Mick-Boy's work gear (what and why)

[Mick-Boy]

TheBelly and coloccw, How does that differ from what you're taught (and teach)?

RE - Hemorrhage control and TQ application.

If I'm putting a TQ on a guy, I'm going to cause him pain. That's just the nature of the beast. A casualty on the ground that needs a TQ (ANY high pressure OR high volume bleeding) is going to get my knee on the offending artery first and foremost.

This would be on the inside of the arm (turn your bicep to the sky and push your fingers in between your bicep and tricep, that's your brachial artery) or on the pelvic girdle (about halfway between the base of your dick and the edge of your hip there is a hollow, push your fingers in until your can feel a pulse. That's the iliac artery right before it becomes the femoral artery).

That knee is to decrease/stop the blood flow while I apply the TQ on the limb. It's not going to feel good (it doesn't) but I don't necessarily know how long the casualty has been bleeding or how bad the hit is. I can't guarantee that I can get to him right after he goes down. That little bit of blood that I save by getting firm pressure (the point of my knee) on the pressure point may make a world of difference.

There was a thread in the survival section a few days ago where coloccw posted this. I've highlighted a couple of bits that I think anyone who carries or uses guns should keep in mind.

For those of you reading along and not familiar with TCCC/NREMT stuff I'll expand briefly: In the field, we cannot TREAT traumatic injuries (EMT-Ps excluded), only try to prevent further harm and package them up for transport to a Doc. This applies CONUS as well as OCONUS. If bullets are flying it doesn't matter if you are here or there: it is combat and combat proven protocols should be used. Stopping the bleeding, however you can, should be the main priority. If you think that pressure and elevation will work, then go at it. However, if it doesn't work then you just wasted all that time for nothing. Properly placing a TQ takes 10 seconds and works almost every time. Now you can take all the time you need to make a nice pretty pressure dressing and have the patient remain calm, etc... Taking off a TQ is not part of preventing further injury; it is treatment. A licensed Doc (CONUS) is needed to legally treat traumatic injuries. Whether a bystander on the range or an EMT-B, we cannot treat traumatic injuries. Basically, we can only stop bleeding, use basic methods to maintain an open airway, control hypothermia/shock, check and record vitals, and keep the patient calm. Get proficient at those basic skills and you can do a lot of good after an incident. Think of those as medical fundamentals: if your pre-hospital care or fundamentals are good, then the outcome should be better. Shitty fundamentals= shitty results.

[SuperiorDG]

There is a class this Sunday over at Bowers that gives a lot of info and on TQ usage.

http://www.ar-15.co/threads/27336-Ca...28th-0800-1200

[cmailliard]

There is a class this Sunday over at Bowers that gives a lot of info and on TQ usage.

http://www.ar-15.co/threads/27336-Ca...28th-0800-1200

So far nobody has signed up, we will most likely cancel it.

[275RLTW]

Nice video Mick. You can easily see that you thought out why you do things and if you are doing them for the right reasons. To illustrate the differences between "guy A" vs "guy B," and that neither line of thinking is wrong, I prep my CATs differently (routed through the inner loop). Although I know and understand that routing the TQ through both loops provides better tension, especially with environmental factors present, I keep all my CATs set up for a worst case scenario in which I need to get one on NOW and have only 1 hand available to do this. Since in the Care under Fire portion of TCCC, utilizing Self Aid/Buddy Care is before anyone coming to help me, I want to be utilizing my gear as efficiently as possible by myself. If I can stop the vast majority of the blood loss in less time, every time, then according to TCCC guidelines I can then (ideally) move to a position of cover and begin reassessing the TQ (most likely putting another one on, routed through both loops this time) as part of my Tactical Field Care. My priority for Care Under Fire is less of fixing the problem as it is making sure I can get somewhere with cover and time to properly fix it. While this approach may double the work I am doing on the same wound, I don't mind the reassessment on a potential life threatening injury. Under fire I am likely to miss something, and that could be a fatal mistake. Knowing that I have to expose the wound(s) and reassess the TQ placement gives me a chance to take a more thorough, calmer, and collected look at the problem and determine the best solution for it.

Either of the methods for prepping a CAT is acceptable provided that you 1) know how it is prepped, 2) are competent with the device and have trained with your gear prepped this way, and 3) continue to consider what you are doing any why you do them. Never stop trying to make things better, more efficient, or testing new methods/gear (in the appropriate environments, of course). Complacency kills as fast as an enemies bullet.

[Mick-Boy]

Never stop trying to make things better, more efficient, or testing new methods/gear (in the appropriate environments, of course). Complacency kills as fast as an enemies bullet.

I try to be a complete nerd in this area. It's how I've ended up with footlockers full of gear in the basement and why I've spent thousands of dollars on additional training.

For gear; the technology is always advancing. Things get lighter, cooler (temperature wise), more bullet resistant, etc. all the time. And I always want to play with the new fancy-sauce.

For TTPs; At the end of the day, there are no "keys to the kingdom" for gunfighting. Just little pieces to the puzzle and multiple ways to solve most problems. Identify what you want to work on, find an instructor (or several) qualified to teach you, set your ego aside and get to learning.

[stoner01]

Good thread. You and I think a lot alike. Always interesting to see how others have evolved their gear preferences over time.

[Mick-Boy]

Would you mind expanding on your mindset a bit?

For me, the adage "Let the mission drive the gear" is always be in the back of my mind.

Mission and threat are going to play a huge roll in selecting my equipment. For instance, awhile back we got some Crye blast belts that someone thought would be a good idea. If we were still getting slammed with IEDs all the time that might be a piece of gear that I'd look to implement. But for walking in the mountains and driving around in civilian vehicles? Not just no, but hell no. Doesn't fit the mission, doesn't fit the threat, shouldn't be included.

[stoner01]

Who me?

[TheBelly]

Mick,

The training I've received from Uncle Sugar has been pretty lax/rudimentary in the area of how to keep someone alive. Luckily I've only had to use it minimally. My side of the spectrum doesn't really get as down into the weeds as it should. It's all about pack 'em up and get 'em on the bird. I understand a reason behind it comes down to the resource of student throughput. The other reason is that I'm not in a job path that walks around. We move big trucks full of supplies. With today's armor, it really does take a lot to penetrate the hull of an MRAP. Also, the risk of IEDs has gone down almost exponentially since my first trip in 2006-2008. We're talking one or two per week, rather than 5-10 per day that I saw 'back-in-the-day'...

We were taught the 'one-loop' method on our TQs that coloccw mentioned. We also carried three of them on each person, one on their kit and one in each of the calf pockets of the standard uniform. Having uniformity across the formation has its pros as well as cons. The big pro there was that we knew where to find them, regardless of the person.

I forced my dudes to be more proficient than required, as far as medical. One dude ended up patching himself up (pressure dressing/isreali bandage) and limping out of the blast zone of a Suicide vest IED just in time for the second SVestIED to go off. That was a pretty bad day all around.

The biggest hiderance for me is the lack of continuing and sustainment training in the medical field.

[275RLTW]

The other reason is that I'm not in a job path that walks around. We move big trucks full of supplies.Careful...dangerous mindset there. Jessica Lynch and the 11 from the same convoy that were executed thought the same thing. We dug their rotting corpses out of a shallow grave 3 blocks from the hospital.

We were taught the 'one-loop' method on our TQs that coloccw mentioned. We also carried three of them on each person, one on their kit and one in each of the calf pockets of the standard uniform. Having uniformity across the formation has its pros as well as cons. The big pro there was that we knew where to find them, regardless of the person.
Keep TQs close to center of your body. If you lose your leg, then your TQ in your calf pocket is gone too. Not to mention if you cant reach it (MRAP rollover???) Its very easy to just keep one looped on you belt. Even keep one on you PT belt as well (yes, you can get attacked and injured while doing PT or going to the DFAC).


The biggest hiderance for me is the lack of continuing and sustainment training in the medical field. I believe there are postings about TCCC classes locally. If there is a noted deficiency in your training or gear=FIX IT.