9 Liners and IFAK

[apod]

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.

[The real Jack]

and there was me thinking rhodes was the biggest idiot in this thread....

[knocker]

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

[Knucklehead]

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

[Flamingo]

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! )

[Hello Alaska]

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.

[trellheim]

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.

[apod]

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?

[rod and serpent]

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.

[Flamingo]

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.

[Flamingo]

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.

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.

[apod]

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.

[Hello Alaska]

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.

[sofa]

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.

[apod]

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.

[RoyalGreenJacket]

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.

[trellheim]

Good :

We already have TOETs for Rifle, SINCGAR and ITs; medical would be a good one too.

[Liachta Cultaca]

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

[fiannoglach]

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.

[apod]

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.

[morpheus]

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?

[fiannoglach]

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.

[Hello Alaska]

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.

[apod]

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?

[fiannoglach]

I heard it's to be issued for this rotation.