I had the great privilege to take the S.O.B. Tactical Basic Trauma Management Course (BTMC) from Mike “Witch Doc” Voytko this past weekend down in North Carolina near Fort Bragg. If you don’t know who Mike is, you should…because he knows his stuff. Besides being a retired Special Forces Medical Sergeant (18D), Mike currently teaches at the Joint Special Operations Medical Training Center (JSOMTC). This is the schoolhouse that produces 18Ds after a 50-week course. Mike also had the distinction of serving on a Special Mission Unit as a Saber Squadron medic…so; to say he has some experience in trauma management is an understatement.
The class started at a little after 9:00am on Saturday on a picturesque piece of property outside of Ft. Bragg with warm November temperatures, plenty of sun, and some gentle breezes (that would soon change). The class size was small with 7 students starting and 6 students finishing (a student left mid-class), which made for a great class size. The even number also made it easy to pair up for the practical exercises conducted throughout the day.
Since this was a basic class, Mike started with the basics of trauma management and laid out a general theme that would be brought up numerous times…trauma management is about doing the best you can with what you have until you can get the patient to more definitive care. In other words, try and stabilize the patient, package the patient up, and either wait for EMS to arrive or get them to definitive care as quickly as possible. At the end of the day, there is only so much you can do to manage trauma…but, the goal should be to get the individual to a hospital where trauma surgeons can take over and hopefully save the victim’s life.
With that general theme laid out the rest of the class focused on the primary drivers of trauma and the treatment of said trauma. Mike had some great methodologies for trauma treatment, but I’ll not give those away as they are worth the cost of admission. Since this was a “tactical” class, we talked in-depth about penetrating trauma (gunshots, stab wounds, etc.) and the treatment of such with the use of hemostatic agents, bandages, and tourniquets. Tourniquet use has come a long way since 2001 and I really believe if you are not trained in tourniquet use and carrying one with you…you’re doing yourself and others a disservice. We practiced with all types and improvised tourniquets and bandages to ensure that we could apply said items easily and with confidence. For many it was the first time they had ever applied bandages or tourniquets and there were a lot of surprised faces as the tourniquets were tightened down on arms and legs. To say tourniquets are a sadist’s delight would also be an understatement…I am sure many of the students are carrying bruises around today. I know my forearm has a nice present from an improvised tourniquet made from a cravat and hardy stick; which makes me thankful that I carry CATs and SOFTT-Ws in my trauma bag.
After we covered other principles from eye injuries to hypothermia we broke for a quick bite to eat before we started more practical exercises. At this point in the day, the first cold-front of winter decided to move in. The winds shifted from a nice steady breeze to a good 10 to 15mph wind with some strong 30mph plus gusts thrown in for good measure and the temperature began to drop from the low-70s down to the mid-50s. Someone could have gotten some great amusement watching grown men chase trauma gear around as the wind whipped up gauze and HALO seals.
The practical exercises were great and many pants and shirts were rapidly cut in the name of treating simulated injuries ranging from gunshots to stab wounds. There was plenty of simulated blood to go around as well (which made for an interesting scene as I walked into the hotel later in the evening) and Mike provided scenarios for the victim and first responder. To say that we had a gifted class of thespians would be a very accurate statement. While Mike had a theater performance to catch later in the evening, I would wager that the true performances of the day were on that little hill outside of Ft. Bragg.
We finished the day strong with everyone learning lessons and getting their hands wet while treating a victim. Mike took the time to answer questions and to talk through different types of recommended gear. One of the great things about a class like this is the practical exercises. We all know of “that guy” or “that gal” that shows up to classes or the range with more trauma gear than an Air Force PJ but, the fact is most people don’t take medical classes and that is a travesty.
So, I will leave you with this (something I tell all of the folks that I teach in my own classes and at Overland Expo):
If you are not investing in good quality medical training, you are doing yourself, your loved ones, and your fellow man a disservice. While it may be “cool” to have that next fancy firearm (for the shooting community) or that next great piece of recovery gear (for the overlanding / off-roading community) it’s not as “cool” as being able to help save someone’s life…maybe even your own.
Mark Farage: https://www.farageprecision.com/blogs/news/after-action-report-s-o-b-tactical-basic-trauma-management-course-11-19-2016