Letter Re: Holster, Sling, and Web Gear Recommendations

Howdy Mr. Rawles!
Before I begin, I’d like to offer my congratulations on your fine novel being republished. I’ve read it once myself, then again to my family (I hate television, reading is good family entertainment) which should be considered high accolades in itself. Currently my copy is in the Pacific Northwest, bound for the midwest next, as it continues to travel the country within my circle of friends.

I read the posted letter by R.P. on 26 August, and associated recommendations on holsters, slings, and web gear, and thought I’d offer some discussion on the matter:

The main reason pistols are currently worn on thigh rigs has less to do with ‘CDI’ [“Chicks Dig It”] factor and more to do with accessibility. When one wears a vest festooned with pouches, the bulk of these tend to hinder proper presentation of the pistol when the holster is worn conventionally on the pants belt. That is, if the pants belt can even be seen, as most wear their vests low enough to preclude such. The addition of body armor only exacerbates the situation. The pistol, therefore, is typically moved elsewhere – mostly onto a thigh rig or integrated into the vest itself. This is far from a new style though – the old leather 1911 holsters hung down from the frog clip to accomplish the same purpose.

As you noted, thigh holsters typically aren’t comfortable while ‘on the move’ . They are good for one thing though, and that’s an assault. Thus the reason that laden troops are often seen with them – those troops are equipped for an assault. Additionally, a conventionally mounted holster will typically interfere with a ruck waist belt. If not precluding ruck use entirely, at a minimum compromising comfort.

I’ve been working through these issues for years, and have come to some conclusions:

No one rig will ‘do it all’. Compromises abound and are mandatory. For the vast majority of time (as it applies to me) a light vest, at the
most, is all that is called for.

I am not personally a fan of the heritage [LC-1/LC-2 series] deuce gear. Not that the concept is wrong, bad, or anything else – but the ALICE clips (or as my associates and I came to call them, “meat hooks”) really did need to be jettisoned. They rub body parts raw, blistered, and cause other similar problems when used for any significant length of time. As well, the magazine pouches were designed more for extreme magazine retention and protection (security) than allowing a speedy reload, and the closure hardware on them never was very robust. When I had evolved my deuce gear as far as it would go, my pouches were all lashed to the pistol belt with gutted paracord. Using the grommets of the belt and the freshly-emptied ALICE clip slots on the pouches, paracord can be worked tight enough to prevent pouch movement laterally and vertically. Another consideration is that by using paracord, there is less metal to clink against other items. This technique worked well in my opinion, and happened to be identical to the way – in both layout and attaching – one of my closest friends independently evolved his LBE in Ranger school. If one is really attached to that generation of equipment, then I recommend this method of pouch attachment, as it is a quantum step up in comfort! Just make sure that the knots are oriented away from your body and melted somewhat, to prevent them from coming loose and the paracord sheathing from unraveling.

In my opinion the new generation of MOLLE load bearing vest (LBV) is superior to the old deuce gear – of course allowing that everyone is different. Not only are the MOLLE vests superior in comfort, but the modularity offers the capability of repositioning your pouches to find the placement where they feel best for that individual. I personally prefer the slightly older models that use two buckles in the front, as opposed to a zipper. Conveniently, these vests are low enough in cost that purchasing one per rifle, carbine, or shotgun isn’t cost prohibitive.

Like R.P. and yourself, I have attended Front Sight. I’ve also attended other top-notch institutions – I typically attend at least one course per year. As such, it should come as no surprise that after significant attempts at finding “a better way”, I also advocate using a conventionally mounted belt holster. It seems we prefer the same manufacturers as well – Blade-Tech and Milt Sparks specifically. The Milt Sparks folks talked me into trying the Summer Special II and I’ve been happily using that for the last three years or so and actually prefer it to the original Summer Special. I would also add Lou Alessi to the recommended holster-maker list, as I’ve been using his leather belt holsters for the last decade or so and am quite taken by his execution of the old Bruce Nelson design, which Lou calls the DOJ holster. Specifically, I prefer the slightly modified version he made for Dick Heinie. Those can still be ordered as such directly from Lou, as Dick quit carrying them. I’ve used several gun belts over the years, but eventually stuck with the Riggers Belt offered by The Wilderness. I prefer mine with the optional 5-stitch reinforcement, to make the belt less flexible under load.

I have found that the key to proper pistol presentation when wearing a vest is to have the vest ride high enough that it doesn’t interfere with the holstered pistol; not quite as high as a chest rig, but almost. As well, when laying out the pouches for attachment, I leave a open area on my front and both sides; approximately 10:45 to 1:15, 2:00 to 4:30, and 7:30 to 10:00 are all open space. This allows unimpeded access to a properly holstered pistol, as well as the spare pistol magazines and such on the opposite hip. The open area directly to my front is so that I can assume a solid prone position without lying on full magazine pouches; I space the pouches such that they act as wheel chocks when I’m in the prone. With the vest riding at this height, other items can be carried on the belt with decent access – a knife, pistol magazines, flashlight, multi-tool, and compass for example. With all that open area though, the vest really doesn’t carry much. As I’m not employed to assault enemy positions, I don’t need an assault vest. What I do need – and what the vest provides – is water, more ammo for the pistol and carbine, navigation, communications, and a blow-out kit. If called for, a PVS-14 or PVS-7D in rigid case can be quickly and securely attached to the water carrier on the back. As the unofficial motto of my favorite school says, “shoot, move, and communicate”, this vest is geared to meet those needs. What it is not geared to meet is self-sustainability. This vest shouldn’t be confused with a rig meant for patrolling, what one would choose to wear when knowingly venturing into unfriendly areas, or anything to sustain oneself longer than a few hours. Essentially this is a vest to be worn when contact isn’t expected, just something to work ones way back to a nearby resupply.

For the applications where the light vest isn’t sufficient, a ruck is called for, as well as a vest that works well with a ruck but also has the volume capabilities for sustainability. Of course, this is a trade-off, and there are many trade-offs involved in choosing kit. As always, determined by METT-T [Mission,+Enemy,+Terrain,+Troops+Time Available]. At this time, for a patrolling / heavy vest, I’m evaluating the K171 Arktis model. It’s heavier, bulkier, doesn’t allow unimpeded pistol usage (the pistol is stowed in a cross draw integral holster and meant to provide security over speed), and favors security over speed in reloading – but it does carry a patrolling load well.

On the topic of slings, I realize this is personal preference, but I prefer different slings for different applications. On a battle rifle or a precision rifle, I prefer the Quick-Cuff from Tactical Intervention Specialists. I’d been using these slings for years before our military adopted them as part of issue sniper kit – they really are top-drawer quality. I’ve used them on long-range courses and competitions and never regretted it. It doesn’t do anything that a good loop sling doesn’t do – it just does it faster and easier. For shotguns and carbines, it’s difficult to find better than the Giles or Vickers slings, in my opinion. When set-up such that the buttplate is approximately one fist height below the chin, these work very well.

At this point though, I’d like to reiterate your admonition that training must be sought. If a trip into the Arizona or Nevada deserts, the Oregon mountains, the Oklahoma hills, isn’t a viable option at the moment, then I also advocate the Appleseed Program [rifle matches and clinics]. These fine, hospitable folks will get you spooled up on the basics of marksmanship quickly and efficiently – I should know, I’ve been volunteering as an instructor for almost a year now. All the best, and God Bless! – Bravo



Two Letters Re: Survival Medicine and Ditch Medicine

James
Josh’s article [on Survival Medicine and Ditch Medicine] was very good. I wanted to address the fact that a medical oxygen bottle is illegal to possess without a prescription and/or doctor’s care.

Actually, I don’t think the bottle itself is illegal. Just illegal for someone to fill it with medical oxygen without a prescription. But that’s beside the point because there is a simple, legal alternative: Aviation oxygen.

Aviation oxygen tanks and gas are easily obtained and not inordinately expensive ($150-to-$250 depending on size). Aviation, medical and welder’s oxygen are all pure, dry and inexpensive. With the “ABO” (Aviator’s Breathing Oxygen) label the tank can only be filled with aviation oxygen. Remove the ABO label and it can be refilled at an industrial gas supplier that sells welding oxygen. No prescription required in either case.

The same people who sell the tanks also supply disposable nasal cannulas and masks. Best, – Matt S.

 

JWR,
I was glad to see Josh in Montana submit his article on basic medical intervention. I just came off my duty shift as an EMT-I crew chief. I wanted to make you aware of a great online resource:

The AAOS EMT Basic 9th Edition is the current curriculum for all Army Combat Medics. My son went through Fort Sam last year and this site proved a good study aid for him and his fellow students. It provides a handy chapter selection tool if you are also using the textbook so you can stay coordinated with class study. But would also be a good overview for anyone.

Some features are:
Interactive Scenarios
Interactive Anatomy
Vocabulary
Chapter pre-tests

– Steve P. , EMT in Wisconsin



Odds ‘n Sods:

I’ll begin with some positive news from an Australian newspaper, by way of reader Kevin A.: Fifty Reasons To Thank NASA

   o o o

FerFAL (SurvivalBlog’s correspondent in Argentina) recently posted some quotes and commentary on Gabe Suarez’s description of his training trip to Argentina.

   o o o

Pamela mentioned a commercially-made fireplace log rolling machine that speeds the newspaper rolling process that was described in a SurvivalBlog article posted earlier this year.

   o o o

SurvivalBlog’s Economic Editor Cheryl N. sent us another batch of economic news and commentary: Credit Crunch Cancer Metastasizing, US National Debt Clock, World Heads for Deflationary Collapse, Scramble for Cash as Central Banks Dry Up, Lehman Bros. Faces Korean Takeover Bid, and Credit Crisis Financial Armageddon.

   o o o

Reader B.P. mentioned that he watched a recent television show about children in Africa being saved from starvation by a new a new product called Plumpy’nut, which requires no refrigeration and that has two year shelf life. B.P. notes: “I was thinking that this product would also be a good [supplementary] food source for infant children in a SHTF scenario.” JWR’s comments: Since it is a paste, it might also be useful for anyone in rehabilitation from jaw or dental trauma, or for elderly patients that are sans dentures. It is also a captivating possibility for a lightweight, compact food source for G.O.O.D. kits. (Although, to provide nearly complete nutrition it should probably be supplemented with blue-green algae tablets, jerky, honey, some selected vitamins, and a source of dietary fiber.) The only big downside I can see is that it can’t be eaten by anyone with a peanut allergy. I predict that if a food packager in the US were to sell it, it would be an ideal candidate for a BOGO arrangement, to support an international charity.



Jim’s Quote of the Day:

“…anyone who has been dragging his feet and has still got the bulk of his savings in the banking system, particularly the U.S. banking system, it’s getting almost too late to act. You need to move very quickly to get the bulk of your savings out of the weaker banks…ideally…you should own U.S. Treasuries directly in a money market fund…don’t sit around until it’s too late…finding yourself at the back of the line in front of your bank.” – Robert Prechter, quoted in Once in 100 Year Crisis?



Notes from JWR:

Today we are pleased to welcome our newest advertiser, Hardened Shelters. Be sure to visit their web site and check out their amazing engineering, architectural, and construction management expertise. They design and oversee the construction of blast shelters, fallout shelters, safe rooms, panic rooms, vaults, storm shelters, photovoltaic power systems, shelter ventilation systems, and more.

The Memsahib will be at the hospital again starting this week for further treatment. Please pray for a miracle for her. (She’d appreciate your prayers upon Psalm 20:1-5)



Letter Re: Hurricane Gustav–Learning From Mistakes

Jim,
A friend first introduced me to your blog, and I have begun to seriously consider many of the suggestions made by you and others for preparedness. One of the biggest indicators of a person’s level of preparedness is an actual or potential disaster event

My wife and I have lived in Northwestern Louisiana for a little over two years. On the eve of Hurricane Gustav, we realized how unprepared we were for lack of power, water, let alone social breakdown. I certainly didn’t expect a major disaster, and we didn’t have one, but it is better to be prepared and not need it than get caught wanting.

My wife and I were traveling from a camping trip outside of Houston back to our home, and had the chance to learn by watching others. Halfway home, we stopped at a WalMart to gather some needed supplies (batteries, food, water, etc.) which we thought would be exhausted at home. To our surprise, most people had filled their baskets with chips, sodas, and frozen foods. It was Labor Day, but this particular town seemed to be at a heightened sense of alert for the Hurricane, so I didn’t think all these people were prepping for a barbeque. Quite a few were stocking up on beer, coleman fuel, and flashlights.

The rice, beans and canned food shelves were full, as were the ammo shelves. Fruits and Vegetables were stocked to the brim, and the entire produce section was deserted.

While in the checkout lane, my wife and I decided that we need to spend a night a week planning and preparing and keeping inventory of our food supplies. My brother and his wife are beginning to understand the ramifications of being unprepared, and also have decided to take stock of their preparedness situation. I have thought long and hard about becoming prepared, but have taken very little action.

This mild scare has motivated me to get it in gear.

Thank you for your dedication to teaching and sharing your knowledge and experience with others. Without your blog, I would have never begun to think about being prepared in bad times. Thanks, – Matt S.



Letter Re: How Much Ammo to Carry?

Hello Mr. Rawles,
You are a great man for what you do! You have shaped my life in many ways and most certainly opened my eyes to many things, and for that thank you. I have recently started my own small TEOTWAWKI preparedness group of like-minded Christians.

We have standardized our gear but I have no idea how much ammo we should carry on our web gear, and if we should have a combo of rifle and pistol ammo. We have a lot of ammo stockpiled but we are wondering about patrols and other times when we would need to be away from our retreat location.
Thank you for any help you can offer. – California Guy

JWR Replies: My general guidance for a retreat security “basic load” for truly inimical times is:

.308 semi-auto rifle: Four spare 20 round magazines.

AK-47, AK-74 or .223 semi-auto rifle: Six spare 30 round magazines

Pistol caliber SMG: Eight spare 30 or 32 round magazines .

M1 Garand:10 spare loaded 8-round clips.

.30 caliber bolt action rifle: 80 rounds. (Hopefully, you’ll have a rifle with either a detachable magazine or a stripper clip guide, for faster loading.)

SKS: 120 rounds on 10 round stripper clips. (12 full stripper clips.)

Riotgun: 50 buckshot shells, and 7 to 10 rifled slug shells (depending pouch configurations)

Handgun (supplementing a rifle or riotgun): four spare magazines for single stack magazine pistols, or three spare magazines for double stack guns.

Revolver (supplementing a rifle or riotgun): six spare speed loaders or full moon clips.

All of the above noted quantities might vary, depending on the situation. For example, if you are foraging for game you’d surely want to substitute some soft nose ammo, and birdshot. If you are on a preemptive offensive raid (God forbid), you’d probably want to carry much more ammo. Ditto for stocking an LP/OP or what you’d carry in a vehicle, where weight and space are not paramount concerns. If on a long range “avoid all contact” reconnaissance patrol or if you are inside your perimeter doing chores, you’d probably carry much less ammo.

I generally recommend carrying semi-auto rifle magazines loaded with tracers for the last three rounds in each magazine. (In the stress of defensive shooting situations you almost certainly won’t be counting rounds, so the flash of tracers will cue you to switch magazines.) Your state/local laws and wildfire conditions, of course might preclude this.

Again, varying circumstances might very likely necessitate some increases or decreases to what I’ve suggested. And, of course, your physical stature and fitness or mountainous terrain might also dictate some changes.

One closing note for readers in California and other hoplophobic states that have enacted magazine bans: You will likely have to make do with smaller magazines. Make the best of it until you can move to state with greater freedom. At least California’s “high capacity” magazine ban has a grandfather clause for any 11+ round magazines that you legally possessed on or before December 31, 1999. New York (state) also grandfathers any 11+ round magazines that were made before September of 1994, regardless of when you acquired them. Consult your state and local laws!



Letter Re: Is a Little Ice Age Approaching?

Hi Jim,
Thought you might find this article interesting: Sun Makes History: First Spotless Month in a Century

As a scientist (Oceanography) I have been astounded with scientists who can not see the forest through the trees when it comes to global warming. The ocean temperatures have been dropping over the last 1-to-2 years (as well as the overall temperature on Mars). Correlate the ocean temperature with sun spot activity and you do not need any more “proof” as this will show the direct cause-effect relationship of the sun to the temperature of the oceans.

Note that if we do get a “mini-ice age” in the next 10 years, then there will be a massive shift in demographics as northerners head south! Retreat locale may have to rethought for more northern regions unless you like living in “Siberia”. God Bless, – MRL.



Odds ‘n Sods:

I noticed that the spot price of silver dipped below $12.70 per ounce for the first time in many moons. Given the pitiful intrinsic value of the US Dollar, in my opinion silver priced anywhere south of $13.50 is a bargain. Buy on the dips!

   o o o

Reader “MGB” flagged a web site that illustrate which countries to avoid for offshore banking: This US IRS page shows the countries that have “transparency” via tax treaties And MGB recommend the Sovereign Society web site as a resource for comparing banking privacy of various nations.

   o o o

Naish Piazza’s blog features a link to a great video produced for the US Marine Corps: In the Fight… Even When Shot. OBTW, speaking of Naish Piazza, Front Sight “Get a Gun” training and gear package offer will be ending soon. This is your chance to get five days of awesome training and an XD pistol and a lot of other gear and useful references for less than the normal cost of the training alone. Don’t miss out on this deal, or you will regret it later!

   o o o

Simon in England sent us some evidence that the public fear of guns in the UK Nanny State has gone absolutely ballistic. Simon writes: “A SNP (Scottish National Party) councillor – Jahangir Hanif – almost got the sack for shooting a gun legally (years before he became a councillor) when on holiday in Pakistan. Instead, he got “a two-month suspension”. No, you have not read that wrong. He broke no laws in Pakistan, Scotland, or the UK but there is still a call to sack him.” Here are some links to news stories about this man’s public humiliation for daring to shooting a gun recreationally: Councillor Kalashnikov, Kalashnikov councillor suspended, SNP refuse to kick out ‘Kalashnikov councillor’, Kalashnikov councillor escapes SNP expulsion, What has become of Scotland the Brave? William Wallace must be restless in his grave. OBTW, if any politicians from Scotland would like to engage in some similar “foolish and inappropriate conduct”, they are welcome to come visit the Rawles Ranch. Perhaps we’ll even fire some “evil” tracer ammo or detonate some Tannerite charges with one of my L1A1 (“SLR”) rifles. That should send the UK tabloid press into an absolute paroxysm of hoplophobic frenzy.



Jim’s Quote of the Day:

“The amount of gold in existence is finite. It cannot be increased any faster than by 1.6% per annum (the rate at which mines are producing gold). Whereas the amount of money in circulation is currently expanding at double-digit levels, on a worldwide basis, the U.S. M3 money supply back in 1980 was 1.8 trillion dollars. Today, according to economist John Williams, the U.S. M3 money supply has ballooned to almost 15 trillion dollars. Some of that extra money has the potential to move into gold.” – Peter Degraaf, in Is the Price of Gold Artificially Depressed?



Notes from JWR:

The high bid in the SurvivalBlog Benefit Auction is now at $350. The auction for a mixed lot that includes: Two cases of Mountain House freeze dried foods in #10 cans, (donated by Ready Made Resources–a $320 value), a NukAlert radiation detector, (donated by KI4U–a $160 value), a Wilson Tactical COP tool, (donated by Choate Machine and Tool Company, a $140 value), a DVD of 480 E-books on Alternative Energy (donated by WK Books–a $25 value). The auction ends on September 15, 2008. Please e-mail us your bid.

Today we present another entry for Round 18 of the SurvivalBlog non-fiction writing contest. The contest prizes include:

First Prize: The writer of the best contributed article in the next 60 days will be awarded two transferable Front Sight  “Gray” Four Day Training Course Certificates. This is an up to $4,000 value!
Second Prize: A three day course certificate from OnPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses.
Third Prize: A copy of my “Rawles Gets You Ready” preparedness course, from Arbogast Publishing

Round 18 ends on September 30th, so get busy writing and e-mail us your entries. Remember that articles that relate practical “how to” skills for survival will have an advantage in the judging.



Survival Medicine and Ditch Medicine, by Josh in Montana

There may come a time when we are no longer afforded the luxury of dialing 911 to receive prompt emergency medical care within minutes. You yourself may be faced with a sick or injured loved one, having nobody to turn to but you and your skills as well as inventory of supplies to provide critical interventions.

My lively hood is emergency pre-hospital medicine. Having earned a degree in Paramedicine in 2002, I have worked and currently still work as a full time paramedic for a department that sees over 4500 runs a year. I myself serve as lead medic or, “team leader” on close to 200 runs or “calls” per year. Over the past six years, I have participated in over 2500 emergencies first hand. I feel obligated to offer this article to those of you who may not have such an exhaustive exposure to injury and illness in the out of hospital setting. I also serve as a local tactical paramedic on the police department SWAT team, where I am affectionately referred to as “Doc”.

I would recommend to any of you interested, in researching your local educational programs or community colleges in search for a Emergency Medical Technician Basic course. This is a short duration and fairly entry level class on basic life support.

Most of us here are familiar with a G.O.O.D. pack. Equally as bulky and most likely as heavy would be a medical bag. Now, any tactical team with a medic is than going to have one guy, the medic, carrying a large medical bag. The one I carry for SWAT is easily over 35 pounds, perhaps 40. In addition, every member of the tactical team should also be personally equipped with a, “blow out kit”. This is a small personal medical bag that is clipped to either a hip or belt rig and part of your web gear. I will provide inventories for all of these items later on.

More important than all the trinkets, goodies, cool stuff and gnarly items you can purchase and put into a pack, is the knowledge of how to use and apply those items to an injured or sick patient. You must educate yourself on the pathophysiological process of the many illnesses and injuries you may encounter. This can be done over time, with the right books and reference materials. I recommend Mosby’s Paramedic Textbook in conjunction with the Merck Manual, Emergency War Surgery, and Where There Is No Doctor. Another book that I value as a paramedic is The Street Medic’s Handbook.
Knowing the priorities of the sick or injured patient is broken down into a simple and common pneumonic called. “the ABC’s”. It is the fundamental order in which the caregiver approaches the sick and injured patient. I will try to walk you through the mindset of find and fix patient care that hopefully you can put into your tool box and never have to use.

When first alerted to the fact that you have an ill or wounded individual, you must first take into consideration your own personal safety. You must ask yourself, “Is what happened to them, going to happen to me?” This is critical not only for your safety, but to prevent you from also becoming wounded and no longer being of use to your team or others. After determining or making the scene safe, by either neutralizing the threat or dominating the location with support from other members you can begin to approach your patient. Keep in mind this would be different in an indoor verses outdoor scenario and also different for medical versus trauma.

When approaching the patient, you need to begin to observe them. Look for their movements, obvious injuries that you can see as you approach. Listen for gurgling or difficulty breathing. Talk to them and see if they respond. With this information, as you approach, you can form a general impression of the patient. Are they conscious? Can they move on their own power? What is the nature of the illness or the injury? Can you see any bleeding? Are their eyes open and staring, fixed, gazing, or looking around and able to focus? Are they conscious or not?
Once you are at their side, you begin a rapid assessment of the ABC’s. You find and fix problems as you go. Keep in mind on an emergency scene with a critical patient, we often use up to 3-5 paramedics for a serious patient. Two is the minimum number of caregivers you would want for a patient.

First you assess their level of consciousness. Ask them four simple questions. Who are you? What happened? Where are you? What time/day/month is it? This is referred to as alert to person, place, time and event. Most of us can answer these four questions 100% of the time. Unless severely intoxicated or suffering from a head injury, stroke, or shock, people can answer these questions. This gives you an idea as to the patients mental status and level of consciousness.

Next comes the all important (A) Airway. The airway is key. The airway refers to the nose and passages behind it (nasopharynx), the mouth and the area posterior or behind the tongue (oropharynx). Without an adequate airway, your patient will die and die quickly. The airway must be checked and rechecked on all critical patients. Common problems you will encounter with the airway on the sick or injured will be: fluids such as blood or emesis (vomit), foreign body obstructions (choking), broken teeth, tongue blocking airway, and head positioning. The airway of the patient, if the patient is unable to clear themselves, must be cleared by a caregiver. Depending on the mental status and present condition of your patient, will depend on how involved you will need to be in maintaining the airway. Also I must state that any severely injured patient due to trauma (car accidents, falls, assaults, etc.) must be thought of as having a cervical spine (neck) injury. This makes all care more complicated, as this patient requires cervical spine immobilization as well as full body immobilization to a long back board until cervical and spinal injury have been ruled out. This is a complicated and controversial issue, and different agencies have different protocols on how and when paramedics can rule out a spinal injury with assessments done in the field. Any numbness, tingling, paralysis, “electrical shock” feelings, in the hands or feet or legs must be thought of as indicative of a spinal injury. In that case, God be with you.

When approaching the airway, look inside and only remove items you can see. The fluids can be remedied with a portable hand suction. A patient that continues to actively vomit should be placed on their left side and allowed to expectorate (cough up) the vomit. Assist with suction to remove fluid. The risk of aspiration is increased in the unconscious patient. Aspiration is the act of taking in foreign material into the pulmonary (lungs) space. This can lead to aspirated pneumonia and death. I will not explain the many Basic and advanced procedures for maintaining an airway, as these can be found in further reading. Remember, if you don’t have an airway, soon you won’t have a patient!

(B) Breathing is the next assessment stage. In tactical medicine bleeding comes before breathing. Just remember here, that you should look for and immediately fix any profuse bleeding, especially arterial bleeding. I will address this in the circulation portion next. For breathing, you need to look, listen and feel to see if the patient is breathing adequately to support life. An adult should be breathing 12-20 times per minute. Interventions are required for respirations less than 8 per minute and more than 30. Look for chest rise to see and count if the patient is breathing. Listen for the movement of air at their mouth, as well as listen for adventitious sounds that indicate problems with the airway or lungs. Look to make sure the chest is rising equally on both sides. A stethoscope and the knowledge of what to listen for is critical to understanding the respiratory status of a patient. Wheezes, rales, rhonchi, stridor, silence, all of these represent a variety of different events that may be taking place in a patients pulmonary system. Problems with the breathing must be properly diagnosed or ruled out and fixed as you find them.

(C) Circulation, is as you guessed, the “C” in the ABC’s . Find and fix bleeding. When I say bleeding, I mean the kind of bleeding that is going to kill them today, not the little raspberry on their knee. Here you will ascertain the hemodynamic status of the patient. Feel for a pulse at anterior lateral forearm where the wrist and thumb come together. Right over the joint of your wrist you should feel a pulse, if not you are in the wrong spot. Look it up, this is the radial pulse. With this present you can be pretty certain that the patient has a blood pressure of anywhere from 80-90 systolic. Also count the rate. Count the beats in 15 seconds and multiply by four. That is how many beats they are doing in a minute. The average adult is at 80-100 beats per minute. Without exercise, anything past 100 indicates a fast hear, or tachycardia and can indicate blood loss, shock, illness, sepsis, or a variety of other problems. Other locations to assess a pulse are the neck or carotid, the femoral (over the crease where your upper thigh meets you pelvis).

Controlling bleeding is done by a variety of measures. If one does not suffice, continue to do it while moving on to establish the next treatment. First is direct pressure over the wound with bandage or gloved hand. Next, elevate the wound above the heart. Then there is the pressure point. The pressure point is the major artery that feeds the area you area attempting to control bleeding from. You go above the wound, or between the heart and the wound site and provide direct pressure to the artery. Last and highly controversial, requiring training and experience is the tourniquet. Many new products have arrived due to recent global conflicts. QuickClot is a new product designed to hasten the clotting factors and form a clot over a wound. This can be ordered from numerous Internet vendors.

While assessing circulation after you assess the pulse rate, quality and rhythm, you should look at their skin color. Are they pale? Is there skin dry or sweaty? Are they cool or hot? If you are privileged to have a cardiac monitor, put them on it and see what their heart is doing. You most likely don’t have one, and if you do you most likely know how to look at rhythms, so I don’t need to go into that and you don’t need this article. Circulation is this, pink warm and dry is good skin. Pale, cool and diaphoretic (sweaty) is bad.

Assessment of the skin and circulation will aid you in determining if your patient is suffering from shock. Shock is the lay person word for hypoperfusion or the lack of oxygen carried to cells. Cells start to die and this causes more cells to die. The five types of shock are hypovolemic shock (low blood volume) either due to blood loss or dehydration, Cardiogenic shock (bad heart), neurogenic shock (spinal injury), anaphylactic shock (severe allergic reaction), and septic shock (severe infection). All of these require rapid and correct interventions within short time frames for patients to survive.
After your initial assessment, you can move on to assess the patients disability and neurological functions. Check their grip strength, sensations in feet and hands being equal, motor skills, etc. For the elderly or any potential stroke patient I perform a Cincinnati stroke scale here or earlier if that is my suspicion. Get a set of vital signs now. Heart rate, Blood pressure and respirations. Splint and stabilize any fractures returning them to the anatomical correct position. Assess the pulses of any fracture before and after adjustment. Administer oxygen if you have not done so already.

Finally if time allows, get a SAMPLE history from the patient. This acronym stands for Signs and Symptoms, allergies, medications, pertinent past medical history, last oral intake and events leading up to event.

Supplies For Medical Kit:
Oxygen Bottle*, Non-rebreather mask, Nasal Cannula, IV supplies*,
Magill Forceps, Leatherman tool, Stethoscope, Blood Pressure Cuff,
Gloves, Face shield, Flashlight, Advanced airways*,
Hand Suction NPA’s OPA’s, CPR Pocket mask, Bag valve mask,
Syringes, #10 Scalpel, Variety of Gauze pads,Stretch bandages,
Trauma pads, QuickClot, Waterproof tape, SAM splints x2,
Trauma Shears, Hemostats, pen-light, Glucometer,
Glucose gel, Occlusive dressings, Transpore tape 3”, Cloth tape,
Advanced Life Support Medications*

*Indicates prescription only and illegal to possess items unless under a doctors care, supervision or operating in the emergency pre-hospital environment.

A “Blow out” kits contain far less items and only essentials for minor wound care.

I hope this helps someday in a time of need, and serves as an introduction into pre-hospital care. Provisos: Do not take this as gospel. Do nothing illegal. Do not perform any of this care based on this article alone. Always use discretion and call 911 immediately in an emergency (while it is still up and running). Educate yourself further and be diligent. Medicine is important and the knowledge you gain may save your life or the life of a loved one. Take care.



Letter Re: Some Storage SNAFUs

Jim:
Why do the incredibly robust “cheap” imported AKs have chrome lined bores , yet some of the expensive and finicky American-made ARs not chrome lined? Well, if you live in a humid climate, it makes a difference. I made the classic error of storing my guns in gun cases. In fact, that’s the worst way to store them as the humidity accumulates inside. One of them had nearly rusted solid in three years.

Thanks to the ministrations of another firearm enthusiast, all my guns are being de-rusted, dipped in preservative oil and mylar bagged along with oxygen absorbents, rust inhibitor tabs and desiccants.
I don’t want to talk about what happened to the barrel of my M21 so just don’t ask. If you live in a humid climate, then consider the PS90. Mostly plastic, hi capacity, very ergonomic.
I also learned about the weight limitations of gamma seals. I just noticed that when I put ammo in five gallon buckets with Gamma seal ls on them, if I go over three buckets high, the bottom seal breaks and falls into the bucket. Now I limit it to two high and only lightweight buckets on top. – SF in Hawaii

JWR Replies: Thanks for being so frank. Perhaps other readers learn from your mistakes and avoid some costly problems.

A humid climate dictates extreme vigilance for gun storage. Here is my general guidance:

1.) Clean thoroughly, lubricate heavily, an a inspect frequently.
2.) If storing guns in a vault or a wall cache, invest in a Golden Rod dehumidifier. But don’t expect it to be a miracle panacea. Mark your calendar with reminders for monthly inspections!
3.) Never, ever use a muzzle cap for more than an hour or two. They are for use in the field, not for storage!
4.) R.I.G., silica gel, and and VCI paper are your friends.
5.) If you use grease or a heavy coating of oil in a gun bore and/or its chamber, then be sure to tag the gun with a prominent reminder to yourself to remove the grease it before firing. (Not doing so can be a safety hazard!)
5.) Do NOT use oxygen absorbing packets for gun storage! These are designed specifically to kill insect larvae in stored food. These packets use a chemical reaction of moisture, salt, and ferric oxide (rust!) to consume the oxygen in a confined space. These packets can be bad news for stored guns. Instead, I recommend that you use silica gel to prevent rust. Silica gel packets also have the advantage that they can be re-used many times if you dry them out in an oven or a dehydrator overnight. (Since they employ a chemical reduction process, oxygen absorbing packets can only be used once.)



Odds ‘n Sods:

KAF recommended this: Documentary shows tough reality of doctors in war. (Warning: Not for children or for the squeamish!)

   o o o

Cheryl N. sent us yet another raft of economic news and commentary: Stagflation Becoming Economic Reality, FDIC Admits Short-Term Loans Might Be Needed, The Building Storm: Gold, the Dollar and Inflation, WAMU The Killer Bank, US Thrifts Lost $5.4bn in 2Q, Second Largest Ever, Bankruptcy Filings Near 1M in Past 12 Months; Up Almost 30%, Economic Depression: Who Will Suffer Least?,
Credit Crunch: It’s Just The Beginning Of The End, Private Foreign Investors Dump US Debt, and Bankruptcies Soar for Senior Citizens. OBTW, in recognition of her many hours of tireless research, I think that it is time that we elevate Cheryl to “Economics Editor”, and send her some more free books.

   o o o

An friend that is an American ex-pat wrote to ask about the EcoloBlue water generator. Do any SurvivalBlog readers have first-hand experience with one of these? I’m curious about how much current they draw, and their maintenance requirements. If they are indeed practical and low maintenance, then they might make sense for someone that lives in an area with plentiful sunshine (and excess photovoltaic power capacity) and a shortage of drinking water. Buying one of these is beyond my budget, but perhaps not for some SurvivalBlog readers.

   o o o

Hurricane Gustav was downgraded to a Category 2 tropical storm, but it still packed a wallop: Hundreds of thousands lose power as Gustav pounds coast



Jim’s Quote of the Day:

“Depression, especially in a highly leveraged world that is accustomed to prosperity, would likely result in serious civil strife. Politically, it must be avoided no matter what the economic or financial costs. Despite ‘spin-talk’ to the effect that the Fed is pursuing a dual mandate to both fight inflation and promote growth, in reality they are simply trying to promote growth pure and simple. This is the reality that few market analysts or journalists dare to mention.” – John Browne