The Armed EMT

“I’ve been stabbed and my guts are hanging out.” When he removed the cloth over his belly I realized he was telling the truth. Repeatedly in the security business, guards are going to be put into situations that are significant, uncomfortable and dangerous. We are placed into situations that have life threatening consequences and carry substantial liability. The best way to offset this risk and prepare is to train. 

 

My body armor is external and worn outside the uniform shirt. On my body armor is a trauma kit. These kits are essential and must be compact, complete and capable of treating life threats. The greatest preventable cause of death in trauma is bleeding. Bleeding in most cases can be stopped. Bleeding may be severe and must be addressed quickly otherwise death is certain. However, even in cases of significant bleeding, there are many things that can be done to help the victim get to a higher level of care.

 

Ultimately the goal when out in the wild is to keep the patient alive long enough to get to the hospital. In Portland Oregon, there are two main level one hospitals capable of caring for any traumatic injury. This means that good medical care is usually a short time away. 

In EMT school, it was called a critical fail. If you didn’t say it, you failed the test station. The saying is BSI / Scene Safe. BSI is short for Body Substance Isolation. In short, your ick must remain yours. I don’t want it. This means gloves, eye protection and gowns if needed. A tragic outcome to a lifesaving event is that one party contracts a communicable disease, like hepatitis c, to the other. Don’t let that happen. Your health is important and making sure that you don’t catch something awful is your responsibility. I offset this risk by carrying nitrile examination gloves on by duty belt. In many circumstances, I will hang safety glasses on my vest. Safety glasses are great for blood and contaminants, but they are also great for helping keep pepper spray out of your eyes.

Scene is safe means that until the scene is safe, you can’t treat the patient. Imagine trying to do CPR in the middle of an intersection. That can’t be done safely until traffic is stopped and blocked or until he critically ill patient is moved to a better location.  

 

Over the past few years, tourniquets have become widely accepted and carried. I can remember not that long ago when they were frowned upon. That said, they can save the life of a critically bleeding patient. 

 

Many tourniquets are well made and will do the job without failure. However, I have seen cheap knock offs break and a critical piece of equipment should always be top quality. Buy yours from a trusted source and get a good quality tourniquet.

 

One size fits most. This is also true for tourniquets. Did you know that adult tourniquets may not collapse small enough to work on children or the elderly? This comes back to knowing your equipment and what its limitations are. I personally carry two styles of tourniquets. One is capable of stopping the bleeding on a leg that is like a tree while the other is capable of a limb like a broom handle. Both scenarios are possible and carrying the proper equipment means I am more capable of treating every patient. 

 

Does your kit have gauze and a compression bandage? So much good can be done with these two simple items. They are versatile and small in size. Pack one of each in your smaller kit.

The first aid kits you have need not be a pharmacy on wheels. You still need to move. Consider how to eliminate unnecessary items like Band-Aids from your primary trauma kit. If the wound needs a Band-Aid then you likely have plenty of time to go get one. If not you can use your gauze and compression bandage. Adding additional non-life saving first aid supplies only increases the size of your kit and thus can decrease your mobility.

 

The importance of training here cannot be understated. The human body is complex and injuries are wildly unpredictable. Electrical burns, penetrating trauma like stab wounds, blunt force trauma like steering wheel in a car crash can make treating patients in the wild complex. As a security guard you must be familiar with your local laws and be trained to work within your skill set. Stick to your training and if this is an area you lack in then enroll in a class. I can tell you from personal experience that the first shooting victim I came upon breathed his last in my arms. At the time I was grossly undertrained and that was a helpless feeling. Even though there was nothing I could have done for him, I did not have the training to know that. I carried a sense of false guilt for a long time. Looking back I know I would not have been able to save that man, but I would have been able to save myself the false guilt of thinking I could have. 

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