Saturday, December 29, 2007

The training I felt uncomfortable about - and shouldn't have

I didn't really feel all that good about taking Combat Life Saver training. I am not a natural with first aid or trauma medicine - not that I am squeamish or such, but I just don't have a natural talent or inclination for it (after I put in my first saline lock and IV, I later called my Dad - a retired MD - and he was tickled about it, heh). I did OK and learned enough to help out in a pinch.

But one thing that good first aid/trauma training can get across to you is a sense of, for lack of a better term, "priority". Certain things must be done if naught else is accomplished.

Like, seeing what is wrong in the first place.

I am currently home on leave, and I was driving on a back road when I came upon a two car accident. 911 had been called by an eyewitness - and the other two people standing near the wreck had done...naught.

I didn't have to do anything drastic that I had been taught in CLS (no tourniquets, heh heh) but at least I could talk to two people who had been hurt (I think one was either a broken collarbone or dislocated shoulder and the second was acting concussed and complained of a hurt neck) and make sure they did not aggravate their injuries, and reassure them help was on the way (it was not long in coming at all, thanks to the small fire protection district's station being reasonably nearby). Once the gathering group of bystanders saw someone actually doing something, a couple of people did lend a hand - particularly one older gentleman that stayed and spoke soothingly to a toddler who was in the car that had received the worse of it.

SPECIAL ASIDE: Seat belts and children's car seats WORK! Use them. Please. Oh, and thank goodness for cell phones - often they are disparaged, but when you have an emergency on a rural road, they are a Godsend to contact help.

The small police force of the nearby village and the local FPD arrived quickly, and I gave them what information I had and got out of the way. I would stress that last point - once the people trained and employed to take care of the situation have the proper information and get to work, the best thing to do is not impede them.

I did nothing all that special, but I did take advantage of what the Army has taught me. Oddly enough, it was at home and not on a battlefield.


Blogger Patrick said...

Start the breathing, stop the bleeding. Everything else is negotiable.

9:26 AM  
Blogger Gail said...

When you put in an IV, just remember to do what my OB nurse did when I was in labor with my first child. You stand there with the needle in your hand, close your eyes real tight, bow your head, and pray in your most earnest voice,"Dear Jesus, help me to get this right." After that, everything else you do will seem highly competent.

5:05 PM  
Blogger JB said...

Nice work! Airway, breathing, circulation, defib. If you take can take care of the first one or two before the arrival of fire rescue, you give them a much better shot of surviving.

God bless you, both for your service, and your "service".

7:27 AM  
Blogger M. Simon said...

One of the best bits of training for family life was the training I got in combat lifesaving.

You are so right. One of the best things you can do for a hysterical mother is EVALUATE the situation and explain to her the reasons for your judgment.

The ability to keep calm when the world is going to shit is also useful.

7:32 AM  
Anonymous Anonymous said...

Bravo! Well done indeed!Nice to know there are people willing to do something in these situations.



7:41 AM  
Blogger The Grey Man said...

After 15 yrs in the ER, remember the Emergency Prayer: Lord, don't let me Fuck Up!

7:51 AM  
Blogger Jeff said...

Major John,

Thanks for the reminder. My CO had as many of our Company as possible take it. He and I both did.

I think we hit around 25%, and always ensured we had at least one in every vehicle in a convoy -- two for longer/riskier trips.

I felt a little uncomfortable too -- not sure how competent I'd feel when the shite hit the fan -- but I was always gald to see the number of our guys and gals who were prepared.

That, and my two IV sticks were clean :)

7:54 AM  
Blogger LTC John said...

After 15 yrs in the ER, remember the Emergency Prayer: Lord, don't let me Fuck Up!

ALl I can add to that is..."Amen!"

Jeff - it is now 100% CLS for MiTTs. I guess smaller teams that often don't have medics or PAs have to have something.

8:59 AM  
Anonymous Anonymous said...

I had a remarkably similar experience (almost identical, down to the people standing around after calling for help, although they called 999, not 911!) soon after I received combat first-aid training as a Royal Navy. In fact I was returning from my brother's passing out parade as an army officer, so I was in uniform. Helps stamp authority over the situation. Good publicity for the service too!

Sound advice, and a reminder to all how important first-aid training can be.

9:03 AM  
Anonymous Anonymous said...

Good on you, Major, and amen on the seatbelts. I've been an absolute stickler for them since I took a left turn a few years ago "certain" I had a green arrow. I hit a big truck with a bigger trailer head on w/ a combined speed of at least 60mph. Almost certainly would have killed or maimed me without a seatbelt, but other than soreness and a cracked sternum I didn't have a scratch. Safety engineers rock.

9:17 AM  
Anonymous Anonymous said...

Concur with your cellphone comment as well. I was cruising down I-75 one afternoon and just happening to be glancing to my right and saw a motorcycle and cyclist laying in a field. He had lost contol on a circular on-ramp. The dust was still in the air where he had crossed the shoulder of the ramp so it couldn't have happened more than a minute or two before. Called 911 and someone had already called it in!

9:37 AM  
Blogger Donald Sensing said...

When I was a college student I was riding with friends westward down the interstate when we started to pass a tractor-trailer wreck on the eastbound lane. My two buddies in front decided to stop since there was a pass-through just ahead. We drove back to the site and, like you said, the crowd of people standing there had done absolutely zip for the injured man, wife and daughter.

This was before I entered the Army, so I had not had military first-aid training, but I did have the BSA merit badge (don't laugh, it's much better than you think, and entirely trauma-oriented) and some Red cross training.

The woman was the worst injured, with large gash across the side of her head. I examined her and saw there was no evidence of skull damage. Her husband and daughter were more banged up than anything else.

You are right that talking to the injured is one of the vital things to do. The woman was covered with blood and very frightened. I told her that her injury looked worse than it really was and that scalp injuries always bled a lot, but that she really was in pretty good shape.

This was in the mid-1970s - no cell phones - so the wait for emergency crews was much longer than today. I examined the husband and daughter and assured them they were okay.

Really, the main thing I did was to keep them company and provide assurances, over and over, until the ambulance got there. I had no first aid kit and there was no trauma care to do, anyway. The woman's head wound had pretty kmuch stopped bleeding by the time we got there.

But when you're hurt, scared and mind-shocked from the sudden violence of a wreck, it matters beyond imaqining to have someone hold your hand and tell you everything will be all right.

For some reason, non one, including my two buddies, did anything at all.

When my son was in Iraq (USMC) he had had combat lifesaver training. When a bomb wounded two dozen other Marines in Fallujah in 2004, where my son was based, they sent him to the field hospital to help out. It was pretty sobering for him.

9:49 AM  
Blogger Skip said...

There were a series of posts from an EMT on a lefty-libertarian blog I sometimes read about basic trauma skills. I think they're well worth reading. But they can be summed up with:

Air goes in and out. Blood goes around and around. Variations are bad.

I recommend reading them to the interested.

Part 1
Part 2
Part 3

10:20 AM  
Blogger Tiny Bunch said...

I get annoyed at the term "first responder". I believe it takes the responsibility off the general public who is really the first people on the scene.

I recently watched an accident occur. I called 911, checked the driver, and waited for the professionals. I was very glad to see them.

But I was prepared to give first aid if it had been necessary. Shortly after, I signed up for a Red Cross first aid class to update my BSA training.

10:34 AM  
Anonymous Anonymous said...

I'm interested in the comments about bystanders. My experience driving in New York State some years ago was that the bystanders did do nothing helpful, but they sure argued with each other and kibitzed what I was doing, calling out advice.

10:49 AM  
Anonymous Anonymous said...

Just another true story to add. While serving as an instructor at Ft Benning, "Home of the Infantry", there was a truck full of soldiers in basic training that had overturned. One of my instructors was already on scene doing triage so I joined in. We were placing the causalities along the grass on the side of the road. In evaluating one young man it appeared that he had a broken leg. No big deal right? Well when I told him and begin to splint the leg he just went white. He was going into shock with a broken leg. I talked to him and calmed him down and got him back around. Later I found out the young man was one of those new generation we hear about and had never had a rough and tumble life as a child and the news of a broken bone sent him over the edge. What he was doing at Infantry school I have no idea but hopefully the experience helped to make him a better soldier.
Sometimes all that is needed is a calm, reassuring voice even if the person behind that voice ain't so calm and reassured himself.

10:53 AM  
Anonymous Anonymous said...

Bystander come in a few different flavors. The best are those that do what they can and then get out of the way. Stay calm, stop the bleeding and start CPR if they don't have a pulse. The worst are those that do things beyond what they can handle and get in the way once the squad arrives.

Surprisingly, a large percentage of 'the worst" are medical doctors. If you are on the street bleeding and someone comes up and says "It's OK, I'm a proctologist" ask them to move along.

D-Diesel and/or Defibrillation.

I agree with the comments on the BSA first aid course, first rate.

11:29 AM  
Anonymous Anonymous said...

After 40 years of doing surgery and trauma I concur with all the above, especially with the ER prayer

1:21 PM  
Blogger LTC John said...

"This was before I entered the Army, so I had not had military first-aid training, but I did have the BSA merit badge (don't laugh, it's much better than you think, and entirely trauma-oriented)"

DOnald, I have served with two soldiers who were Eagle Scouts first, then joined the Army. I would NEVER laugh at BSA training (I never got past Star m'self, heh).

just a grunt, Don't be too hard on the Infantry trainees you saw - 23 years ago I signed up as an 11B and probably wouldn't have been too receptive to a broken leg either! A little time and the finishing course at the Fort Benning School for Boys does wonders for ya!

12:28 AM  
Blogger Jamie said...

In a New Age kinda vein... I say, visualize, visualize, visualize. You can have the training and still be too scared to use it; visualizing a situation- actually, making a habit of visualizing a situation - in which it's up to you to do something can (I believe) help you prepare to do something if the need actually arises. Ever since 9/11, every time I get on an airplane I not only do my usual "seat back count" between myself and the exit but also note the things I have that could be thrown or otherwise used to create a distraction (at least - though actually disabling an evildoer would be better, and I try to figure out how it could be done even though I'm also hoping somebody way better trained than I might be sitting in the seat across the aisle from me) in case one were needed.

3:36 AM  
Anonymous Anonymous said...

I remember in 1988 or 1987 when I took that same training. Even though I was an elisted I knew a lot of the officers my job was in the Fire Support TOC of an infantry battallion. So I met all of the FA officers at some point as they rotated in for fire support training. We got to IV part and the pairing and since there was only one officer and I knew him, I got paired with him.

Well he stuck me first, and of course suddenly a black circle appeared where he stuck me. Called out to the medic and he said he had went through the vein and I was now bleeding a little inside my arm.

I said, "My turn", but of course I did it perfectly. That training did not upset me as much as in basic training. The medical training in basix can be boiled down to, if you see your guts your a dead man, but a sucking chest wound you will live.

8:39 AM  
Blogger Inner Prop said...

The only "new" thing in CLS that I didn't learn in BSA was the IV.

We did a BSA First Aid meet with TA312s (so the kids could "actually" call in a 911 call) and Army Molage kits (or some such French spelling). It was the most effective training I have EVER received regarding First Aid.

The guy that put it all together? My father, the retired ILARNG BG.

11:26 PM  
Anonymous Anonymous said...

Hallo Mayor John,

Ich wünsche Dir ein frohes neues Jahr ....

Liebe grüsse an Dich....

11:33 AM  
Blogger Steve B said...

Between the training we got in The Basic School as Lieutenants, and the follow on training we got in the Fleet getting ready for Desert Storm, I knew more than the corpsman we got fresh out of field med. I probably could have almost qualified for an EMT with a little extra training.

Combat lifesaving skills and field triage are great skills to have. I always try to keep a pretty decent first aid kit in the car, just in case. And rubber gloves.

It's just a little scary though, what with everybody sue happy the way they are. I suspect a lot of the bystanders don't pitch in for just that reason.

Us military types seem to generally take a little different approach.

3:25 AM  

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