Takeaways from Training: Tactical Emergency Casualty Care

“Takeaways from Training” will be a series of occasional articles detailing some tips I’m passing on from a law enforcement training class I recently attended. Going to a day or two of training does not make me or anyone else an expert on the topic. I can’t stress enough the importance of finding training classes and going through them yourself.

This week I attended a training class put on by the Department of Homeland Security with a focus on Tactical Emergency Casualty Care. That’s a fancy way of saying emergency medical aid during active shooter and/or officer down scenarios. It’s one of the best classes I’ve been to and I highly recommend going to it if they come to your area. Here are some of the biggest things I took away from the class.

Know what resources are available to you

Most departments will supply their officers with some sort of emergency first aid kit. Hopefully the one issued to you contains more than just some band-aids. I know mine contains a tourniquet, some gauze, a pressure bandage, a chest seal, and one of those nasal things to help open up an airway with a fancy medical name that I can’t remember. Take some time and familiarize yourself with each of the items. Keep it somewhere easy to access and know where each of the items is inside of the kit.

Practice, Practice, Practice

To go along with knowing what is available to you, you should also know how to use them, especially something like a tourniquet. You can buy cheap tourniquets to practice with (though make sure to never use these in a real life scenario) and it might end up saving you or your buddy’s life in the long run. I’ll be the first to admit I probably hadn’t practiced with one but one or two times since the academy prior to this training. Know which one you have and how to use it on yourself and someone else. It might also help to know which tourniquet neighboring agencies use, just in case you run into a situation where you need to use it. There are tons of varieties, but all work in similar ways. If possible, try and familiarize yourself with different ones. Like anything else, the more you practice, the easier it will be under high stress situations.

Always have a tourniquet on you

You never know when a situation will arise where you’ll need to apply immediate aid to yourself or your partner. You might not have time to run to your car and into your first aid kit. If your agency won’t supply you an extra one, invest some money on a tourniquet to carry on your belt or vest. You (should) carry at least 2 or 3 flashlights, especially on nightshift, and the same principle can apply to these. I haven’t done so, but definitely will after taking this class.

Acronym: SCAB-E

In terms of applying aid, the acronym we were taught is SCAB-E. I’ll point out that some of the EMS guys in the class pushed back against this order, but I think it’s a pretty good system for law enforcement trying their best to provide aid while Fire/EMS stages.

S- Situation: This is pretty simple. Eliminate the threat as much as possible before applying any sort of aid. You are just going to put yourself and others in more danger trying to apply aid with bullets still flying. Take care of the threat, then focus on treating yourself or those around you.

C- Circulation: The next few steps are based on which wounds to tend to first based on how long you have before too much blood is lost. If there is a life threatening wound to an extremity such as an arm or leg, this is where you need to take care of that with a tourniquet and/or packing the wound with gauze/pressure bandage. Circulation wounds can cause the victim to bleed out in as little as 1-3 minutes, so it’s important to apply whatever pressure you can to stop that clock until more aid can be rendered.

A- Airway: After taking care of any circulation injuries, next make sure the victim’s airway is clear of any obstructions. You can roll them on their side which should help their tongue move clear, as well as any blood or fluids. If needed, here is where you can use that nasal tube to ensure that airway stays open. Airway injuries and closures can be fatal in 4-6 minutes.

B- Breathing: The last injuries to focus on are the ones that may affect breathing. These are any wounds between the belly button and shoulders. Chest seals are most effective for this. The idea is to ensure no air is entering the body through these holes and causing the victim to not be able to breathe normally. These injuries can be fatal in 10-20 minutes. Always be sure to check the back for exit wounds and apply some sort of seal to those as well.

E- Extraction/Everything else: This one is pretty self explanatory. In a perfect world you will have some help in getting that victim out at this point. There are tons of different drags and carries you can utilize for this. Find what works best for you and, again, practice it.

This is by no means all we learned in the course and I won’t pretend like I’ve explained it very well. These are just some pointers and tips I picked up on from the class. I can’t urge you enough to take this class or one similar. Learning the basics like these can be the difference between life or death between you, your partner, or a civilian when you’re the first one of scene of a mass casualty event.