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  1. #76
    Commander in Chief apod's Avatar
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    Quote Originally Posted by Knucklehead View Post
    Casualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
    Living up to your usename i see.Well done.Now back to your corner while the grown ups talk.
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  2. #77
    Non Temetis Messor The real Jack's Avatar
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    and there was me thinking rhodes was the biggest idiot in this thread....
    Everyone who's ever loved you was wrong.

  3. #78
    Closed knocker's Avatar
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    Quote Originally Posted by Knucklehead View Post
    Casualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
    Have you ever seen active service ? By that i mean
    Beyond your mum telling how great you are
    No playstation for more than 4 hours
    Spending more than 5 minutes in direct sunlight
    Having a normal conversation with " actual" people
    Wearing a uniform that doesnt belong to thunderbirds

    Take your time knucklehead..alot to take in
    Last edited by knocker; 22nd May 2011 at 17:46.
    Every man thinks meanly of himself for not having been a soldier - Samuel Johnson

  4. #79
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    Your comments were expected. Have a nice day and keep waving the Blue flag.

  5. #80
    Hostage Flamingo's Avatar
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    Quote Originally Posted by sofa View Post
    Is it the case that when a doctor discovers that a tourniquet has been used

    he will amputate due to the danger of gangrene setting in. ????
    Sorry, just seen this post. (Bear with me, I'm trying to remember this from a few years back, it's not the day job any more - if I am not using the most technical terms, forgive me)

    When a tourniquet is applied, then blood is not being pumped to the limb.

    Now for the science bit (Biology 101) Blood carries Oxygen (O2) to the cells, and carries away the waste products of cellular respiration. When a tourniquet is applied, this can't happen.

    After a relatively short time, the build up of waste products, both from normal cellular respiration and the enzymes etc released by the damaged tissues can be such that when the tourniquet is released the flow of these back into the body can result in organ damage, with acute renal failure a major risk.

    This is akin to Crush Syndrome, (and the reason why release of crushed limbs has to be carried out within a certain time-scale, after which amputation on-site is considered an option, as it's easier to live without an arm than kidneys.)

    Releasing the tourniquet regularly will allow the re-perfusion of the limb before these toxins build up to dangerous levels.

    Gangrene itself is a relatively slow process, with the limb taking a few days to turn green and smelly - think how long a piece of meat can last before it starts to rot - certainly not within two hours.

    The other big risk from a tourniquet is that if incorrectly applied, they can cause increased bleeding. Veins are much thinner walled (and closer to the surface) than arteries. If a tourniquet is applied that closes the veins, but does not close the arteries, then blood is getting pumped into the limb, but can't get out - except through the hole!

    There is a risk of further significant trauma to the soft tissues of the limb if a tourniquet is applied too tight as well.

    They are a useful tool, but don't be too gung-ho about their use. Direct pressure on a wound is very effective for closing it off. Indirect pressure on a pressure-point is also very effective, I've used both to good effect (mainly in a clinical environment, I will admit), and whilst tourniquets are at times necessary. don't forget that direct pressure and elevation makes a huge difference. A limb that is below the heart will bleed like buggary, as soon as it is above the heart it decreases significantly.

    (Sorry if any of the above is teaching anyone to suck eggs. If anyone wants me to re-write it using lots of big words like "Traumatic Rhabdomyolysis" and "Hyperkalaemia", then I'll pull out my old textbooks and start again! )
    'He died who loved to live,' they'll say,
    'Unselfishly so we might have today!'
    Like hell! He fought because he had to fight;
    He died that's all. It was his unlucky night.
    http://www.salamanderoasis.org/poems...nnis/luck.html

  6. #81
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    Quote Originally Posted by Knucklehead View Post
    Casualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
    That's great but what happens after the assault? Or your platoon isn't in a position to send your casualties back to the RAP?

    Basic first aid isn't good enough. Well, in most professional armies it's not.

  7. #82
    Lord Chief Bottlewasher trellheim's Avatar
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    Excellent post Flamingo, truly excellent. I'd always wondered down through the years of first aid courses the whys and why nots of tourniquets.

    Surely from Iraq and the 'Stan over the last decade there must be a serious update to the manuals and courses - this is what works in general ( what the rifle section must change and what we must change in basic training ) , and what we need to carry on us.
    "Are they trying to shoot down the other drone? "

    "No, they're trying to fly the tank"

  8. #83
    Commander in Chief apod's Avatar
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    Quote Originally Posted by Knucklehead View Post
    Your comments were expected. Have a nice day and keep waving the Blue flag.
    Fcuk off Muppet.Back to whatever airsoft academy you graduated from.
    Now.Where were we?
    Good point Flamingo about elevating the limb?What do you if the limb has been blasted off?
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  9. #84
    In Arduis Fidelis rod and serpent's Avatar
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    Quote Originally Posted by apod View Post
    Fcuk off Muppet.Back to whatever airsoft academy you graduated from.
    Now.Where were we?
    Good point Flamingo about elevating the limb?What do you if the limb has been blasted off?

    Elevate the stump.

  10. #85
    Hostage Flamingo's Avatar
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    Quote Originally Posted by apod View Post
    Good point Flamingo about elevating the limb?What do you if the limb has been blasted off?
    Well, then the limb has probably already been elevated, you just need to check the surrounding trees / tops of buildings to see if it's high enough

    Seriously, what Rod said, elevate the stump.

    With a traumatic amputation, the risk of Crush Syndrome is reduced, as the limb is not there to produce the toxins. Put the tourniquet on as close to the end of the limb as possible, and don't get too hung up about the release times, it's less important in these cases.

    Another thing to remember about tourniquets is to apply them as close to the wound as possible, and also, don't use anything too narrow if improvising. Use a belt of a bandage rather than para-cord, the wider the pressure is spread the better.

    Of course, if available (and the injured site allows access), the best tourniquet is a BP cuff, as it is designed to cut off blood, and can be released and re-inflated easily.
    'He died who loved to live,' they'll say,
    'Unselfishly so we might have today!'
    Like hell! He fought because he had to fight;
    He died that's all. It was his unlucky night.
    http://www.salamanderoasis.org/poems...nnis/luck.html

  11. #86
    Hostage Flamingo's Avatar
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    Quote Originally Posted by trellheim View Post
    Excellent post Flamingo, truly excellent. I'd always wondered down through the years of first aid courses the whys and why nots of tourniquets.
    Thanks, Trell. I'm going red.

    Quote Originally Posted by trellheim View Post
    Surely from Iraq and the 'Stan over the last decade there must be a serious update to the manuals and courses - this is what works in general ( what the rifle section must change and what we must change in basic training ) , and what we need to carry on us.
    I've been a bit loath to post much on this thread for that very reason. Serious updates must be going on both in terms of treatment algorithms and equipment. I've been out of practice about 6-7 years now, and I don't want to mislead anybody with out-of-date thinking.
    'He died who loved to live,' they'll say,
    'Unselfishly so we might have today!'
    Like hell! He fought because he had to fight;
    He died that's all. It was his unlucky night.
    http://www.salamanderoasis.org/poems...nnis/luck.html

  12. #87
    Commander in Chief apod's Avatar
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    Excellent posts Flamingo.Such a terrible,terrible pity that its gonna take Irish soldiers getting maimed by IED's overseas before we catch up with the rest of our PFP partners in terms of Trauma management training for our non medical personel.
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  13. #88
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    Quote Originally Posted by apod View Post
    Excellent posts Flamingo.Such a terrible,terrible pity that its gonna take Irish soldiers getting maimed by IED's overseas before we catch up with the rest of our PFP partners in terms of Trauma management training for our non medical personel.
    Even then, they'd probably just pull us out and stick their heads back in the sand.

  14. #89
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    Quote Originally Posted by Flamingo View Post
    Sorry, just seen this post. (Bear with me, I'm trying to remember this from a few years back, it's not the day job any more - if I am not using the most technical terms, forgive me)

    When a tourniquet is applied, then blood is not being pumped to the limb.

    Now for the science bit (Biology 101) Blood carries Oxygen (O2) to the cells, and carries away the waste products of cellular respiration. When a tourniquet is applied, this can't happen.

    After a relatively short time, the build up of waste products, both from normal cellular respiration and the enzymes etc released by the damaged tissues can be such that when the tourniquet is released the flow of these back into the body can result in organ damage, with acute renal failure a major risk.

    This is akin to Crush Syndrome, (and the reason why release of crushed limbs has to be carried out within a certain time-scale, after which amputation on-site is considered an option, as it's easier to live without an arm than kidneys.)

    Releasing the tourniquet regularly will allow the re-perfusion of the limb before these toxins build up to dangerous levels.

    Gangrene itself is a relatively slow process, with the limb taking a few days to turn green and smelly - think how long a piece of meat can last before it starts to rot - certainly not within two hours.

    The other big risk from a tourniquet is that if incorrectly applied, they can cause increased bleeding. Veins are much thinner walled (and closer to the surface) than arteries. If a tourniquet is applied that closes the veins, but does not close the arteries, then blood is getting pumped into the limb, but can't get out - except through the hole!

    There is a risk of further significant trauma to the soft tissues of the limb if a tourniquet is applied too tight as well.

    They are a useful tool, but don't be too gung-ho about their use. Direct pressure on a wound is very effective for closing it off. Indirect pressure on a pressure-point is also very effective, I've used both to good effect (mainly in a clinical environment, I will admit), and whilst tourniquets are at times necessary. don't forget that direct pressure and elevation makes a huge difference. A limb that is below the heart will bleed like buggary, as soon as it is above the heart it decreases significantly.

    (Sorry if any of the above is teaching anyone to suck eggs. If anyone wants me to re-write it using lots of big words like "Traumatic Rhabdomyolysis" and "Hyperkalaemia", then I'll pull out my old textbooks and start again! )
    No need for the big words Flamingo, Your post is very good.

  15. #90
    Commander in Chief apod's Avatar
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    Just learnt today that there will soon be an annual Medical TOET to be passed along with the usual APWT's ,IT's etc.
    Wonder what it will include?CPR for definete.
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  16. #91
    Commander in Chief RoyalGreenJacket's Avatar
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    Quote Originally Posted by apod View Post
    Just learnt today that there will soon be an annual Medical TOET to be passed along with the usual APWT's ,IT's etc.
    Wonder what it will include?CPR for definete.
    sounds like our MATT's - we have about 8 subjects we cover though.

    BCD (Battle Casualty Drills - including BLS) is one of the most important with an intensive theory part and then a full battle exercise to test everything you know practically too.
    RGJ

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    The Rifles

  17. #92
    Lord Chief Bottlewasher trellheim's Avatar
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    Good :

    We already have TOETs for Rifle, SINCGAR and ITs; medical would be a good one too.
    "Are they trying to shoot down the other drone? "

    "No, they're trying to fly the tank"

  18. #93
    BQMS Liachta Cultaca's Avatar
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    Quote Originally Posted by apod View Post
    Just learnt today that there will soon be an annual Medical TOET to be passed along with the usual APWT's ,IT's etc.
    Wonder what it will include?CPR for definete.
    Look forward to this....can you elaborate where you heard this from ?

    PM if necessary
    I went into an Italian restaurant and ordered dessert and they gave me tiramisu and a blindfolded horse and I said No, I said mask a pony (mascarpone)

  19. #94
    CQMS fiannoglach's Avatar
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    Quote Originally Posted by Knucklehead View Post
    Casualties slow up the assault.....most of them are screwed when they are hit. The way to prevent the casualties is to destroy the threat quickly, all of them .......usually with lots of bombs, bullets, knives and well trained aggressive killers that expect to be hurt if they screw up. Basic first aid works on the battle field. when you start training guys in high speed low drag medical techniques ..it only distracts them from killing the enemy....."Blood makes the grass grow"
    Actually, this isn't very far from the truth. It's self aid, then buddy aid and so on.
    The mission takes priority.
    Anyone with catastrophic hemhorrage will get a CAT, non responsive will get an NPA and put into the recovery position......if possible.
    The best possible treatment for casualties under fire is superior firepower.

  20. #95
    Commander in Chief apod's Avatar
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    I totally agree.Winning the battle is priority.You can then deal with casualties.
    But "Blood makes the grass grow"?FFS who does he think we are the? The west side boys??
    My opinion still stands.He is a muppet for a comment like that.
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  21. #96
    Space Lord of Terra morpheus's Avatar
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    I know of a certain RDF person

    he is at the highest level of EMT/PARAMEDIC training you can be in this country

    he has been brought in by the D.F. as an instructor to train medics, and other certain people (in depth and to the highest levels) for overseas numerous times.

    yet get this...

    this same instructor,

    hired by the army to train the army,

    happens to be an RDF member...

    AND his qualifications are not RECOGNISED!!!! ?????

    WTF?
    "He is an enemy officer taken in battle and entitled to fair treatment."
    "No, sir. He's a sergeant, and they don't deserve no respect at all, sir. I should know. They're cunning and artful, if they're any good. I wouldn't mind if he was an officer, sir. But sergeants are clever."

  22. #97
    CQMS fiannoglach's Avatar
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    Quote Originally Posted by apod View Post
    But "Blood makes the grass grow"?FFS who does he think we are the? The west side boys??
    My opinion still stands.He is a muppet for a comment like that.
    So Apod, He's a muppet, airsofter, wannabe and idiot because he posted "Blood makes the grass grow"?
    You shouldn't be so quick to judge.


    I believe all DF personnel will be trained to First Responder in the near future and I believe the Lebanon bound battalion will be issued with Tourniquets and Celox Gauze.

  23. #98
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    Thumbs up

    Quote Originally Posted by fiannoglach View Post
    I believe all DF personnel will be trained to First Responder in the near future and I believe the Lebanon bound battalion will be issued with Tourniquets and Celox Gauze.
    That's good to hear.

  24. #99
    Commander in Chief apod's Avatar
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    So Apod, He's a muppet, airsofter, wannabe and idiot because he posted "Blood makes the grass grow"?
    You shouldn't be so quick to judge.
    Why not?If you make idiot comments like that you can generally expect to be considered an idiot.The people here who contribute meaningful,serious,advice and information (yourself included)dont behave like that.If he isnt any of the above why degrade himself with moronic comments?Oh,and i wasn't the only one here who thought his comment was idiotic.

    I believe all DF personnel will be trained to First Responder in the near future and I believe the Lebanon bound battalion will be issued with Tourniquets and Celox Gauze
    Good to hear and about time.I assume you mean for the next rotation?
    Infantry Corps - An Lámh Comhrac


    "Let us be clear about three facts:First of all.All battles and all wars are won in the end by the Infantryman.Secondly the Infantryman bears the brunt of the fighting,his casualties are heavier and he suffers greater extremes of fatigue and discomfort than the other arms.Thirdly,the art of the Infantryman is less stereotyped and harder to acquire than that of any other arm".
    -- Field Marshall Earl Wavell.1948

  25. #100
    CQMS fiannoglach's Avatar
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    I heard it's to be issued for this rotation.

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