Trauma is the leading cause of death for ages 44 and younger. It is also the leading cause of productive life years lost for ages 75 and under. That is greater than heart disease and cancer combined. As a result of a poor understanding of bystander trauma care, people die unnecessarily. You do not want to find yourself at the Disaster Gap unprepared and have people die while you stand helpless. Other times, you may find yourself caring for a trauma victim from a car accident. There are a few essential medical items everyone should carry in their vehicle.
- Bleeding is the leading cause of potentially survivable deaths in combat and in civilian trauma. Based on a report from 2016, there have been over 400,000 potentially survivable deaths in the last decade. Effective bleeding control alone can make a significant impact on that number. The idea of tourniquet use has a contentious history. They have been used for hundreds of years, however, around the time of the Vietnam War, we got away from aggressive bleeding control by tourniquets. Many felt it was a dangerous tool and the wounded would lose their extremity if a tourniquet was applied. Most of this was based on poor science and flat-out medical myths. Thousands of trauma victims died because of these myths. The fact is, at least two hours of tourniquet time is very safe. Many thousands of tourniquets have been applied in Iraq and Afghanistan with zero limbs lost from the tourniquet use. There are several tourniquets available, but based on the current scientific data, the two best tourniquets are the Combat Application Tourniquet® (C-A-T) and SOF® Tactical Tourniquet Wide (SOFT-TW). Both the C-A-T and SOFT-TW have been proven effective in combat and in bystander use. Police officers regularly use tourniquets to save lives. Ensure you understand how the tourniquet works and that once you apply it, you do not remove it. You can get training here.
- Trauma Shears/Scissors/Knife. This may seem like an odd medical item to carry. One might think pressure dressings or needle decompression needles. However, trauma shears do not only help cut off the clothes of the wounded to identify where they are injured, but you can make many other medically necessary tools. An example would be pressure dressings and packing material. One can make improvised slings, traction devices, and even construct a litter.
- During traumatic events, the body can have trouble with coagulation or forming stable clots to stop bleeding. This is a very complicated and convoluted process that is still poorly understood by physicians and researchers. Even though it’s not well understood, we do know a little about some of the causes. The coagulation factors and proteins in your body like to work at a certain temperature and acidity level. You have little control over most of it when on the side of the road after an accident. After you stop the bleeding with you tourniquet, there is one thing you can do, you decrease the amount of heat escaping the body by using a blanket. Most blankets will not completely stop heat loss secondary to trauma, but can significantly slow it down.
This list is not the end-all of what to carry; certainly, there is room for other items such as chest seals, tape, and chest decompression needles, but these should help out the majority of issues. No matter the situation you may find yourself in, whether it’s a terrorist event or the more likely car accident, you will be caught off guard. However, your response will be optimized with the appropriate preparation and training. Training and more importantly, preparation, enables you to react and respond quickly and appropriately. Get trained, be prepared, and help save a life.
Andrew is now a medical student at Texas A&M College of Medicine after serving many years as a physician assistant with the U.S. Army. He joined the Army in 1993 as a Light Infantryman and spent three years at 1st Battalion, 75th Ranger Regiment before leaving the Army to pursue a college education. He is a 2006 graduate of the Interservice Physician Assistant Program. His previous assignments as a PA include UNCSB-JSA (Republic of Korea) and 1st Battalion, 75th Ranger Regiment.
He has deployed seven times in support of the Global War on Terror/OCO. Andrew has taken care of more patients in the 75th Ranger Regiment than any other person since October 2001 and is the 2010 Army PA of the Year. Known as Old Man River, he is always angry, irritable, and cynical; at least it appears that way. He considers himself to be the least talented writer for the Havok Journal, but is very appreciative to have the opportunity. In his spare time he enjoys… who are we kidding, he has no spare time.
This article first appeared in The Havok Journal on August 2, 2018.