June 23, 2015 at 6:28 pm #18674texasfredericbastiatParticipant
Just got finished re-reading the CUTT article that goes into depth about 4 teams, each with a designated ‘Team Medic’. The main guy would be the ‘SQUAD MEDIC’. Hopefully this person has EMT training, or was a 68W, or SF medic, or similar.
My question is – what all would this person be carrying, in addition to their regular patrolling gear? The squad medic from HQ team would probably have more than the 4-man team medics, otherwise 4 out of 16 will be burdened by huge medical add-on loads…
Assumptions: Everyone on the team has a SOP IFAK/blow out kit on their person. (Ideally with two CAT or SOFTW tourniquets ready access up front, and IFAK in standard location(s) clearly marked). AND everyone takes care of themselves with wet wipes for general body cleaning and pooping, alcohol gel or soap for washing hands/food containers, and foot powder for footcare.
My attempt to answer this question is below:
please edit it and refine it so i can learn and use the information
a quote from DuaneH from another post dealing with this article:
“1. Training trumps gear.
2. Mission drives the equipment.”
Most likely needs for ‘medical related gear’:
A – hygiene and sanitation
B – footcare
C- Gunshot wounds –
D – Casualty evacuation
E – Wilderness first aid
F – Medicine – pharmaceuticals or other
G – Advanced procedures
Potential Lists for the above –
A – Quality water filter – such as a first need Elite XLE., plus camp soap. It would be best if everyone on the team had some form of water purification just in case, as well as a smaller bottle of campsoap. But it might be smarter to have one guy designated to carry the big fancy water filter, and a bigger bottle of soap.
B- Everyone would probably have their own tub of corn starch or other foot powder, as well as some moleskin, and take care of their feet. Should the medic need to get involved, it might be a good thing for him to have benzoin swabs and larger amounts of moleskin, as well as a set of toenail clippers
C- IFAK with NPA, Pressure dressing, 2x occlusive dressing, compressed gauze, tape, gloves, a 14 ga 3.5 inch decompression needle and additional petrolatum gauze. Perhaps the team medic carries some additional pressure dressings, gauze, and a set of shears, and maybe a larger abdominal dressing/big OLAES bandage
E- Wilderness first aid is the non tactical – sprains, breaks, cuts, etc- cravats, ace wraps, coban, sam splints, rolls of athletic tape, mylar blankets, bandaids, butterfly closures/steri strips, burn gel, etc
F- I have no clue on this arena, other than what some random list on articles like the grid down med have, or what ready to go kits from chinook or other have setup. Pain meds, poop meds, rehydration meds, cough meds. Since I’m a prepper i have studied herbalism more than pharmaceuticals, specifically wildcrafting local species to use for various ailments. So far I’ve been really impressed with their performance, especially with allergies, virus control, and cough/colds.
G – Advanced stuff – like Endotracheal intubation, Cricothyrotomy kit, Bag valve mask, portable suction, IV bolus and start kits, surgery kit, suture kits, etc. Stuff the average person wouldnt be qualified or successful with. This would definitely be in the hands of the Squad medic
Who carries what?
– SQUAD medic carries B, E, D, F and G: special footcare, the nicest litter of the bunch, the majority of wilderness first aid/general first aid, Rx and pills for the squad, and any advanced tools and kits. The squad medic’s entire ruck would be medical focused, with whatever space remains for his sleep kit. [Edited – as Diz mentioned, the heavy stuff like a SKED or cheaper litter could be passed off to another person to carry for the squad medic.]
– Team Medics carry A, C, D, and maybe some E: fancy/big team water purifier/filter (wouldnt have to be carried by each team medic, but I wanted to bring that topic up under hygiene and sanitation), an extra supplemented IFAK, an MVT lite litter or similar, and possibly a boo-boo kit with bandages, steri-strips, an ace wrap, and a few cravats.
This load would be a manageable add on of three bags – fancy water filter (takes up 1L of space), supplemented IFAK (at least 1L, probably 2L in size), and MVT litelitter (also seems to be about 1L in size). So 4Lish of space (using nalgenes as my correlary for 1L of space in a pack)
This would allow the 4 man team medics to respond to minor sprains, booboos, etc, as well as gunshot casualties when the squad medic might be off somewhere else tending to others, without using up their own IFAK contents, and be able to get a litter system for the teams to move a casualty. [EDITED] Not every ‘team medic’ has to have a litter. Perhaps one has a SKED/deer sleigh type litter, and another has a MVT litelitter.
[EDITED] Alternatively – the 4 team medics might only carry a minimal extra medical load such as some cravats and ace wraps, or carry crap for the squad medic (like the heavy litter), and then merely be the designated guy to go render aid to whoever’s down, using the casualty’s IFAK.
thoughts? looking forward to feedback –
thanksJune 23, 2015 at 7:51 pm #18684MaxKeymaster
Chinooks is expensive and you can usually assemble a kit for much less by buying it in individual pieces.
I have no affiliation with the links posted, they are just to show examples of what I am talking about.
Tincture of benzoin. http://www.amazon.com/Compound-Benzoin-Tincture-U-S-P-Swabsticks/dp/B002GXAZO0
When a person is diaphoretic, clammy, or bloody, bandages often won’t stick to the skin. The benzoin will provide for a dry area for the bandage to stick. An example is trying to get a tegaderm dressing to adhere to the skin after starting an IV on someone with an aforementioned condition.
3″ wide foam tape is great for securing dressings to the chest. Carry a few disposable razors to remove hair.
You mentioned NPA, remember to carry individual packets (or a tube of surgical lube) to aid in the insertion of the NPA. Also I didn’t see where you mentioned an oral airway. It would be a good idea to have a set or two of these. You can use them in conjunction with the NPA (nasal airway).
A few small bottles of betadine are also handy for cleaning wounds or prepping a surgical site.
4×4 cotton gauze bandages, sterile and non-sterile.
Skin Stapler http://www.amazon.com/s/?ie=UTF8&keywords=sterile+skin+stapler&tag=googhydr-20&index=aps&hvadid=31601420797&hvpos=1t1&hvexid=&hvnetw=g&hvrand=2358638756232637518&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_4l5iusuqft_b
and a staple remover.
3M is one of the better manufacturers of this product IMHO, however I have found other brands in our local feed store that are camouflaged color vs. tan, pink, white, etc..
Most importantly,get training. Enroll in an EMT program at a community college, take any number of the first aid and wilderness medicine classes found on the internet.
PM me with any questions, I don’t / won’t pretend to know everything. If I don’t know the answer I’ll find out what the answer is (gives me an opportunity to learn as well).
This November will make 9 years as an RN, 8 of that mostly in level 1 & 2 ER’s.June 24, 2015 at 7:20 am #18691DiznNCParticipant
Also, instead of extra water/ammo, it would make sense if the medic carried only his “aid” bag in lieu of a “standard” assault pack. Depending on how much he carries, his gear might also have to be cross-loaded amongst the other guys.
The point is he only needs enough gear to get back to “definitive” care, wherever that may be. So a long range recce patrol would be different from a standard short-range area domination patrol.
Also consider casevac procedures. Perhaps quad runners or something similar on call, just behind the battle area, like in “Patriot Dawn”.
If you can keep the distance/time down, then the medic doesn’t need to carry quite as much stuff. If not, then perhaps you tie in with the locals?
It would seem to me that most of what you listed under wilderness medicine would be more appropriate for base camp, rather than each medic schlepping it around on patrol. If a guy gets to that level of treatment, then he needs to be evac’d back to base camp.
If I was the medic, I would make sure these clowns carried as much of their own shit as possible, like full pill kits and such. He should only have truly emergency stuff like SAM splints, larger wound compresses and maybe a “big bag” of IV fluid. Hell, even someone else could carry the field litter. Want to keep doc happy!
CTT 1505, NODF 1505, CP 1503, LN 1, RC II, RiflemanJune 24, 2015 at 7:38 pm #18702DuaneHParticipant
This posting I am writing is more about philosophy behind what I actually carry. So I’ll start with some underlying principles.
1. Training trumps gear.
2. Mission drives the gear.
3. Training will help answer what gear you need.
Obviously everyone in your team needs to be trained in TC3. It’s not rocket science. They used to teach it to the boyscouts before the Rangers said that’s a good idea. This is the bare minimum. The designated medic should have more training. If it is a lay person starting out as the medic, then that person should start off with TC3, CPR, Basic First aid, and more advanced classes like wilderness first aid. Ideally the individual will have had some other training like EMT, medic or better (preferably with hands on experience). Even a nurse’s aide with a 6 wk OTJ training that works in the ER is GTG.
In the Army the medic functions as part of the squad or platoon, but they typically are not the lead man and frequently held back from the tip of the spear as they are a valuable asset. In a CUTT situation, you may not have this option so make sure everyone is cross-trained.
What gear should the medic carry? Well I can’t answer that directly. It really depends on the mission. You will need more gear for a 5 day LRRP than you would a 6 hr patrol of your AO, but you still can’t carry a hospital so you will need to keep it as light as possible.
Obviously each individual should be carrying an IFAK. One thing many people forget is a boo-boo kit. I can’t tell you how many times I have been woken up at 0200 by some PV2 wanting a bandaid. A small cut left untreated can kill you sometimes. Aside from the IFAK and the boo boo kit, each individual should be carrying their own personal sustainment kit. This could be anything from baby powder to medications. You don’t want to have a team in the woods all of the sudden get the shits and the medic only has 4 doses of pepto. What gear goes into the sustainment will depend on how long you are out there away from the golden conex and the needs of the people and the area you are operating in. Hydrocortisone cream is worth it’s weight in gold in the humid swamps of South Carolina in the summertime. It relieves insect bites and more importantly chafing. Antibiotics are needed by everyone.
Aside from IFAK, boo boo kit and personal sustainment supplies, you may want to consider each individual carrying some of the consumables like gauze or IV solutions. It’s easier to have 5 guys each carrying a 500 ml bag of LR than the medic carrying 6 pounds of IV solution.
Things that the medic would carry would be the things that the medic would use (or in some cases be the only one that knows how to use them). Litter, IV needles, IV meds, advance airway, surgical tools and the like.
In a CUTT situation it probably would be better not to over specialize the medic too much. You don’t want 80% of your class viii material on one person that gets shot; however, the larger your team, the less likely the medic will have to be at the tip of the spear (hopefully).
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TEAM COYOTE!June 25, 2015 at 7:11 am #18714DiznNCParticipant
I think DH is pretty much our resident guru on this stuff. I also think he’s on the right track here. The mission will drive the gear.
The mindset in the military is you’re the outsider, traveling through strange lands, and so need to have all this shit. For us, or the guerilla in general, this should be reversed. Hopefully, you have the goodwill of the surrounding people to depend on. So you should be able to get your people to help, within your AO, rather than thinking in terms of evac’ing them out. It’s 180 out from how we have been trained.
How does this affect what we carry? Well, as Duane said, we need to think in terms of keeping it as light as possible, carrying only what we need to get that guy to the nearest care facility, which in our case, will probably be that farmhouse with the RN.
This goes to the “battlespace prep” as they say today.
CTT 1505, NODF 1505, CP 1503, LN 1, RC II, RiflemanJune 26, 2015 at 9:55 am #18747texasfredericbastiatParticipant
agreed – thanks for your replies, guys.
Training is definitely a must, and mission defines what you need to have with you.
That makes sense about having each guy carry a little bit of ‘boo boo kits’ for the small stuff an small supplies of pills, instead of relying on bothering the medic every 5 minutes.
If every fire team has a ‘designated guy who will go help with medical stuff’, and perhaps carries a bit of extra gear matching his training ability it will all work out. Now, to find a medic to get on the team…
… and to go enroll in some more advanced medical classes…
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