Ballistic First Aid International Association of （弹道急救国际协会）.pdf

Ballistic First Aid Pre-First Response James M. Berry, MD Professor, Dept of Anesthesiology Vanderbilt University Nashville Tennessee Disclaimer Co-founder and research director of Tactical Medicine, LLC Nashville TN The opinions expressed here do not reflect those of the US DOD or any other federal agency Statement of Problem Penetrating trauma is both common and deadly 30K fatal - 70K nonfatal (firearms only) annually Some injuries are potentially lethal within minutes Trained paramedical professionals are limited: In numbers In training In access Both civilians and LE are vulnerable Real-world Example Active shooter, Newtown school 20 child, 6 adult fatalities 154 rounds of .223 in ~5 min LE entry at 14 min EMS/medevac delayed for sweep/clearance Penetrating Trauma Knife Firearm Handgun Rifle Immediate mortality highly variable US Military Approach Extensive experience in penetrating trauma Tactical Combat Casualty Care (TCCC) – US SOCOM 1996 Significant reduction in preventable death Injuries of Concern Extremity bleeding Chest injury Abdominal injury Airway obstruction Critical Assumptions Immediate response to injury Individually-carried supplies (IFAK) Medic available for additional (field) care Medevac to definitive care within an hour Individual First Aid Kit (IFAK) Tourniquet Pressure dressing Hemostatic gauze Chest seal Nasal airway Gloves TCCC Phases Care under fire (CUF) Tactical field care (TFC) Tactical evacuation care (TEC) Care Under Fire - basics •Take cover – self-assess •Win the fight •Observe for casualties •Encourage self-aid •Tourniquet high and tight if needed •Do NOT attempt rescue One Essential Tool