As docs, all of us spend a lot of time training people how to do this basic medical stuff themselves. We do this for several reasons.
First, remember Combat Medicine Axiom #1: We may be busy looking for work and pulling triggers.
Second, you guys are gonna have to do your best to stay in the fight, so do as much as you can on your own.
Finally, the current conflicts have shown that in some cases docs are the first ones the bad guys aim for.
If you are the main med guy, don’t advertise it.
Since 85% or more of preventable deaths on the battlefield are due to hemorrhage you absolutely must know how to stop bleeding (knowledge and skill, not just gear).
Every drop of blood you keep in your body equals time. The faster you lose blood, the sooner you die. You need to buy time by stopping the bleeding.
The best treatment for bleeding is direct pressure on the wound. The best direct pressure is focused pressure on the blood vessel that is leaking. As a student, my finger was frequently scrubbed into the operating field while the surgeon got ready to sew.
Your gloved palm or fist jammed in the wound is a good place to start. Just be aware your casualty may try to kick your ass or shoot you if you cause them pain.
If you follow AXIOM #1, it may be your knee in your buddies wound while you return fire. Get creative at combining fire superiority with well-timed medicine.
Once you get to cover (get off the X), pack the wound full of gauze. Use a hemostatic gauze if you can get it (future post) and apply a pressure dressing (future post) or a wound seal (future post) to maintain that pressure. The pressure dressing frees up your hands to look for work.
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As far as which hemostatic agent to choose, stick to the gauze type, either roll or z-folded, and make sure you have at least enough to cover the base of the wound. Most come in 1 yard or 4 yard long strips.
Most US troops carry either Combat Gauze from Z-medica or Chitogauze from HemCon.
Allied teams often have these or Celox. From a comparative standpoint they are all roughly the same. Just stay away from powders and gels since they may not be the latest generation products. Just keep in mind that most SOF medical innovation is happening at the system and hospital levels. For the average Joe the best first aid hasn’t significantly changed since Napoleon’s day.
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