag. This clown had a tourniquet and an Israeli dressing but no gauze pads or med tape.

I was an EMT working for a volunteer squad while I worked in surgery. And I quit over the over-eagerness of staff (EMT, EMT-I, PARAMEDICS) to OVERTREAT injuries. Don't tourniquet oozing wounds. Don't defib patients not in arrest. Don't start IV's on patients that seem alert, hydrated and healthy that are just injured somehow.(Broken bones, dislocations, minor cuts and abrasions) Argued and pleaded with the station chief and then finally decided I valued the sleep more than I did time at the station. Did manage to force all of them to go to a review on Defibulator use after I mentioned to the Director of Emergency Medicine for the county that a patient in a stable but odd heart rhythm had been shocked. Did no good to the patient. (you know, some folks walk around in A-Fib all the time. My dad does. Weird as heck.)

SO...Please get trained. The guys at Dark Angel Rock. The NOLS and their Wilderness Medical Program is incredible. And if you have been trained, get some more! Or get a refresher. It is amazing to me the amount of stuff that has changed or been COMPLETELY rethought since I was first trained in the 80's.
 
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1/9/2017 10:41 AM
 
Thank you TomBenson for your rant. Spot on.
 
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1/9/2017 6:13 PM
 
Good thoughts Tom. I have some friends in EM and they really hate how common supergluing cuts has become: guy gets cut in the field, superglues himself together, walks out, doesn't think about. It gets infected, and then they have to debride a much larger portion of tissue and run antibiotics and the whole shebang. My wife is a doc (of the animal variety) and we've had many a good conversation about emergency medical care, and a lot of what she says runs counter to some of the popular "prepper" medical stuff, such as guys wanting suture field kits. (She thinks that's an awful idea.)

I love tourniquets, and have seen them work... but applied to the wrong type of wound (non-arterial) or too tightly (cutting off venous return), they can be incredibly damaging. Might still save a life, but... Same with clotting agents. Heck, same with just about everything in healthcare (NSAIDS, tylenol, opioids, whatever).

I would say I can't believe that defib story, but sadly I can. Oy. Ouch.

- J
 
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1/10/2017 11:20 AM
 
GoKartz wrote:
Good thoughts Tom. I have some friends in EM and they really hate how common supergluing cuts has become: guy gets cut in the field, superglues himself together, walks out, doesn't think about. It gets infected, and then they have to debride a much larger portion of tissue and run antibiotics and the whole shebang. My wife is a doc (of the animal variety) and we've had many a good conversation about emergency medical care, and a lot of what she says runs counter to some of the popular "prepper" medical stuff, such as guys wanting suture field kits. (She thinks that's an awful idea.)

- J

I'm afraid I have to disagree regarding the use of superglue.  As a Special Forces Medic, I used it more than a few times to close lacerations on my Team guys, and also on Indig....definitely on a few Kurds, and one Somali.  As long as the wound isn't too deep and has been thoroughly cleansed and disinfected, it does, in fact, work....very well in my experience.  Bear in mind, my use of superglue has always been situations where I had no Lidocaine and suture kit with me, and Steri-strips weren't doing the job by themselves.  My use of superglue has also always been in a field environment.  SF Medics have often used field expedient means to manage things.  Improvisation and resourcefulness are hallmarks.  I've also sutured using fishing line and a patient's own hair on a scalp wound.  I've knocked burn patients out using Vet-Ket (ran out of the human stuff in our Kurd camp) in order to debride and apply Silvadene to their wounds in way less than sterile conditions...I'm talking in a tent on the side of a mountain in Kurdistan.  I also did a cricothyroidotomy using a cut-in-half IV drip chamber.  Sometimes....you gotta run what you brung.

Case in point: During my last jungle trip to Peru, I made a stupid mistake by taking my big, extremely sharp, Condor Warlock chopper out of its sheath improperly and sliced open my palm big time.  My own fault.  We had a SOF-trained medic on the trip with us and he grabbed his aid bag.  Unfortunately, the Lidocaine he had with him was very old....no good.  So, I then asked him if he had ever used superglue.  He had not.  My wound was fairly deep...into the muscle, but no tendon involvement and only venous bleeding.  We were about 12 hours away by vehicle from any decent medical care.  I was damned sure not going to trust the local clinic in Satipo Province on the edge of the Amazon River Basin!  I let it bleed a bit, and then we busted out plenty of sterile gauze and wound cleanse.  I used some elevation and direct pressure (Kerlix balled over the wound) to staunch most of the bleeding.  We then got some Tincture of Benzoin, Steri-strips, and superglue out of the IFAK / trauma kit I had with my jungle load-out.  After copious cleansing and irrigation, we then dried the wound with more gauze.  I then held it closed with gloved fingers and my medic buddy laid a bead of superglue over the entire wound.  That stopped pretty much all of the bleeding right there on the spot.  We then painted some Tincture of Benzoin around the outer skin edges and backed everything up with Steri-strips.  We then placed a nice dry, sterile dressing over that and taped it down.  I spent the next several days out in the dirty, wet jungle environment during our training.  I did 1-2 dressing changes per day, taking care to keep the wound as dry and clean as possible.  That was no mean feat, as that we had a few jungle rainstorms and also were living in a dirty environment.  As needed, I would reapply superglue to keep things well closed, and I also tried to limit the movement of my thumb, in order to not have the wound split back open.  During and after the jungle training, I continued to closely monitor the wound for any signs of infection.....nada...zilch.  The wound healed fine.  In fact, right after finishing in the jungle, we had to fly to Paraguay immediately after we got back to Lima, to conduct more training.  By the time I got back to Lima from the jungle, all I needed was a bandaid over it.  By the time I got to Paraguay, it was open to the air.  This was only about 7 days after sustaining the laceration.  So, as far as I am concerned, superglue does have applicability....as long as certain parameters are met and if the person knows what they are doing with the stuff.  Here are some photos for proof:

17 August.  About 7 days after sustaining the laceration.  The flaky stuff is old superglue.



 21 August.  Wound is closed, but the skin edges split open a little due to me moving my thumb too much while performing different tasks.  No infection, very little discomfort.



13 September.  Some scarring, but zero infection...a bit of dead skin is all.



Today (10 January).  Hardly a scar to speak of.




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