Saturday, February 18, 2012

He's Having A Heart Attack, Where's My Tourniquet?

Napping Street Vendor in Amman
When was the last time that a domestic executive protection detail had to provide medical care while under  attack?  I'm open to input, but I can't think of a single instance.  Then why are protectors so hell-bent on spending money and time on learning tactical medicine, i.e. providing medical care while under fire?  The answer is that it's fun and sexy, but the hard truth is that it's useless for domestic details.

I'm not saying that tactical medicine does not have it's place, but that place is on SWAT teams, and in military and other high risk environments, not on U.S.-based executive protection details. Security details and contracting protecters are waisting their time and money pursuing those skills.

What kills?  In other words, if you were pushed into any emergency room which common afflictions are going to get you seen right now by an anxious physician because your life is in immediate danger? They are:
  • Myocardial infarction (heart attack)
  • Active seizures
  • Suspected cerebral vascular attack (stroke)
  • Airway compromise:
    • Anaphylaxis (allergic reaction)
    • Foreign body (choking)
    • Pulmonary embolism (not a true airway compromise though)
    • Severe asthma attack
  • Hypoglycemic coma
  • Severe trauma
That's it, everything else can wait.  Take a seat in the waiting room.

How many of these afflictions are discussed in your tactical medicine course?  Trauma of course, but only as it applies to gunshots wounds while under fire, which, as noted, are exceedingly rare.  The rest, which are infinitely more common, are going to kill your client while you stand by with tourniquet and QuikClot in-hand. 

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