md-textil e.K. is showing off some of their new stuff including the Expandable Medic Rucksack.
This pack includes a variety of modular pouches and a stiff Velcro divider to handle your needs.
Archive for the ‘Medical’ Category
TMS Tuesday – The M.A.R.C.H Algorithm
Tuesday, March 1st, 2022Tactical Combat Casualty Care (TCCC) emerged in 1996 by special operations forces stemming from lessons learned during previous conflicts with large scale adoption by US and allied forces after the events of September 11, 2001. Tactical Combat Casualty Care guidelines are evidence-based and battlefield-proven to reduce deaths at the point of injury (POI). Department of Defense (DOD) and most NATO allies require TCCC training for deploying forces because it combines effective tactics and medicine to reduce preventable death. TCCC teaches first responders to treat casualties in the proper order, treating the most critical situations first. This is accomplished by using the MARCH algorithm for easy memorization for seasoned medical providers as well as immediate responders using self-aid and buddy aid. There are many variations of the MARCH algorithm that adds tasks both before and after, but the base to prevent most preventable death is MARCH.
The MARCH algorithm is laid out differently from Advanced Trauma Life Support (ATLS) which used Airway, Breathing, and Circulation (ABC’s) as the order of treatment. MARCH stands for Massive Hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head injury. This order prioritizes bleeding control as the first step since morbidity and mortality linked to massive hemorrhage can happen in some cases twice as fast compared to airway and breathing complications.
What is Massive Hemorrhage?
Massive hemorrhage is the number one potentially survivable cause of death at the POI. This includes life threatening bleeding from a compressible wound and/or extremity injuries. More than 90 percent of 4,596 combat deaths after September 11, 2001 were a result of hemorrhage-associated injuries. There are many opinions and definitions of what should be considered massive hemorrhage. They include color of the blood and rate of loss but most of these are hard to qualify and quantify under the stress of the scenario combined in some cases with the operational environment and tactical context. There is always a focus of bright red bleeding vs dark red and while one is more important that the other, they both should be addressed immediately. Additionally, penetrating trauma is not selective and commonly injures both arteries and veins which present externally as a mix of bright red and dark red blood. The nature of serious bleeding leaves little time to consult the paint chart obtained from the local hardware store to compare colors and develop an appropriate treatment plan. Apply pressure! Pressure stops all bleeding.
Massive Hemorrhage in the Extremities
The hasty application of a tourniquet is the recommended management for all life-threatening extremity hemorrhage during the care under fire (CUF) phase. It should be placed immediately over clothing, if necessary, proximal to the wound and high and tight. During the tactical field care phase, the deliberate application of a tourniquet is addressed when the threat has been suppressed and/or aid is being rendered behind cover to ensure proper hemorrhage control. In this phase, the tourniquet is placed against the skin, 2 to 3 inches above the wound. In either scenario the application time is written on the tourniquet at some point before the patient is evacuated or handoff is performed. Additionally, if one tourniquet is not able to control the bleeding, a second tourniquet can be placed adjacent to the first to obtain occlusion. Splinting and immobilizing the extremity after a tourniquet and pressure dressing have been applied will assist with hemostasis but should only be done after all life threats have been addressed using the MARCH algorithm and other associated treatment protocols.
External Compressible Hemorrhage
Bleeding that is not amenable to limb tourniquet use should be treated first using direct pressure in the TFC Phase until a hemostatic dressing can be applied to pack the wound. Once the bleeding is controlled, pressure should be maintained according to the manufacturer’s recommendation using manual compression, pressure dressings, or other commercially available devices.
Tools to Stop Massive Bleeding
TacMed™ Solutions offers a variety of products built to help stop the bleed including the SOF® Tourniquet, OLAES® Hemostatic Bandage, OLAES® Modular Bandage, BLAST® Bandage, ChitoGauze®, Combat Gauze, and more. Two prominent products are the SOF® Tourniquet and the OLAES® Hemostatic Bandage. The SOF® Tourniquet sets the benchmark for prehospital tourniquets with purposeful upgrades to allow for smoother and faster one-handed and two-handed applications for the most effective bleeding control. The OLAES® Hemostatic Bandage is the world’s most versatile trauma bandage by combining the globally recognized OLAES® Modular Bandage with battle tested HemCon® ChitoGauze® PRO to create the most comprehensive trauma bandage for multiple injury profiles.
Stock Your Kit to Prepare for Uncontrolled Bleeding
To stock your kit with essential tools to stop massive hemorrhaging, check out TacMed™ Solutions at tacmedsolutions.com.
TMS Tuesday – Types of Training: Online vs. In-Person
Tuesday, February 22nd, 2022A dryer, a toilet, a flashlight, and a refrigerator door. Although you may not be an expert on these items, you could probably find out how to fix them all by watching a YouTube video. But can you expect the same success by watching a video or taking an online course on a trauma-related skill? Let’s try and figure it out.
Over the years, trauma and austere medicine is often described as a contact sport; let’s face it, when things get hectic, you have got to get in there and get your hands dirty. However, to do this well, you need competent instruction. You will probably not be able to achieve this through online education alone. While online training has its strengths, it’s a poor substitute for quality in-person training for trauma medicine. It all comes down to getting your hands dirty, and that is where online training loses out. Having a competent instructor watching you or watching them demonstrate a task (especially one that you might have to perform under stress) is still not replicable online.
That’s not to say online training is without benefits. For example, in today’s pandemic, factors like ease of access, cost-effectiveness, and social distancing sometimes make online training the only option available for staying current or improving your skills. Here are some ways to use online training to augment and enhance your knowledge, skills, and even improve your in-person sessions:
Pre-Training Materials:
Online materials like videos, PDFs, or PowerPoint presentations you provided to students or read before attending the class. Having a better understanding of the subject before training cuts down on time spent hammering in on more straightforward topics and allows you and the instructor to focus on the more complex subjects.
Post-Training Materials:
Online training works great to refresh our memory after hands-on training is over and later provides reference materials for study.
As you build your skills in trauma medicine, in-person training with a competent trainer teaching solid, evidence-based instruction should always be your first choice. However, using online training to augment this will only make you a more qualified provider in the long run.
At TacMed™, we offer TMS University™, our online training portal, for e-learning and information-sharing to find relevant information of pre-hospital trauma treatment and equipment. This online platform is a great opportunity to have better knowledge pre-training and serves as a great tool to refresh your memory post-training.
For access to TMS University™, check out tacmedsolutions.com/tms-university.
TacMed Tuesday – Customizations for Every Need
Tuesday, February 15th, 2022
Tactical Medical Solutions™ got it’s start by creating the original SOF® Tourniquet in 2003 and has created components and custom kits to meet customer specifications and mission needs ever since. With a primary focus on military and law enforcement applications, we have created custom kits for not only them, but also consumer organizations and small businesses in many other cross-over markets from the outdoor and overland markets to concealed carry and arborist communities.
TacMed Solutions holds an ISO 13485 certification and can provide medical devices and related services that consistently meet customer and applicable regulatory requirements. Our capabilities range from support in selecting products specific to your mission needs, designing your brand’s printed labels and packaging, creating custom nylon solutions, and more.
SwitchBack Outdoor Safety took advantage of the customization capabilities of TacMed™ Solutions. Aaron Paris, owner of SwitchBack Outdoor Safety, reached out wanting to build out custom emergency trauma kits for his company. His company aims to provide education and equipment for those who desire to take the road less traveled, so we were able to aid in customizing two medical kits that helped align with his goal.
“I really like working with TacMed because of the ease of being able to make kits adjustable to our needs and our customer’s needs,” Aaron said. Our partnership with SwitchBack Outdoor Safety, a key leader in the overlanding and off-road community, led to the creation of the SOS Trauma Kit and the SOS First Aid Kit and refill packs for each. “I have worked with other companies in this space and though they gave a custom kit, the attention to detail just wasn’t there and there was a lack of willingness to be as modular. For us, this was a 180 in some ways and it gave it a much more professional appearance.”
Solutions are part of our culture, not just part of the name.
To learn more about our capabilities in creating a custom kit for your specific needs, check out: tacmedsolutions.com/pages/customizations
To learn more about SwitchBack Outdoor Safety, check out: www.switchbacksafety.com/product-category/first-aid
Vermont Taps US Army to Offer NETCCN for Tele-Critical Care in Fight against Omicron
Thursday, February 10th, 2022Fort Detrick, MARYLAND – The U.S. Army Medical Research and Development Command’s (USAMRDC) Telemedicine and Advance Technology Research Center (TATRC) and Vermont Hospital and Health System Association (VAHHS) are collaborating to make the National Emergency Tele-Critical Care Network (NETCCN) available to hospitals across Vermont.
NETCCN consists of networks of critical care clinicians and providers that can deliver virtual care “from anywhere to anywhere” through use of secure, smartphone-based telemedicine platforms. Through NETCCN “apps,” supported hospitals across Vermont can request and receive on-demand, 24/7 virtual assistance from critical care physicians, nurses, respiratory therapists and other specialty clinicians.
“NETCCN addresses a fundamental challenge for our healthcare system during disasters like COVID-19 surges: enabling easy communication between those working outside of their comfort zone or scope of practice and clinical expertise at the right place and time to affect best possible outcomes. This is especially true for the care of severely-ill patients needing intensive care level support but who may not have access to an intensive care unit due to patient volume or lack of available transport,” said Col. Jeremy Pamplin, TATRC’s Commander and an intensive care physician. “In contrast to patients dying from hospitals’ inability to provide hemodialysis, NETCCN has responded to calls for support within hours to help a small hospital unable to transfer patients to a referral center provide this life saving therapy.”
VAHHS has rapidly brought together healthcare leaders from across the state to raise awareness, coordinate and streamline availability of NETCCN for Vermont’s hospitals. VAHHS’s assistance in harmonizing licensure rules and credentialing processes accelerated availability of NETCCN and reduced burden on its member healthcare organizations.
“Many of Vermont’s hospitals don’t have Intensive Care Units (ICUs), so they don’t have the critical care experts needed to care for our sickest COVID patients. During normal operations, we are able to transfer patients to referral centers with this capability, but during surges, those hospitals are full and unable to accept additional patients. NETCCN brings instant access to experts through an easy-to-use and secure platform, allowing our smaller hospitals to optimize care for these severely ill patients until transfer is possible. Perhaps just as important, access to these experts relieves the stress and anxiety felt by clinicians in our small hospitals by helping them know they have done the best possible for their patients, even when the outcome may not be ideal,” said Devon Green, Vice President of Government Relations, Vermont Association of Hospitals and Health Systems (VAHHS).
NETCCN is presently live in 4 hospitals in Vermont with additional hospitals scheduled to go live next week.
NETCCN is available at no cost to supported hospitals and healthcare. Through the pandemic, NETCCN has delivered over 5,000 patient-days of care to over 40 hospitals in 13 states and territories.
Blunt Force: The Underreported Threat Of The Security Professional
Saturday, February 5th, 2022What is ‘blunt force’, and what type of injuries result from blunt force impact?
Please let me answer this question in the shortest possible way, without throwing some hyper intellectual medical terminologies at you, I don’t understand myself. Let me do it in reasonable simple and understandable terms, and more importantly, within context of this article.
Severe injuries and deaths resulting from blunt force trauma are some of the most common cases encountered by forensic pathologists. For instance, almost all transportation fatalities, including those involving road traffic collisions and pedestrians being hit by vehicles result from blunt force trauma.
Blunt force trauma is also the consequence faced by homeland and private security professionals after being hit by a solid object, such as a fist, foot, knee, elbow, iron bar, extendable baton, baseball bat, crowbar, brick, bottle, can, chair, fire extinguisher, to name but a few, or indeed after being pushed hard against another solid object e.g. door, wall, floor or car or down a flight of stairs etc.
Something that remains widely underreported since shootings and stabbings seem to make more dramatic headlines in the mainstream media.
When asking a couple of law firms how they would define ‘blunt force trauma injuries’ they responded with the following answers:
“A severe traumatic episode caused to the body (or head) with the sudden introduction of a blunt instrument used with great force.”
“Blunt force trauma is when the body is hit with an object that is blunt, or not sharp, with enough force to cause significant damage”.
According to Wikipedia, blunt abdominal trauma (BAT) comprises 75% of all blunt trauma and is the most common example of this injury.
The severity of such injury is mostly determined by the speed, velocity, size and weight of the object, and can range in severity from a tiny bruise to internal haemorrhages, bone fractures, cardiac tamponade, airway obstructions/rupture, and in the worst-case scenario result in ruptured organs, rapid internal bleeding and ultimately your death.
I do believe most security professionals will be aware of the potential severity of injuries resulting from blunt force. But I don’t believe many will chose to document and report every incident of this nature. “Too much admin”, some may say, and “it’s part of the job”, others will state.
Many security professionals have a reasonable understanding of the most realistic risks and threats they face, and subsequently are either being issued, or they themselves invest in body armour.
However, it is worth noting that any type of flexible body armour made from either an aramid fibre (i.e. Kevlar®) or a polyethylene (i.e. Dyneema®) including the latest high performance body armour produced by top secret manufacturers at top secret locations for top secret agencies, do not offer anywhere near enough protection from this specific operational risk.
On a domestic level (meaning homeland or private security, rather than military) the risk of being punched, beaten, kicked, or faced by someone throwing stuff at you is hundred times higher than being stabbed or shot. Therefore, it is rather saddening to see that more than 99% of body armour issued to domestic homeland security professionals offer insufficient protection from this specific risk.
Again, in the context of a good body armour, the key objective must be to offer sufficient levels of protection from the most realistic threats and risks you faces whilst on duty.
I urge you to make a conscious decision when investing in such type of PPE. Simply ask yourself the question, what is the most important criteria for YOU? The concealability, the weight, the thickness, or the level of protection from the risks and threats you have identified?
If the concealability of a body armour is key for you (i.e. covert operations and surveillance) then you may well need to look for the thinnest body armour, and the ‘blunt force trauma’ protection may have to become of secondary importance.
However, please understand that in general the most likely risk you face on a daily basis, is also the one you should seek protection from, and as I have stated earlier on in this article, the probability of you getting punched, hit, kicked or pushed around or have someone throwing stuff at you is far greater than the risk of being stabbed or shot.
To achieve the maximum level of protection from blunt force trauma injuries a body armour would have to be of a rigid structure, rather than a soft/flexible structure. Two diverse protective devices which highlight in a brilliantly understandable way the importance and the effectiveness of such protection are:
1. Motorbike Helmets: Never mind the fact that wearing a helmet is law when riding a motorbike. Wearing a helmet during a motorcycle crash significantly reduces the risk of damage to one’s skull, traumatic brain injury, and even death, countless studies have shown. We all know motorbike helmets are of a rigid/solid structure. They would not offer the blunt force protection and perform to the level it is required if the structure would be soft or flexible.
2. Riot Shields: A riot shield is a lightweight protection device, typically deployed and used by police in almost every country during riots, protests and mass disturbances. They are typically constructed from a rigid material to offer maximum levels of protection from attacks with blunt weapons and thrown projectiles. The officers’ lives depend on the performance of this piece of equipment. Again, to offer this high level of blunt force protection, it is required for its structure to be rigid, not soft or flexible.
The most in-depth research study on ‘blunt force trauma injuries’ or in more tactical terms ‘backface signature injuries’ sustained while wearing such body armour was produced by Marianne Wilhelm back in 2008, and is titled “Injuries to law enforcement officers: The backface signature injury”. It really is worth a read.
This great piece has raised important questions regarding the protection afforded to officers wearing personal body armour, along with the current test methods used to assess the true performance of the equipment. Some test results showed that some revealed deformations exceeding the NIJ Standard’s backface signature limit. Such increased deformation can lead to serious injuries, including blunt force trauma or backface signature injuries, which have occurred in the field over and over again.
Although your body armour might be successful in containing the round fired by a weapon or the knife thrusted at you by a hostile individual, it might not protect you from the impacting energy during other types of assaults, unless it is offering you officially certified protection from this precise risk. The most respected standard for body armour in relation to blunt force trauma protection is Germany’s VPAM (Vereinigung der Prüfstellen für Angriffshemmende Materialien und Konstruktionen) Standard, titled: “Testing of Impact Resistance against Throwing and/or Striking Objects” and its rating will be W1 (lowest) – W9 (highest).
It is also worth pointing out that our Technical Director Colin Mackinnon, a man who served 26+ years with the UK’s Police Forces, delivered an online presentation to a large audience of security professionals recently. Following his presentation, he asked a question: “Does your armour protect against knife, spike, needle, and blunt force trauma?”
Out of those questioned 55% of people did not know what protection their vests provided.
About the Author
Robert Kaiser is the CEO and Founder of PPSS Group, a UK headquartered company specialising in design, production, and supply of high-performance body armour. Robert and his senior team all have significant level of operational frontline experience in military, law enforcement or homeland security. His written word has been featured in several industry leading, international publications.
Arctic First Responder Course Preps Paratroopers for Extreme Conditions
Saturday, February 5th, 2022JOINT BASE ELMENDORF-RICHARDSON, Alaska — Jan. 10-14, 2022, Paratroopers with the 4th Infantry Brigade Combat Team (Airborne), 25th Infantry Division, “Spartan Brigade,” completed the inaugural Arctic First Responder Course held at Joint Base Elmendorf-Richardson, Alaska.
The Arctic First Responder Course is a prototype Combat Lifesaver Course that adapts Tactical Combat Casualty Care for operations in the Arctic environment. It was developed using lessons learned by medical personnel during exercise Arctic Warrior 21, where temperatures exceed -40F. The course prepares Arctic Paratroopers to provide lifesaving aid in any environment.
“Every Soldier should take part in an Arctic First Responder style training,” said Spc. Kenyi Foster from Avalanche Company, 725th Brigade Support Battalion. “This course has better prepared me for any combat situations I may face and helped me in being able to administer aid in any weather condition.”
Spartan Paratroopers from the 725th BSB learned cold weather injury identification, treatment and prevention. They also learned about and exercised patient transport and packaging in extreme cold weather environments.
The training comes as the 725th BSB prepares to support JPMRC 22-02 — a home station combat training center rotation in March that takes place in Central Alaska where winter weather can be unpredictable and dangerous.
“I now feel more comfortable if I’m ever under fire and know I have to administer aid whether that’s in the Arctic or the desert,” said Spc. Lisvette Vasquez from Avalanche Company, 725th BSB. “After taking this course I feel I could proficiently perform in medical lanes for ESB as well as know medical related questions for any Soldier of the month board.”
The Spartan Brigade is the only airborne infantry brigade combat team in the Arctic and Pacific theaters, providing the combatant commander with the unique capability to project an expeditionary force by air in both Arctic and Pacific environments.
Story by MAJ Jason Welch
Photos by 2LT Paul Campbell
TacMed Tuesday- Adaptive First Aid Kit
Tuesday, February 1st, 2022What is TacMed’s Adaptive First Aid Kit?
The TacMed™ Adaptive First Aid Kit, or AFAK, is a compact kit that provides an individual soldier or law enforcement officer with the necessary lifesaving equipment to effectively treat injuries commonly associated with combat trauma.
The innovative design of the pouch and included tourniquet strap allow for the kit to be mounted either vertically or horizontally to any MOLLE surface, allowing the user to take advantage of unused space and prioritize preferred individual equipment layouts.
The AFAK can also be adapted to a MOLLE belt for operators that require a self-aid capability when not able to find space on a body armor system.
The removable insert and optional lanyard allow for “small of the back” placement with positive retention of the kit.
An additional MOLLE platform on the exterior of the pouch aids in maximizing available space for user equipment preference. The included tourniquet strap system is also fully adaptive for vertical and horizontal placement based on user preference for access with both hands.
This kit contains:
• 1x SOF® Tourniquet w/ Tourniquet Strap System
• 1x 4″ OLAES® Modular Bandage, flat-packed
• 1x Fox Chest Seal
• 1x Nasal Airway w/ Lube
• 1x 5.5″ Trauma Shears
• 1x 14GA Decompression Needle
• 1PR Black Nitrile Gloves (size XL)
As with many of our kits, this kit can be customized to fit your specific mission need. If you want to customize a kit or are interested in learning more, check it out at tacmedsolutions.com/products/tacmed-adaptive-first-aid-kit or email us at info@tacmedsolutions.com.
