Dealing With Gunshot Wounds

Robert and James discuss how to properly care for different kinds of wounds while out in the world. 

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Episode Transcript

Speaker 1 (00:05):
It's like a bunch of different illustrations of dictators all done.
It's like little anime chicks. So they're all hot, so
like pol Pot's this like sexy girl and a throat
of skulls. But Tito they made into a milf like
she's got all of her kids around her. It's the
only it's the only one with kids. Um. I don't
know why they picked Tito for that, but it does

(00:25):
kind of work. This Is It Could Happen Here a
podcast about which anime war criminals are hottest and it's idiomine. Actually,
the idiomine in that book is pretty pretty pretty smoking
as a like wearing black lingerie on a throne of skulls. Okay, nice,
just kissing you make it in No, no kissinger all

(00:47):
all like like world leaders. Um I would I would
argue that, but he does not make the book. No,
It's sad tragic anyway. This Is It Could Happen Here
podcast Things Falling Apart and other stuff. I'm here again
with my buddy James. James. Hi, Hi, Hi one. Which
dictator do you think would be hottest? They were like

(01:11):
gender ben Yeah, yeah, I don't know. I'd have to
go for like one of the old timey ones press,
one of the one of the one of the one
of the os. Yeah. I think Kauzar Nikki had nothing
to do but like look hot and he was a
big workout guy. Yeah, big workout, got nice to rip,
nice nice outfits, tight trousers. I think I'd probably go

(01:31):
with him. Yeah that that scans now which was hottest
as they were? Like, which is the most fuckable war criminal?
That's a tough one. I'd probably have to think about that,
I know, not a coming to mind. Actually, oddly that
Stalin pictures of fake Yeah, not not not nearly. Actually
that's sexy. Um, Joseph the Stallion, I gotta go. I

(01:55):
gotta go with Saddam Hussein. Yeah, that's true. He has
a sort of full mustache and it's good that mustache.
Fox James, we should probably talk about something that's not
which dictators are most falcable UM. Today we're going to
chat about he fat courses UH, and about emergency UM

(02:17):
and particularly like combat medicine, which is a more relevant
topic for a lot of people. In the wake of
a couple there's a mass shooting at a protest in Portland. Uh,
there's been a whole lot of threats made against LGBT people. Uh.
Jack poss O Biak launched a T shirt that was
basically threatening a mass shooting at Disney World. All sorts
of fun ship has been happening. Yeah, it does seem

(02:38):
like we're aspiringing towards the end of times. Yeah, it
certainly seems if you want to be less, you know,
apocalyptic than that. It certainly seems credible to say that
there's a pretty good chance people there are people listening
to this who have not been present at a shooting,
who will be present at a shooting at some point
in their lives. Yeah. And I think given that, it

(02:58):
doesn't make sense to like, I'm joking about the end
of times, right, Like we shouldn't panic and things. We
should think about ways we can protect each other and
keep each other safe. Yeah. So what is a he
FAT course because you recently went through. Yeah, so he
FAT is an acronym right Hostile Environment First Aid training. Um,
it's a British thing. I think that's the syllabus I
believe is standardized by the government in the UK. So

(03:19):
most of the courses you'll find are in the UK
clustered around Hereford for pretty obvious reasons, but that there
are there are a couple in the United States, and
there are some in other countries too, And it's for journalists,
aid workers and geo staff and anyone else who's working
in an environment that would be considered like high risk
or hostile and out to your point, that includes most

(03:41):
of the United States at the minute, right, Yeah, well,
I mean we are in this funds place where literally
any moment could turn into a situation with the intensity
of of a low density war zone. Yeah, I mean,
we have more weapons and than most war zones, and
also people who think it's okay to kill other people
because they like Mickey Mouse, and it does seem like it,

(04:03):
like you said, it is more likely that we will
see more shootings, even bombings and that kind of thing.
Like we can't say for sure, but yeah, now you
you have done some of the same kind of work
that that I and some other colleagues of ours have done,
you know, in in hostile environments, difficult places prior to
going through this course. Obviously, when we're talking about like

(04:26):
what sort of first aid skill should people have, the
most basic stuff is like how to apply a tourniquet,
which we'll talk about a bit more later, how to
um if it's not because tourniquets are really only for extremities,
you know, you can't really turniquet a gut wound or whatever,
and so for that it's more like packing it but outside.
So I'm going to assume you had your more than

(04:46):
your share of experience with that kind of stuff. What
did you learn new going through this course? Like, what
was the stuff that emphasized that's kind of beyond the basics? Yeah, so, um,
the stuff I've done before has been some of that
basic start the bleed stuff and then a fair amount
of wilderness medicine stuff, so some of the improvised stretches
and stuff I was familiar with. I enjoyed some of

(05:06):
the releases they did, Like I'm not talking about like
necessarily like a hand to hand combat or open hand combat,
but like ways to release yourself in a non violent fashion.
I thought that was very good. Ways to move through crowd.
I found that very interesting. And we did a lot
around how to move under fire, how to react around explosives,

(05:27):
how to react around indirect fire, and most of that
had already covered, and then some of the stuff around
hostage situations, to include a simulated a hostage situation where
you're blindfolded or hooded and sort of ask questions and
poked with a blank firing weapon. As such, I think
it's really good. You can't really have enough fix what
you can have too much experience for that, but to

(05:47):
simulate that and as realistic as setting as possible I
found was super helpful. So I think, yeah, I think
that was probably the most interesting thing for me now
when it comes to what kind of training people can get,
because the heath had courses a couple of thousand bucks,
which is beyond I know. We have some colleagues listening,
and I think it's a good thing for people who
are going to do this kind of journalism to consider,
or if you're in you know, an aid worker or

(06:08):
someth someone who is going to be going into these
situations for a living, that's but for a normal person listening,
it's probably more than you're likely to want to get
um or have the resources to get. So what what
people because because especially in the wake of shooting is
pretty much any time there's a mass shooting or violence
at a protest, I will tweet about I FAX again

(06:30):
and I FACT is an individual first aid kit. It's
what like every soldier is supposed to have on their
belt or on their plate carrier. And it generally consists
of what are called and this is when people ask
like what should I get to be ready for a
shooting UM. Generally it consists of consists of two chest seals.
These are called eclusive dressings. They're basically like kind of

(06:50):
sheets of adhesive plastic. I would say that you like
put over if you get shot in like the lungs,
you your lungs kind of depressure rise UM, and that's bad.
I'm not a I'm not a biology expert, but you're
not supposed to have a whole three year lungs UM.
And one of the things that you do to treat
that immediately is you put this kind of addressing over it,

(07:12):
which stops the lung from collapsing basically UM. So that's
one thing you'll find it an IFAC. You'll also find
what's called a combat tourniquet. There's a bunch of kinds
of tourniquets. UM. I was doing a stop the bleed course.
We'll talk more about that in a bit, but that's
the thing everyone should do, like in terms of you know,
he fat is kind of more advanced and for people
who are going to professionally put themselves in shitty situations. Um,

(07:35):
stop the bleed is for everybody. And one of the
things I was having a chat with people who were
teaching them, we were doing a little meeting, um, and
one of the things that was brought up people always
talk about, well, I wear a belt in case I
need to make a tourniquet or this or that, and
virtually never works, like close to zero percent success, right, Um,
even when it's someone who's trained and experience providing tourniquets,

(07:56):
like random ship does not make a good tourniquet. Tourniquets
make good tourniquets. Yeah, they're more that easy to carry.
They don't cheap, right, But on the same you shouldn't
cheap out on them either, right, Like we've I know
we've talked about this on Twitter, and I know, like
Amazon sales m they also had a problem with selling
fakes sort like North American Rescue I think it's called

(08:19):
emergency rescue. I'll give you something. Yeah, North American Rescue
is really good one of the so yeah, rescue essentials.
So what a combat tourniquet is, because there's different. Some
tourniquets are just like a plastic band almost almost like
if you go to a gym, those things that people
like wrap around their legs to do squats or something
or lifts. It's kind of like it looks a little

(08:40):
like that. Um and those Yeah, obviously like those can work,
but they're not nearly a combat tourniquet is. Basically it's
a little um like kind of nyloni fabric belt thing
that you strap around and you tighten it um and
velcrow it tight and then there's something called a windless,
which is basically a metal or plastic stick that you

(09:02):
then twist around. Uh, and that twisting action when you
twist it, that's going to tighten it and that's going
to stop the artery from bleeding. Um. And then you
lock it into place. There's a little place to lock it.
And so when you get a cheap tourniquet, it generally
means the windlass is made out of something flimsy or
the fabric at hearing the windlass to the belt thing
is not very good and it will break when being tightened. Yeah,

(09:24):
and you don't want what you don't want to do
is not have enough pressure, have sort of weird pressure,
because what you're going to do tomorrow, I'm not that
kind of doctor. Right, is you can cut off the
venus return and not the arterial flow, and that's what
you can give yourself compartments in direct right. I just
wanted to backtrack quickly, and we're talking about how expensive
he facts are. If people are listening and they are
in that kind of line of work. The International Women's

(09:46):
Media Foundation is doing free he FAT courses for women,
gender nonconforming, non binary people, and I gotta I got
a grant from the Rory Peck Trust to go and
do mind so for journalists. Both those are really only
for journalists, and media really encourage people to apply. Yeah, UM,
and that's that's great information because if you can, even
if like your journalism has been sort of like citizen

(10:09):
journalism where you're showing up at a protest and you know,
taking pictures or whatever, UM, give it a shot. Like
if you like, the more people who have this kind
of training, UM, as a general rule, the better. UM.
When it comes to stop the bleed, courses are generally
going to be much more available. Some of them are
operated as charities and we'll give out an I fac

(10:29):
or something at the end. Some of them have a
nominal fee. It kind of depends on where you are.
I've seen both. Portland has a lot of stop the
bleed courses, which is why when we had our most
recent mass shooting at a protest um more people didn't
die because folks had equipment and we're ready. Um, you're
you should expect to spend about thirty bucks generally on
a combat tourniquet um, sometimes twenty, but like the good

(10:53):
ones are all about thirty. Um. I would shoot for
something with a metal windless that's generally assign Again, there's
like Rescue Essentials and a couple of other brands that
are reliable. But it's called a Tactical Committee on Combat Care,
which is the government finding thing it so like if
you let them do the research so you don't have to.
They provide a list of cornic tornic case torn cats.

(11:17):
The one that most people have is that could cat
right combat application tornic. If you get that, even if
it's not the best one or the smallest lights or whatever,
every that's the one most people train with. They know
how to use and I think you've said this before, like,
even if you don't know how to use it, if
you are in a situation where it's needed and you
just say I have this, have a tornic that someone
might take it and use it. So Yeah, and it's

(11:39):
it's like, it's okay if you panic, as long as
you get that into the hands of somebody who can
use it. But it's also important if you're going to
carry it to train with it. I heard when I
posted about this recently, someone said that they and their
friends have a game where when they're like hanging out,
somebody will toss a tourniquet at someone else and say, like,
you know, right arm or something like that, right arm

(12:00):
above elbow or something like that, and they'll have to
apply the tourniquet and get it on as quickly as
they can in that place, which is a good game.
You're not going to like in twenty or thirty seconds.
Like you know, you don't have to like injure yourself
doing it, but you can you can get it on
and get familiar with the motions and build like a
competence with it. Yeah, work out when you're going to

(12:21):
last through the limb and when you're gonna take it
off and go all the way around. But I think
standardizing one thing certainly among you and your affinity group
or your friends is probably a good move. Yeah. Yeah,
And it's it's one of those things the kind of
injuries that tourniquets are most needed for our like arterial
bleeding um, which is the kind of thing that if
you don't get a tourniquet on that you're dead um

(12:45):
very quickly, Like people will bleed out in seconds, sometimes
from like a femoral Yah, you've seen an arterial bleed,
and I'm sure that I know I have. I'm sure
you have. You know that that person has an arterial
bleat I that is a pressurized gushing of blood. It's
like bright the blood arterial bleeding. It comes out in spurts,
and it is like bright. It is not it does
not look like when you cut your finger the blood

(13:07):
tends to unless you're really cutting the ship out of
that figure. Yeah. Yeah, you. And one of the things
we did at this course, which is called at You
is they had like a simulated arterial bleeds and the
person was wearing it like a camelback, and then they
had like a hose pipe and it was just gushing
out and then you could actually sinch down on it
right with the strap and that actually stopped. Now, I

(13:35):
mean when it comes to like more advanced bleeding care,
because there's some wounds where number one, if it's like,
for example, too high up in your like crotch or something,
you know, you're not necessarily going to be able to
get a cat up there. Sometimes people will literally hold
the artery closed like that is a thing that and
that is more advanced certainly, um, but it is. It

(13:55):
is also like the physics of this are very basic.
If you can figure out where blood is coming from
and close is that blood will stop coming out, right, Like,
that's the principle of all immediate wound care for that
kind of thing. Yeah, there's an acronym that you use,
right Dr March, which we can go over and danger right. So,
and I think this is the thing that often gets
forgotten actually, especially if you're doing like somebody's start to bleed,

(14:18):
which is focused on first aid rather than specifically in
kind of combat care. But if you get hurt, not
only are you useless of that person, not only are
you hurt If someone comes to help, Now they have
to think about which person they're going to help. Right,
is how much harder to carry two people than one person?
So don't do that? Uh? And then response right, so Robert,
I see you've been shot. Doesn't look great? You okay?

(14:41):
And then massive bleed, airway respiration, check head to toe
and then hypothermia and you know one of the things
that is so like a combat turner kit, you just
generally you can keep it in like a kit. It's
also fine to keep it loose in your pocket. You
are not worried about sterility when you are applying a tourniquet.
It does not matter if you get shipped in the

(15:03):
wound like because they will note they'll be dead in
a minute if you don't get the tourniquet on um anyway, right, yeah, yeah,
you're not putting it in or whatever like it. So yeah,
so that's that's one kind. And that's again you're talking
about extremities, right. You can't put a tourniquet on the
neck because that would kill the person. Um. You would
use an inclusive a lot of times on the neck,

(15:24):
especially if like the airway gets Again, this is stuff
that you would you would get in to stop the
bleed course, and I recommend people for that. So we're
not going to go over treatment outside of like these basics,
but we'll talk about like you should have an inclusive dressings.
Two is what most effects come with. People I know
who have responded to shootings say you want more like
four because they are a lot wind up getting used. Yeah,

(15:46):
I think about I think those spectly chest seals and
something that I've been told by people with a lot
more experience than me. It's like when you're dealing with
a military setting, most people have their chest covered with plates, right,
and plate carries, and a civilian setting most people want
so gonna see a lot more of these like a
sucking chest wounds or penetration of the thoracic cavity. So yeah,
and in that setting, and they are very small, right,

(16:08):
you can put them into back pocket of your skin
e geet to, no one would notice. So another kind
of thing that you'll find in an I fact that's
useful is combat gauze. So there's two types of gauze
that you'll get in kits. One is just gauze, which
you know what gauzes um most wounds if they are
not life threatening packing with gauze and wrapping is perfectly
sufficient at least for immediate care. But combat gauze is

(16:32):
impregnated with a thing called cell locks, which is our
little granules. You can actually get them, just as the powder.
You shouldn't because it's it's not going to be useful
to you as a random person. UM. You should get
it in gauze, like impregnated into gauze. But it's made
from ground up crustacean shells and it basically makes blood
clot very quickly. UM survivability of arterial wounds in combat,

(16:54):
which was extremely low before cellos jumped to something like
or so like. It's it's pretty remarkable the degree to
which it's made certain, particularly like for moorl bleeds survivable UM.
And it can be used if you've got like a
serious arterial bleed. It will often be used in conjunction
if it's on an extremity with a tourniquet UM. But
you can just use it to pack a bleeding wound.

(17:16):
And if you pack it and apply pressure, sometimes you'll
pack the combat galls into there and then add other
gals outside of it. Like. But it's it's most wounds
that are bleeding aren't going to require sellock scaus and
it's pretty expensive, but it's another really useful thing to
have if there is like an arterial bleed. Yeah, I
think actually the where we first I think Kalin might

(17:37):
be what the stuff is called. I believe it comes
from indigenous practices using it to stop bleeding. But yeah,
it comes in a small package. Quicklot is the normal brand,
And yeah, it's a lot of what we've learned about
stopping arterial bleeds has come from twenty years of war, right,
And they're obviously a lot of town sites, but yeah,
learning about how to stop those things is one of

(17:58):
the things that has got a lot better in the
last dec aid or so. That's another thing. And you
can always buy these kids pre made. A lot of
people make various premate kids. Yeah, you can google i
fac and make sure it's you know, rated, well, Dottle,
do your research. Um, we've mentioned some brands here, but
like it's not hard to find I Fax. They're they're
made constantly And it's one of those things we talked

(18:18):
on this show about being armed and whether or not
people should should have firearms, and I'm broadly supportive of
of particularly threatened people having guns. But there's downsides to
having a gun. Um, a number of them. We don't
need to get into the statistics, but there are a
bunch of downsides to being armed. There's no downside to
having an I FAC and keeping one in your car,

(18:39):
keep one in your backpack, you know. Um, there's absolutely
no way you will have a negative experience as a
result of the fact that you keep an eye fact
on you and it might save somebody's life. Yeah. I
have a little ankle holster um that I use when
I'm working in places where we wouldn't look very you know,
it would look off to have it on my belt. Uh,
And I don't want to carry backpack, maybe I need to.
It's wrapped around my ankle. And it has a tiny

(19:01):
combat dressing which you haven't really talked about Jesse Seal Tornique.
And it doesn't have the quick clot but the combat
dressing has its own goals. Yeah, we can talk about
that in a second. But like I just have like
I have a couple of effects. But also just in
all of my light jackets because you know Oregon, usually
you can wear some sort of jacket. I just have
a bunch of cats and quick clot gauze packets just

(19:23):
kind of scattered around, like there's nearly always something just
in my pocket or in the center console in my car,
um in addition to the actual packed I fax and
yeah it's handy. Um, it's just good to have around.
It never hurts to have more of that stuff, or
you have the means or you know, if you are
in a situation where something horrible has happened, right like
what happened in Portland, if you in your truck have

(19:45):
three or four of those and you can just be
to go, go go. Does anyone know how to use these?
Use these if they're in your backpack when you're at
a protest, like, you could potentially save several lives. So
if you have the means, said, give them to strangers.
Like it's not like it's not like a gun, right,
Like you can't end your life with it with quick clot. Yeah,
so yeah, I would. It's a thing that everyone should

(20:06):
feel good about having. We should note again you wouldn't
want to use quick clot on a wound that was
not serious, because there's some concept like it burns. It's
it's kind of nasty stuff in some ways, Um, it
can cause some complications for for like when the E
M T s get there, Um, it's often recommended that
you keep the packaging and give it to them. But
if it's if someone is clearly going to bleed to

(20:27):
death like that, then that then that's when you use
quick clot And if you're questioning whether or not a
wound is serious enough that someone might bleed to death
from it, assume they will. Right like air On the
side of that, if you're wondering is that a deadly bleed,
you're probably should probably treat it as if it is. Yeah,
I mean you're always better of keeping more blood inside
the person, right Yeah with that, Yeah, I've been told

(20:49):
to tape that to the person, and the same with
the torn Right, we should say that there will be
blood around. You can put a t on their forehead
with the blood. It's pretty normal and that works in
almost any language. And then you want to write the
time it was applied to and again you can do
that with the blood. But I have a half sized
sharpe that often comes in those kids. Yeah, And it's

(21:10):
one of those things like assuming it kind of is
dependent on your situation. Whether or not you'd likely to
have the time to mark that before the e m
T s arrive. But it is one of those things
even if it's even if your first responding is a
minute and a half or two minutes with a serious bleed,
that can be the difference between life and death for somebody. Yes, absolutely, yeah, yeah,
And it's different what you do when carry than coming

(21:30):
to what you do when carrey is coming. But the
first steps are not right stop the blood coming out
of the person. So we should probably talk about combat
dressings a little bit. Yeah, yeah, there are several types.
The one I've had suggested that I prefer, I think,

(21:51):
I don't know how it's pronounced. It's O l A
yes olas dressing and has a little eye cup in
it as well, which you can use for in injuries.
Like and someone more of qualified than me to teach
you how to do that. I don't need to get
into that. Yeah, but it's it's a pad with gores
in it and then a sort of ace bandage, right,
And what it does is is provides compression and obviously

(22:12):
like an absorbent goals, you can also pull the goals out.
A fun thing to do is to find an expired
one and pull all that goals out and there is
just an unfathomable amount of gores there. So you can
use that to pack a wound, and practicing packing a
wound is also something that you can do. They're like
little little bottles. Yeah. The team I know who does
stop the bleed courses will take phone rollers and cut

(22:34):
holes in them and use that as like to so
you can and you can do different sizes, right, you
can actually just like get a knife and like jam
at its stab at a bunch and like use those
as different practice wounds. Yeah, it's a good idea. Can
you pack with two fingers? You know more than that
even one finger? People can pack with one finger, So
like what this dressing does is opposite. It's sometimes they're
called is rarely bandages, olas bandages. They often come in

(22:58):
like a tan package the Israeli once. Yeah, yeah that's right. Again,
like I would buy that from a reputable source and
they come in various sizes. Emergency dressing is another name,
and yeah, those are great for things where you don't
need to use quick clot where you may not need
yees significant bleeding but not like immediately life threatening. Yeah,

(23:19):
in some area as well like sometimes in the forearm, right, Like,
it can be hard because of these bones structures to
get the tornic a to work, So like you might
be able to use that start the name might have
to use quick clot right, but like having those options
is important. And again they're pretty small, probably the cheapest
of the things we've suggested so far as well. And
again and then then they make giant ones from abdominal

(23:41):
wounds to um and so like, I actually have one
of those in my truck, have a bunch of more
stuff in my truck. I wrote a piece about the
first aid kit for your vehicle, which might ve look
slightly different, right if you imagine again, like we've talked
about shootings, but car accidents. That's that's when I the
only time I've had to use those dressings of in
car accidents. It helped pull a fucking dude out of

(24:02):
a truck that flipped on the way outside of Los
Angeles during a rainstorm. And it's like whole fucking like
right here in his hand had been gouged open where
like the it was quite a bit of blood. Um.
But yeah, like that that's a bit. It's not all
just like action movie ship like it's something you should
keep on you because there's a wide variety of things
that can cause people to bleed a lot. Yes, exactly. Yeah, yeah,

(24:24):
and I think we are we always underestimated risk of
these drivings by the most dangerous thing most people do.
And yet having that in your car, you know, you
don't have to worry so much about carrying it. It
can just always be there. Don't leave it where it's
going to bake in the sun if you're in a
hot place. But yeah, again, the potential for you saving
a stranger's life or a friend's life. Yeah, he's high. Yeah,
keep it in a center console, keep it in a trunk,

(24:46):
you know, keep it in a trunk alongside a machette
in a golf club. You know, you're always ready for
anything with that. I'm never ready for golf. But aside
from that, i'd be Oh, I wasn't saying for golfing. Yeah.
For crime, exactly. For crime. Medical actually make a read. Yes,
they make a lovely vehicle first aid kit and the
very nice people to so yeah that that's want to
look into. And they also do the bags. I have

(25:10):
a mystery runch bag that also clips onto it. Replaces
the hood or my backpack, and I have that in
my truck and then if I'm going out, especially when
I'm going out climbing, I'll just click that on and
have a slightly different kit that I take just for climbing.
But that's one of those scenarios where like, you could
hurt yourself climbing, and even if people are coming very quickly,

(25:31):
it's going to take you a while, right and thinking
another thing, I would be prepared to self rescue. That's
part of why you bring that kind of stuff. Self
rescues a massive part of climbing, right, learned learning the
lots sing the transfer of learning, the ways that you
can get yourself off of one of you hurt yourself
on the wall. And the American Alpine Club actually publishes
a thing called Accidents in North American Climbing and climb
this Okay, this person sunked up at this, and they

(25:51):
did this and this and this, and they were okay,
they weren't okay. So I think that's a very good
practice learning from other people. And with that, a big
thing that you focus on a wilderness medicine is rather
than what can I bring with me, what do I
have to already have with me, and how can I
use that? Right? So, uh, for instance, you need to
splin a leg, right you have a broken leg using

(26:12):
a sleeping pad or something which already has its redd
sleeves to do that. And that's something that like I
don't want to obviously advise people too much. Yeah, I
don't want to, like because again, so the difference this
is useful. People should be thinking about this UM when
it comes to emergency first aid, Like somebody was a
broken leg. If you're not, like, there's no real response

(26:33):
that you should like, that's not what stopped the bleed
is for right, like UM. One one of the nice
things about emergency medicine like this, like when you're talking
about someone is bleeding to death, is that one of
the ways I guess that you can you can you
can separate the two kinds of like first responding, because
there's the first responding where you can make it worse

(26:53):
and if you like, somebody like breaks a bone or
something and you can make that worse arterial. But yes,
but if somebody has an arterial bleeding, you can't make
that worse. There. It's the same thing with like UM
chest compressions right when you get trained as an e
M T. One of the things they'll point out is that, like,
you shouldn't use UM an A E D on an infant,

(27:13):
but you do because if they needed they're dead and
in that case, Yeah, I think it's important. Also in
the thing I didn't mention that I found very helpful
about this court, some of the sort of psychological aspects
of this is to remember that if you do find
yourself in this situation and you try and help and
that person dies anyway, then you did your best right
and that is of value. Like I've been in situations

(27:36):
where I've tried to help someone and they've died anyway,
and I think just remembering that, like that person hadn't
something terrible happened to them, and that your help didn't,
you know, like you tried your best to give this
that person at the chance it is not. If you
are responding to somebody who has this kind of injury,
there is a pretty good chance what you do won't matter.

(27:58):
Like it's the same thing if you are giving someone
chest compressions, that's very unlikely to save their life. Like
a fraction of the time when that happens does it
save anybody, But it can't make it worse if they're
not breathing. If they're not breathing, yeah, they're going to die. Yeah, yeah,
and I think you know, it's not like the movies
on television, and sometimes it doesn't work. It's important to

(28:19):
talk about that in the context. Yes, at much probably
much more likely the person will survive if you're doing
this stuff right, you're slapping on the torn again. You
do it right, you will stop that person, yes, yes,
and and but you know again it is a lot
of times what you might be doing is keeping them
alive long enough to get to the hospital. And you
can't guarantee anything other than that they don't bleed out
right there, right, And then maybe other injuries you haven't
seen this why we need to check head to toe

(28:40):
right and stuff like that, like especially in blast injuries.
You might not notice injuries to the back. Yeah, shrapnel
is a whole I mean, but all you can do
is like try to treat what you can see, yes, exactly,
and make sure that you don't miss anything by going
through that doctor March procedure right, which you're learning the course.
But yeah, you're having a procedure that you do where
you make check so that you don't miss something that

(29:02):
you could have stopped, because then I imagine you will
feel bad. Yeah, none of what we've said we should
probably bring this to a close should be seen as
like the end all be all, or our attempt to
give you comprehensive training on this is in no way training.
This is advice on number one, the equipment that's necessary
for stopping someone from bleeding to death, and number two
the kinds of training you should get in order to

(29:23):
use it, and you should seek training. You should find
a stop the Bleed course. You should take a wilderness
medicine course if you can. If you if you are
someone who is in a field that it's relevant for,
you should try to get a heap at course. UM, don't,
don't just like be okay, I listened to a thirty
minute podcast. I'm ready to stop a bleed. Go go
get some training. Um, but definitely get a tourniquet and

(29:45):
practice with it. You can do some training yourself. You
can find videos online by reputable people who are affiliated
with different rescue organizations talking about and showing how to
apply tourniquets, how to apply dressings. UM that that's available
and you can provide yourself with a useful amount of
education and some of the basics that way. Yeah, I

(30:07):
think just to give out some resources on how you
can get the education right to stop the league dot
org should be free almost anywhere you are and you'd
like to get more training. Most community colleges have an
e M T course that is very affordable. Yeah, a
heathat course can run you a couple grand if it's
not subsidized. The last time when I took my impute training,
it was a thousand dollars. Yeah, I think it's less

(30:28):
than that now. I know people don't have many students
who are going through MT training and it's pretty affordable
free often enduring California, it's often free. The other things
you can do are wilderness medicine that is expensive. The
American Alpine Club has grants like more and more diverse.
Group of people should apply because all of the outdoors
could do with a lot more diversity, and encourage people

(30:49):
to apply. Yes, So for all of these training there
are grants, and I would encourage more people to apply
to them. But you, yeah, you can learn a lot
for free or on line. You can and should try
and educate your friends. Like we're saying is some of
this stuff is hard to funk up. And even if
you don't feel confident, confident using stuff rescue essential with
North American Rescue Medical there's a place where you can

(31:12):
buy a pre made I fact, carry that around and
someone else can use it. And again for talking about
like the benefits of this versus the cool looking tactical
gear and guns and stuff, It's entirely possible to have
a bunch of military equipment that is worse than useless
if you don't know how to use it is actively
a danger to other people. If you have a bunch

(31:32):
of medical gear and you don't know how to use it,
but you have it on you, you can always shout
like I have a tourniquet, I have like a combat
dressing or something like does anyone know how to use it?
No one is going to make fun of you in
the make of a mass shooting for trying to hand
off your gear to someone who knows how to use it. Yeah, exactly.
And like you don't have to carry around a little
green multi camp out or something like you can get

(31:53):
a bum bag put in a fucking purse, like whatever,
It doesn't matter. Yeah, it doesn't matter at all. They
have a very small, very compact and like a bumbag
of family pack. It's very handy because you can switch
it from the back to the front get to all
your stuff. So yeah, you don't have to be all
like tactical fucking Sammy savior. Just be sensible and safe. Yeah,
even if you don't, even if you pay a neck

(32:13):
or whatever and can't be the one to use it,
you can still help save somebody's life by fucking having
the ship because it's it's irreplaceable when it's not there. Yeah,
I would just encourage people to not use to the
elastic cornic. Yes, don't go and buy Nils up stuff
because you know you can probably pay the same price
to get some that's not expired and to Yeah, just

(32:36):
be conscious buying from those reputable people. They often have sales,
especially around holidays. You can you can hold out and
wait for those. Um. There are pretty good resources on
Reddit as well. Actually, there's a Tactical Medicine subreddit where
people will sort of list their kits and often posted
as a sale. So sometime's worth cruising that if this
is something, Yeah, do some research. Um, you may find

(32:56):
right now, especially from places like rescue Essentials. It is
harder to get combat tourniquets because the war in Ukraine
has caused a shortage of the good ones. But you
can still find them. You just may need to search
around a little bit. Yeah. What I found was that
because you've posted about this after New York shooting, was
that they were out of the straight tornicut that they

(33:16):
were not out. They wanted to go with the pouch.
Pouch you cost like six or eight dollars. I know
that that that's more of an expense, but if you can,
if you can afford that, then getting that's not a
bad idea anyway, because that you can put on your belt,
put it and have one of my backpack but hiking, right,
So that's definitely something that Yeah, all right, well that's
gonna do it for this episode, James, you want to
plug anything. Um anarchism? Oh good, yes, absolutely, um yeah,

(33:41):
go uh to find a hierarchy and like throw a
rock at it. Yeah, just look after other people and
don't resort to the state to do it. Be kind
to each other and uh, get getting MP training if
you can. It could happen here as a production of

(34:01):
cool Zone Media. For more podcasts from cool Zone Media,
visit our website cool zone media dot com, or check
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or wherever you listen to podcasts, you can find sources
for It could happen here, updated monthly at cool zone
media dot com slash sources. Thanks for listening.