AAR: RNM Trauma Class #3 - Dec. 12, 2010

[wag1911]

I want thank both Matt & Bob for putting this on for us. BTW, also wanted to thank Jared - forgot your name until it was posted below and didn't want to put 'combat lifesaver' dude!

I also wanted to correct something I said in class that I had learned from reading a book. In regards to the elasticity of the liver. The liver is less elastic and less cohesive than other organs and will sustain more damage than surrounding tissue & organs. Temporary and the permanent cavities produced in the liver are larger than those in the muscle. In livers struck by high velocity bullets, the permanent cavity is approximately the size of the temporary cavity.

The temporary cavity is significant because it has the potential of being one of the most important factors in determining the extent of wounding. For this potential to be realized, not only must a large temporary cavity be created but it must develop in strategically important tissue, e.g., a cavity in the liver is more significant than one located in the thigh.

Handgun bullets produce a direct path of destruction with very little lateral extension within the surrounding tissues. Only a small temporary cavity is produced. The temporary cavity plays little or no role in the extent of wounding and a handgun bullet must strike that structure directly. The exception is with high velocity rifle bullets where there is a backward hurling of injured tissue. This material may be ejected from the entrance.

I highly recommend reading Gunshot Wounds- Practical Aspects of Firearms Ballistics & Forensic Techniques, 2nd Edition by Vincent DiMaio to learn more.

 

[irishfan]

I had a great time and learned a lot of things at this class. Huge thanks to Matthew, Bob, and Jahred for teaching and demonstrating for us how on how to be better at treating an injury. Honestly, I had several questions that were answered tonight and even a few things that never crossed my mind that really will be helpful in the future.

 

[PeaShooter]

I learned a ton! Thanks to Matt and Bob for the instruction. I will never forget the order of the nervous/venus bundle as it traversed through the pelvic opening...NAVY...Nerve, Artery, Vein, Yin-Yang!!!!!

Awesome.

PeaShooter

 

[redneckmedic]

Jahred.... WTH is wrong with your left arm... got a little Back to the Future body disappear thing going on.

 

[88GT]

A big to the instructors for a great day of instruction.

Thanks so very much.

 

[88GT]

Jahred.... WTH is wrong with your left arm... got a little Back to the Future body disappear thing going on.

Somebody applied the tourniquet a little too tight, maybe?

 

[shooter521]

I have taken other courses in the past that covered much of what was taught/discussed here, but I still found this course to be worth my time and money.

Redneckmedic and Rotor Talker are very knowledgeable and engaging speakers; they were easy to listen to, and presented information in a way that was easy to comprehend. Hats off to both of you. Additionally, Gamez235 did a capable job filling in for Indy Gunworks on short notice with his presentation on combat trauma care.

I have two criticisms:

1) The Powerpoint/lecture portion seemed to be a bit disjointed in terms of what was discussed and when. We were warned ahead of time that this might be the case, given that material had recently been addedto their presentation. I trust that the more Matt and Bob work with the new curriculum, the smoother and more cohesive their presentation will become.

2) I would've preferred if the break-out groups at the end had provided an opportunity for the participants to actually practice the skills being discussed, rather than just watch them being done.

That said, time spent learning or reviewing important information such as this, and meeting more of my INGO brothers and sisters is never time wasted. Thanks to Matt, Bob and Jahred for putting this program on, to the guys and gals who brought the awesome snacks, and to the fire department for hosting us.

 

[indianajoe]

Originally Posted by redneckmedic
Jahred.... WTH is wrong with your left arm... got a little Back to the Future body disappear thing going on.

You beat me to it...

 

[indianajoe]

Photo AAR - Moved from other thread

Peashooter practices up for Mardi Gras....

 

[wag1911]

My thoughts...

The class was primarily geared for moderate to intermediate care for those with all sorts of wounds - knife, gunshot, car crash etc. It explained human physiology, dealt with bone breaks & splinting, minor and mass bleeding, treatment of shock, and some head trauma.

My primary goal of attending this class was to learn a few new things, work my wife into the 'after the shoot' mindset, and what she might face should I be injured. Chances are, she will be the first responder to save my life and vice-versa. I think the class fit most of these goals on almost everything.

I thought the class was most effective for me by updating my knowledge on the latest techniques. It's amazing what has been changed and debunked in the past 10 or so years. Such as the use of tourniquets being more prevalent - in the past that was considered to be almost taboo unless the victim was absolutely going to die without it. Another brief talk about the change of CPR procedures (though CPR was not the focus of this particular class) - mouth-to-mouth now considered unnecessary - chest compressions only.

Criticisms........I think more time should have been devoted to treatment of shock, not just the symptoms. I think CPR should have been part of this class if more about shock was included. Given that many victims that go into shock lose the capability of breathing on there own. However, possibly a day long class, or 3 hour longer class would be necessary.

Overall, this was well worth the small cost of both time and money and I would recommend this class for both beginners, as well as folks with prior knowledge that may be somewhat dated.

 

[redneckmedic]

I have two criticisms:

1) The Powerpoint/lecture portion seemed to be a bit disjointed in terms of what was discussed and when. We were warned ahead of time that this might be the case, given that material had recently been addedto their presentation. I trust that the more Matt and Bob work with the new curriculum, the smoother and more cohesive their presentation will become.
Fair enough, it appears our fears, became reality. Poor, 1-on-1 prep time, I suppose thats what happens when you put a class on in mist of hunting season

2) I would've preferred if the break-out groups at the end had provided an opportunity for the participants to actually practice the skills being discussed, rather than just watch them being done.
This was actually our goal. However, it seems that time always gets away during lecture and talking shop. We leave every class wanting the students to get more hands on. I am having a hard time finding the balance in a time convienent class length and info/skill ratio. If the class is too long, I'm afraid that the folks will lose intrest or not want to commit to the class. Yet I still feel like I'm rushing to fit it all in. This balance is by far the "weakest link" in a custom class.

That said, time spent learning or reviewing important information such as this, and meeting more of my INGO brothers and sisters is never time wasted. Thanks to Matt, Bob and Jahred for putting this program on, to the guys and gals who brought the awesome snacks, and to the fire department for hosting us.

Thanks for your feed back, keep it coming

 

[PatriotPride]

Another brief talk about the change of CPR procedures (though CPR was not the focus of this particular class) - mouth-to-mouth now considered unnecessary - chest compressions only.

That depends on what organization you have recieved your training from. The community tends to be in agreement that chest compressions only will get the job done, but there are many of us for whom giving mouth-to-mouth is still required by policy, so it's not really "unnecessary" at this point in time. I'm hoping to see all training organization get on board with compressions only in the near future, but who knows how long that will take.

 

[redneckmedic]

***snip*** but there are many of us for whom giving mouth-to-mouth is still required by policy, so it's not really "unnecessary" at this point in time. I'm hoping to see all training organization get on board with compressions only in the near future, but who knows how long that will take.

I would revise that statement to hold a bit more validity. Mouth to mouth is NEVER required by anyone, anywhere, and hasn't been for a very long time. However, artificial ventilations although now a dated practice for the lay-rescuer, might still be in some policies that haven't been through the roll-out programs yet.

 

[Fenway]

cwood in da hizzy? Great turn out and sounds like an excellent class!

 

[VUPDblue]

cwood was in da hizzy! he is currently driving home in da snizzy

 

[indianajoe]

Much appreciation to redneckmedic, Rotor Talker, and Gamez235 for a great class. A couple things I learned:

• When using personal experience to explain how to deal with certain medical emergencies, redneckmedic’s stories will sometimes begin: “I was helping out a buddy. A box-knife was involved….”
  
  
• EMTs and paramedics will stop talking and listen to whatever follows the tones, even if they’re off-duty or in someone else’s house.
  
  
• In a pinch, 2-lb test Trilene monofilament fishing line will serve as adequate backup if you’re going Rambo and need to stitch yourself up. Practice up on pigs feet ($6.00 per pound at Wal-Mart).
  
  
• Veterinary suture kits can be had at Tractor Supply. (No recommendations were actually being made around these last two points; guys were just saying….)
  
  
• If you have a pair of Craftsman vise grips laying around and you find that an artery needs clamping, use the dang vise grips.
  
  
• Despite the fact that QuikClot puts bicycles and hikers and fly-fishermen on its packaging, redneckmedic said ambulance crews don’t carry it and Gamez235 says the Army pulled it from IFAKs in 2006. Neither guy would use it, or would only use it as a last resort, and recommended H-bandages and pressure, or Israeli bandages and pressure, for most cases.
  
  
• Deer hunting and paramedic work sometimes require similar tracking skills.
  
  
• A good set of EMT shears can cut a penny in half.
  
  
• Generic contact-lens saline is cheap, works great for irrigating wounds, and is good stuff to have in a crash bag.
  
  
• Shooter521 has some cool toys.

 

[shooter521]

cwood was in da hizzy! he is currently driving home in da snizzy

And climbing the stairs made him dizzy.

 

[Rotor Talker]

Feedback is always appreciated

Thank You

Always appreciate a view and comments form those attending, you help to make the class work, we appreciate your feedback more than you know, and are already working on changes.

Sincerely folks, Thank you

Bob

 

[shooter521]

Part of RNM's bleeding control demo:

YouTube - RNM_bleeding control.wmv

 

[indianajoe]

That I-Kam takes good-quality video.