Last Man Standing Defense: Defensive Medicine

Last Man Standing Defense: Defensive Medicine

Location: Twin Cities Rod and Gun Club, Indoor Range. Yuby City, California

Date: March 10th 2008

Cost: $200

Course Summary:

My first opportunity to train with LMS Defense was learning how to fight with a pistol. Mastering mindset, weapon manipulation and marksmanship is critical to remain the last man standing in any adverse situation – always fight, never quit. However, after 16 hours of this training and hours of dry fire practice, what will you do when you or another is severely injured? The last time I checked, Pistol I didn’t discuss how to treat injuries. What good are you dead?

My most recent experience with LMS Defense is through a Defensive Medicine class instructed by John Chapman. Utilizing the curriculum put together by a renowned medical expert, Dr. Keith Brown, Chapman teaches the citizen and operator alike how to react within the first five minutes after a life-threatening injury. We’re not all emergency medical technicians or surgeons, but I’ll be damned to not do anything until they arrive. Nonetheless, Chapman advises that this is not an end-all, be-all training solution – “armatures do it until they get it right. Professionals do it until they can’t get it wrong.” When preserving life, we should all strive to be professionals and consistent training must reflect that.

The 8- hour course emphasizes on “The Five B’s” to ascertain a life-threatening predicament. The protocol, listed by priority, analyzes:

– Bullets and Bombs
– Bleeding
– Breathing
– Brains
– Bones

Bullets and Bombs: Finish the fight and continue to do so. Avoid becoming dead weight by summoning your will power to live. If one is injured yet conscious, continue the fight to avoid condition black at all costs.

Bleeding: Heavy blood loss will lead to death very quickly. Stabilizing their circulatory system will keep them alive.

Breathing: Without a source to supply oxygen to the rest of the body, it will fail.

Brains: Assess the consciousness of the injured. Typically, one might look for symptoms of shock and might treat for it regardless. Checking for uneven resistance might indicate other injuries.

Bones: The last priority, check for broken bones and secure them as to avoid further injury. Beyond that, one can only wait – “we’re not x-ray technicians.”

Using the protocol above as a guideline, Chapman introduced methods on how to treat each priority through the use of a blowout kit. From what I recall, the blowout kit provided each pair the following contents:

– Cinch Tight Compression bandage
– Nasopharyngeal Airway Tube, Size 30 with surgical lubricant
– 6 Ply Kerlix bandage.
– SOF Tourniquet

Chapman reviewed several situations where anything above might be required. For example, if one were squirting blood from the thigh, a tourniquet must be applied first on the femoral artery to decrease the blood pressure in that area. Followed by stuffing the wound with Kerlix or similar bandage then wrapping it with a compression bandage to continually apply targeted pressure. If safe to do so, elevate the wound above the heart and ensure that the person remains calm. While a tourniquet is applicable to limbs, torso wounds might prove to be a greater challenge.

Depending on the severity of a torso wound, it will determine how much action is required. A graze shot on the side might be controlled with simple pressure, whereas a ballistic cavity might require careful placement of Kerlix, the application of haemostatic agents and immediate professional medical attention.

Suffice it to say, gear is very nice to have, but when it counts – anything will do. T-shirts, dirt, rocks, and the will power to live might be just enough to see the light of day again. Otherwise, Chapman reviewed the necessities and tools of the trade as well. The minimum recommended is as follows:

– Pressure bandage
– Haemostatic agent (Celox recommended)
– Rolled gauze bandage
– Nasopharyngeal Airway Tube (size depends per person)
– Tourniquet

It was emphasized that it’s not expensive to set up a kit – it can be cheap. However, it’s recommended to spend good money on a haemostatic agent and tourniquet. The first line kit, the minimum described above, is a personal one that is only meant for personal use, or use by others to use on you. Having extra supplies for multiple persons isn’t feasible or practical.

Should the situation require one to do so, transportation of the injured was discussed. One and two person carry methods were discussed. Another carry method I found really interesting was the use of a heavy duty plastic liner and straps called a litter (think drag bag or carcass sled).

Lecturing is one thing, however practical application is another. Chapman incorporated a lot of hands on experience that allowed us to learn to assess and treat injuries through random drills. This alone is what makes a class worthwhile.

Reflection:
In Boy Scouts; First Aid, Emergency Preparedness, and Lifesaving merit badges were my favorite. There’s something about being prepared that’s empowering, yet, many of my peers find it more cumbersome and prefer to just wing it. Society at large seems to reflect that. Not everyone has an emergency kit inside the car or home. If they do, it’s a kit that is rarely inspected or the person has no to little idea what to do with the contents inside. First Aid/CPR classes provide some insight on how to prepare, but the quality of instruction will vary let alone few seem to understand the difference between casual practice and practice that emulates the real thing under pressure. Furthermore, the Red Cross refuses to lecture on the use of tourniquets and perpetuates the myth of “surface pressure” on “all wounds.” I was enlightened when Chapman said that much of the training promoted surrounds urban incidents – traffic accidents or home injuries. I’m looking at the Red Cross pamphlet right now; nowhere does it discuss gunshot wounds. In fact, the closest I can find is “care for a major open wound” despite it noting that homicide is the second leading cause of workplace injury-related death.

– Control bleeding by placing a clean covering, such as a sterile dressing, over the wound and applying pressure.
– Apply a bandage snugly over the dressing
– Call 911
– Wash you hands immediately after completing care

<rant>
Uniform Crime Report (2004) indicates that at least 85.7% of homicides (5.5 incidents per 100k) involved firearms. I know, statistically, it’s not likely I’ll get shot, but I find it interesting that despite all the bitching about gang-bangers and illegal immigrants (aka “the children”) shooting at us or each other, first-aid treatment, from a citizen perspective, for ballistic wounds is almost unheard of. After taking this class, I entirely agree with Chapman when he says that death can be prevented if one has the knowledge to treat it.
</rant>

This isn’t a knock down on Red Cross, but only a realization that I can never have too much training. The particular training LMS Defense provides seems to encompass all facets of life, even if one is inclined to not own a firearm. We are given the tools; it is up to the individual to use them. Through LMS Defense, I can be assured that I was given the guidance and constructive criticism to ensure that I use the tools effectively.

I found this class especially important because of my new found trade. Being around firearms is like driving (no, I’m not going to discuss licensing); you must assume that everyone around you are negligent idiots. This is why “all guns are always loaded.” If you happen to meet a real dumbass and get shot, you will live another day to make them sorry for it; assuming that any training you partake pulls through.

Conclusion:
What I took from this class was how to prioritize, treat, and prepare for injuries. Being in a class taught by an experienced instructor (not an armchair professional) with two students who are paid professionals, is a strong indicator that I am receiving top-notch education. Your decision to train with LMS Defense should not be determined by age, sex, race, religion or profession – only your desire to “be prepared.” During the class, I felt we were all treated as capable individuals and were given solid information– it would behoove anyone to take this class.

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10 Comments on “Last Man Standing Defense: Defensive Medicine”

  1. March 14, 2008 at 11:47 pm #

    Really, really sorry I missed it. Good writeup.

    FWIW, I’m probably going to be unable to take the Defensive Medicine class offered in October as it conflicts with the Gunblogger Rendezvous and my wife actually wants to go — I ain’t turning that down. So I’m going to try to take Pistol I in the summer in San Jose if I can.

    I’m interested in the preference for Celox. My trauma kits have QuikClot (not cheap). Do you recall the basis for Celox being the preferred agent?

  2. March 15, 2008 at 4:48 am #

    You can always host a class in your area – and it’d be free! All you’d have to do is get a bunch of buddies together and ensure that John has a place to sleep at.

    I looked at last year’s Gunblogger Rendezvous pictures on Mr. Completely’s page. That looked really fun! I’m contemplating if I should make the trip to meet everyone.

    QuikClot actually cauterizes the area rather than actually promoting coagulation. Chapman noted that when soldiers attempt to apply QuikClot too high above the wound may end up in the eye, resulting in permanent eye damage (ouch). QuikClot also has an “actual” expiration date, it must be replaced. Celox on the other hand has an expiration date that’s more flexible. It was noted that either haemostat agent will work just fine, it’s jut that Celox removes the concern of burning unnecessary areas. So don’t replace it with Celox until it expires.

  3. March 21, 2008 at 3:22 pm #

    Hey Derek- I was looking at taking some defensive Pistol classes and you seem to know what makes a good one from a bad one-

    what should I look for in an instructor to gauge quality if testimonials are not available? what should I expect to bring? what should I expect to pay?

  4. March 22, 2008 at 7:13 pm #

    Mike,
    I’ve only taken two classes from LMS Defense, so my experience regarding bad ones vs good ones is quite limited. However, if you look at it from a student’s perspective, you will find something new to learn in every class you take.

    I’ve come to class prepared to listen, do, and reflect. I suppose those are the three things you’ll want to look for in a class: lecture material, practical exercises, and relevancy to your life. I think as long as a class can touch on all three aspects, you’ve got yourself a good class.

    For example, I mentioned Red Cross’ First Aid/CPR class. Lecture material was sufficient, but hands on exercises were almost non-existent. When I say hands on, I am referring to conditions that you will likely encounter while using such skill. If I were to design a First Aid class, I would have incorporated a live exercise: walk upon the scene, check surrounding area for safety precautions (have classmate crowd the scene), instruct someone to call 911 (have the participant vocally tell a classmate to call), and care (performing hands on care until professionals arrive).

    Relevancy is important too. The ARC FA/CPR class was a good refresher; however, it didn’t go over likely scenarios for me. I’ve been muzzle swept by company I hope to never encounter again. Had I been shot and the ARC class was all I knew, it’s likely I wouldn’t treat the wound efficiently.

    The above is the only thing I can think of. That’s all I really took with me to my first LMSD class: listen, do, and reflect. As far as looking for your first class, you’ll likely have to browse local forums to get a good recommendation. In fact, LMSD will travel if you host a class. That means finding the range, hotel accommodations, the date, and others who will take the class with you. I would encourage you to contact them and see what you can arrange with them. Their course cost is usually $200 a day – not including ammunition.

    Classes will shoot between 700-1500 rounds of ammunition – it really depends on the course work too. Each class will vary.

  5. March 24, 2008 at 3:58 pm #

    thanks for the heads up! I’ll reach out to them and see whats available in Upstate NY. I really just want some basic defensive handgun classes, then maybe get a bit more advanced later on.

  6. January 21, 2009 at 5:28 pm #

    Thanks for the great write up my friend. I just found this, almost a year later. I’m in Iraq right now, but I’ll be home in April 09, and doing another Defense Medicine course in Yuba City. Hopefully you can stop by and say hi.

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