Tactical EMS Treatment of High-Velocity Gunshot Wound

This case study is of a good friend of mine (written with his consent) who sustained a through-and-through gunshot wound from an AK47 round from a range of approximately 200m. The operator who was shot belonged to a US Government Agency, and my element and his were on a combined counter-narcotic job in Southern Afghanistan at the time.  As with any casualty in a tactical or high-threat environment the highest priorities are to control the threat situation if possible, minimise the likelihood of sustaining further casualties, or becoming a casualty yourself, and only then move on to casualty assessment and treatment. The video below demonstrates these principles in what has been coined by the Committee on Tactical Combat Casualty Care (CoTCCC) as Care Under Fire. The video is of a Reality Based Training (RBT) scenario in which an operator in the open has sustained a gunshot wound to the leg and is bleeding arterially. The responding operators assess the situation without exposing themselves to the fire-lane in which the simulated casualty has been shot. After encouraging the casualty to apply his own tourniquet and crawl to them, the responding operators use a combination of suppressing fire and smoke to suppress the threat and conceal the extraction of the casualty to a position of cover. From there a rapid assessment and treatment of only the immediately life-threatening injury is performed before further extracting the casualty to a safer locality.  
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Trauma Patient Care Source Type: news