Often when folks talk about personal
defense and personal defense scenarios the conversation revolves around tools.
Mostly about the firearm and maybe a little bit about other self-defense tools
like OC spray, kubatons, knives etc… These are all tools we use in the context
of a dynamic critical incident. Pre-incident avoidance is another subject
talked about quite frequently. How can
we avoid being involved in these incidents in the first place? Pre-incident
indicators and other things are discussed.
Another item that needs emphasis are post
incident actions. These actions may include rendering some kind of medical aid
to yourself or others. I often tell my students that the number one self-defense
skill I believe they need is medical training. Medical training can be used in
all aspects of your life. From your child skinning a knee to you assisting at a
motor vehicle accident. Knowing what to do and when to apply life saving measures
is a vital part of being “every day ready.”
A good starting point is to get certified
through the American Heart Association or the American Red Cross in basic first
aid, Cardio Pulmonary Resuscitation (CPR) and Automated External Defibrillator
(AED) use. The quick application of high quality CPR and AED use during a
cardiac arrest has been proven to enhance survival rates. Cardiac arrest can
happen subsequent to other injuries and is a definite life threatening issue.
Just like for any other incident we need to have a plan to bridge the gap until
more experienced providers or law enforcement arrives on scene.
Once you have basic skills in place,
individuals interested in using medical skills as part of a holistic personal
defense training regime need to look at mitigating the most common traumatic
injuries. According to the US Army study on
Fundamentalsof Combat Casualty Care the three primary causes of preventable death on the
battle field were, airway obstruction, tension pneumothorax, and hemorrhage
from extremity wounds. These will potentially be the same issues faced by the
concealed carrier should they be involved in an incident were shots have been
fired.
Lay persons can use the Tactical Combat
Casualty Care acronym MARCH to help
them assess and treat victims post incident.
M-
Massive Hemorrhaging: The early application of a tourniquet to extremities
whether it be prepackaged such as a C.A.T or improvised tourniquet can go a
long way towards keeping blood in the body where it is needed. The use of hemostatic
gauze or agents to pack a wound, pressure dressings and bandages are also
essential to controlling hemorrhage.
Airway-
Without an airway survival chances are low. Basic Head-Tilt-Chin lift or
Jaw thrust maneuvers can be used to ensure a patent airway. If properly trained
and equipped, individuals can employ nasal or oral pharyngeal airways to keep
the airway open if the victim cannot maintain their own airway.
Respirations-
Agonal or absent respirations may indicate the need for CPR. Elevated or rapid
respirations may indicate that the victim is going into shock or has internal
bleeding. A tension pneumothorax results when air enters the chest cavity and
puts pressure on the lungs causing one of them to collapse. This could happen
if the chest wall is compromised by a projectile or broken ribs. If possible
the application of a non-occlusive dressing to cover the entry and exit wounds
will help slow this process.
Cardiac-
The theory that pulse presence at different anatomic locations correlates to
blood pressure has come under some scrutiny in the last few years but the
presence of a radial pulse, taken at the wrist, is a good indicator that the
brain is being perfused with oxygen.
Head
injury/Hypothermia- Gently disarm any confused/disoriented or unresponsive
patient if necessary. Avoid further injury. Take cervical spine precautions if
needed by stabilizing the patient’s head and neck. Avoid hypothermia or low
body temperature by covering the patient with a warm blanket or clothing.
Medical training can go a long way towards
giving the concealed carrier the confidence and skills needed to manage the
post incident scenario, should they ever be involved in a self-defense shooting.
Medical training is important, get some.
