Letter Re: Wounding Patterns

Aloha HJL,

I have a response to the post from 30 July 2016 regarding the wounding patterns of civilian public mass shooting (CPMS) events versus military wounding patterns. ShepherdFarmerGeek sent this in, and it is fantastic to review anything regarding survivability in the coming times. I agree with the last line: “Time to reevaluate the preps and training.” That should be a daily occurrence for every one of us! But, I respectfully disagree with the view that “…we may be training and prepping wrong…”.

I read the article and was somewhat surprised by the data revealed; though I think 12 events with 139 fatalities is a very small research sample to derive definitive results and then compare and contrast against thousands of combat fatalities. Having been in three combat roles in the 80’s, 90’s, and 2000’s, most recently in Iraq with a secondary role as a medic for our Cav Troop, I have some personal experience that doesn’t fully contradict the “Study”, but does reflect different experiential results. The study assumes that the Shooter was laser-focused on mayhem and took carefully aimed torso and head shots at UNARMED victims. I can see how the Study author would deduce that a less “Massive Exsanguination” focused approach may be warranted, but I caution SurvivalBlog readers that his study assumed a different environment than what we will see in a SHTF scenario. Without someone shooting back, the Active Shooter had a much higher kill ratio than we professional Marines and Soldiers can achieve in combat. I believe many shooting incidents in a SHTF scenario will not be against unarmed victims but will involve Patriots defending their nation, family, and supplies. We should train accordingly.

Myself and my partner, who is still an active duty 18D SF Medic, teach a rather extensive trauma class titled “Grid Down Trauma Care: What to do when 911 doesn’t answer.” Our program has been peer reviewed by active duty 18D Green Beret medics, as well as by a USAF Orthopedic Surgeon, a Trauma Center ER Nurse, and a USAF Pediatrician (who is also a contributor to SurvivalBlog.) We foresee the SHTF scenario to be VERY MUCH like our collective experience in combat within the past 30 years, and possibly even worse in that there will be no Dustoff available! Therefore, we still use the TCCC format and the SMARCHRV-S algorithm to guide our “Prepper Medics”:

S- Security/Situational Awareness,
M- Massive Hemorrhage Control,
A- Airway Management,
R- Respiratory Concerns,
C- Circulation,
H- Hypothermia,
R- Recovery Position,
V- Vital Signs,
S- Stabilize, and Package for Transport.

Our assertion is that destroying the threat first, and immediately evaluating massive hemorrhaging and determining immediate tourniquet application to extremities is STILL the way to go in an austere environment. In TEOTWAWKI, few of us will have plenty of oxygen, surgical supplies, and 24 bags of IV fluids cached. (24 bags plus blood products is the average for ANY GSW trauma patient.) Thus, it will be critical to provide immediate aggressive treatment in the field in order for a trauma patient to have a remote chance for survival. There will be no 911, paramedics, trauma centers, or definitive care available only ten minutes away. There will only be the Patriot and his or her patient.

I’m not knocking the Study, just ensuring the readers have more data to make informed decisions. – S4H