It Could Happen Here - Dealing With Gunshot Wounds

Episode Date: May 3, 2022

Robert and James discuss how to properly care for different kinds of wounds while out in the world. See omnystudio.com/listener for privacy information.

You should probably keep your lights on for Nocturnal Tales from the Shadowbride. Join me, Danny Trejo, and step into the flames of fright. An anthology podcast of modern-day horror stories inspired by the most terrifying legends and lore of Latin America. Listen to Nocturnal on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. It's like a bunch of different illustrations of dictators all done as like little anime chicks.

So they're all hot. So like Pol Pot's this like sexy girl on a throat of skulls, but Tito, they made into a milf. Like she's got all of her kids around her. It's the only, it's the only one with kids. I don't know why they picked Tito for that,

but it does kind of work. This is, it could happen here, a podcast about which anime war criminals are hottest. And it's Idi Amin, actually. The Idi Amin in that book is pretty smoking. How's Pol Pot depicted?

As a, like, wearing black lingerie on a throne of skulls. Okay, nice. Does Kissinger make it in? No, no Kissinger. All like world leaders. He's a world leader in some things. I would argue that, but he does not make the book. No, it's sad. Tragic tragic Anyway, this is It Could Happen Here

Podcast, things falling apart And other stuff I'm here again with my buddy James Hi, James, hi Which dictator do you think would be hottest? If they were like Gender bent Yeah, yeah

I don't know, I'd have to go for like one of the old timey ones perhaps one of the one of the one of the uh one of the czars yeah i think uh because our nikki had nothing to do but like look hot yeah and he was a big workout guy yeah big workout guy nice to rip nice nice outfit tight trousers yeah i think i'd probably go with him yeah that that scans now which was hottest as they were like which is the most fuckable war criminal that's a tough one i probably have to think about that i don't know none are coming to mind actually oddly yeah who do you go that stalin pictures are fake oh yeah yeah not not not nearly actually that sexy um No. Um, Joseph the Stallion. I, I gotta go.

I gotta go with Saddam Hussein. Yeah, that's true. He has a sort of lustful mustache. It's good. That mustache fucks. Yeah. James,

we should probably talk about something that's not which dictators are most fuckable. Um, today we're going to chat about he fat courses, uh, and about emergency, emergency um and particularly like combat medicine which is a a more relevant topic for a lot of people in the wake of a couple there was a mass shooting at a protest in portland uh there's been a whole lot of um threats made against lgbt people uh jack posobiec launched a t-shirt that was basically threatening

a mass shooting at Disney World. All sorts of fun shit's been happening. Yeah, it does seem like we're spiraling towards the end of times. Yeah, it certainly seems, if you want to be less apocalyptic than that, it certainly seems credible to say that there's a pretty good chance there are people listening to this who have not been present at a shooting who will be present at a shooting, who will be present at a shooting

at some point in their lives. Yeah, and I think given that, it doesn't make sense to like, I'm joking about the end of times, right? Like we shouldn't panic and things. We should think about ways we can protect each other and keep each other safe. Yeah, so what is a HEFAT course?

Because you recently went through one. Yeah, so HEFAT is an acronym, right? Hostile Environment First Aid Training. It's a british thing i think this the syllabus i believe is standardized by the government in the uk so most of the courses you'll find are in the uk uh clustered around hereford for pretty obvious reasons um but that there are there are a couple in the united states and there are some in other countries too and it's for journalists aid workers ngo staff and anyone else who's working in an environment that would

be considered like high risk or hostile and to your point that includes most of the united states at the minute right yeah well i mean we are in this fun place where literally any moment could turn into uh a situation with the intensity of a of adensity war zone. Yeah, I mean, we have more weapons than most war zones, and also people who think it's okay to kill other people because they like Mickey Mouse. So it does seem like, like you said, it is more likely that we will see more shootings, even bombings and that kind of thing.

Like, we can't say for sure. Yeah, now, you have done some of the same kind of work that I and some other colleagues of ours have done, you know, in hostile environments, difficult places, prior to going through this course. Obviously, when we're talking about like, what sort of first aid skills should people have, the most basic stuff is like,

how to apply a tourniquet, which we'll talk about a bit more later. How to, if it's not, because tourniquets are really only for extremities, you know, you can't really tourniquet, which we'll talk about a bit more later, how to, if it's not, because tourniquets are really only for extremities, you know, you can't really tourniquet a gut wound or whatever. And so for that, it's more like packing it. But outside, so I'm going to assume you had more than your share of experience with that kind of stuff. What did you learn new going through this course?

Like what was the stuff they emphasized that's kind of beyond the basics? Yeah. So the stuff I've done before has been some of that basic stop the bleed stuff and then a fair amount of wilderness medicine stuff. So, uh, some of the improvised stretches and stuff I was familiar with. Um, I enjoyed some of the releases they did like, uh, I'm not talking about like necessarily like a hand to hand combat or or open hand combat but like ways to release yourself in a non-violent fashion i thought that was very good uh ways to move through crowds i found that very interesting and we did a lot around how to move under fire how to react around explosives how to react around indirect fire and most of that i'd already covered and then some of the stuff

around hostage situations to include a simulated hostage situation where you're blindfolded or hooded and sort of ask questions and poked with a blank firing weapon and such uh i think it's really good you can't really have enough fix well you can't have too much experience with that but uh to simulate that in as realistic a setting as possible i found was super helpful so i think yeah i think that was probably the most interesting thing for me now when it comes to what kind of training people can get, because the HIFAT course is a couple of thousand bucks, which is beyond, I know we have some colleagues listening, and I think it's a good thing for people who are going to do this kind of journalism to consider, or if you're in, you know, an aid worker or someone who is going to be going into these situations

for a living, that's, but for a normal person listening, it's probably more than you're likely to want to get or have the resources to get. So what people, because we, especially in the wake of shootings, pretty much any time there's a mass shooting or violence at a protest, I will tweet about IFACs again. And an IFAC is an individual first aid kit. It's what like every soldier is supposed to have on their belt or on their plate carrier. And it generally consists of what are called, and this is when people ask like, what should I get to be ready for a shooting? Generally, it consists of two chest seals. These are called occlusive dressings.

They're basically like kind of sheets of adhesive plastic. I would say that you like put over, if you get shot in like the lungs, you, your lungs kind of depressurize. And that's bad. I'm not a, I'm not a biology expert, but you're not supposed to have a hole through your lungs. And one of the things that you do to treat that immediately is you put this

kind of addressing over it, which stops the lung from collapsing basically. So that's one thing you'll find in an IFAC. You'll also find what's called a combat tourniquet. There's a bunch of kinds of tourniquets. I was doing a stop the bleed course. We'll talk more about that in a bit, but that's the thing everyone should do.

In terms of, you know, HEFAT is kind of more advanced and for people who are going to professionally put themselves in shitty situations. Stop the bleed is for everybody. And one of the things I was having a chat with people who were teaching them, we were doing a little meeting. And one of the things that was brought up, people always talk about, well, I wear a belt in case I need to make a tourniquet or this or that, and virtually never works. Like close to 0% success rate, even when it's someone who's

trained and experienced providing tourniquets. Like random shit does not make a good tourniquet. Tourniquets make good tourniquets. Yeah, they're small, they're easy to carry. They aren't cheap, right? But on the same, you shouldn't cheap out on them either, right? Like we've, I know we've talked about this on Twitter

and I know like Amazon sells them. They've also had a problem with selling fakes. Uh, so like North American rescue, uh, I think it's called emergency rescue. I'll, I'll give you some links so we can tweet out. Yeah. North American rescue is really good. One of the, so yeah, rescue essentials. So what a combat tourniquet is. Cause there's different, some tourniquets are just like a plastic band, almost, almost like if you go to a gym, those things that people like wrap around their legs to do squats or something or lifts. It's kind of like, it looks a little like that.

And those, yeah, obviously like those can work, but they're not nearly, a combat tourniquet is basically, it's a little like kind of nylon-y fabric belt thing that you strap around and you tighten it and velcro it tight. And then there's something called a windlass, which is basically a metal or plastic stick that you then twist around. And that twisting action, when you twist it, that's going to tighten it, and that's going to stop the artery from bleeding. And then you lock it into place. There's a little place to lock it. And so when you get a cheap tourniquet it generally means the windlass is made out of something flimsy or the fabric adhering the windlass to the belt thing is not very good and it will break when being tightened yeah and you don't want what you don't want to do is not have enough pressure or have sort of weird

pressure because what you're going to do tomorrow i'm not that kind of doctor yeah right is you can cut off the venous return and not the arterial flow and that's where you can give yourself compartment syndrome right i just wanted to backtrack quickly and we were talking about how expensive he fats are if people are listening and they are in that kind of line of work uh the international women's media foundation is is doing free he fat courses for women gender non-conforming non-binary people and i got a i got a grant from the rory peck trust Trust to go and do mine. So for journalists,

both of those are really only for journalists and media. I would really encourage people to apply. Yeah. And that's great information because if you can, even if like your journalism has been sort of like citizen journalism where you're showing up at a protest

and taking pictures or whatever, give it a shot. Like the more people who have this kind of training um as a general rule the better um when it comes to stop the bleed courses are generally going to be much more available some of them are operated as charities and we'll give out an ifac or something at the end some of them have a nominal fee it kind of depends on where you are i've seen both. Portland has a lot of stop-the-bleed courses, which is why when we had our most recent mass shooting at a protest, more people didn't die because folks had equipment and were ready.

You should expect to spend about $30 generally on a combat tourniquet, sometimes $20, but the good ones are all about $30. I would shoot for something with a metal windlass that's generally a sign again there's like rescue essentials and um a couple of other brands that are reliable but uh it's called the tactical committee on combat care which is a government funded thing it's like if you let them do the research so you don't have to they provide a list of of corn toonicase uh tonicates the one that most people have is a called cat right called application toonicate if you get that even if it's not the best one or the smallest or lights or whatever every that's the one most people train with they know how to use and i think you've said this before like even if you don't know how to use it if you're in a

situation where it's needed and you just say i have have this, I have a tourniquet, someone might take it and use it. So, yeah. And it's it's like it's OK if you panic as long as you get that into the hands of somebody who can use it. But it's also important if you're going to carry it to train with it. Someone said that they and their friends have a game where when they're hanging out, somebody will toss a tourniquet at someone else and say, right arm or something like that, right arm above elbow or something like that, and they'll have to apply the tourn doing it, but you can, you can get it on and get familiar with the motions and build like a competence with it. Yeah. Work out when you're going to lasso the limb and when you're going to take it off and go all the way around. But I think standardizing one thing, certainly among you and your affinity group or your friends is, is probably a good move. Um, yeah. Yeah. And it's one of those things, the kind of injuries that tourniquets are most needed for are like arterial bleeding,

which is the kind of thing that if you don't get a tourniquet on, you're dead very quickly. Like people will bleed out in seconds sometimes from like a femoral wound. Yeah, if you've seen an arterial bleed, and I'm sure that, I know I have, I'm sure you have, you know that that person has an arterial bleed. i'm sure that uh i know i have i'm sure you have you know that that person has an arterial bleed that is a pressurized gushing of blood it's like bright the blood for arterial bleeding it comes out in spurts and it is like bright it is not it does not look like when you cut your finger the blood tends to unless you're really cutting the

shit out of that finger yeah yeah yeah you um and one of the things we did at this course which is cool actually was they had like a simulated arterial bleed. So the person was wearing, what, like a camelback, and then they had, like, a hosepipe, and it was just gushing out. And then you could actually cinch down on it, right, with the strap, and that actually stopped it. Welcome.

I'm Danny Thrill. Won't you join me at the fire and dare enter? Nocturnum, Tales from the Shadows, presented by iHeart and Sonora. An anthology of modern day horror stories inspired by the legends of Latin America. From ghastly encounters with shapeshifters to bone-chilling brushes with supernatural creatures. Take a trip and experience the horrors that have haunted Latin America since since the beginning of time. Listen to Nocturnal Tales from the Shadows as part of my Cultura podcast network available on the iHeartRadio app,

Apple Podcasts, or wherever you get your podcasts. Now, I mean, when it comes to like more advanced bleeding care because there's some wounds where number one if it's like for example too high up in your like crotch or something you know you're not necessarily going to be able to get a cat up there sometimes people will literally hold the artery closed like that is a thing that and that is more advanced certainly um but it is it is also like the physics of this are very basic if you can figure out where blood is coming from and close it blood will stop coming out right like that's the principle of all immediate wound care for that kind of thing yeah there's an acronym that you use right dr march uh which we can go

over but uh danger right so uh and i think this is a thing that often gets forgotten actually um especially if you're doing like somebody's start to bleed which is focused on first aid rather than specifically in kind of combat care but if you get hurt not only are you useless to that person not only are you hurt if someone comes to help now they have to think about which person they're going to help right because how much harder to carry two people than one person so don't fucking do that uh uh and then response right so robert i see you've been shot it doesn't look great are you okay uh and then massive bleed airway uh respiration yeah uh check head to toe and then hypothermia and you know one of the things that is so like a combat tourniquet you just generally you can keep it in like a kit.

It's also fine to keep it loose in your pocket. You are not worried about sterility when you are applying a tourniquet. It does not matter if you get shit in the wound, like, because they will die. They'll be dead in a minute if you don't get the tourniquet on. Um, yeah.

Yeah. You're not putting it in or whatever. Like it. So yeah. So that's, that's one kind. that's again you're talking about extremities right you can't put a tourniquet on a neck because that would kill the person um you would use an occlusive a lot of times on the neck especially if like the airway

gets again this is stuff that you would you would get in a stop the bleed course and i recommend people for that so we're not going to go over treatment outside of like these basics but we'll talk about like you should have an occlusive dressings two is what most ifx come with people i know who have responded to shootings say you want more like four because they a lot wind up getting used yeah i think about i think those especially chest seals and something that i've been told by people with a lot more experience than me it's like when you're dealing with a military setting most people will have their chest covered with plates, right? And plate carriers.

In a civilian setting, most people won't. So you're going to see a lot more of those, like sucking chest wounds or penetration of a thoracic cavity. So yeah, in that setting, and they are very small, right? You could put them in the back pocket of your skinny jeans and no one would notice. So another kind of thing that you'll find in an IFAC that's useful is combat gauze. So there's two types of gauze that you'll get in kits. One is just gauze,

which you know what gauze is. Most wounds, if they are not life-threatening, packing with gauze and wrapping is perfectly sufficient, at least for immediate care. But combat gauze is impregnated with a thing called cellox, which is our little granules. You can actually get them just as the powder. You shouldn't, because it's not going to be useful to you as a random person. You should get it in gauze, like impregnated into gauze,

but it's made from ground up crustacean shells. And it basically makes blood clot very quickly. Survivability of arterial wounds in combat, which was extremely low before Cellox jumped to something like 70% or so, like it's pretty remarkable the degree to which it's made certain, particularly like femoral bleeds survivable. And it can be used if you've got like a serious arterial bleed, it'll often be used in conjunction if it's on an extremity with a tourniquet. But you can just use it to pack a bleeding wound.

And if you pack it and apply pressure, sometimes you'll pack the combat gauze into there and then add other gauze outside of it. But most wounds that are bleeding aren't going to require cellox gauze, and it's pretty expensive. But it's another really useful thing to have if there is an arterial bleed. Yeah. I think actually the,

um, where we first, I think KLN might be what the stuff is called. I believe it comes from indigenous practices using it to stop bleeding, but yeah, it comes in a small package. Quick clot is normal brand. And yeah, it's a lot of what we've learned about stopping arterial bleeds has come from,

uh, 20 years of war. Right. And there are obviously a lot of downsides but uh yeah learning about how to stop those things is one of the things that has gone a lot better in the last decade or so so that's another thing and you can always buy these kits pre-made a lot of people make various pre-made kits yeah you can google ifac and make sure it's you know rated well do a little do your research um we've mentioned some brands here but like it's not

hard to find ifacs they're they're made constantly, it's not hard to find IFACs. They're made constantly. And it's one of those things we talk on this show about being armed and whether or not people should have firearms. And I'm broadly supportive of particularly threatened people having guns, but there's downsides to having a gun. A number of them, we don't need to get into the statistics, but there are a bunch of downsides to being armed. There's no downside to having an IFAK and keeping one in your car. Keep one in your backpack. There's

absolutely no way you will have a negative experience as a result of the fact that you keep an IFAK on you. It might save somebody's life. I have a little ankle holster that I use when I'm working in places where it wouldn't look very... It would look off to have it on my belt. And I don't want to carry a backpack, maybe.

And it's wrapped around my ankle and it has a tiny combat dressing, which we haven't really talked about. Chest seal tourniquet. It doesn't have the quick lock, but the combat dressing has its own gauze. Yeah, we can talk about that in a second. But like I just have like I have a couple ofs, but also just in all of my light jackets, because, you know, Oregon, usually you can wear some sort of jacket. I just have a bunch of cats and quick clot gauze packets just kind of scattered around.

Like there's nearly always something just in my pocket or in the center console of my car, in addition to the actual packed IFACs. And yeah, it's handy. It's just good to have around. It never hurts to have more of that stuff. You have the means or, you know, if you are in a situation

where something horrible has happened, like what happened in Portland. Right. If you in your truck have three or four of those and you can just be like, go, go, go. Does anyone know how to use these? Use these. If they're in your backpack when you're at a protest,

you could potentially save several lives. So if you have the means, like we said, give them to strangers. It's not like a gun, right? You can't end your life with a quick clot. So, yeah, it's a thing that everyone should feel good about. How do you stop the upline? We should note, again, you wouldn't want to use quick clot on a wound that was not serious because there's some consequences.

Like it burns. It's kind of nasty stuff in some ways. Um, it can cause some complications for, for like when the EMTs get there. Um, it's often recommended that you keep the packaging and give it to them. But if it's, if someone is clearly going to bleed to death, like that's then that, then that's when you use quick clot. And if you're questioning whether or not a wound is serious enough that someone might bleed to death from it, assume they will, right? Like err on the side of that. If you're wondering, is that a deadly bleed?

You probably should probably treat it as if it is. Yeah, I mean, you're always better off keeping more blood inside the person. Yeah, with that, yeah, I've been told to tape that to the person. And the same with the tourniquet, right? We should say that. There will be blood around. You can put a T on their forehead yeah with the blood uh it's pretty normal and that works in almost any language uh and then you want to write the time it was applied to and again you

can do that with the blood but i i have a half-size sharpie that often comes in in those kits yeah write that on it yeah and it's one of those things like it assuming it kind of is dependent on your situation whether or not you're likely to have the time to mark that before the EMTs arrive. But it is one of those things, even if it's even if your first responding is a minute and a half or two minutes with a serious bleed, that can be the difference between life and death for somebody. Yes, absolutely. Yeah. And it's different what you do when care isn't coming to what you do when care is coming. But the first steps are not right. stop the blood coming out of the person welcome i'm danny thrill won't you join me at the fire and dare enter nocturnal tales from the shadows presented by iheart and Sonora an anthology of modern-day

horror stories inspired by the legends of Latin America gasoline counters with shape-shifters to bone-chilling brushes with supernatural creatures. I know you. Take a trip and experience the horrors that have haunted Latin America since the beginning of time. Listen to Nocturnal Tales from the Shadows as part of My Cultura podcast network, available on the iHeartRadio app. Apple Podcasts.

Or wherever you get your podcasts. So we should probably talk about combat dressings a little bit. Yeah, yeah. There are several types. The one I've had suggested that I prefer, I think, I don't know how it's pronounced, but it's O-L-A-E-S, Olay's dressing. it has a little eye cup in it as well um which you can use for eye injuries like find someone more qualified than me to teach you how to do that yeah don't need to get into

that but yeah but it's it's a pad with gauze in it and then a sort of ace bandage right and what it does is provides compression and obviously like an absorbent gauze you can also pull the gauze out a fun thing to do is to find an expired one and pull all that gau provides compression and obviously like an absorbent gauze. You can also pull the gauze out. A fun thing to do is to find an expired one and pull all that gauze out. And there is just an unfathomable amount of gauze there. So you can use that to pack a wound. And practicing packing a wound is also something that you can do. There are like little bottles. Yeah, the team I know who does Stop the Bleed courses will take foam rollers and cut holes in them

and use that as like a, and you can do different sizes, right? You can actually just like get a knife and like jam it, stab it a bunch and like use those as different practice wounds. Yeah, that's a good idea. Can you pack with two fingers, you know, more than that, even one finger, people can pack with one finger.

So like what this dressing does is opposite. Sometimes they're called Israeli bandages bandages uh ole's bandages they often come in like a tan package the israeli ones yeah yeah that's right uh again like i would buy that from a reputable source and they come in various sizes emergency dressing is another name yeah and yeah those are great for things where you don't need to use quick clot where you may't need to use quick clot, where you may not need to use a tourniquet. Yeah, significant bleeding, but not like immediately life-threatening. Yeah, and in some areas where like sometimes in the forearm, right, like it can be hard because of these bone structures to get the tourniquet to work.

So like you might be able to use that and stuff. You might have to use quick clot, right? But like having those options is important. And again, they're pretty small, probably the cheapest of the things we've suggested so far as well. And again, then they make giant ones from abdominal wounds too. And so like, I actually have one of those in my truck.

I have a bunch more stuff in my truck. I wrote a piece about a first aid kit for your vehicle, which might even look slightly different, right? If you imagine again, like we've talked about shootings, but car accidents, that's when I, if he looks slightly different, right? If you imagine again, like, and we've talked about shootings, but- Car accidents. That's when I, the only times I've had to use those dressings have been car accidents.

I had to help pull a fucking dude out of a truck that flipped on the way outside of Los Angeles during a rainstorm. And his like whole fucking, like right here in his hand had been gouged open where like it was quite a bit of blood. But yeah, like that's a bit, it's not all just like action movie shit. Like it's something you should keep on you because there's a wide variety of

things that can cause people to bleed a lot. Yes, exactly. Yeah. Yeah. And I think we, uh, we always underestimate the risk that is deriving. It's probably the most dangerous thing most people do. Uh, and yeah, having that in your car, you know, you don't have to worry so much about carrying it. It can just always be there. Don't leave it where it's going to bake in the sun if you're in a hot place yeah but uh yeah again the potential for you saving a stranger's life or a friend's life

yeah is high yeah keep it in the center console keep it in a trunk you know keep it in a trunk alongside a machete in a golf club you know you're always ready for anything with that yeah i'm never ready for golf but aside from that i'd be oh i wasn't saying for golfing okay just for yeah for crime yeah exactly for crime medical actually make a re yes yeah they make a lovely vehicle first aid kit and they're very nice people too um so yeah that's one to look into and they also do the bags uh i have a mystery ranch uh bag that also clips onto it replaces the hood on my backpack. And I have that in my truck. And then if I'm going out,

especially when I'm going out climbing, I'll just clip that on. I have a slightly different kit that I take just for climbing. But that's one of those scenarios where like, you could hurt yourself climbing. And even if people are coming very quickly, it's going to take you a while, right? Yeah.

And thinking another thing. Be prepared to self-rescue. That's part of why you bring that kind of stuff self-rescue is a massive part of climbing right learning the lots earning the transfers learning the ways that you can get yourself off a wall if you hurt yourself on a wall and uh the american alpine club actually publishes a thing called accidents in north american climbing where climbers oh okay this person fucked up like this and they did this and this and this and they were okay or they weren't okay so i think that's a very good practice learning from other people and with that a big thing that you focus on in wilderness medicine is rather than what can i bring with me

what do i have to already have with me and how can i use that right so uh for instance you need to split a leg right you have a broken leg using a sleeping pad or something which already has those rigid sleeves to do that um that's something that like i don't want to obviously advise people too much yeah i don't want to like because again so the different this is useful people should be thinking about this um when it comes to emergency first aid like somebody who has a broken leg if you're not like there's no real response that you should like that's not what stop the bleed is for right like um one one of the nice things about emergency medicine like this like when you're talking about someone is bleeding to death is that one of the ways i guess that you can you you can you can separate the the two kinds of like first responding because there's the first

responding where you can make it worse and if if you like, somebody like breaks a bone or something and you can make that worse. Turn that into an arterial bleeding. Yes. But if somebody has an arterial bleeding, you can't make that worse. It's the same thing with like chest compressions, right? When you get trained as an EMT,

one of the things they'll point out is that like, you shouldn't use an AED on an infant, but you do, because if they need it, they're dead. Yeah, and in that case, yeah. I think it's important also, and the thing I didn't mention that I found very helpful about this course, some of the sort of psychological aspects of this,

is to remember that if you do find yourself in this situation and you try and help and that person dies anyway, then you did your best, right? And that is of value like i've been in situations where i've tried to help someone and they've died anyway uh and and i think just remembering that like that person had something terrible happened to them and that your help didn't you know like you tried your best to give those that person another chance yeah it is not if you are responding to somebody who has this kind of injury,

there is a pretty good chance what you do won't matter. Like it's the same thing. If you are giving someone chest compressions, that's very unlikely to save their life. Like a fraction of the time when that happens, does it save anybody, but it can't make it worse. If they're not breathing,

they're not breathing. They're going to die. Yeah. And I think, uh, you know, it's not like the movies or television like sometimes it doesn't work it's important to talk about that in the context yes actually much probably much more likely the person will survive if you're doing this stuff right if you're slapping on torn again you do it right you

will stop that person yes yes and and but you know again it is a lot of times what you might be doing is keeping them alive long enough to get to the hospital and you can't guarantee anything other than that they don't bleed out right there right and then maybe other injuries you haven't seen that's why we do the check head to toe right um and stuff like that like especially in blast injuries you might not notice injuries to the back yeah shrapnel is a whole i mean but all you can do is like try to treat what you can see yes exactly and make sure that you don't miss anything by going through that Dr. March procedure, right, which you'll learn in a course. But yeah, having a procedure that you do where you make checks so that you don't miss something that you could have stopped, because then I imagine you will feel bad. or our attempt to give you comprehensive training on it. This is in no way training.

This is advice on number one, the equipment that's necessary for stopping someone from bleeding to death. And number two, the kinds of training you should get in order to use it. And you should seek training. You should find a stop the bleed course. You should take a wilderness medicine course if you can. If you are someone who is in a field

that it's relevant for, you should try to get a HEFAT course. Don't just like be, okay, I listened to a 30-minute podcast. I'm ready to stop a bleed. Go get some training. But definitely get a tourniquet and practice with it. You can do some training yourself. You can find videos online by reputable people who are affiliated with different rescue organizations

talking about and showing how to apply tourniquets, how to apply dressings. Like that's available and you can provide yourself with a useful amount of education and some of the basics that way. Yeah, I think just to give out some resources on how you can get the education, right?

Stopthebleak.org should be free almost anywhere you are. If you'd like to get more training, most community colleges have an EMT course that is very affordable. Yeah, a HEFAT course can run you a couple grand if it's not subsidized. The last time when I took my EMT training, it was $1,000. Yeah, I think it's less than that now. I know people have many students who are going through EMT training.

And it's pretty affordable, free. Often, if you're in California, it's often free. The other things you can do are, yeah, wilderness medicine. That is expensive. The American Alpine Club has grants. A more diverse group of people should apply because all of the outdoors could do with a lot more diversity. And I encourage people to apply.

Yes, so for all of these training, there are grants, and I would encourage more people to apply uh yes so for all of these training there are grants and i would encourage more people to apply to them but you get you can learn a lot for free or online you can and should try and educate your friends like we're saying it's some of this stuff is hard to fuck up and even if you don't feel confident using stuff rescue essentials north american rescue chinook medical those are places where you can buy a pre-made ifac carry that around and someone else can use it. And again, for talking about like the benefits of this versus the cool looking tactical gear and guns and stuff,

it's entirely possible to have a bunch of military equipment that is worse than useless if you don't know how to use it, is actively a danger to other people. If you have a bunch of medical gear and you don't know how to use it, but you have it you you can always shout like i have a tourniquet i have like a combat dressing or something like does anyone know how to use it no one is going to make fun of you in the wake of a mass shooting for trying to hand off your gear to someone who knows how to use it yeah exactly and like you don't have to carry around a little green multi

camp pouch or something like you can get a bum bag. Put it in a fucking purse. Like, whatever. It doesn't matter. Yeah, it doesn't matter at all. They're very small. They're very compact. And a bum bag or family pack is very handy because you can switch it from the back to the front. Get to all your stuff. So, yeah, you don't have to be all, like, tactical fucking Sammy Savior.

Just be sensible and safe. Yeah, even if you don't, even if you panic or whatever and can't be the one to use it, you can still help save somebody's life by fucking having the shit. Because it's irreplaceable when it's not there. Yeah. I would just encourage people to not use the elastic cord.

Yes. Don't go and buy Milsurp stuff because you can probably pay the same price to get something that's not expired. And so, yeah, just be conscious. Buying from those reputable people they often have sales especially around holidays you can uh you can hold out and wait for those um there are pretty good resources on reddit as well actually there's a tactical medicine subreddit where people will sort of list their kits and often post that's a sale so it's sometimes worth cruising that if this is something that's interesting to you yeah Yeah, do some research.

You may find right now, especially in places like Rescue Essentials, it is harder to get combat tourniquets because the war in Ukraine has caused a shortage of the good ones, but you can still find them. You just may need to search around a little bit. Yeah, what I found was that, because you'd posted about this after the New York shooting,

was that they were out of the straight tourniquet, but they were not out of the tourniquet with the pouch. The pouch costs like $6 or $8. I know that that's more of an expense, but if you can afford that, then getting that's not a bad idea anyway because you can put it on your belt, have one on my backpack when I'm hiking, right? So that's definitely something to know, to look for. All right, well, that's going to do it for this episode. James, you want to plug anything?

Anarchism. Oh, good. Yes, absolutely. Yeah, go find a hierarchy and, like, throw a rock at it. Yeah, just look after other people and don't resort to the state to do it. Be kind to each other. And get EMT training if you can

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