It’s a beautiful Saturday morning and you’re headed out to do something fun with your family or friends. You know that it’s unlikely the bad guy will come today, but you have your daily carry gear anyway… and, likewise, you put your seat belt on even though you know it’s also unlikely you’ll be in a car crash.

Unfortunately, it turns out that today IS that day, and as you scan the scene you find someone you’re with has been shot… and now you’re actively engaged in a gun fight.

It’s your move.

A tactical first aid kit should be part of your daily carry gear and the tactics and skills needed to deploy it effectively should be in your toolbox. It’s important to know the realities of civilian gunshot wounds and how to handle them. Most penetrating injuries are not immediately life-threatening but there are some injuries where death can occur before the fire department responds if they’re not managed properly and quickly.

However, considering you’re actively engaged in a gun fight, treatment is going to be much different than if the injured person was in a hospital. Generally, you don’t treat under fire. The first step is to neutralize the threat to prevent further harm to victims and rescuers. The next step is to have the injured individual move to a defensible position or move them if they’re unable to do so under their own power.

Once the threat is removed, the patient is in a safe place, and 911 has been activated, the most important thing to do is to stop critical bleeding. Immediate stoppage of bleeding may make the difference between living and dying. For major bleeding tourniquets may be the answer and, if so, they need to be applied immediately. Hence, they’re one item which should be part of your daily-carry kit once you obtain appropriate training in their use. There are many necessary tools and supplies to carry as the variety of wound possibilities requires a variety of treatment options. Yet, at the same time, it’s not practical to carry around the entire Harborview ER on your back so we must optimize our kit to treat what we need to while being able to carry it. No different from a handgun – if it’s too large and/or uncomfortable to carry, it’s unlikely you’ll carry it… and it doesn’t do you any good if you don’t have it when you need it.

In sum, tactical first aid is an aspect of training and daily carry gear which is commonly overlooked. Just like a tactical flashlight, the daily-carry medical kit is a piece of gear you may use frequently. Fortunately, a tourniquet isn’t likely to be needed very often, but there are other items that may be. Just remember to restock your kit when you use something from it. Prepared parents are well-served to stock up on Elmo bandages in addition to the trauma supplies. They don’t take up much room or add weight, and every parent out there knows what can come following the statement, “watch this!”

There is obviously much more to care under fire than we can cover in a blog post. To learn more, our next Tactical First Aid course will be taught by Dr. Mike Shertz on May 4th.

Content by Greg Hamilton
Written by Doug Marcoux