Well that was humbling. I started our second day thinking I was ready to deal with any basic trauma situation like a rock star. I was dead wrong. We returned in the morning and our instructor, Ross Francis, went over any questions we thought up the night before. He then continued with more PowerPoints. Ross covered environmental injuries from heat, cold, envenomation, and burns. We then covered techniques for moving a victim and triage for mass casualties. He defined this as anytime patients exceed medical resources. If you find yourself alone treating two car accident victims with a single medkit, you're in a mass casualty situation, and must triage accordingly. Triage is kept deliberately simple for speed. "30, 2, Can Do" allows you to assess a victim in a few seconds, and designate them as green, yellow, red, or black. Our last lesson involved calling 911 and how to respond to arriving EMS.
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| "Bring a damn marker!" |
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| Fair Weather Farms cotton gin barn converted to meeting hall |
After lunch, we returned to find practice stations for many of the skills we learned. At the NPA station, we practiced inserting a nasopharyngeal airway into a dummy and familiarized ourselves with the SWAT-T and SOFTT-W tourniquets.
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| NPA & Tourniquet Station |
At the wound packing station, we packed inert combat gauze into a small gunshot wound, gunshot wound with exit, and severe laceration.
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| Wound Packing with practice Combat Gauze |
The third station was for using Israeli, Olaes, and mini-compression bandages. We crated slings with triangular bandages to treat arm and collarbone breaks, and used SAM splints to make a neck collar and general leg splint.
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| Bandages |
Once the entire class had rotated through the practice stations, we spent the last 3 hours running scenarios. Each one of us was given a scenario with another student role-playing as the victim. I went first. It took me about six minutes to complete what should have taken two at the most. My victim was suffering from a gunshot to the upper leg. I had the tourniquet applied in less than 30 seconds but soon after drew a blank. I was completely overwhelmed, trying to recall everything we had learned all at once. Ross reminded me to remember H.A.B.C.D.E. and figure out what step I was on. My mind was swimming but I managed to assess the victim, check vitals, perform a blood sweep (albeit poorly), treat the wound, and expose the victim, before finally wrapping him in a mylar blanket. By the end I was sweating and forcing myself to take slow breaths. Fortunately, I was not alone. Every single student, including the repeat students had the same problems I did. As a spectator, it was easier to figure out what the injury was and the next step in care, without feeling the eyes of the entire class and instructor watching for mistakes. It took one student forever to realize her victim had been bitten by a snake, and another misinterpreted the feedback from the victim and almost began CPR on a conscious patient. Fortunately, none of us actually killed out patient. We often forgot small but vital steps, like assessing level of consciousness, or remembering to periodically check pulse and capillary refill. We finished the scenarios with triage. Two students would arrive on scene, while the rest of us were, dead, dying, or injured. It was chaotic trying to assess a dozen people, all with varying degrees of injury, then having to recall the triage classification of each victim afterward.
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Dark Angel Challenge Coin
"Life or Death" |
Class concluded with a final lesson and short video. We watched body cam footage of a soldier being treated after he had stepped on an IED that took off his right leg and sent shrapnel into the left. We watched other soldiers apply two CAT tourniquets and make victim assessments while under fire. I could sense the mindset of the class had changed since yesterday, including mine. We were all following along, putting ourselves in that video, and mentally treating the victim. Finally, Ross provided us with some additional resources to for continuing training, and some advise on dealing with the psychological aftermath of a stressful event. After receiving my challenge coin, I shook a lot of hands, and spend the next four hours driving home with the radio off. I silently reflected on the last two days. I though about how little I knew on day one, how confident I was starting day two, and how much I realized I still didn't know and needed to practice by the end. I played "what if" the rest of the way and evaluated my performance and gear.
If I could improve one thing about the class, it would be to make it three days. I'd like to spend two days in class, learning and practicing skills, and then a full third day running scenarios. My biggest takeaway is how quickly things can go bad. A medkit in my car, even if I can get to it and back in 10 seconds, is still too far away to make much a difference before the victims condition goes south. If the victim is me, I'm dead. I'll be spending a lot of my ammo budget this year on tourniquets and Chito-Gauze. I plan to sign up for another Dark Angel class in the next few years, to brush up on my knowledge, and learn of any new advancements in gear and techniques. My wife however, will be signing up ASAP.
-Carry On
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