Tactical Treatment of Gunshot Wounds Course in Boone County, IN July 19, 2008

[Fenway]

Tactical Treatment of Gunshot Wounds

Boone Country Sheriff's Office
1905 Indianapolis Ave
Lebanon, IN 46052
Class Coordinator: Sheriff Ken Campbell
kcampbell@co.boone.in.us
(765) 483-3359




Doc Gunn, Inc. will offer a one-day course on the Tactical Treatment of Gunshot Wounds at the Boone Country Sheriff's Office in Lebanon, IN on Saturday, July 19, 2008.

Our course is based upon Tactical Medicine principles, but while TacMed is designed for military/police tactical entry team members with specialized medical training, our course is for non-medical personnel who may become involved as primary responders to treat and stabilize victims of gunshot wounds. Originally designed primarily for firearm instructors, home owners/defenders and street police officers, we have also given this course to Federal and Local Law Enforcement Emergency Response Teams and as a Train-the-Trainer program for elements of the United States Marine Corps.

This is a shooting course combined with what you need to do immediately afterward to increase the survivability of gunshot wound victims, including yourself. Important topics include the Effects of Bullets on Human Tissue, Where to Shoot and How to Place Bullets with Surgical Precision. Following Threat Elimination, we teach How to Identify the Seven Life-Threatening Injuries as well as How to Control Hemorrhage which is the major cause of preventable death from gunshot wounds. Accessing Emergency Medical Services and Maintaining an Emergency GSW Response Kit is also covered.

The course will run from 9 AM to 5 PM and students should bring a suitable defensive handgun of caliber .38 Spl/ 9mm or greater. 250 rounds of jacketed, factory ammunition will suffice. A minimum of three magazines should be available for semiautomatic pistols and two speed loaders for revolvers are advised. A rigid holster (belt or inside-the-waistband,) magazine/speed loader pouches, eye protection and head-phone-style hearing protection are mandatory. A hat with a brim (baseball-style) is also needed to prevent ejected brass from wedging behind your glasses. Shirts must be closed at the top to prevent brass being trapped against your chest. Drinking water will be provided. You may bring lunch or go to a near-by fast food restaurant, but down time will be kept to a minimum..

Prior firearms training to the level of DTI’s Basic/Intermediate Defensive Handgun or its equivalent from a recognized school such as Gunsite, Yavapai Firearms Academy, Thunder Ranch, InSights, etc. is a pre-requisite. (Consult the class coordinator if in doubt.)

Tuition is $240.00 and is due upon registration.. We intend to limit the class size to 16 students so an optimal student-to-instructor ratio may be maintained. Checks should be made out to "Doc Gunn, Inc." and sent care of Ken Campbell at the address above. Please direct all inquires to Sheriff Ken Campbell at his contact information above. You may also contact Doc Gunn via e-mail at dtirnk@yahoo.com

The following DTI link further describes our course.
http://www.defense-training.com/courses/tacmed.html

We feel that the Tactical Treatment of Gunshot Wounds is an important skill that should be part of every shooter's armament that has previously been neglected. We look forward imparting these skills and training with you.

Doc Gunn

"Willingness is a state of mind. READINESS is a statement of fact!"

Sheriff Ken P. Campbell
Boone Co. Sheriff's Office
1905 Indianapolis Avenue
Lebanon, IN 46052
(765)482-1412

[rhino]

This is a REALLY good class. I recommend it to anyone who is around guns ... at all. I'll probably be there helping as much as I can.

[Fenway]

Rhino, have you posted an AAR on this class somewhere in the past that we might be able to view.

[rhino]

Yes. I don't know where you could find it now because it was back in 2006. I shall therefore post it here:

Tactical Treatment of Gunshot Wounds with Doc Gunn

05 August, 2006

Copyright © 2006 by rhino

On Saturday, 05 August, 2006, I completed a one day “Tactical Treatment of Gun Wounds” with Doc Gunn of DTI Roanoke (dtirnk@yahoo.com ). Assisting Doc were Frank S. and Angelo N. of DTI, and our affable host, Captain Ken Campbell of the Boone Co. Sheriff’s Department (Indiana). The focus of the class was on the necessity of accurate shot placement and the immediate treatment of life-threatening injuries resulting from gunshot wounds.

The class started with introductions and a brief overview of the course material. The prior medical knowledge of the students spanned a spectrum from a paramedic who works with a tactical entry team, to a veterinarian, to those with minimal or basic first aid skills. Doc provided all students with a manual summarizing the essential concepts and other important information, so I chose to listen carefully rather than take notes during the class. After listing the course objectives, the four Universal Safety Rules and range rules were reviewed. Another very important topic was having a pre-existing plan for emergencies. This was especially interesting to me, since one of the main reasons I was in the class was to help me develop emergency plans for two shooting clubs.

Most of the morning session was devoted to how to make our handgun bullets more effective than those of the assailant. The importance of situational awareness was stressed, and that it’s vital to eliminate all threats before shifting focus to treating injuries (your own or someone else’s). Defensive movement was also an essential part of the package, as avoiding being shot is the best way to minimize the effectiveness of an attacker’s bullets. Doc explained what to expect if you’re shot, or if your enemy is shot, which is generally not the same type of reactions you see in the movies.

The fact that all handgun rounds are “puny” regardless of caliber was stressed, and that the key to making them as effective as possible in stopping threats is accurate shot placement. On the surface, that was not news to me, but in the past I had underestimated the level of accuracy truly required for defensive shooting. Most handgun wounds are very survivable, and among those that are not, few will incapacitate a determined individual before they have time to do great harm to you. The mechanisms of why people are stopped by wounds were covered in detail, including the effects of bullets on living tissues. Finally Doc raised the point that the only target that is a “guaranteed” immediate fight stopper with a handgun round is a direct hit to the brain stem.

Following the lecture was a session of drills on the range which served two goals (at least). First, it demonstrated clearly how important accuracy really is. The second (unspoken) purpose was that it allowed Doc Gunn and his assistants to verify that we could handle our weapons safely, which was essential for the final exercise of the day.

After lunch, we went into the medical aspects of the class. First was a brief summary of what “tactical medicine” is, and that our class was a subset skills taken from that discipline that we could use to save lives as well as teach to others afterward. Doc explained that in tactical medicine, there are seven categories of life-threatening injuries. After eliminating all threats, the injured individual is then assessed based on those seven. We spent most of our time discussing diagnosis and remediation of airway obstructions, tension pneumothorax, and bleeding, with some time spent on “flail chest” and sucking chest wounds as well.

That brought us to the equipment portion of the class, which covered:

· Recommendations for a minimal kit;
· Insertion of a Naso-pharyngeal airway to maintain airways;
· Proper use of a needle catheter to reduce tension pneumothoraces;
· Application of occlusive dressing for sucking chest wounds; and
· Use of the incredibly versatile “Israeli Battle Dressing” (IBD) to apply pressure to wounds, immobilize limbs, etc.

For those who are unfamiliar with the IBD, it is a combination wound dressing, elastic bandage, and tourniquet. Because of its unique design features, it can be used in place of a variety of other items (separate dressings and bandages, etc.). In addition, it can be applied very quickly and efficiently, even with one hand when necessary. Increasing or decreasing the amount of compression is simple and does not require removal of the elastic bandage to do so. I admit that when I first learned about the IBD last year that I initially dismissed it as a “gimmick.” Now that I’ve seen it demonstrated and learned to use it with my own hands, I am a believer that it is an essential part of anyone’s personal or range first kit.

After a demonstration of the proper application of IBD and its many uses, the class worked in pairs, applying the IBD to each other in several different configurations. Using the IBD on arms, legs, and torsos was straightforward, but applying it to neck or head wounds required some simple but interesting configurations, as demonstrated by Doc Gunn. In addition, he showed us how to immobilize a limb (such as for an injured shoulder), as the IBD can also work in lieu of an Ace® bandage, with or without a penetrating injury.

The final exercise of the class brought all of the day’s concepts and ideas together into one scenario. Working again with partners, the students were faced with two threat targets down range. While issuing verbal challenges and then engaging the threats, a “tactical sock” was thrown at one of the two, which was the sign that they’d been “hit” by a bullet. Both students continued to move and engage the threats until the signal to stop. At that point, both reloaded and the injured party declared their status to their partner. While maintaining situational awareness, both went to the ground, where the injured partner kept their weapon trained forward from a prone position to cover the downrange direction and engage any threats. The other partner holstered their weapon (prior to getting on the ground) and while applying the IBD to the injury, also maintained vigilance over the uprange direction. At another signal, the wounded partner resumed engaging the threats downrange. During all of this, constant communication between the two was required, both to update status of threats as well as to assess the alertness and condition of the partner who was shot. After successfully applying the IBD, the uninjured partner helped their wounded comrade to their feet.

The exercise focused on:

· Situational awareness before, during, and after the fight;
· Defensive movement;
· Accurate shooting;
· Communication;
· The necessity of staying in the fight and eliminating threats before tending to injuries; and
· Application of the IBD under the stress of the scenario.


The class concluded with some final remarks and distribution of certificates of completion.

Overall, it was an excellent class and Doc Gunn is a great source of knowledge and experience. In addition to the simple yet effective new skills I have, which I can now teach to others, I also have a much better understanding of what my clubs need to incorporate into their respective emergency plans. Hopefully I’ll never have to use anything I learned in the class, but if the need arises, I am far better prepared than I was before, as will be two shooting clubs in central Indiana. I recommend both Doc Gunn (dtirnk@yahoo.com ) and his class without reservation.

[Fenway]

Nice report. Thanks!

[rhino]

Doc's real name is Anthony Barerra, MD, by the way. He's been an emergency room/trauma physician for well over 20 years and has studied "tactical medicine" quite bit, most notably with the late Chris Dwiggins.

You get a couple of IBDs when you take the class too. One you will use for practice, which you can keep using for practice and demonstrations after you take the class. The other will still be in the wrappers, and you can use it as the nucleus of your "kit." My kit has:

• One (1) six-inch Israeli Battle Dressing (IBD)
• One (1) naso-pharyngeal airway, size 30 French
• One (1) #14 gauge needle catheter
• Two (2) strips of tape (wound around the whole thing)

That's all I need (and exactly what Doc G recommends for a minimalist kit and actually carries all the time himself). It fits in a large pocket or small pouch easily.

[Barry in IN]

So I don't need to buy that stuff before the class then?

[rhino]

Nope. You just need your safety and shootin' gear. What you buy afterward will probably be affected by what you learn and you'll probably change your mind many times (just like everything else!). What size nasal trumpet you buy (the naso-pharyngeal airway) if you decide you want to carry one will depend on what size (approximately) will fit you.

Some people go minimal, and others . . . like to have lots of gear.

Oh! I know you probably always have at least one on you all the time, but make sure you bring a knife. When you do the practical exercise at the end, you will simulate cutting a trousers leg to get access to a wound. It's embarrassing to have to borrow a knife!

[shooter521]

A buddy and I just signed up for this class. I've been wanting to take it for a couple years now – basically after reading Rhino's review back when he originally posted it. And Rhino, your '06 review can still be found online via a Yahoo or Google search. In fact, it was the *only* review I could find when I looked yesterday!

Looking forward to seeing some fellow INGO members there.

[rhino]

D'OH! I'm famous! Like a rock star!

Now I won't be able to move around in public without being hounded by the paparazzi!