Crisis Medicine (pt 1)

Question 1

“Barring CNS hits there is no physiological reason for an individual to be incapacitated by even a fatal wound, until blood loss is sufficient to drop blood pressure &/or the brain is deprived of oxygen.” What are the two ways people become incapacitated?

Answer 1

1. Psychological incapacitation is not predictable - it is completely unrelated to the potential for any given bullet to cause damage. That is, if the wounded person is motivated enough to fight, they will continue to do so.
2. Physiological incapacitation involves the mechanical effects of the projectile causing damage to the body. The only reliable way to incapacitate an individual is to interfere with the brain’s ability to command the body. There are two ways to do this: one, direct destruction of the brain / brain stem, or hypovolemic shock = blood loss.

Question 2

What are common injury types and what does this mean for tactical medical training?

Answer 2

Upper extremities injuries are very common; plan for using only one hand

Question 3

Directions for wound packing

Answer 3

1. Probe first looking for the squirting blood
   Direct pressure at the source of bleeding
2. Make power ball and place at the source of bleeding
3. Every nook and cranny within the wound needs to be filled
4. Direct pressure 10min direct pressure on regular pressure gauze; 3-5min with quick clot
5. Follow up with a pressure dressing
   [probe towards heart (source of bleeding); make a small ball of gauze as initial instrument of pressure]

Question 4

What is the anatomy of the tourniquet?

Answer 4

1. Windlass Rod
2. Windlass Clip
3. Windlass strap
4. Inner strap
5. Outer strap
6. Stabilization Plate.

Question 5

Tourniquet effectiveness

Answer 5

Lower ext.
1. one, 82%
2. two, 92%

Question 6

Why can tourniquets loosen over time?

Answer 6

1. Clothing underneath
2. Padding/objects underneath
3. Movement of limb
4. Getting caught on something
5. Velcro comes undone (especially if all the velcro is not secured)