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!


Midwest Chick said...

Many moons ago, I used to shoot at the Silver Bullet range in Sangamon County.

Great synopsis of the class!

Don said...

That might be Bullet Express now . . . which has moved to Auburn, right on the southern edge of the county. It was probably in Springfield back then, but I've always known it as Bullet Express.

Or there's just a lost legendary range out there, like a temple in a Lucasfilm jungle. . .

Hat Trick said...

The Silver Bullet was located in Curran. Not sure when they closed but I think it was mid '90s

Don said...

Ohhh . . . nope, never got there. That must be the place people confuse with Lefthanders Gun Club sometimes.