Forum Posts

SOARescue
Feb 26, 2018
In Kit & Equipment
So... This is one of the most impressive truck bed storage systems we've seen. There have been a plethora of traditionally designed systems that are insanely expensive and well flat heavy. The Decked system has disrupted the bed storage system. The engineering that has gone into this system is impressive! They have taken HDPE and molded it with a steel subframe to make a pretty darn stout system. This design was incredibly easy to put together. The system came in a single box on a pallet. Which was not an issue for us, but just ensure if you order one that there is adequate room to get the system delivered. When it came to the install the system was incredibly easy to put together, and the instructions very clearly say to utilize hand tools, no impact drivers or otherwise. Watching the videos on the website were of benefit and clarify some of the instructions. All in all it took approximately 1.5 hours to put together. The System Installed The System Installed With Drawers Open This system has incredible implications for the public safety setting. While the set up above is simply a starting point, we have began to look at all of its uses and so far has been a win. The drawers each have a 200 lb weight rating, and the platform has a 1 ton rating, both of which are incredible! Check out more at decked.com
Decked Truck Bed Storage System content media
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SOARescue
Feb 11, 2018
In Kit & Equipment
Without a doubt CRO has continually put out incredibly well thought out and well made gear. We just had the opportunity to put the new IFAK to the test, and this is a little bit of what we thought! First the delivery. CRO shipped the package quick, and the entire ordering process was painless. We got it incredibly quickly, but part of that is due to us being in the same state. On to the kit itself. The kit comes ready for you to set up how YOU want it. Now this is a shift from the traditional IFAKs available, and may leave some people wondering what to do. The laser cut panel on the inside comes with shock cord allowing you to weave the cord, and fit the items you wish. The pouch itself is made incredibly well. The pouch is and belt is all American made, with fantastic materials and YKK zippers. The IFAK is meant to be worn independently of a battle belt or like. Even though it is meant to be worn separate, there is still real Austria Alpin hardware on the belt. This adds to the obvious thought that went into construction. So there are a million and one ways to set this kit up but initially we set up the kit with the following contents. Hemorrhage: 2x CAT Tourniquet 1x Pressure Dressing 1X XGauze 1x Cravat Airway: 1x 28Fr NPA 1xCurved Kelly Forceps 1x 7.0cm ETT 1x 10cc Syringe Breathing: 2x HALO Chest Seal 2x ARS 14g Chest Decompression Needle Circulation: 1x NAR Saline Lock Kit Admin: 1x Roll of Tape 2x Sharpie 1x IR Chemlight 1x Green Chemlight 1x Eye Shield 1x Trauma Shears 1x Reference Card 3x 1380 TCCC Cards
The CRO Medical Gear IFAK content media
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SOARescue
Feb 08, 2018
In Pharmacology
Screen Shots of the medication math .PDF
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SOARescue
Jan 21, 2018
In Law Enforcement Medicine
A great resource for Fentanyl and Synthetic Opioid Response, decontamination and PPE Selection from the Interagency Board. https://interagencyboard.org/sites/default/files/publications/IAB%20First%20Responder%20PPE%20and%20Decontamination%20Recommendations%20for%20Fentanyl.pdf Table 1. outlines the risk levels and response functions of the responder. Refer to the color coded matrix once you have determined your role and the perceived risk of the facility. The table below outlines the required PPE for the different types of response. Table 3 is the breakdown of PPE types and suggestions for use during response. The tables have been captured from the IAB document linked above. For more information feel free to comment or add to this thread.
Responder PPE Recommendations for Synthetic Opioids content media
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SOARescue
Jan 17, 2018
In Pharmacology
Before providing an in depth look at TXA lets get some thoughts on how it works. In your words explain the MOA of TXA and its benefit to traumatic hemorrhage patients.
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SOARescue
Jan 17, 2018
In Prolonged Field Care
Arguably one of the most underutilized tools in the tactical medics tool box. With timelines extending, the care of a patient may exceed even your own anticipation. So what does a foley do, and why should you care? According to AACN "Urine production is the result of continuous filtration of plasma through the kidneys, which receive approximately 20% to 25% of the cardiac output. Normally, less than 1% or approximately 1500 mL of the 180 L of plasma filtered daily leaves the body as urine. However, this quantity can vary from 600 to 2500 mL/d. Urine production generally occurs at a rate of 1 to 2 mL/min but can reach a maximum of 20 mL/min and depends on several factors. Urine volume has a direct relationship with fluid intake and the rate of renal circulation and an inverse relationship with the amount of water lost through other routes. In addition, the volume of urine depends on hydrostatic (blood) pressure; the number of active glomeruli; the permeability of the glomerular membrane; tubule reabsorption, which depends on antidiuretic hormone; and the osmotic pressure within the renal tubules." While there has been debate on the subject, there is little debate that a foley when placed properly will offer significant insight to resuscitation of the patient, as well as allowing for voiding of the bladder which can lead to much larger issues as time progresses. What are your experiences and opinions on the foley catheter's use and function in the PFC setting? (Yes, we know you should wear gloves on in the picture to the right) Fallis W. Crit Care Nurse April 2005 vol. 25 no. 2 44-51
The "Tactical" Foley content media
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SOARescue
Jan 17, 2018
In Kit & Equipment
Arguably one of the most versatile set ups to come out in a while. Their equipment is simple and can be used for just about anything. This case we have set up in a variety of configurations. Below is just one example of an IV case Setup. We have set this case up with the following: 2x 20g IV Catheter 2x 18g IV Catheter 2x 14g IV Catheter 2x Tegaderm Patch 2x IV Pigtail (PRN Adapter) 2x NACL 10mL Flush 2x 5mL Syringe 2x 18g Blunt Needle 6x Alcohol Prep Pad 1x Sharps Shuttle You can find it at: www.CROmedicalgear.com
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SOARescue
Jan 17, 2018
In Aircraft Operations
If you have flown on a rotor wing platform (primarily) civilian, theres a chance you had shore power connected. A s part of your walk around and pre-flight checklist this should be confirmed that it is disconnected. Unfortunately this doesn't always happen. Utilizing something as simple as a remove before flight streamer can minimize your chances of forgetting something that could be detrimental to the performance of the aircraft.
The Simple Things Matter content media
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SOARescue
Jan 17, 2018
In Prolonged Field Care
Prolongedfieldcare.org has done an incredible job of organizing resources, educational content and podcasts pertinent to the PFC community. Check them out, follow or download and listen you will not be disappointed.
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SOARescue
Jan 17, 2018
In Tactical Medicine
The Fire Service is well known for their tools of the trade. Whether it be an engine company or a set of Hurst tools, much of what is used is built for a specific purpose. The same is true when it comes to tactical medicine. Each of the tools made are made with a purpose. CAT Tourniquet Being that these “tools” are being used on humans there is a great deal of research and revision that goes into each before it becomes an accepted device. In previous articles we’ve covered some of the rationale behind, and steps to planning and responding to active shooter events. In this article, were going to talk more in depth on specific tools that many may not be familiar with. We’re going to talk about design, components and use of each. Tactical medicine in its current form is a relatively young branch of pre-hospital medicine. With that, many of the tools being used are also new, as there were no previous tools to do the job they fill. Hemorrhage Control Background The first and most innovative set of these new tools, are used to treat massive hemorrhage. Within the past 14 years we have seen more improvement in the way we treat hemorrhage, than we had seen in the previous 100 combined. This has been due to the wars in Iraq and Afghanistan. We have been able to collect, analyze and make sense of the data on wounding. Hemorrhage has been deemed the leading cause of preventable death in the battlefield. This leads to the reason so much effort and change has gone into finding formidable solutions. The tourniquet, what was once voodoo to utilize is now the go to treatment for extremity hemorrhage. So how did it make a comeback, and what goes into a good tourniquet? Let’s look into these questions a little further. The tourniquet until recently was deemed a “last ditch” attempt to stop bleeding, it was the go to when every other attempt failed. It was assumed that one would lose the limb the tourniquet was placed on, 100 percent of the time. This was a falsehood that allowed practices to be shaped around misunderstanding. A tourniquet does come with some risks. The risk of limb loss certainly is present, but much of that can be mitigated by the tourniquet itself. Previous tourniquets have been made of just about anything from shoe strings to belts, etc. This variation offered little consistency in effectiveness, thus leading to mixed results with tourniquets. With the data that has come from Iraq and Afghanistan, it has been proven that one can keep a tourniquet in place for over an hour and keep a limb. The proper device and proper use make this possible. So what goes into a good tourniquet? This relatively simple question has been dissected by physicians, medics, engineers and other professionals until some answers have risen to the surface. The days of a stick and bandana are no longer. Commercial tourniquets are one of the biggest drivers in improved trauma care in the pre-hospital setting. The most recognizable of these is probably the Combat Application Tourniquet (CAT®) by North American Rescue Products. This device was developed purely through the need that was seen overseas, and is now one of the most widely used in the world. It consists of a few parts, which ultimately lead to its effectiveness. The first of which is the self-adhering band. It is made of a nylon strap, which is much like both sides of Velcro in one. This quite possibly is one of the main reasons that there is such a high percentage of limbs saved. Through much research they have determined that this strap must be at least 1.5 inches wide to distribute pressure, minimizing the damage to tissue below. This is the main band that makes up a majority of the device, it is meant to be placed around the limb, and then placed back through the friction buckle. This buckle is much like the buckle on a riggers belt, with some additions. Next is the windlass. This is the “stick” of the tourniquet; it is the mechanical advantage that allows for further tightening of the main band once the self-adhering band has been placed around the limb. This windlass is attached to the internal band that runs the length of the self-adhering band. The self-adhering band is much like a piece of tubular webbing, which allows for the internal band to pass through. As you twist the windlass, it takes up the internal band ultimately tightening the whole device. Once you have tightened the device, the windlass is then secured in the securing clip, which ensures it stays tight. The idea behind a tourniquet is to “block the river, upstream.” The bleeding is coming from an injured blood vessel/s. If you compress all of the tissue around the vessel enough it will also compress the vessel, stopping flow beneath that point. However, the pressure must be circumferential, or all the way around the limb to be effective. SOFTT-W Tourniquet Another one of the most popular tourniquets is the Special Operations Forces Tactical Tourniquet Wide or SOFTT-W. This device is made by Tactical Medical Solutions, another leader in Tactical Medical Products. It too has gone through change, since its inception. This device also is attempting to accomplish the same mission. It does have a few changes in its design. The first of which is the band itself. It is not a self-adhering band but rather a single nylon strap, which routes through a metal friction buckle. This buckle is more along the lines of that on a bailout belt. The middle bar moves and tightens the more pressure is against it, using friction to hold it in place. This device also utilizes a windlass that is made of aluminum; it tightens the main band instead of a nylon internal band. On each device they achieve the correct amount of pressure that is required to stop blood flow, approximately 350 mmhg. They just accomplish through slightly different techniques. Tourniquet Takeaways Hopefully through this article you have gained some understanding on tourniquets. If you or your department have or are going to purchase a tourniquet here are some key considerations. Does the tourniquet meet the 1.5” width minimum? There are many tourniquets available, some even claiming to be Tactical Combat Casualty Care approved, they are all not. Some will claim that through wrapping the device they are able to achieve this 1.5” minimum, it is not true. Does the device have a windlass, or a mechanical device for tightening after initial application? Choose a device that is simple. Less parts to break, or remember how to use in the heat of the moment. Also having a device that allows you to tighten after the initial band has been put on, is a must. The windlass design has been the most widely adopted for its ease of use as well as consistency. There are some pneumatic and other tourniquets that use different ways of tightening, just remember Murphy’s Law in these cases. If it looks too complicated it probably is. Lastly, how is this device being stored, and where? There are multiple commercial cases made to make a tourniquet easy to access, as well as keep out of the elements. A good storage solution is a must to ensure this tourniquet will work when it needs to. Where you store it is key as well, specifically in the law enforcement and tactical environment. Keeping it in the car or somewhere else does no good, when it’s really needed. On your person easily accessible is a must. With the return of tourniquets, I hope this is helpful in understanding how they work, as well as the anatomy of some of the most successful tourniquets available.
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SOARescue
Jan 17, 2018
In Tactical Medicine
SOARescue, in partnership with multiple organizations, officially announced the National Tactical Medicine Competition (NTMC) to be held on Sunday, May 13th in Charlotte, North Carolina at the Charlotte-Mecklenburg Fire and Police Training Academy at 1770 Shopton Road. Registration for competitors and vendors alike opened Dec. 1, 2017 and competition team slots filled in 5 Hours! The National Tactical Medicine Competition is an event created to allow tactical medical providers from around the country the opportunity to collaborate and compete in a community of peers. Civilian Tactical Medicine is a relatively new discipline within the world of pre-hospital medicine. We are hoping to create opportunities to increase awareness, collaboration and training. This competition is a great opportunity to bring like-minded individuals together and support a cause greater than self. The National Tactical Medicine Competition is based on the Tactical Emergency Casualty Care guidelines and all simulated patient care will be in line with the currently approved guidelines. The Committee for Tactical Emergency Casualty Care (C-TECC.org) endorses the NTMC. Proceeds from the competition will benefit the equipping and training of first responders, with the skills and equipment needed to save lives. Teams of two competitors will negotiate through a series of events to challenge both clinical and physical abilities. While the “lanes,” as they are called, will be agnostic to provider level, they will require competency and skill to negotiate successfully. Competitors will proceed through the phases of care. Beginning at direct threat care, minimal treatment is performed but physical ability will be required to move the patient. Teams will transition to indirect threat care where they will be expected to further treat the patient and prepare for evacuation. Following, teams will evacuate the patient to a given location and continue to provide care during evacuation. Teams will then have to continue through specialized skill sets found only in tactical medicine. The mission of the competition is simple, To Preserve Life. Through friendly competition among peers in a community of professionals, competitors and observers alike will all be able to take something away from this unique event. The Competition will consist of 12 two man teams and will be held over eight hours. Banquet to follow. Event Details: 2 competitors per team, 12 Teams Webpage: www.Tacmedcompetition.com
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SOARescue
Jan 16, 2018
In Aircraft Operations
When operating in and around the aircraft there are many things that you need to be sure of. If you're anything like me, then you understand the somewhat hermit crab type memory. When lifting- specifically in the civilian HEMS setting there is always a pre-take off confirmation. That checklist may look a little like this. Crew: Flight Release Pilot: Check Crew: Shore Power Pilot: Disconnected Crew: Engine Switches Pilot: 2 To flyCautions/Warnings/Rotor Pilot: No Cautions, No Warnings, Normal 2 Advisories, Rotor 100% Crew: Fuel Pilot: 2 plus 10 Crew: Autopilot Pilot: On Crew: Flight Controls Pilot: Unlocked Crew: Seats- Belts- and Doors Pilot: Check, and Crew Check Crew: Risk Assessment Pilot: 15 (Some kind of number usually ranging from 5-30) This is just an option of what lists exist, but it is a good starting point to get a glimpse at what is reviewed.
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SOARescue
Jan 16, 2018
In Critical Care
So the concept of critical care seems to be a mysterious figure for those looking from the outside in. For those of you that have experienced the CCT life, what suggestions or observations do you have for others?
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