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May 16, 2011
West of Boston
April 11, 2021

Ben DeWalt, Matt “Doc” Hilton
Location: ACADEMI Northeast, Salem CT, Indoor classroom
Time: 9:30-5:00
Cost: $150


I took the same class with my daughter in January 2019, we are back to brush up on skills and relearn what we had forgotten. She now almost 16 and has completed about a dozen shooting classes since her last medical class and I thought it was time for both of us to revisit this incredibly important material.

Ben started off with a short talk on how important it is to have the skills and medical supplies on your body when you need them. Paraphrasing Ben: Not in your car, or in your bag on the loading table but actually on your body no matter where you are. Shooting, biking, hiking, food shopping, rolling up to a vehicle collision, you never really know when you are going to be called to step up and save your own life or someone else’s life. You must have the knowledge, confidence, and tools to successfully do what needs to be done in that second!

Ben introduced Matt his senior medical instructor. Matt gave us a short bio. He has been in Army for just shy of 30 years and 100% of the time he has been in a healthcare role. He knows his shit, he has been there done that, and is an advocate for up-to-date training. Matt was my instructor last time in this class and it was good to see him again.

Matt started with his presentation, these are the notes I took:

MARCH (massive bleeding, airway, respiration, circulation, head injury/hypothermia).
We talked about care under fire.
Stopping life-threatening bleeding fast. The leading cause of death is blood loss.
Good tourniquets, which are not so good ones, fake ones, how to tell if they are fake, where to purchase real ones.
How and where to apply tourniquets. We were shown a variety of them and how each of them worked and how to apply them. We each had a CAT TQ in front of us when we sat down in our seats.
Move the casualty to safety. Reassess make sure things have not changed. Do an RTA Rapid Trauma Assessment looking for life-threatening injuries.
Apply tourniquet on extremities & hemostatic gauze in transition zones (neck, groin)
Expose the wound, cut clothing: Trauma naked. Determine what kind of bleeding control needs to be done. (TQ, pressure bandage, hemostatic gauze, etc..)
There may be more than one wound. Exit wounds are larger than entrance wounds. Both need to be bandaged.
Don’t clean or remove anything from the wound.
We were shown how to apply & different types of pressure bandages
We were shown how to pack wounds and stick gauze into holes correctly keeping pressure on the bottom as we pack it. If we use a hemostatic gauze attach the package to casualty so higher-ups know it is in the wound.
Compress hemostatic gauze for 3 minutes wrap with a pressure dressing
We were shown where to apply pressure on the body to slow blood flow to a specific area to help with coagulation.
Airway considerations: let them assume a comfortable position. Don’t make them lie down if they want to sit up.
The correct recovery position
Open maintain airway, look listen and feel, if unconscious place in the recovery position.
May have to place NPA use lube, right nasal is normally larger
Treat injuries as you find them if you bypass them you will probably forget about them.
Holes in the chest area: apply chest seal, monitor tension pneumothorax, use pulse oximeter if have one
If the casualty has mentally deteriorated and loses radial pulse think BLEEDING reassess immediately.
Hypothermia prevention. Make sure they stay warm, very difficult to reverse.
Always keep talking to them, reassurance, keep them informed, they will be scared and you’ll be able to see if they go downhill by the conversation. Ask them open-ended questions, not yes or no.


A- alert knows who they are day date
V – not alert, responds to verbal commands
P- responds to pain, not to verbal commands
U – unresponsive (unconscious)

We were shown how to insert a Nasopharyngeal Airway

Check for chest wounds front and back. Rake your fingers on their body to feel for holes. Apply chest seal. Place them sitting position.

Document whatever you do on an index card or a commercially purchased TCCC card or their write on their body.

Call for help and get ready for evacuation to a higher form of care.

Stages of care: care under fire, tactical field care, tactical evac

Preventable causes of death: Bleeding, Tension pneumothorax, airway, hypothermia

We were shown how to correctly use splints for legs and arms.

After the lecture and demonstrations, we went into another room where there were stations set up and different scenarios we had to participate in.

Some were self-care stations where we needed to put a TQ on ourselves. Some of us were to put a TQ on someone else. Matt would make you crawl to a downed person and apply a TQ to a specific place on their body.
There was wound packing cubes and gauze stations
NPA, and a dummy to practice inserting it correctly.
Pressure bandage stations, and a large abdominal bandage station where you simulated a gut wound that needed to be dressed.
On some people, Matt would apply a TQ on your leg and make you walk to the other side of the room. We practiced most of the things we could from the presentation.
There were a lot of different scenarios going on in the room and you had to work through each of them to get some hands-on practice doing them.

Matt and Ben watched and coached as we did things correcting things as they saw. It was great. The best part of the class in my view. This review is probably massively incomplete. I am sure I missed so much as I was trying to absorb all the information. I very much enjoyed this class and the instructors. I urge everyone to take some medical trauma class especially if you carry a gun daily.
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