TCCC at 5.11 Hamburg: Treat first what kills first ...

...it said again in the workshop "Stop the bleed Part III" at the 5.11 Flagship Store in the Free and Hanseatic City of Hamburg on July 20, 2019.

Medical first aid secures the survival of the individual and those with whom they serve not only to maintain the mission. This knowledge can also be lifesaving in everyday urban settings, as we must experience daily.

The threat of radical Islamist-motivated terrorist attacks in Germany has become a reality since the attack on the Berlin Christmas market on December 19, 2016. Experiences from terrorist attacks in Boston, Paris, Madrid, and Mumbai, among others, have shown that the concepts established in Germany for mass casualty incidents (MCI) need to be reconsidered during terrorist situations. In addition, other threatening situations such as rampages, attacks on emergency services personnel, and the increasing violence in police operational environments (knife attacks, family disputes with intent to kill, etc.) also show us these deficits in our environment.

The problem not considered here lies in the fact that the rescue service (RS) and the hospital nowadays mainly treat "modern" diseases such as heart attacks, strokes, and blunt injury mechanisms, such as those following traffic accidents. Accordingly, the focus is on training, treatment algorithms, and equipment.

Today, the rescue service is increasingly confronted with injury patterns known from war.

Looking at the injury patterns that occur in threatening situations, penetrating traumas from gunshot or knife wounds are largely represented. Additionally, there may be explosive and incendiary devices to cause the greatest possible harm.

In these circumstances, the percentage of injuries in the overall volume mainly consists of accident-related traumas (impalement injuries) and stabbings - making the percentage of injuries from firearms even lower.

Consequently, the RS and the hospital are extremely rarely confronted with gunshot wounds. However, this situation also means a lack of experience in handling these traumas due to lack of routine. The same conclusion applies to knowledge and treatment of possible causes of death and how to handle appropriate medical supplies.

It is also difficult to note that the crew of a single German ambulance is more capable of treating a single patient at a very high level than multiple patients simultaneously in one of the scenarios mentioned above. The same principle applies in German emergency rooms.

The 5.11 Flagship Store Hamburg regularly offers workshops on various topics of the tactical setting (Introduction to Long Range Shooting, BattleBelt, Dog Handling, Stop the Bleed, etc.) with highly ranked instructors from their respective fields with backgrounds and experience in these areas.

Gerald "Jerry" Mayer is undoubtedly one of the names in Tactical Medicine that holds an extremely high position alongside professional associations. Since 2007, he has been offering high-quality training in tactical emergency care and, as a former Commando Field Sanitaire (Medic) of the German Special Forces Command (KSK) and holder of high-quality U.S. qualifications, including Special Forces Medical Seargeant (US Army 18D), Flight Medic, Healthcare Specialist, and TCCC Instructor according to NAEMT. Operational experience from the public and civilian security sectors makes the Instructor of our workshop a true specialist in the subject.

After a brief "spotlight" on the target group in terms of training level and background, the focus swiftly shifted to the area of treatment algorithms. Over the last few years, well-defined algorithms and treatment schemes have been established in tactical emergency care. Here, the order of treatment steps is prioritized according to urgency.

Massive Bleeding, Airway, Respiratory, Circulation, Hypothermia / Head

The main causes of death in the discussed setting are Massive Bleeding, Airway, Respiratory, Circulation, Hypothermia / Head. It must meet the needs of the user, as a scheme designed for a medic can overwhelm the regular user and shift focus, causing harm. Anything from other wounds to narcotics should be reserved for the appropriate and trained user, as Jerry Mayer knows all too well.

After a brief reassessment of "Stop the Bleed Part I / II" and the specifics of using tourniquets (specifically the SAM-XT Extremity Tourniquet) and sensitization to competing products, the workshop then focused on the treatment of penetrating trauma and its management through wound packing with and without hemostatic effects.

An excursion into wound ballistics and the presentation of various injury patterns depending on caliber and ballistic effect make the workshops an absolute benefit for the "inexperienced" user as well as for the occasional professional from the public sector.

For me, a big "thumbs up" to Gerald "Jerry" Mayer, SAM Products, and the 5.11 Store Hamburg.

Save the next Date!

Andreas Fitschen is a teacher at the Vocational School for Paramedics of the Hamburg Fire Brigade, Medical educator, FKP A&I, Flight Medic and self-trainer for tactical emergency medicine.

More workshops with Jerry Mayer from SAM Medical/Tactical Responder are planned. We will keep you updated.

5.11 Store in Hamburg. Location: Brandshofer Deich 68, 20539 Hamburg.

TACTICAL RESPONDER online: www.tacticalresponder.eu

5.11 TACTICAL online: www.511tactical.com