Warfare Medical (HRE)

High Risk Event (Warfare) Medical Course

This course can be modified to the level of expertise in the audience and can be adapted in the classroom for multiple levels of experience and understanding. It is designed as a “hands-on” workshop designed to develop applicable skills in the area of operational medicine and combat field medical care, including applied anatomy/physiology and the basics of self and buddy care under fire.

Training Goals and Objectives

The goal of the training program is to prepare and condition law enforcement officers in an extensive practical utilization of medical information to enhance combative physical performance, via injury prevention and establishing medical capability in hostile environments.

Training Audience, Format and Content

This is an intermediate / advanced skill development course designed for the Tactical Law Enforcement Officer that needs to have medical knowledge and skills to improve physical capability and initiate medical care in hostile a violent situations.

This course is most successful when taught and received with audiences of 15 officers or fewer. The smaller groups enables students a more direct dialog & contact with the instructors and the other students.

The course is designed in twelve (12), day sessions with each day involving the exploration of a different topic and the reinforcement of previous learned material. The course is generally designed to run from 0800 to 1600 hours daily, but can be manipulated for evenings and extended days as needed.

Daily content and course schedule/agenda:

Note: Students will be engaged in over 60% of hands on training during each day of instruction. The instructor will lead each day in the topical instruction, and then implement related practicum simulations at the student’s workstations. This course is physically and mentally challenging and is designed for participants who maintain an above average level of physical fitness.

Day 1

Physical Training

· Stretch Run Stretch

· Discuss Medical Implications of running for fitness

· Oxygenation, Respiration, Heating, Cooling, Hydration, Joint/Muscle Injury

Medical Terminology

· Present handouts & PP presentation on basic medical terminology

Anatomy and physiology

· Present handouts and Power Point (PP) presentation of Gross anatomy pictures and models for examples

Care under Fire (C.U.F.)

· Present Power Point presentation with practical exercise

· Stress the importance of first returning fire until the scene is safe “battle field clearing”

o Scenario #1 Bleeding: Israeli bandage and tourniquet use

o Scenario #2 Airway Jaw thrust

o Scenario #3 Shock Hemo static agents

o Scenario #4 Self Aid with weapon in hand

Primary Survey & Practical Exercise

· Power Point presentation with Practical exercise

o Litter existing & field expedient

§ Israeli

§ Skidco half and Full

· Carries

o Two man

o Rope assisted

· Backboards

o When where and why

o Where to carry during combat

· Dinner with the Doctors and LEO SWAT Municipal/Parish/Federal

Day 2

Physical Training

· Litter obstacle course

· Medical considerations of the Human Weapon System

o Field Hand Knee Shoulder Evaluation

Secondary Survey

· Power Point presentation and video of Hands on evaluation

· Medics go over Unit SOP’s

· Practical Exercise with Max reps with treatments mixed in following treatment class

Treatment

· Massive Bleeding

o Bandaging

o Splinting

o Hemostatic agents

· Airway (advanced intubations and cricothyroidotonmy

o Chest seals

o Needle Decompression

o Chest tubes

o Demonstration

o Anatomy

Day 3

Physical Training

· Combative Review Training Injury Ground fighting (High Gear)

· Human Weapon System as it relates to Combat injury prevention

· Stretching

Live Tissue

· Class on anesthetizing role model

· Progressive wounds Blunt, knife, amputations

· Anatomy class done at the end with Ballistics

Range

· Static Vehicle placed near dirt mound

· Replace wind shields to myth bust shooting into & out of glass

· Team runs whatever other drills the deem necessary (their range time)

· Vehicle exercises Demo and practical

Day 4

Physical Training

· Introduction to Kettle-bell (drills)

· Medical Considerations and the Human Weapon System

· Introduction to Clinics

o What is the purpose

o Apply to Combat Environment

Clinics

· Ortho

· Neurosurgery

· Occupational Medicine / Sports Medicine

o How to open sterile packages

o How to take a blood pressure

o How to clean a wound

Ortho

· Lecture combined with hands on exam

· Best questions to ask on physical exam (how to on Hx taking)

Neuro

· PP on how nerves work and work up to how the body interprets stimuli

· How to trouble shoot nerve damage

· Practical exercise on a comprehensive neuro exam including GCS

· IV therapy

· Lecture on types of fluids

· Discuss operational concerns of IV bags vs. saline locks

· Evaluation of pt for IV Tx

· Risks to hemostasis

Pain Management

· Anesthesia/ Blocks

· Operational Considerations for the use of narcotics

· All about Morphine. Valium, Fentanyl

· Blocks on self

· Top five pain medications that I would use in an austere environment

Day 5

Physical Training

· Stretch run Stretch

· Combative Ground fighting / Gun fighting

Casualty Collection Point/Medical Communications

· PP and lecture on CCP operations

· Site selection

· Triage mass casualty

· In the field

· Considerations for marking

· Secondary Surveys

Extraction Platforms

· Vehicle lecture how many pts can you get on a HMMV etc…Setting up a civilian vehicle to transport casualties

· Dismounted Techniques for movement while treating

· Optional for Military(Rotary Wing With litters in a Blackhawk How many casualties can you fit in various aircraft Equipment considerations while in flight Jungle penetrater / hoist operation)

· Clandestine Methods of low visibility med kits Considerations for low visibility in Tx in the field

· Boats

o How many casualties can you fit in various boats

o Where is the best place to purr them

o Focus on boats you have available must cover Zodiacs

o How to pick up a combat swimmer

o Beach Landing Site

Shoot House

· Practical exercise on CCP setup and operations followed by extraction

· Isolate the aspect and maximize reps

· Vary exfil platforms and Tx scenarios

Day 6

Med Survey

· New Orleans Damage and Urban destruction

· Discuss medical problems that resulted from Katrina

· Discuss duties lessons learned by those involved

Day 7

Commanders’ time

· Physical Training

· Laundry

· Church

· Family

Day 8

Physical Training

Clinics

· After Action Reports after clinics for practical field applications

Medical / Close Quarters Battle

Simple Structure Simple Wounds

Day 9

Physical Training

Medical /Close Quarters Battle (CQB)

Simple Structure

Complex Patients

Anatomy and Physiology

Clotting/Shock/ Multi-system Trauma

Ballistics

· Femur Artery Laceration

· Spleen / Liver Laceration

· Practical Training Exercise

· Cric

· Open Abdomen

· Amputation from Blasts

Day 10

Physical Training

Clinics

After Action Reports after clinics for practical field applications

Medical / Close Quarter Battle

o Complex Structure/ Simple Wounds

Day 11

Practical Training Exercise

Practical Problem with Operational Units and patient care in woodland and urban environment with various medical scenarios of expanding difficulty and pt management challenges, including extraction and maneuver problems.

These scenarios are designed to engage active participation from all levels of the team and are to facilitate practical application of the course material.

Day 12

Clean Up
Written Examination
Issuance of Certificates
Closing Remarks

Prerequisites: Students must possess basic medical skills, knowledge and be able to conduct CQB as a small unit with a high degree of proficiency.

Maximum Enrollment: 15

Student Evaluation

Each workshop will consist of participants developing medical knowledge and skills in a self contained and controlled training environment. This environment will provide students with the ability to demonstrate their ability to meet the minimum requirements of each learning component provided by the instructor.

Practical application testing / evaluations in these areas will be required by participants to obtain a certificate of completion. Additionally, written examination requirements can be provided upon request.

Limitations / Special Instructor Needs:

Any audio/visual or POSTC/Academy facility or staff needs will be addressed on a case-by-case basis

Student Materials

Depending on student understanding, a wide range of video, audio and PowerPoint presentations will be used in the training session, and the instructors will come prepared with everything they will need to make his an informative, fast-paced learning experience. The materials will range from commercially driven video, personal case studies of the instructors, and detailed hands on training exercises.

Each student will receive copies of reference material and background reading lists.

Training medical equipment bandages, splints, tourniquets, airway materials and mannequins, are provided. If the unit has High Gear.

Student needs / Requirements (if any)

o All “kit” tactical gear

o Exercise clothing

o Team medical equipment

o Team communication equipment