Emergency Medical Planning

[SinistralRifleman]

We use our guns for fun and sport, but let us never forget they are potentially deadly tools. While few people have actually been shot or shot themselves in action shooting competition, it is not an impossibility. Riccochettes can also cause a significant damage. In addition to the use of firearms our sport can be inherently dangerous due to the type of physical activity involved. People can hurt themselves simply taking a fall on a stage.

The simple fact is there are a number of injuries that can and have occurred at shooting competitions. In spite of this, medical supplies and planning are often overlooked by individual shooters, and match staff. The care given in the first few minutes after a life threatening injury can make the difference between life, permanent dehabilitation, and death.

Match Directors, what's your medical plan should something go wrong at your match?

Have you ever had any injuries at your match that required Emergency Medical care?

[uscbigdawg]

Russell,

Great topic and I'll give an example of what happened to us on two different ranges I was on, what I have done (not always do) and what maybe 'should' be done.

One was at my second home range. During a field course a shooter goes down with what appeared to be a badly sprained ankle. As he's a pediatrician, he knew immediately that he had ruptured his achilles. So we called 911 and the local EMS team got there. Before their arrival, we secured his pistol, took his gear off of him and made him comfortable. It's about all we could do honestly. They took him quickly to the hospital. Although their speed was great in packaging him, I think it was to get away from the 15-20 of us standing around with pistols on.

What I have done. I don't do it all the time as it's kind of cheesy. However, since completing much of my training, if I go out to a match or area that's rural, I'll make a point to throw one of my aid bags into the truck just in case. Each (I have 4) has a different degree of care that they can provide. 2 of them are for work, and I would never carry them as there are waaaay too many drugs in there to not be secured. One is for first aid and some minor injuries and the other is a trauma/blow out kit that I'm designing for sale.

I'm in the process of compiling suppliers that can meet a package requirement for what I'm looking for on a trauma/blow out kit that I would like to market to the shooting community. This would be sold seperately as well as made available to MD's, RM's, and ranges to have for themselves and their staff after completing a training course from me and/or one of my partners. When I return from Afghanistan (late '07/early '08) all of the supply issues should be resolved and hopefully the actual "bag" will to. I don't want anything to large, but at the same time, there needs to be a place for everything that you need.

The biggest thing that match staff that DOES know first-aid, first responder, EMT, etc. skills is do not overdue the necessary amount of care to get that injured person to a higher level of care. If you do too much that doesn't fix the problem then we (advanced providers) usually have to undo a lot of what's been done, before doing our own procedures or we're slowed in providing our care.

If folks are interested in this course, please e-mail me. I will be soon becoming a member of the Dealer Forums for this and other medical products, training as well as shooting sports equipment/training we will be providing.

Hope to hear from y'all soon.

Rich

Edited February 14, 2007 by Flexmoney

[SinistralRifleman]

Rich, I guess we both recognized a need for similar goods and services for the shooting community...see my latest post in our dealer forum.

For the past couple years I've been running a medical kit on the vest I use for 3 Gun. It has several rolls of curlex, ace bandages, a trauma dressing, and quick clot in it. I keep a smaller kit on my pistol belt so something is on me even if I'm not wearing the vest. I've had red cross basic first aid/CPR training. Your squad/team mates should know where your medical gear is on you or in your bags so they can find it if you are the one that is injurred.

At most bigger shooting events we have Brad with us, he's a certified EMT. He keeps a large multiple trauma kit with him at all times. We try to let the people in charge know we have an EMT on site with us in case anything goes wrong. He's treated people, including myself several times, for all kinds of issues in matches and training classes. One of the first things to do at a shooting event is to ask who has medical training and what level to establish a hierarchy should something go wrong. At least one match I have been to contracted EMTs to be standing by in case there was a medical emergency.

The event itself should have medical supplies on site, just in case. Everyone should know where these are.

Depending on the location of the range, it may be more time effective to meet the medics at the major highway, or even to drive to the hospital directly depending on where it is at. Designating a vehicle as an ambulance and letting everyone know where the keys are is an important thing to do. Orient the vehicle so it can pull straight out to get on the road, remember seconds count.

Rich, if you have any other general organizational suggestions I think we'd all like to hear them.

[Flexmoney]

Have you ever had any injuries at your match that required Emergency Medical care?

I'm going to ask that we keep any answers here completely general in nature...as in "yes or no". Please don't post any 'so-and-so' was shot stories. As rare as they are, they would be used against us and our ranges.

-Admin

[bigbrowndog]

I have made sure that the Trauma Flight Service has GPS coordinates to the ranges that I frequent.

I can't speak for Rich, but I know our Medical Director frowns on the use of A clotting agent, generally speaking bandaging and pressure, (like gravity, always works). Its also easy for responding services to undo bandaging if need be.

If I know the match director, I will normally let them know that if something arises and they need help, to come and get me.

If an ambulance service is not available for transport, make sure whoever takes the Pt. can remain calm, and not drive recklessly.

Trapr

[John Heiter]

This is kind of interesting to me in a "Gee I hope I never need to know" sort of way. I've had basic CPR but that seemed to primarily deal with airway, breathing, cardio stuff. Are there any classes available to the general public that deal with first reaction to more traumatic injuries? I know the first step is to get qualified personnel enroute, but what should I do in the meantime? I know nothing of pressure, bandaging, compression, etc. and I'm thinking it might not hurt me if I did know.

Thanks,

John

[smokshwn]

Seeing as I do this stuff as a profession my plan is to simply point and laugh since it will definitely happen on my day off

[BritinUSA]

I have seen first-hand the need not only for good medical equipment at a range but also the need to keep it up to date. Our range in UK was part of an old armoury and was inset into a hill, so there were trees and stuff growing on the roof. This made the conditions inside rather damp all year round. This can cause mold to form on bandages etc..

During an emergency we found that all the bandages were expired. There was a date stamped on to all of them and some were older than I was.

The moral of this story is that having a medical kit available is NOT the solution; Having a medical kit that has all items within their expiration date IS a solution. Maintenance of the medical kit is as important as having it. Using expired bandages or other medical equipment can actually cause more harm than good.

Varying temperatures and humidity can all have an effect, so good storage for your med. kit is very important as are regular checks on the contents.

Edited February 15, 2007 by BritinUSA

[BigDave]

If there was an ER doctor, trauma EMT or someone with the appropriate training for the "worst case" situation we might run into who would be willing to put on a class(es?) at say one or all of the Nationals, I think attendence would be pretty high and the subject matter well received.

[Catfish]

If there was an ER doctor, trauma EMT or someone with the appropriate training for the "worst case" situation we might run into who would be willing to put on a class(es?) at say one or all of the Nationals, I think attendence would be pretty high and the subject matter well received.

If I get into nats (Tulsa) I'd participate.

Great idea.

[smokshwn]

If someone wants to do the legwork I would have no problem conducting the classes at Open Nats and 3 Gun Nats this year. Also if anyone wants it wouldn't be too much work to put together some instruction that would be consistent for the other venues.

[uscbigdawg]

I'm in the process of starting a civilian medical training business, specifically for corporations and organizations like ranges, etc. So, when I get the F out of the Army, I'd be happy to teach a course anywhere any time (ideally in conjunction with a match; gotta have some fun when I'm on the road ).

Note that for non tactical personnel (MIL/LE/DOD/Civ. Contractors) the use of clotting agents will be discussed however at the level of our use (matches, ranges, etc.) should only be left in the hands of educated and capable personnel.

Rich

[SmittyFL]

Rub some dirt on it.

[dajarrel]

This is kind of interesting to me in a "Gee I hope I never need to know" sort of way. I've had basic CPR but that seemed to primarily deal with airway, breathing, cardio stuff. Are there any classes available to the general public that deal with first reaction to more traumatic injuries? I know the first step is to get qualified personnel enroute, but what should I do in the meantime? I know nothing of pressure, bandaging, compression, etc. and I'm thinking it might not hurt me if I did know.

Thanks,

John

John,

Contact the local branch of the Red Cross. Not only do they have CPR instructors, but usually in most relatively large cities they will have instruction for First Responders. This is a class to basically keep someone from bleeding out, immobilize fractures and basically stabilize a patient until an ambulance with basic or advanced life support can arrive.

I became a Basic EMT a few years back for just that purpose. I didn't want to stand around and watch someone further injure themselves or just die while I stood there. I have since let my license expire but still refresh in first aid each year at work.

You hope you never need it but feel much better knowing you can help if help is needed.

Also, It might not be a bad idea on match apps to put a selection box to check if you have basic first aid, EMT or Parametic skills.

FWIW

dj

[uscbigdawg]

Rub some dirt on it.

Ahh...Treatment 101 from Special Forces Medics.

Rich

[dajarrel]

Rub some dirt on it.

Worked well when we were kids, didn't it?

dj

[bigbrowndog]

Actually A really cool idea would be to offer a discounted price(match fee) to a Certified/qualified individual, who was willing to bring/provide basic gear, and work on an injured party.

A valid license or certification card could be sent in with the match app.

Trapr

[smokshwn]

Trap,

I am liking that idea, I gots lots o cards.

I do just this thing for one of the local clubs. We also try to have a yearly training for the members that do the bulk of the so/ro'ing. We also keep a kit for the match director to carry around as well as writing up a medical plan for the club.

In all seriousness it would not be a bad idea for medical planning to be made a part of USPSA matches. If (god forbid) anything serious were to ever happen the organization could show a good faith effort was made to plan for adverse events.

Craig

Edited February 16, 2007 by smokshwn

[HI5-O]

Craig,

I'll be sure to request squadding with you just in case......

Barry

[Garryowen]

Actually A really cool idea would be to offer a discounted price(match fee) to a Certified/qualified individual, who was willing to bring/provide basic gear, and work on an injured party.

A valid license or certification card could be sent in with the match app.

Trapr

That's a pretty good idea.

[bayoupirate]

Best Idea is to include medical personnel as part of the Match Staff along with RO's and have them assigned no other, or very minimal, duties during the match.

Proper Credentials: ie State Certificates and/or National Registry

Of course, they should receive the same compensation/discounts as the RO's.

I carry my kit with me everywhere I go.

If I leave it behind, I'll surely need it.

[bigbrowndog]

I've been to matches where people have sprained ankles, had bad bullet splatter, and even had a gas attack feel like a heart attack. So, there are lots of other "emergencies" besides getting shot, some matches need to be concerned with frost bite others with heat stroke.

Keeping volunteers duties minimal I think is not necessary, most EMT types, know that when they are "needed" everything else is second priority. Shooting / ROing / or whatever can wait

till after the situation is handled.

When I shot competitive Archery, we always had Emergency staff on hand, at outdoor venues simply because of Heat, Snakes, Ankles, and such. Most of the time it was Volunteer County Emergency services, and we provided lunch, drinks and allowed them to try any equipment out that they wanted.

Trapr

[kevin c]

As a doc who hangs around the range a lot, I've gotten the call many a time for medical issues. My experience is that the most likely problems at the range are sprains, cuts, and sun and heat related injuries. As far as injuries that draw blood, the most likely bullet related injury is backspatter off steel, and that isn't as common as geting a cut or scrape from falls or collisions with props. Gunshot wounds, per se, are exceedingly rare. The only thing I've seen that was even close was a fluke ricochet injury.

Still, there is absolutely no harm, and a lot of good sense, in preparing for the worst case scenario, however unlikely. It's just much more likely that you'll use the bandaids than the trauma kit (bandaids and sunblock are the most used items in our first aid cabinet).

There are some tricky liability issues to having a formally designated medical person available. The decision at our club, which I advised on, was basic first aid until the EMT's arrive. We can do this because we are a near urban location. Remember also, that Good Samaritan laws cover liability for whomever renders aid on a volunteer basis, but not necessarily so if there is a formal obligation/responsiblity made by designating a person or creating a role for medical staff.

Edited February 28, 2007 by kevin c

[John Dunn]

Having a First Aid kit....good.

Having 911 on speed dial...good.

Much more than that is a waste. The Army had a requirement when I was in that all live fire ranges be supported by a medic. I can't tell you the number of wasted hours spent sitting in a cracker box waiting for someone to get shot...never happened. That time would have been better spent training. In my unit the medics got the least MOS training just because we were always at some darn range or PT test. Developing a formal action plan and hiring or designating specific personnel to handle a rare event is a waste, especially when common sense will handle the situation.

I also suggest shooting with Fire Chiefs and Search and Rescue gurus.

[Sam]