GSWs (cops and .mil please don't answer)

[rhino]

So everyone remember: If Jeremy is ever shot in the head....

But where do we put the sling if he breaks his neck?

You, sir, are witness to the one time I really, really needed an IBD, but all of them were in my truck and not accessible to me! Never again!

 

[Bill of Rights]

But where do we put the sling if he breaks his neck?

You, sir, are witness to the one time I really, really needed an IBD, but all of them were in my truck and not accessible to me! Never again!

I wasn't going to mention it, but.....

 

[MACHINEGUN]

Jeremy.. You have a fan club!

 

[jeremy]

Jeremy.. You have a fan club!

I know...

Sigh...

I suppose this means I know need to project a less juvenile persona...

 

[bwframe]

...I suppose this means I know need to project a less juvenile persona...

...and loose your fans?

 

[jeremy]

...and loose your fans?

Crap, I hadn't considered that...

 

[rhino]

I wasn't going to mention it, but.....

Indeed! Hopefully I'll never have the need again in the future, but at least now I won't be caught with my IBD AWOL!

And in case I haven't said it enough times or recently enough, thank you again, my friend!

I know...

Sigh...

I suppose this means I know need to project a less juvenile persona...

Don't even suggest that any of us project a less juvenile persona. It would ruin my career if it catches-on.

 

[DownByTheTracks]

I haven't witnessed major trauma, and just recently took the Armed Dynamics 10-Minute Medic course. I now carry a trauma bag with multiple TQs, Izzys, gauze, etc.

"A medic without a med kit is just another bystander."

 

[rhino]

I was simply curious about other's experiences. I have taken trauma and treatment of GSW classes in the past, and they are great, but they cannot replicate the feeling that comes over you when faces with such things. I think some of the replies here illustrate that....like "I stood there like a dumbass wondering what to do". whatever you have pictured in your minds eye of what a GSW looks like may not be actually what one looks like. some are obviously catastrophic and some look like a large needle prick with little to no bleeding.

I just wanted to start this thread to get some replies and maybe open a few eyes since we all enjoy spending time with these instruments that are capable of seriously injuring or killing us.

My head laceration of a few years (pics available on INGO! https://www.indianagunowners.com/forums/break_room/50029-rhino.html) wasn't a gunshot wound, but it was traumatic and it did require immediate attention. Initially I treated myself with direct pressure as soon as I was aware of what was happening. It was a simple thing to do, but I suspect I did it without much thought because I'd been conditioned to apply direct pressure as a first response to bleeding.

 

[MACHINEGUN]

Jeremy.. you loosey goosey!

 

[jwfuhrman]

Now it's an integral part of the Marion County bleeding protocol and is used relatively frequently. Experience with the military in Iraq and Afghanistan has shown that a limb can survive much longer without circulation than was initially thought. I believe even the police carry them now.
So throw that old info out and keep a tourniquet handy, it may save yours (or someone else's) life.

problem is if we use a TQ to "early" or not as a last resort, we can lose our certification.....

Indiana's EMS system is ****ed.

 

[jwfuhrman]

I love the discussions I have with our local ems director and the Volunteers on Trauma Management....

lol, yep. I basically just told my local EMS service that teaches EMT-B thru Paramedic courses that if they need volunteers just call me, I can come cover a shift as a basic.

Adams County(and what I'm finding is a lot of larger services) only hire Paramedics and nothing lower, so I cant even find a damn job as a driver lol.

Gonna hopefully take their Paramedic course this next year.

 

[gvonpaul]

problem is if we use a TQ to "early" or not as a last resort, we can lose our certification.....

Indiana's EMS system is ****ed.

I'm sorry, but that's not correct. A direct quote from the Marion County trauma management protocol:

3. Control all massive or life-threatening bleeding with direct pressure.
a. In extremity injuries, utilize a pressure dressing.
b. If unable to control bleeding in an extremity with a pressure dressing and elevation,
consider use of a tourniquet.

This is listed in the BLS skill section, so it applies to everyone. While obviously a tourniquet is not your first line of treatment for bleeding in an extremity, there are almost no conditions for its' use other than to try direct pressure and elevation first.
The State of Indiana makes no distinction about the use of tourniquets that I can find. While your medical director may not allow their use, and stepping outside of your protocols may result in loss of certification, there is no statutory distinction specific to tourniquets.
Edit- I have practiced as a paramedic for nearly 30 years in Indianapolis. I made it that long by being aware of my protocols (and the constant changes to ) and staying within them.
To paraphrase: "There are old paramedics, and there are bold paramedics, but there are no old, bold paramedics..."

 

[jwfuhrman]

I'm sorry, but that's not correct. A direct quote from the Marion County trauma management protocol:
This is listed in the BLS skill section, so it applies to everyone. While obviously a tourniquet is not your first line of treatment for bleeding in an extremity, there are almost no conditions for its' use other than to try direct pressure and elevation first.
The State of Indiana makes no distinction about the use of tourniquets that I can find. While your medical director may not allow their use, and stepping outside of your protocols may result in loss of certification, there is no statutory distinction specific to tourniquets.
Edit- I have practiced as a paramedic for nearly 30 years in Indianapolis. I made it that long by being aware of my protocols (and the constant changes to ) and staying within them.
To paraphrase: "There are old paramedics, and there are bold paramedics, but there are no old, bold paramedics..."

I'm sorry, I JUST finished my classes, so I'm going by what the STATE just told us. Not what MARION County has to say.

 

[nick89302]

I'm sorry, I JUST finished my classes, so I'm going by what the STATE just told us. Not what MARION County has to say.

I'm a Paramedic, and I'm not sure why you think this is so. Our protocols are very similar to those posted above.

I'm not sure why the application of a tourniquet (particularly when their medical director has specifically allowed their use by protocol) would cause someone to lose their cert when there are BLS ambulances staffed by EMT-Bs (not basic-advanced) placing their patients on cardiac monitors and continuous waveform capnography with the apparent blessing of their medical director and no sanctions by the state. Or even Basic-advanced EMTs performing IO insertions, again with their medical director's knowledge and when allowed by their protocols.

 

[gvonpaul]

I'm sorry, I JUST finished my classes, so I'm going by what the STATE just told us. Not what MARION County has to say.

I understand, I'm not being critical. The point I was trying to make, and I apologize because I really didn't state it clearly enough, is that the state only offers loose guidelines, your local protocols dictate the specifics of your practice.
Ten years ago, the use of tourniquets was in fact discouraged, as conventional wisdom of the time stated that tissue damage resulted from loss of circulation to the limb. However, new research has shown that an extremity can go for up to five hours without circulation and suffer no permanent impairment. In fact, they are even being used in surgery now to prevent blood loss.
A tourniquet can and will save a life. A layman can apply one with no fear of reprisal under the Good Samaritan law. Of course an EMS professional always has to follow the guidelines laid out by their medical directors, if they want to remain certified...
I certainly am not trying to make anyone look bad, just trying to bring home the point that a tourniquet is not the horrible thing it was once thought to be. In a case of uncontrolled bleeding, they can and should be used.
Here is a good article for reference:
U.S. military widening use of tourniquets - baltimoresun.com

 

[jeremy]

gvonpaul,

Some Counties have not quite caught up with the current times...

 

[gvonpaul]

gvonpaul,

Some Counties have not quite caught up with the current times...

I just want people (non EMS people) to know that they CAN use a tourniquet without fear of causing the loss of a limb and without fear of legal reprisals.

 

[jeremy]

I just want people (non EMS people) to know that they CAN use a tourniquet without fear of causing the loss of a limb and without fear of legal reprisals.

For me, if I can not control the bleeding with a simple dressing. I go straight to a TQ and bypass Pressure, Pressure Dressings, and Elevation. But that is my Protocal...

 

[Cat-Herder]

Stop the Bleeding
Start the Breathing
Protect the wound
Treat for shock

USMC mantra....

I always carry a GSW trauma kit in my vehicle. Most of the places I go for sport shooting are nowhere near a hospital.