Brushbeater: Contact Medicine


No shit.

This material will be on the final exam.

30 responses to “Brushbeater: Contact Medicine

  1. That picture really struck a nerve with me,forced meself to keep looking at it,as I became used to it noticed the tourniquets high up on legs near the groin,something someone with a lot of training/experience would notice immediately.My only hope is whether I have to patch meself up or someone else that there is the next level of professional able to take over.I have seen worse pictures but for some reason this one hits home and will have me check all my patch up stuff and take any opportunity to learn more.

  2. One of those tourniquets appears to be an actual combat tourniquet like what I was issued in the Army, but the other looks makeshift. Maybe a muslin bandage and ink pen?

  3. Thank you, great post..

  4. thats some good info there thanks

  5. Something that’s bugged me about the IFAK since they came out is the NPA. I like to call it “the outcome indicator”. Way back in paramedic school the axiom was that a patient that can tolerate an NPA can darn near tolerate an OPA and a patient that can tolerate an OPA will tolerate an ET tube without sedation. If you can tolerate an ET tube without sedation you need a trauma center in one zero minutes. Or an undertaker.

      • NPA= Naso-pharygeal airway (the nose trumpets)
        OPA = Oro-pharyngeal airway (the hard or soft plastic knuckle throat airways)
        ET = Endotracheal Tube (the long tube that docs and paramedics slide down your throat and inflate in the pharynx beyond the vocal cords, to create a protected, vomit-proof airway)

        Brushbeater’s outline is spot-on.

        And FWIW, trauma medical journal articles, last I looked, noted that contrary to popular myth, tourniquets like the CAT-T and SOF-T had been placed on patients for between 4 and 6 hours during OIF/OEF, and subsequently removed in trauma treatment settings afterwards with no loss of function whatsoever.
        Bear in mind the survey sample was almost exclusively young, otherwise healthy males, not 75-year-old morbidly obese couch potatoes with diabetes, high blood pressure, and two to ten other co-morbidities (habits/problems that can kill you, and do). The simple answer is that correctly applied, they prevent relatively minor extremity bleeds from becoming major blood loss/shock/death cascades, with minimal to no risk of causing harm, and a huge shot at solving your problem for the time it takes to get your patient to higher levels of care.

        Tourniquets for extremities are not last ditch, they are first-line.
        They also potentiate trauma dressings and direct pressure after the TQ is applied, allowing natural clotting to work for you, provided you get them on fast and first, then follow up with the bandaging. All the platelets in your blood that help you clot don’t work if you waited too long, and most of them are all over the ground around your casualty.
        And in high-volume blood loss, you may not get enough of a natural clotting response. (This is frequently an indicator that things aren’t going to go well for your patient.)

        You have four limbs; you should have at least four TQs on you, and readily available. (E.g., one on each side of the belt near the buckle, one on vest/LBE, one on the weapon stock, and one in each of any bicep pockets on Marpats or multicam play clothes, with a couple or four more inside your actual IFAK.) Thus six to eight is better, in case one or more goes away due to sudden traumatic wear and tear on your LBE.
        It also gives you one or more to spare in a pinch for someone not as forethoughtful.

        And if you’re carrying the group aid bag, a dozen more is a good place to start.
        If all your people are carrying bunches themselves, and you know because you’ve checked, and re-checked, this number in the aid bag can be adjusted downwards, in favor of other expendable supplies, like trauma dressings and such. (If the aid bag isn’t bulging a little, you aren’t stocking it properly.) Also, buy the real deal, and stick with standardizing on the CAT-T and SOF-T. When you need it is a really shitty time to find out the “bargain” brands, factory “seconds” reject pieces, and cheap foreign counterfeits aren’t quite up to the task. They’re your arms and legs we’re talking about, so spend on your gear what you think your parts are worth.

      • Nasopharyngeal airway is NPA. In the nose to open the airway.

        OPA is the oral version, goes in the mouth instead.

        ET is endotracheal. Full intubation. Usually done under sedation by a physician, or in the field. If you have to get intubated at all, you’re in bad shape.

  6. Like this one better than the Israeli bandage

    Right now, everyone reading this thread should be thinking about their IFAK.
    You need to ask yourself “Self, if I need to use all of the things in an IFAK do I know how?”
    Go to your IFAK, take out all of the contents and see if you know how they are used. Specifically the TK and the Pressure Bandage.
    You can be excused for not sticking an Airway up your nose or a needle in your chest but the TK and Bandage need to be something that you have used PRIOR to getting injured.
    Work with the gear that you have and get some advanced TC3 training.

  7. outlawpatriot

    That picture is a perfect example of what I’m talkin’ about. As of the moment, we have no capability to take care of such wounds past basic trauma first aid. And I’m bettin’ most here about don’t either. Risking the killing or capture of others to hump that guy anywhere just doesn’t make sense. Better to leave him to the enemy. At least he might have a chance. Then there is also the consideration of what he knows and the possible downside if you leave him alive.

    Sure hope it doesn’t come down to that.

    • Understood but even his identity is information that can be used.
      If he expires make sure you can put him in a hole so OPFOR cannot use his ID to go after his family, otherwise folks fighting for you are going to do the calculus and figure out that getting a serious wound is a death sentence not only for them but the thing they are fighting to save.

      • outlawpatriot

        G, if the whip does in fact come down, a lot of folks are gonna have to pull their heads out of their asses. To not understand that some wounds ordinarily survivable with expeditious evac and top flight medical care are in fact a death sentence is just plain living in a fantasy world.

        Now, tell me I have air evac and a safe facility to take them to that can treat such wounds then I’m your huckleberry. Otherwise, he stays in place. I’ll sing his praises later. Assuming of course that I survive and win. 🙂

    • SemperFi, 0321

      Another reason to have a suppressed .22 pistol.
      Hope somebody uses it on me if it ever gets that bad. That level of pain, and who wants to lay around waiting to die slowly?
      In this case, it’s not murder, it’s mercy.

      • I for one appriciate your Frank honesty Semper Fi, without the might of the military medical facilities, this guys gone. Should our group sustain injuries like that, a medical solution just isn’t an option.

        I to would ask my brothers, my family to do the right thing. I’ve got a suppressed 22 Ruger semi with a Thunder Beast attached for pests., with subsonic ammo, all you hear is bolt slap.

        While tough, a quick out, under those circumstances is honorable.


        • SemperFi, 0321

          My buddy has the same rig, he drove 6 hrs to Cheyenne, did the paper work and drove right back home again. We needed it yesterday for a huge Blue grouse while elk hunting, dumbass left it at home!

          I believe the conversation was about what to do when there is no medevac, and when that happens, there is no sterile hospital to patch you up. Electricity is out, nothing runs anymore, including hospitals. Live here in rural Wyoming, it’s a couple of hours even on a good day with the power and cars running.
          OP had it right, some of you folks need to come to grips with reality, that there is not going to be an ambulance or helicopter to haul your bloody carcass to a ER. So you either take a slug to the brain, or bleed out screaming all the way!!!
          Read up on the fall of Germany in 1945, tens of thousands of people died from lack of medical attention. Think it can’t happen here?

    • You keep acting like this will occur in BFE, 200 miles from anywhere habitable, with a battalion of terminators tracking you with hunter-killers, hovercraft, and pulse rifles.

      Unless you’re operating north of the Artic circle, or somewhere as equally godforsaken (in which case, WHY???), you’re not that far from civilization, or at least defensible shelter.
      Good Holy Christ, people dragged each other’s gut-shot bear-chewed asses hundreds of miles for aid, without crying and bitching about it, back in times when modern medicine wasn’t even a glimmer on the horizon, so if the lack of instant 21st medicine one dark future day is just too hard to mentally cope with, just suck-start your pistols now, and get it over with.
      You shouldn’t be hanging it out so far from help that you can rely on, even after civilization goes away, or a place you can regroup and defend, that you can’t make any effort at all.
      And if you are hanging it that far out with no visible or reachable means of support…WTF?!?

      If someone’s going to die, they’ll do it fairly quickly, and without any outside assistance, in which case, it’s out of your hands. Split their gear, dig a hole, and drive on.
      But if they don’t, they could have been gotten to better care than what you have in your ruck. Whether that’s to someone else’s place, your own base area, or some nearby rally point.

      You keep using expected casualties, well within the realm of everyday occurrence, as an exemplar of a rationale to shoot the wounded, like it’s some unforeseen black swan scenario.
      Which is simply retarded, counter-productive, and a good reason to question WTF anyone would tag along going to BFE with that bunch in the first place.
      Anyone who has enough ammo to shoot the wounded, but not enough aid gear to treat them, is a sadistic, lazy, and monumentally stupid asshole, and should be used to field test mushrooms for edibility, and clear minefields barefoot at the first opportunity.

      You aren’t going to be, and shouldn’t act like, you’re going to be LRRPs para-dropped on Mars, or doing an E&E from Atlanta to Anchorage. You’re either going to be in and around your own local AO, or else a guerrilla swimming in a sea of local support. (And if you’re not, you weren’t paying attention in guerrilla class, and deserve to die a nasty death for being so foolish.)

      Anybody in such a hurry to thin their own herd is probably too stupid to save. Fer crying out loud, tetanus infections will kill you deader than canned tuna. Are you going to shoot everyone who steps on a nail, or gets bitten by anything that walks or slithers??? Man the fuck up already, get educated what the hazards are, and find the time and balls to deal with the foreseeable problems, while there’s both time a resources to cope with them. That’s why it’s called prepping, and not bushido. You want to start slapping a rising sun headband on everyone every day, you’re in the wrong program.

      If anything and everything beyond Band-Aids and Bactine is grounds to start slitting your own guys’ throats, maybe start with doing that before you go outside your own wire, or just have the sense to cancel the trip. And if taking those sorts of casualties inside one’s own wire still equals head shots as prophylactic pain relief, they’ve already fucked the dog on preparedness so hard they might as well just stock up on cyanide and grape Kool-Aid from the get-go.

      • outlawpatriot

        Sure, sure. Take it to some level I’m not talkin’ about. Keep in mind brah that your credibility is shaky at best concerning that Ebola gig of yours. And you don’t know me from jump. So lighten up. 🙂

        • SemperFi, 0321

          Some people really have no grasp of reality, they think the lights will stay on 24/7?
          I keep going back to WW2 and the fall of Germany. They too thought they were the pinnacle of society, the greatest scientists and doctors, the most modern hospitals and equipment, it all came to a sudden halt when the bombs and artillery fell day and night. Patients by the thousands laying in dark cold hallways and cellars, no more drugs, bandages, blood, and doctors overworked to death.
          But that can’t happen here, we have cell phones……oh, and we’re exceptional dumbmasses too.

  8. It is really refreshing to see that at least some out there are beginning to grok that what may come will be “war to the knife, and knife to the hilt”. The US military invented, and the civilian medical practice adopted, truly heroic treatments for trauma. What so many fail to see is the phenomenal infrastructure required for these treatments that WILL STOP WORKING about the same time that the grocery stores go dark and dry. Not days, folks, hours. Medical evacuation out of Afghanistan or Detroitistan or your neighborhoodistan with tourniquets on limbs and needles in chests will only work if Landstuhl or Walter Reed is still secure, lit, supplied, and staffed, and you have competent medevac. In what may come there will be no rear. Your options for treatment will rocket backwards 100 years in hours. Whiskey, opiates, and a palliative mindset will become more important than most have ever allowed themselves to imagine. Injuries beyond aggravated boo-boos WILL KILL. Hard, hard hearts, boys and girls.
    Concerned American, NPA is nasopharyngeal airway, the tubey thing in the IFAK. OPA is oropharyngeal airway, a hard plastic curved tongue depressor thingy. Medics carry them as bite blocks and as assessment tools, as it is quick to employ. Slide in the OPA, and if the patient doesn’t gag it out they are very fu, serious. Leave the OPA in a few moments to bag the patient while you get your Endotracheal (ET) tube supplies out, including bottled oxygen, so you can run a foot long plastic tube down the trachea to completely control the patient’s airway and breathing. If a patient needs this intervention, and you’ll know because they are not fighting it, they are waist deep in the big funky and if the grid is down, so to speak, they are almost certainly not going to make it.

    • Rog all.

      Thanks, especially for the big picture overview.

    • Absolutely agree, if I’m that fucked up, I don’t want medical supplies wasted on me, I don’t want people loosing their focus or taking their eye off the ball. Put me down, move forward. Pushing to a hospital, is only half the equation. Then theirs the matter of rehab, and then someone caring for,you until recovery. My quality of life in that scenario is not work the resources, utilized. Put on I’m my head. I’m ok with that.

      We have about 20 ounces of opium seeds, lil tiny things. Granted should we get that far, growing your own opiates is a season down the road, I should note possession of the seeds is also not criminal here in Oregon. Milking the pod would be. ” not that anybody here gives a shit about the law”

      This is Oregon, we can grow cannibis legally here. And I do. I don’t smoke, and most of my medicine is given to vets in need, the elderly whom can no longer afford their pain meds. A major pain solution. An option that should be reviewed by all, for potential incorporation into your medical kit.

      Don’t judge, everybody in our group follows the law and grows exactly what we can legally. In fact were pushing harvest in the next couple weeks, which is a royal pain in the ass.

      My point is simply this. Their are steps available to all of us, to have pain relief solutions on hand. While these two options are not the be all end all, it’s a start in the right direction.


  9. There is some pretty damn bad information in there too. A tampon for an abdominal wound or a sucking chest wound? No one uses tampons for any type of TCCC. Do your own research. Long story short they fall apart, do nothing to stop a serious bleed, and cause a management nightmare for follow on surgeons trying to avoid an infection. If tampons are in your IFAK, go get some training. The author is way out of his lane here.

    • First, thank you for reading.

      Second, I did NOT and would not advocate using a tampon for a sucking chest wound. In fact, I said a primary responder’s best bet if no gauze was available is to simply use a safety pin to secure the wound. Read what I wrote for yourself, again:

      “But wait- you didn’t talk about abdominal injuries- gunshots, sucking chest wounds, etc? No, I didn’t. The reason why is that there’s not that much without extensive training you can do for this type of injury. You can pack it with gauze (or a tampon) to keep it from getting worse, but the best thing to do is close it with a safety pin. You should not consider a needle decompression for a sucking chest wound if you have little medical training either. Doing so incorrectly or overestimating your skill can cause many more problems than it solves, possibly killing your casualty. Understand?”

      This material is written for those with ZERO medical training, repeatedly citing the need for those with advanced training, starting with the second line under the title pic.

      If you still take issue with the material, feel free to email me.

  10. He just got the wind knocked out of him. Get up and walk it off…


    Seriously, this is what volunteering for Uncle Sam will get you. He can always get a job as a crisis actor. Oh wait…

      • SemperFi, 0321

        What is also interesting is the ALMOST empty 2 liter bottles of red Karo syrup still laying around, look very closely at the still photos from that day and you can spot them among the debris. And watch the facial reactions from the black chick as she sits up and then remembers to play hurt, along with the red head. Blond gal with shredded calf was also another fake like Nick.
        An extremely phony crisis drama at play. And it worked, again.

  11. Probably need to be prepped for medical attention circa 1802. I ain’t saying I wouldn’t try to help that guy but “Jim I’m a mechanic not a doctor.” That guy is most likely going to die and the stuff used on him could have been used on others with a higher survival probability.
    Man I hate this mess the commie-lib progressive one-worlders have put us in.
    Got vodka ?