Just wanted to post an AAR of a week long TCCC/CLS course we just wrapped up for deploying USAF Air Advisors and ARNG personnel.
Long story short, clusterfuck and a half.
A few points I wanted to make
- The only thing we do on the X is stop life threatening bleeding.
- Get the fuck off the X. Like seriously. Right now. GTFO.
- You cannot shoot unarmed civilians or curious bystanders if they aren't presenting a threat.
- IED strike sites are bullet magnets. This brings me to our first point. Get off the X.
- Secondary IEDs exist to target first responders. Get off the fucking X.
- Do not take off the casualty's PPE while you are anywhere near the X.
- If you cut the casualty's clothing to expose them while doing blood sweeps, put something back on them. You don't need to add environmental injuries to the list of shit wrong with them.
- After every casualty movement, reassess your interventions. This means check placement and tightness of tourniquets, bandages, etc.
- If the tourniquet has loosened, do not undo it to tighten it down. Put a new TQ on below it (because you already should've gone as high as possible for the first TQ you applied)
- Account for the casualty's weapons/gear. Do not leave their weapons on scene for obvious reasons. In Afghanistan, another unit north of mine had a medevac, left the Marine's suppressed M4/M203 on scene. We later found out the Taliban took control of the weapon after the Marines left.
- Don't forget to pass up your MIST report with your 9 line.
- Have clearly defined roles. The person in charge should not be rendering care to a casualty. You can't call the shots if you're busy doing something.
- Battlefield medicine is very manpower intensive. Don't forget about security. Everyone wants to put hands on the casualty, but if nobody is on security, there's going to be more casualties in short order.
- Keep your treatment area secure. Don't let curious bystanders get too close, but don't fucking shoot them if they aren't a threat or unarmed.
- When applying a tourniquet to the legs, for males make sure you don't TQ their dick or their balls. When applying knee pressure to the femoral artery to occlude it while sliding your TQ up the leg, don't put your knee on the guy's dick.
- Don't get sucked into one casualty. Make sure you look all around the scene and account for all casualties. We had one group who completely forgot about a casualty after dragging him off the X. Once they got him outside, they finally put a TQ on, but by that point he had bled out and died.
- Take the training seriously. It's fine to joke around and have fun, but when it's game time, put your game face on. This is shit that could save you, or more importantly, your buddy's life one day.
- When carrying a casualty on a litter, don't drop the fucking thing. Also when it's time to lower the litter, ease it down to the ground.
- Even if your casualty is unconscious, keep talking to them. Reassure them. They might be able to hear you and just be unable to speak. This is a big deal.
- Keep talking to your casualty throughout the ordeal. This does several things. It assesses their mental state, and you can keep appraised of any new or ongoing complaints they have.
- Disarm casualties with altered mental status. The reasons for this should be obvious.
- If a casualty is walking wounded, let them help with security. That's one more gun in the fight.
- If casualties can get themselves off the X and make their way to you, have them do so.
- Direct the casualties to apply their own TQs if possible.
- When approaching casualties on the X, be sure to ID yourself. You don't want to inadvertently get shot.
- If you suddenly start getting shot at, while on the X, this does not mean blindly shoot in all directions. Figure out where the fire is coming from, suppress that location, and get the casualties off the X while that location is being suppressed. Fire superiority is the first rule of battlefield medicine.
- Be cognizant of where your weapons are in relation to the casualty. Don't flag them, and also, if you're wearing a drop leg holster, be careful around casualties with altered mental status. They may get scared and disarm you because they don't know what's going on. I was able to pull a handgun out of a triple retention Safariland 6004 with ease on more than one occasion while laying down on a litter.
- Everyone should have an IFAK. Use their IFAK before you dig into the med bag. That's why the IFAK is there. Use it.
- Organize your med bag before you step off on a mission. Having to dump your med bag to find something because your shit was fucked up doesn't help anybody.
- Be sure you conduct PCCs/PCIs before you step off. When shit hits the fan, now is not the time to realize that your RTO was the only one who knew how to call in a 9 line, and now he has both legs missing. Or when your Medic or Corpsman gets hit, now is not the time to realize that he's the only one who knew how to work on others.
It's just a short list, I'm sure I'll come up with others as times goes on.
A YouTube personality puts it best: The lessons we learn are written on the tombstones of others. The above points are things I've noticed in my personal experience and are points I pass on to every class that rolls through. I have 7, soon to be 8 names on my arm that illustrate the above points, and then some. One of them is personally known to spenceman and myself.
We train to keep names off the wall. We train so that good men and women don't die for nothing. We train so that we can keep one more person from having to pay the ultimate price.
I train because I struggle with survivor's guilt. I train others so that they don't have to suffer with me.
Stay safe everyone.
Edited by Jersey0311, 30 August 2014 - 08:38 AM.