Showing posts with label EMS. Show all posts
Showing posts with label EMS. Show all posts

Wednesday, May 7, 2014

Ambulance Driver Class on the Care and Feeding of Medical Emergencies for Shooters, or: How I Learned to Quit Worrying and Love the Tourniquet



“Air goes in and out, blood goes round and round. Any variation on the theme is a problem.”

About a month before NRA Annual Meetings kicked off in Indianapolis this year, Ambulance Driver put out a call for students. In real life, AD is Kelly Grayson, emergency medicine subject matter expert and gadfly extraordinaire, and when he’s not running critical care transfers for the voracious and merciless EMS collective known as “The Borg” or writing books, he does a lot of teaching. This time, Kelly and friends had decided to create a class for the average gun owner on what to do about a medical emergency at the range or in the field (including, but not limited to, first aid for gunshot wounds.)  Why’s that matter to you? Well, it might not, but this is my blog, and you’ve got some nerve coming in firing questions. Besides, I think there’s a good chance that this class could be added to Kelly’s offerings, and that means it might come to your town one of these days.
Bro, do you even tourniquet?
Let me cut to the chase: if you aren’t at least an experienced first responder  with experience with gunshot wounds, I think you’ll benefit from this class. Kelly brought three friends in as instructors, including the author of Too Old toWork, Too Young to Retire and two other experienced medics, one with extensive experience in Detroit. Any one of the four have probably treated more GSW than I have car accident injuries, and their experience showed.  Bringing help also meant that the instructors had the manpower to break the class into four sections for small-group hands-on instruction in CPR, use of AED’s, and application of bandages and tourniquets. That time was valuable, and it looked to me like the instructors were consistent and efficient in running their individual groups. I was not expecting OldNFO to stand up deliver a history of hemostatic bandaging (products like Quik-Clot) but it was fascinating.
Aw, snap. Knowledge is about to drop on you like the other shoe, son.
The agenda was intelligently basic and can be summarized as three big questions:
·      What can we do about acute cardiac or respiratory problems at the range? (What if Joe has a heart attack at a remote range?)
·      What can we do about gunshot wounds to the extremities?
(What if Joe shoots himself in the leg at a remote range?)
·      What can we do about thoracic gunshot wounds?
(What if Joe gets shot in the belly or the chest at a remote range?)

What if there's inappropriate touching?
Negatives? Well, obviously, a four-hour course is not going to turn anyone into a medical superhero, so if anyone was hoping to learn to repair wounds surgically in the field with a fishhook and line, they would have gone home disappointed. The course could go longer easily; I believe Kelly mentioned that it may be extended in future versions, and I think that makes sense.

Positives? Brisk pacing, not a lot of superfluous discussion or information, good balance of lecture and participation, well-considered agenda of basic information, and a good job of addressing varying skill levels from medical laymen who’ve never really thought about medical emergencies at the range before to practicing nurses and doctors.
Now you're cookin' with gas, ya big lug! But seriously, you should probably take that thing off at some point.
In the end, I walked out with knowledge and confidence I hadn’t brought in with me, and that’s a win. In particular, I picked up new knowledge and much firmer confidence in my knowledge of thoracic wounds, especially sucking chest wounds, and I no longer fear the tourniquet. I also walked away with a compact emergency kit stocked with a good field tourniquet and appropriate bandages, gloves and cleaning supplies, plus an occlusive chest seal for sucking chest wounds (which has helpfully been covered in notes with a Sharpie™ because I walked in late without a pencil or paper on my person.)
Be prepared! But if you can't manage to be prepared, at least be prepared to be weird. 
It must be noted that the use of St. Francis Hospital’s excellent conference room and the food and drink supplied by Brownells out of the goodness of their hearts added to the experience for most of the attendees.  Personally, I haughtily refused to partake of the delicious breakfast pastries or drink the soda and juice provided, because I am an arrogant monster. But if you’re into that sort of thing, you can see how having one of the giants of the industry step up to support a small class like this one—a class with, it must be admitted, zero application to either Crossfit™ or shooting terrorists in their faces—makes a difference.

My thanks to Brownells, to St. Francis Hospitals in Indianapolis, to Kelly Grayson and TOTW and their fellow instructors. Going forward, I’m going to be sharing a version of what I’ve learned out to members of the Sangamon County Rifle Association. The SCRA met two nights ago, and between my account and the praise delivered by Snooze Button Ronin, I think we have some interest in hosting Kelly for a similar class in the future. I’ll be watching with interest to see if it becomes available!

Monday, July 20, 2009

Yay . . . arrrgh . . . yay . . .arrgh.

It's 4:45 a.m. and I've been awake all night. This is problematic. An hour from now I've got to be showered, awake and on the road with my family to go see the giraffes at the Saint Louis Zoo. But it's been one of those nights.

First, we took the Wee One and the Dust Devil to the park for a picnic and some fishing. Dust Devil caught two small bluegill, so he was hopping and twitching like a speed freak drying out at gunpoint. Wee One chucked some rocks in the water, which delighted him thoroughly. Good times.

Then, we returned to our home. The Dust Devil proposed that we order Chinese take-out; My Bride was sorely tempted. I compromised by making stir-fried chicken and vegetables with homemade sweet-sour sauce and lemongrass/ginger rice. Delicious even if I must resort to saying it myself, and I figure losing the breading on the chicken alone saved a lot of calories. Stir-frying in coconut oil is either a lot healthier or not worth the time (I forget which) but it tastes awfully tasty.

Later, as I told the boys FOR THE LAST TIME to go to bed because I REALLY MEAN IT, the radio went all noisy and I was forced to quit my happy home. Two calls tonight, two people not breathing. Two CPR sessions (not me, I was driving.) Two saves as of the time I went home. The first was an elderly lady. She's probably in a precarious state right now, but she's breathing. The second was an 11-month-old child. She opened her eyes right before we met the ALS (Advanced Life Saving, as opposed to our Basic Life Saving) ambulance. By the time we got to the helicopter, she was pink and crying aloud. I'm calling her a save unless I hear otherwise. That was one of the best nights I've ever had driving that old ambulance, but when it was done it was a strangely muted feeling. I was happy, but I was ready to go home and get some sleep. Alas, it was not to be!

Anyway, that last one kept me out till about two in the morning, and I really wanted to publish an Examiner column I'd started on the national right-to-carry reciprocity amendment coming up for a vote this week in the Senate. I'm going to be gone out-of-pocket all day, and I don't have a fancy internet writing/blogging/twittering laptop/netbook/telephone/implant like the cool kids, so I have to plan these things.

Sadly, I suck and the Examiner Publishing Tool hates me. So although I haven't quite given up yet, maybe you'd better check out some of the other Examiners in the meantime.


Thursday, March 5, 2009

Ogre Will Love This . . . .


So, apparently the skyscraper-dwelling tree-huggers who live along Lake Michigan in Chicago have their frilly underthings in a twist because the Chicago Fire Department made a decision not to send its scuba team into Lake Michigan (through ice, no less) to save . . . a coyote.

Yes, a coyote.

A scavenging predator. A dime a dozen. An animal that thrives and overpopulates even in urban areas. A furbearing predator that is legal both to hunt and trap in Illinois . . . . to the tune of 7,000 taken per year. The animal George "Mad Ogre" Hill used to finance a new pistol, because where he lives, there's a bounty on the damn things. One of the only animals in Illinois that can be taken legally with a centerfire rifle. These people would faint dead away if they saw what goes on out on the back 40 of the average farm in Illinois on the weekends.

They don't appear to be kidding, either. It seems they are actually angry that professional rescue/EMS workers made the decision not to risk human lives to save a game animal some of them probably shoot on the weekends. Hey, folks, I think turkeys and whitetails are beautiful, but if I saved one from drowning within a mile of the farm where I hunt, my good friend the l
andowner would think twice about letting me come back the next year. There's a reason he lets me hunt there for free, and it's at least partly based on controlling the numbers of animals he considers varmints.

This reminds me of a letter to the editor I saw in the Chicago Tribune years ago while I was visiting my in-laws (this was before they were my in-laws.) Wisconsin was considering creating a hunting season for mourning doves at the time. That proposal led a dingbat from Chicago to bleat loudly in consternation. She would never, ever, ever visit Wisconsin again. She would keep her money in Illinois; no state barbaric enough to allow rednecks to blast the bird of peace with shotguns would get another cent from her. They'd be sorry, that's what!

I actually did write a short letter to the editor of my own, pointing out that Illinois has had a legal dove season for as long as I can remember, and that the breasts of the poor little things were delicious rolled in pancake flour and pan-fried. At the end, just to be on the safe side, I pointed out that Chicago is located in Illinois. I don't know whether the Tribune published my rebuttal, but it put a smile on my face and that's all that counts in my little world.

Tuesday, October 14, 2008

Your Attention Please:

Please, please, your attention, a moment only . . . . thank you. Ahem.

The Management would like to announce that the link in the post entitled "Why Do Squirrels Hate Freedom?" has now been repaired and will take you to the full story of a local veteran of the Iraq war, who survived an IED attack and was awarded the Purple Heart, being savagely attacked by a freedom-hating squirrel. Photographs of his wounds are included, of course.

Friday, August 29, 2008

I Can Explain

Just checked my voicemail, and I had a rather testy message from one of the officers at the Ambulance Squid, now several hours old. "Don, Beavis and Betty were looking for you. They want to go to the Girard football game and it's getting late, so call me at the shed when you get this." Well, it's almost 10:00 p.m., so I don't think I'll bother her right now. We DO cover the Virden and Girard football home games, you see, but since each team is playing nearly an hour away tonight, I'm guessing they weren't at the Girard field for very long before they figured out why I hadn't shown up bright-eyed and bushy-tailed with caffeine overdose in hand.

Yes, my fellow Americans (and all you lovable foreigners,) it's football season again, and that means, if you're on a small-town ambulance crew on Friday nights, spending your Friday evenings watching high school football. There are worse punishments in life, but tonight I was exhausted from a long day and a good workout. I bought a paper on the way home and checked it out. My alma mater, the Bulldogs, are playing the Pretzels tonight (no, I'm not kidding) and the game is . . . . away. One down.
The other school we cover, the Big Red (Who have a vicious rivalry with the New French Lick "Juicy Fruit"--OK, that one I made up) are playing the Wildcats . . . . away. Oops. Oh well, kids, I wouldn't worry about it. The greater Girard metropolitan area has many inviting tourist attractions such as car lots and a Whirl-A-Whip, and is always worth the drive down nearly-scenic Illinois Rt. 4, which offers many scenic views of both soybeans and corn.

There's talk of consolidating Virden and Girard schools now, and people are starting to puff up their gills and feathers and dander and whatnot in impressive threat displays to Defend Our Beloved Schools. Except me, and here's why:

1. Consolidation is probably a great idea. Illinois has more school districts for its size than any other state. We are riddled with tiny rural districts that pay lots of redundant administrators and have to maintain their own athletic, transportation, and probably other systems. A consolidated district would be more stable, would be able to mix and match students between more buildings, and could make the transportation work better--probably.

2. It probably has no better chance this time than the previous three or so times it's been tried in my lifetime. It seems to get floated every decade or so. People draw battle lines (most of them on football fields or basketball courts, it seems) and the idea of consolidating becomes a symbol of what the evil, progressive world keeps trying to foist off on us, like gay rights and New Coke. Virden and Girard are vicious rivals of long standing in our athletic programs, and that seems to override all other considerations. Personally, I always figured that if Superman could work with Lex Luthor and Captain America could be on the same side as Joe Stalin (think about it, it's so true!) then we should be able to welcome our toothless, meth-addled brothers from the south with open arms. But not everyone is as loving and respectful as I am.

Saturday, June 21, 2008

What Have I Done to Deserve This Happiness?

So SAFR is rolling along, the twins are at my parents' house, it's Friday night and my wife is in the mood. Unfortunately, I'm on call from 6 p.m. until 6 a.m. Fortunately, we grill our steaks, and there are no calls. We go to bed early (hey, we're old married people) and still there are no calls. I drift off to sleep in the arms of my beautiful wife, still waiting for that pager to go off, but there are no calls. I sleep soundly the whole night through . . . you know the rest.

BeepBEEEEEEEEP BEEP
BEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEP

"Small-Town Ambulance, you are needed for a 911 call at Small-Town PD for a female complaining of back pain . . . be advised, she is combative and 10-56."

It's been such a perfect night, I figure I might as well look at the alarm clock . . . . SUCCESS!
6:16 a.m.
I have won life's lottery.

Friday, June 8, 2007

Here I am. You may adore and venerate my person now.

All right, I'm going to level with you all. I don't know exactly what I'm going to write here. Truth be told, I got really jealous of Tamara, and then I saw that Matt has a blog, too, and, I mean, George has got a Horde. Who doesn't want a horde?

But I got nothin' much to say, so I guess I'll just answer some imaginary questions that nobody asked.

Ummm . . . . aren't you going to get fired for calling yourself an "armed school teacher?"

Well . . . . uh . . . . gee, I hope not. Obviously I'm not going around armed while I'm at school. That's illegal and frankly unnecessary. I'd like to see CCW for teachers approved, but I'm not afraid to teach school without it. The reality is that American schools are not likely places to get shot. We get a lot of threats and assorted silly posturing nowadays, because that's what adolescents do, but my job doesn't involve any more rational fear of some kid with a gun than yours does, because the actual shootings are so very rare.
All that said, I don't make any secret of the fact that I'm a shooter and a knife collector. My bosses know this about me. They really couldn't care less as long as I do a good job of teaching children.

What's with the hat?

If you have to ask, you'd be better off googling "Firefly browncoat" and reading up a little.
If you knew that was Jayne's cunning hat, know this too: that hat was my Christmas present from my beautiful wife last year. She learned to knit so she could knit me Jayne's hat in my size (XXXHuge) by hand. She knows me well. I don't think she expected it to be my daily wear hat, though.

Why guns? Don't you think guns cause too much death and violence? You can't hug your children with nuclear arms, you know.

Why guns? Because I like guns. I enjoy the engineering that goes into a firearm, and I love the capability-and the difficulty--of smacking a target, especially a moving one. I have a modest collection compared to many, but then again, all my guns are shooters. Some are very old, but I own NO safe queens.

Are you really an ambulance driver?

I am; I drive for Prairieland Ambulance Company in Virden, IL . . . . as dismaying a bunch of rejects and misfits as one is likely to find this far from the Illinois State Legislature. I actually get paid a small stipend, which pays for some of our small luxuries like taking the kids to the movies.
Here I have a bone to pick with "Ambulance Driver."
That guy is not an ambulance driver. I am an ambulance driver. The difference is one of skills and training and dedication. You see, I drive an ambulance. That's it. I am not an EMT-B. I am not an EMT-B. I am not, like that faker, a paramedic. In short, I'm not qualified to recommend aspirin for your headache, and under no circumstances am I allowed to treat patients, advise patients, or look patients directly in the face. My job description reads, and I quote:
"Shut up, drive the rig, and make sure you have it spotless by the time it's time to go back in service, plebe."

OK, I haven't read it, but that's how I see it in my mind's eye.

Maybe I'll post more later. Then again, maybe not.