Hopefully you have seen the IFAK article printed by NPR on their website, if not, check out the links on my blog. The article talks about the "silent chaos" present in the aftermath of the shooting in Tucson, which left 6 people dead and changed the lives of a congresswoman and many others. The article mentions "rare little packs". The author then tries to explain what an IFAK is. My previous post describes a typical IFAK. I also make mention of the origins of the IFAK and why it exists at all.
In essence, the IFAK represents a shift in how we provide first aid during and after a shooting incident. I like to call this shift the "New First Aid". Why is it new? The nature of the care is the same. The techniques are age old techniques but they are applied in a new way with new technology. Lets look at the concept of the "New First Aid".
The New First Aid that I mention involves new technology and a new mindset. First the technology. About 10 years ago the U.S. military embarked on a campaign to save lives on the battlefield. The movie BlackHawk Down, based on events in Mogadishu, Somalia in the late 90's documents the running gun battle that cost the lives of a number of soldiers who, despite using first aid, succumbed to their injuries before getting to a higher level of medical care. The army looked closely at every casualty, surviving or deceased, and determined that they needed to improve the average soldier's ability to treat bleeding and prevent shock. Out of that realization came a search for a better way to stop bleeding.
The first step was to add tourniquets to the list of items each soldier carries. The tourniquet can stop bleeding from wounds to the arms or legs. Application of a tourniquet has saved hundreds of lives since its adoption by the U.S. military. The second step was the addition of new clotting bandages. The army invested heavily in chitosan based technology and developed a bandage that eventually became a gauze product. When applied with direct pressure to a bleeding wound the chitosan gauze accelerates the clotting process and results in less blood loss than with "old fashioned" gauze. Today they are several products on the market which are used to stop bleeding. I have used hemcon products over 100 times and have seen impressive results. There is research that suggests that the chitosan gauze is twice as effective as the non chitosan products. I can assure you that there is new technology in development which will continue to improve the life saving ability of the average person.
The mindset which accompanies the "New First Aid" is that of survival during chaos. Traditional first aid training always reinforces the concept of scene safety. This is done to prevent unnecessary injury to the rescuer. It makes perfect sense that a rescuer should wait until the scene is safe before becoming involved in providing medical care. However, it is also recognized that some injuries like major bleeding can lead to death within minutes. The field of tactical medicine developed precisely because a group of docs and medics decided to copy the military model of providing medical care before the scene was safe. Today there are medics and docs on SWAT teams all across the country. There are tactics and techniques which make it possible for an injured person to treat themselves to stop bleeding and their partner can assist if needed. I propose taking that one step further. I believe the New First Aid should be made available to each and every willing person.
If you think I am a bit nuts, just think about Automated External Defibrillators or AED's. The AED provides a rapid solution for sudden cardiac death. The computers can now diagnose and treat a fatal heart rhythm with the press of a button. Cardiac life saving is now in the hands of the public and the solution is prepositioned where the people live and work. Now consider the multitude of violent acts committed against people across the globe. How many lives could be saved if this simple hemorrhage control technology was more widely available? I don't have the answer but it seems intuitively simple to me.
With that I will go back to my job of making as many people as possible aware of the New First Aid and the life saving technology available to them.
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