This October I went through Tactical Response's High Risk Civilian Contractor medical package. It was some of the most intense training I have been though to date. This is the second HRCC class I have taken. I took Small Unit Tactics earlier this year in May. The people in this class were as diverse a group as you could imagine with people there from Law Enforcement, an ER doc, The Monkey, a real estate broker, clinical psychologist, industrial engineers, a mining demolitions guy, some students, a few professional contractors, Military, and several others that I can’t remember. There were 20 people in this class and we were split into two teams. This being a five day class I will break this up by day. Day one saw us in the class room being taught by Doctor Allyn Norman an internist from New York. He is also a retired Marine and has worked all over the world in hostile environments. With a brief overview of the week out of the way he started his presentation. It is simply amazing how much information he presented to us in the short time we were there. Taking us through environment and patient assessment, we got into the 5 B’s (Bad guys, Bleeding, Breathing, Brain, and Body) we started along our crash course in austere trauma care. After going through our personal med kits and identifying the contents we were instructed in the use of tourniquets and where they needed to be applied to maximize their efficacy. We went to the range for the second half of day one and got into the thick of it. This class is much more physically demanding than small unit tactics was. In small unit tactics you really only had to worry about breaking contact and moving yourself out of the way. In Medical you really had to pay attention to your surroundings and your teammates. One to two people went own in every drill, usually necessitating dragging or assisting them in moving. Doing these things in a classroom environment is one thing, but when guns are going off, instructors are yelling, and you are tired you can really see how tunnel vision and exclusion really come into play. Communication is extremely fragile and things are easily missed in the commotion. Day two continued with the third and fourth B’s, covering full body sweeps to check for less obvious injuries. Doc was extremely thorough covering many scenarios to illustrate these points. We went through some classroom scenarios to put this into practice. We also covered airway securement by practicing administration of Nasopharyngeal airways. This was not the most comfortable item I have had up my nose and some folks had some difficulty with it due to past injuries. Like Doc says it’s easiest to just shove it in there, both for the administrator and the receiver. Everyone in the class had it done to them, did one, and had to teach the next person to do it. The range time after lunch further solidified this training by incorporating the material in our drills. Day three was the second most fun and also the longest. We covered some material that I had been wanting to learn for quite some time. We stared off with proper injection procedures. Again, we all had it done to us, did it and taught the next person to do it. We then got into intravenous blood draws. Doc went over the method to find the vein you were looking for and how to stick in the needle. I was able to get my draw on the first stick. Once the fundamentals of that were taught and practices we moved on to IV’s. There were quite a few steps involved in getting the bag and line setup. It was a little intimidating at first. I was able to get my IV drip going on the second stick. I missed the vein the first time(sorry Clayton!). The IV is similar to shooting, as one of my classmates said, “Slow is smooth, smooth is fast. Sight alignment, breathing and trigger control.” All of this related directly to the needle. We finished up around 6pm and James did his low light presentation. Afterwards we moved to the range for the night shoot. Difficulty is upped to the Nth degree when the lights go out. We ended up getting our casualty back to cover and Kyle and I started treatment. Doing this stuff was hard yesterday in daylight. Now Doc has us doing injections we learned just this morning out here in the dark while I have a chemlight clenched in my teeth so I can see. The stress inoculation is amazing. I had no idea I could accomplish this stuff in the dark while keyed up on adrenaline. Talk about a confidence boost when our team nailed this exercise. Smiles abound as we pack up for the night and head back for pizza and rest. Thursday had us covering Hypothermia, Hyperthermia, blast, and crush injuries. One we completed that We had a review session with Doc and had all of our questions answered. We hit the range and started into the drills, doing injections and IV’s under fire. It was amazing to see our team come together and to have such unity after only a few days training together. Doc upped the ante during these drill by yelling at us while we were treating and introducing incorrect information. It really made you have to stop and think about what you were doing second guessing yourself while treating the injured. You really ha to block out what was going on and do what you knew needed to be done and not what someone was telling you. It was one more thing to add to the stress inoculation, one more thing to think about during the chaos. Day five, Final X. Nerves are on high alert. Everyone is keyed up and ready to go. We had another Q&A and Doc covered eye injuries. We received our mission briefing and planned our mission. Omega team was traveling in a convoy and Alpha was to provide QRF if it was called. I’m not going into super detail about the final X as you really need to go through it yourself. All casualties were treated quickly and everyone pitched in dragging our wounded back to cover. I ended up treating one of our wounded. He was shot in the neck. An occlusive dressing was applied in the field, he was alert and responsive. Once I administered Morphine (b12 injection), i started his IV. I had to get him to keep talking to me to calm myself down enough to steady my hands to hit the vein. After a 300 yard drag, shooting the entire way, my adrenaline was up and I had lost a lot of my fine motor skills. I got his IV started and flowing, did a full body sweep then did a quick patient rundown with Doc. I have to say this was the most intense demanding thing I have ever done. I would recommend this class to everyone, especially if you are a shooter. Watching a friend bleed out while you stand there waiting for help is a terrible thing to imagine. Go out and get medical training. It may save a life someday. For gear used during this week, I ran an arsenal SGL-31 equipped with an Aimpoint micro and surefire scout light, M&P9, and a fantastic OSOE NSW rig. Thank you Doc Norman, Jay, James, and the rest of the staff of Tactical Response for the top notch training you provide. Mike
