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Post subject: Range First Aid
Post Posted: Mon May 10, 2010 9:18 pm
Range First Aid


First Aid in general much less at the range seems to be a very overlooked aspect in everyday life. We have become dependant on outside assistance in our everyday lives that we go about with the mindset of "I can always call for help" and while that is true to some degree I still feel it is important for us to be able to provide adequate and proper first aid for ourselves, our family and our friends because we never know when that call for help comes and you are the only help around. That being said I went to a fellow shooter who just happens to be a very experienced medical Doctor and asked him if he would provide me with an "article" on First Aid so that I could pass the information on.

Below is the information that Doc sent to me so please take the time to read and understand the information he has provided us just so we can be prepared if that time ever comes. I have lost count of the times I have been to the range and have seen people without even a band-aide. To me that is uncalled for being we spend THOUSANDS of dollars on rifle, scope, ammo, etc but do not take the time to spend a few $20 bills and get a first aid kit to go along with the "shooting" gear.

Well here is the information:

First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. It is also advised to be prepared for illness while traveling locally or to a foreign country. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.

It is very important for you to get immediate treatment for every injury, regardless how small you may think it is. Many cases have been reported where a small unimportant injury, such as a splinter wound or a puncture wound, quickly led to an infection, threatening the health and limb of the employee. Even the smallest scratch is large enough for dangerous germs to enter, and in large bruises or deep cuts, germs come in millions.

In giving and receiving first aid make sure everyone follows ?Universal Precautions? against the spread of HIV and Hepatitis. Be sure to wear protective gloves and use barriers as appropriate. Wash your hands well before and after giving first aid if possible. And remember that serious injuries may require surgery so don?t give the victim anything to eat or drink unless treating heat injuries.

Since we are addressing first aid in conjunction with firearms I will address the most common first aid scenarios I have encountered at the range.

Eye Injury: One of the most common mistakes I see on the range is lack of eye protection. Eye injuries can range from some dirt or debris in the eye to a puncture of the globe by shrapnel from an explosion or shooting. Debris or dirt in the eye is treated by flushing with water. More serious injuries are treated by covering both eyes, being careful not to place pressure on the eye. If the eye is impaled, a coffee cup with a hole poked into it can be taped over the eye with the impaling object covered over to keep it from being manipulated.

Burn Injury: The next most common injury I have seen at the range is burns. They can range from a simple mild sunburn to extensive flash burns from ammunition or burns from a hot barrel or silencer. There are many different types of burns. They can be thermal burns, chemical burns, electrical burns or contact burns. Each of the burns can occur in a different way, but treatment for them is very similar. For thermal, chemical or contact burns, the first step is to run cold water over the burn for a minimum of 30 minutes. If the burn is small enough, keep it completely under water. Flushing the burn takes priority over calling for help. Flush the burn FIRST. If the victim's clothing is stuck to the burn, don't try to remove it. Remove clothing that is not stuck to the burn by cutting or tearing it. Cover the burn with a clean, cotton material. If you do not have clean, cotton material, do not cover the burn with anything. Do not scrub the burn and do not apply any soap, ointment, or home remedies. Also, don't offer the burn victim anything to drink or eat, but keep the victim covered with a blanket to maintain a normal body temperature until medical help arrives. If the victim has received an electrical burn, the treatment is a little different. Don't touch a victim who has been in contact with electricity unless you are clear of the power source. If the victim is still in contact with the power source, electricity will travel through the victim's body and electrify you when you reach to touch. Once the victim is clear of the power source, your priority is to check for any airway obstruction, and to check breathing and circulation. Administer CPR if necessary. Once the victim is stable, begin to run cold water over the burns for a minimum of 30 minutes. Don't move the victim and don't scrub the burns or apply any soap, ointment, or home remedies. After flushing the burn, apply a clean, cotton cloth to the burn. If cotton is not available, don't use anything. Keep the victim warm and still and try to maintain a normal body temperature until medical help arrives.

Injury Causing Bleeding: Bleeding is the most visible result of an injury. At the range these are commonly small cuts or scrapes. But there may be punctures from gunshot, shrapnel or serious cuts from falls or improper use of a knife. Each of us has between five and six quarts of blood in our body. Most people can lose a small amount of blood with no problem, but if a quart or more is quickly lost, it could lead to shock and/or death. One of the best ways to treat bleeding is to place a clean cloth on the wound and apply pressure with the palm of your hand until the bleeding stops. You should also elevate the wound above the victim's heart, if possible, to slow down the bleeding at the wound site. Once the bleeding stops, do not try to remove the cloth that is against the open wound as it could disturb the blood clotting and restart the bleeding. If the bleeding is very serious, apply pressure to the nearest major pressure point, located either on the inside of the upper arm between the shoulder and elbow, or in the groin area where the leg joins the body. Direct pressure is better than a pressure point or a tourniquet because direct pressure stops blood circulation only at the wound. Only use the pressure points if elevation and direct pressure haven't controlled the bleeding. Never use a tourniquet (a device, such as a bandage twisted tight with a stick, to control the flow of blood) except in response to an extreme emergency, such as a severed arm or leg or gunshot to a major vein or artery. Tourniquets can damage nerves and blood vessels and can cause the victim to lose an arm or leg. Remember to clean superficial cuts and wounds well and bandage promptly to prevent infection.

Shock: Can threaten the life of the victim of an injury if it is not treated quickly. Even if the injury doesn't directly cause death, the victim can go into shock and die. Shock occurs when the body's important functions are threatened by not getting enough blood or when the major organs and tissues don't receive enough oxygen. Some of the symptoms of shock are a pale or bluish skin color that is cold to the touch, vomiting, dull and sunken eyes, and unusual thirst. Shock requires medical treatment to be reversed, so all you can do is prevent it from getting worse. You can maintain an open airway for breathing, control any obvious bleeding and elevate the legs about 12 inches unless an injury makes it impossible. You can also prevent the loss of body heat by covering the victim (over and under) with blankets. Don't give the victim anything to eat or drink because this may cause vomiting. Generally, keep the victim lying flat on the back. A victim who is unconscious or bleeding from the mouth should lie on one side so breathing is easier. Stay with the victim until medical help arrives.

Choking: Ask the victim to cough, speak, or breathe. If the victim can do none of these things, stand behind the victim and locate the bottom rib with your hand. Move your hand across the abdomen to the area above the navel then make a fist and place your thumb side on the stomach. Place your other hand over your fist and press into the victim's stomach with a quick upward thrust until the food is dislodged.

Heat Injury: Heat exhaustion and heat stroke are two different things, although they are commonly confused as the same condition. Heat exhaustion can occur anywhere there is poor air circulation, such as around an open furnace or heavy machinery, or even if the person is poorly adjusted to very warm temperatures. The body reacts by increasing the heart rate and strengthening blood circulation. Simple heat exhaustion can occur due to loss of body fluids and salts. The symptoms are usually excessive fatigue, dizziness and disorientation, normal skin temperature but a damp and clammy feeling. To treat heat exhaustion, move to the victim to a cool spot and encourage drinking of cool water and rest. Heat stroke is much more serious and occurs when the body's sweat glands have shut down. Some symptoms of heat stroke are mental confusion, collapse, unconsciousness, fever with dry, mottled skin. A heat stroke victim will die quickly, so don't wait for medical help to arrive--assist immediately. The first thing you can do is move the victim to a cool place out of the sun and begin pouring cool water over the victim. Fan the victim to provide good air circulation until medical help arrives.

First Aid Kit: In order to administer effective first aid, it is important to maintain adequate supplies in each first aid kit. First aid kits can be purchased commercially already stocked with the necessary supplies, or one can be made by including the following items: Adhesive bandages: available in a large range of sizes for minor cuts, abrasions and puncture wounds Butterfly closures: these hold wound edges firmly together. Rolled gauze: these allow freedom of movement and are recommended for securing the dressing and/or pads. These are especially good for hard-to-bandage wounds. Nonstick Sterile Pads: these are soft, super absorbent pads that provide a good environment for wound healing. These are recommended for bleeding and draining wounds, burns, infections. First Aid Tapes: Various types of tapes should be included in each kit. These include adhesive, which is waterproof and extra strong for times when rigid strapping is needed; clear, which stretches with the body's movement, good for visible wounds; cloth, recommended for most first aid taping needs, including taping heavy dressings (less irritating than adhesive); and paper, which is recommended for sensitive skin and is used for light and frequently changed dressings. Items that also can be included in each kit are tweezers, first aid cream, thermometer, an analgesic and an ice pack.

Reproduced with permission of http://www.longrangeresearchinstitute.com/
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Post subject: Re: Range First Aid
Post Posted: Mon May 10, 2010 10:30 pm
Very good article. Would it be possible for the BFA to look into putting together a nice little kit that would be available at the BFA store for purchase? I know you can purchase one at your local box store but it might be a nice item with our logo onit to have in our range bag. Just a thought. Maybe little first aid cards or a booklet to have in your wallet or bag? I guess you could even print this article out and keep it in your bag.

Jr.....Out

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Post subject: Re: Range First Aid
Post Posted: Sun Jun 20, 2010 5:08 pm
jrohio wrote:
Very good article. Would it be possible for the BFA to look into putting together a nice little kit that would be available at the BFA store for purchase? I know you can purchase one at your local box store but it might be a nice item with our logo onit to have in our range bag. Just a thought. Maybe little first aid cards or a booklet to have in your wallet or bag? I guess you could even print this article out and keep it in your bag.


I am working on starting my own line of safety items to deal with medical and disaster situations. It may take me awhile but I will see if I can't get something together. Once I figure it out I will get with BFA leadership. Good Idea! :idea:

Interested in C.E.R.T? PM me
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Post subject: Re: Range First Aid
Post Posted: Mon Jun 21, 2010 4:59 am
We don't have many problems that need first aid, but do see a few a year.

1. Burns from hot cases when people did not listen to the standard "T-shirt or other high necked shirt and a billed cap or visor" suggestion for wear on the range. Mostly chest hits for women, or getting caught behind the glasses. Both of those covered if they had listened to the standard range wear warnings. Had one go down a buttoned jacket sleeve, not sure how to prevent that.

2. Slide cuts in the thumb when people won't listen and "cross over" with their thumb and get cut with a slide during firing. I always thought that one cut (like one case of M1 thumb) would teach anyone, but we actually had a guy that did it once, got a band aid for it and turned around and did it again, and got the second band aid. He did not do it a third time, so I guess he learned, but I was wondering for a while whether we should certify him or not!

Mostly we just make sure we have band aids, never really wanted to be though of as "prescribing" by providing triple antibiotic ointment, mercurochrome or burn creme.

Much more than that and we will use the cell phone and let the professionals (actually volunteers, but well trained ones at the local FD) take care of it.

What do the rest of you do.?

Buckshot

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Post subject: Re: Range First Aid
Post Posted: Sun Aug 08, 2010 9:42 pm
Quote:
What do the rest of you do.?


Make 'em sign release forms. :lol:

Somebody got slide bite today from thier new Ruger LCP. Wasn't bad, too far from the heart.

Joel
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Post subject: Re: Range First Aid
Post Posted: Sun Mar 03, 2013 8:51 pm
I don't want to belittle anything the original post has to say. There is great information in there. However, you should focus on saving life. If you consider RANGE FIRST AID, then the rules are the same as the rules of the battlefield. Keep it simple and save a life:


Range First Aid falls into two categories:

Blow out or Boo-Boo.

The decision can be made quickly upon seeing the injury pattern. A bullet in a body is generally a blow out. You need a blow out kit and you need to know how to use it.

A blow out kit will address the three killers in field trauma. Field trauma is GUNSHOT WOUNDS for all intents and purposes. If you read any of the Tactical Combat Casualty Care guidelines (THE authority on which all current battlefield trauma protocols is based) you will find that the vast majority of preventable battle field death is due to hemorrage from a limb. Then Tension Pneumothorax, then airway problems.

You don't have to be a paramedic to stop the bleeding, start the breathing. That is what the Individual First Aid Kit or IFAK is for. It should have at the MINIMUM, a tourniquet, (Either a CAT or Soft T) packing gauze and occlusive chest seal.

You SHOULD know how to use the gear. (Tourniquets are no longer the "boogey man" they once were. We know that tourniquets save lives. Stopping bleeding is no longer a secondary concern. It is a primary concern especially in gunshot injuries. Current tourniquet times have exceeded 6 hours without loss of function from the battlefield. Tourniquets are many times first line treatments any more. (See TCCC recommendations.)

I shared this post regarding the Dark Angel Medical Course I took last month.

Weather we shoot recreationally or train to defend ourselves, this hobby carries inherent risk. That risk is ventilation of ourselves or someone else on the range, in the home, in a gun fight. Have you ever stopped to consider what you would do in the event of catastrophic injury?

We know from studying the battlefield that the preventable deaths occur from:

1) Bleeding out from a limb injury
2) Tension Pneumothorax
3) Airway obstruction

A typical first aid class can miss the vital interventions that can mean the difference between life and death in trauma. If you carry a gun, you MUST be familiar with the tools and techniques that are can save lives. It's folly to think that you can prevail in a gun fight without getting wounded. (As it applies to a range setting, an errant shot should be an embarrassing learning experience and not a deadly one.)

We spend hundreds of dollars on a carry gun, ammo, holster, and training. I recommend you spend $160 to get yourself a GOOD kit that has the tools you need in the event of the unthinkable.

The kit that I've decided to carry is from Dark Angel Medical. It's a no-nonsense pack. It holds a pair of gloves, chest seals, quick clot gauze, plain packing gauze, nasal airway, trauma shears, and a CAT Tourniquet.

Buy the kit, then learn how to use it:

Youtube CAT Torniquet Video:
http://www.youtube.com/watch?feature=player_embedded&v=3-WnRUi5UZI

Youtube Halo Chest Seal
http://www.youtube.com/watch?feature=player_embedded&v=ZcKpOI_3KR0

Youtube Quick Clot Packing Gauze
http://www.youtube.com/watch?feature=player_embedded&v=Cj4gSDivxt0

Take a class. Dark Angel Medical does a fantastic job with this stuff. Professional, friendly, and based in evidence based medical practice, everything Kerry Davis teaches is the good stuff.

The biggest take home point is this: Keep the life saving gear where you can get to it NOW. Leave the boo-boo stuff in your big kit in the car/home. Eye injuries, hypothermia, shock, burns, etc are all important to know what to do, but saving lives on the range due to TRAUMA of a bullet wound is simple. It requires a simple but specialized kit. Get one, carry it, learn how to use it.

I will be doing a Shooter casualty class as part of the course offering at Adaptive Defense Concepts in NW Ohio as well. Stay tuned for that. ADAPTIVE DEFENSE CONCEPTS

I am a SWAT Doctor for a regional Tactical Team. I am a former Navy Physician, and currently an Emergency Department Physician. I am an NRA Certified Instructor. My kit is the D.A.R.K from Dark Angel Medical, LLC.

First aid for workplace bumps and bruises is important too, and little things like band aids and bandages go a long way. Maybe some burn cream, antiseptic like peroxide or betadine, or even motrin or tylenol is nice to have. A few band aids, some gauze, some kerlex, and tape is good to have. Saline solution for eye wash is also a plus.

I like having redundant stuff in my kit. I like to have maxi pads. Not only can you put them on pretty sizeable cuts and scrapes, but you never know when someone may need one for what they're designed for. Duct tape is awesome to have. I prefer Gorilla Tape. It seems to last longer. You can use duct tape to hold on gauze and to hold on chest seals.

Consider some multi purpose bandages: Israeli Bandages and/or Olaes Bandages from Tactical Medical Solutions are good ones to look into. The Olaes are a bit bigger, but for a range kit or car kit are pretty good to have.

Here is the video for the Olaes:
http://www.youtube.com/watch?v=om_xyrA4ClA


First aid truly is a custom needs type deal. If you have any injuries you usually see, I would be happy to tell you what gear I would use to treat that in the field. (If you think that would help.)

Thanks for reading.

RJ
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