When I signed up for tactical medical training presented by the Federal Law Enforcement Training Center (FLETC), I had no idea that in the class I’d be back-to-back with two strangers, blind-folded, trying to resolve a life-threatening problem.
Approval from the boss to attend this high-caliber training that teaches critical medical skills only more recently afforded to law enforcement was not an issue, as the training – and the useful individual first aid kit (IFAK) that is included – were totally free, all thanks to the federal government.
The evolution of medical training
The training at FLETC taught me a new acronym that has re-prioritized my previous medical training and clarified zones in which to operate as an LEO. Remember when you could just call a scene safe so the EMTs could arrive? Those lines are blurring.
The new acronym is MARCH and it stands for:
- Massive hemorrhage
- Airway control
- Respiratory support
- Circulation
- Hypothermia or Head Injury.
In this new lineup, bleeding control is prioritized over airway control as the most important risk to life and limb. Everything else falls in place after. The other critical part of this acronym is that massive hemorrhage should be taken care of in a hot zone. Airway, respirations and circulation could be treated in a warm zone, but hypothermia or head injuries are reserved for cold zones only.
Hot, warm, cold
What does this mean? Basically, if you’re bleeding to death, you apply some means to stop it even under fire if possible. Our instructors gave us 60 seconds to accomplish this task and the lesson was not lost on me. When an arterial bleed spurts, operational seconds are ticking away. Everything else could wait until you were either behind cover, the scene had settled, or something else changed.
My FLETC trainers had diabolical ways of teaching me these lessons through stress and repetition. We first started by applying tourniquets in the classroom. Let me clarify. Every time we deployed a tourniquet, it came from the IFAK pouch we were given at the beginning of the class. This began to build familiarity, even muscle memory. Time and time again we placed the tourniquets on our legs and arms, from seated, standing, off-handed and other positions.
When tourniquets are properly applied, they hurt. They actually compress your tissues down to the bone, stopping arterial blood flow. We were made to move about and still accomplish things while experiencing this discomfort. The lesson was that it wasn’t impossible. With effort, you could still move, shoot and do other tasks despite the numbness, pain, or tingling you might experience.
Once it appeared we were getting the hang of it, simulated shots were fired in the class and we all dove for cover. We drew our blue guns, were advised we’d been hit, and were directed to apply a tourniquet to the arm. Keeping our heads low and our eyes out for the suspect, we began to exercise some of that recent memory. Holstering, withdrawing the tourniquet, slipping it on, cranking it down, then getting back into the fight became doable despite the pain.
Instructor Paul Sanchez admonished, “Make the tourniquets tight! You aren’t cheating me; you’re cheating yourself and your families.” We made them tight.
Let’s complicate things
We headed out to the sandpits and were directed to sit back-to-back. We took turns wrecking some tourniquets then handing them to our blindfolded training partners. We then tried to talk them through the complication. I was surprised. I took a long time, but I had to remove and reinstall the buckle on my tourniquet when it was my turn. This built confidence and also made me appreciate the simplicity of a properly staged and deployed tourniquet. Then the instructors taped our hands to further complicate things.
Afterward, we divided up into teams of “officer down” and “responding backup.” Downed officers attempted to communicate important information but quickly passed out (scenario) so we had to approach to render aid. The suspect came out firing so we dove, recovered, dove again, recovered, and kept this up the entire way there. Breathing heavily, we all reached our downed partners and revived them, covering them with our weapons.
One critical lesson is that your IFAK is for you and your partner’s IFAK is for them. Cover officers should apply tourniquets only if the wounded officer is totally unresponsive – encouraging responsive officers to treat their own wounds while providing safety.
We learned how to pack a wound with Celox and QuikClot, actually finding the artery and stuffing the gauze down inside, bit by bit. We learned the benefits of applying direct pressure to junctures near the joints in order to slow or stop bleeding.
Instructor Doug Torres said, “The body won’t go where the mind hasn’t been,” which is a great reminder about the power of visualization.
Rescue carries
We spent a good deal of time learning various carry methods from slightly injured officers to completely incapacitated. Single, two, three, even four-person carry methods allowing for deployed weapons were instructed.
We also learned tips for loading injured officers into vehicles and considerations for secondary surveys once underway to the emergency room or ambulance. Raking the victim with your fingers, seeking holes or blood was a great shortcut method for finding wounds that might be hampering recovery. All these lessons were taught with the provided equipment we took home at the end of the day.
About FLETC
Based out of Brunswick, Georgia, and Artesia, New Mexico, this branch of the federal government trains many of the federal officers employed locally and around the world. They also provide cost-free training for state and local agencies. Their trainers come from a variety of backgrounds but are experts in their fields.
I had some noteworthy observations about the trainers and their methodology:
- They teach at your level, not using unnecessary jargon or medical terms.
- They know the skills they’re teaching save lives and they take it seriously.
- You will get repetition until the skills become rote.
- Classroom time is brief. Most of the class is spent moving around delivering hands-on training.
- They will stress you during the use of these skills to make you better.
Why attend government-funded training?
Most agencies have budget struggles and unfortunately, training is often cut first. FLETC provides high-quality instruction in mission-critical skills. The best part is that the training is free. All agencies need to do is provide a training facility. In my class, a variety of agencies were represented. All the officers who attended that class have a much better chance of helping themselves or another officer in a gunshot trauma scenario. Reach out to FLETC today to learn more about their training schedule.
NEXT: Watch Police1’s on-demand webinar on the evolution of officer-down training
This article, originally published 10/10/2018, has been updated.