Tactical Treatment of Gunshot Wounds After Action Report updated!

by John Boch
(GunNews Magazine) – Fortress Defense Consultants, headed up by Frank Sharpe, offered a Tactical Treatment of Gunshot Wounds course in early December in northeastern Illinois.  Exactly ten students were present, all civilians, and all but one former alumni of either Fortress Defense or John Farnam (Fortress hosts Farnam to Indiana at least once each year).

Sharpe was assisted in the medical instruction phase by Tony Luna and Dave Zielke, both having extensive EMS training and experience.  Also, Dr. David Tyssen assisted in the afternoon force-on-force practical application of what we learned in the morning.

The course itself was created by Doc Gunn, the pseudonym of Dr. Tony Barrerra, a firearms instructor and ER surgeon who has played a significant role in developing the  entire “tactical medicine” field of training.  His course, offered nationwide, teaches how to treat gunshot wounds (GSWs) and stabilize patients for the three to thirty minutes until the professionals arrive.

We spent a fair part of the morning talking mindset and how modern medicine does wonders for GSW treatment.  (Except in the case of 00-buckshot.  Doc Gunn says those patients end up at the morgue, not the ER).

Handgun-inflicted GSWs are quite treatable and survivable, especially with immediate treatment and stabilization – and that’s where this class took us.  We were shown how to treat and mitigate the most common forms of preventable deaths on battlefields:  bleeding out from extremity wounds, tension pneumothorax and airway obstructions.

First though, we talked about priorities in treating a GSW victim.  First and foremost, the threat must be neutralized.  Engage the bad person before trying to treat an injury.  If you are the person shot, you must continue the fight and finish it before initiating treatment.

After assessing for threats and finding none, you first assess the patient.  “Airway, breathing and circulation” as they say in EMS circles.

We covered ways to find bullet holes, which aren’t always readily evident after we’ve torn off the clothes of an injured party.

To treat wounds, Sharpe and Doc Gunn are very strong supporters of the Israeli Battle Dressing, also sold as the civilian-friendly “Emergency Bandage”.  Surprisingly, the IBD is still only in very limited use among professionals in the EMS community.  “We still hear with regularity that the first question emergency room personnel ask when they find a patient wearing an IBD is ‘whoa, what’s this and where can we get some?’” Sharpe said.

The IBD is an Ace bandage with a big piece of absorbent gauze dressing on one end.  Opposite the gauze is a plastic clip and when the dressing is applied correctly, the clip provides remarkable pressure against the wound, stopping bleeding in most cases.  For difficult conditions where bleeding persists, the bandage can be manipulated to provide additional pressure and even an impromptu tourniquet as necessary.

The IBD is incredibly flexible in its uses and is also easily self-applied.

Frankly, everyone should have an IBD on their person when at the range and in their first-aid kits.  Frank Sharpe says he carries one with him in his cargo pocket everyday.

In additional to extensive practice applying IBDs to various extremities (not always so easy when under fire), we also discussed and practiced applying CAT tourniquets.

Tourniquets are coming back in style, and can be safely applied for an hour or more without loss of a limb.  The CAT unit (Combat Application Tourniquet) is simple and very effective.  It’s quickly and easily applied to a patient or to yourself to staunch arterial bleeding.

We also covered treatment for tension pneumothorax (air leaks from a lung into the chest cavity, collapsing the lung and causing pressure against the heart and great vessels).

Overall, the course was well-presented, enjoyable and lively.  The force-on-force exercises certainly helped with burning techniques and tactics into memory (keep your head down and body parts behind cover).

I’ve been learning how to poke holes in bad people for many years, but this is the first formal class I’ve had in fixing holes.  Hopefully I’ll never need to use it, but just the peace of mind is worth the $150 tuition for this course.

Should I ever employ these techniques, they will be priceless.

I encourage those serious about their personal defense to take this course or similar training.  It’s almost a cliche to say, but it’s true:  the life you save may be your own!

This article ran in the January 2012 issue of GunNews.

UPDATE: 

Fortress Defense is offering this class (the indoor version of this class) again this fall on Saturday, November 17th in Crete, IL.  Click here for the mail-in sign-up sheet.  Tuition remains $150.