Fundamental Friday: No more dumpster fires

Tyler, (Iraq 2008)

Does sticking the most expensive gear in a bag make a better medic?

If there's one thing tactical medicine and modern gun culture have in common, it's an obsession with the latest and most expensive gear. If there's one thing I wish I could make them both go back in time to, it's flashing amazing skill sets, not expensive kits.

Today, tactical emergency medicine is filled with new, cool, expensive and sexy gear.  With social media influencers and podcasts from veterans of the "forever wars" have come a large culture change. Brand name recognition items are now making their way as a form of legitimacy and skill of the beholder. This author personally believes that the truly skilled are still the ones producing live patients and no preventable deaths, not the person with the thousand dollar load out. Still, this is a good conversation to have.

My question is this; when did we shift our focus from sexy skills to sexy equipment? I see people with the latest million-dollar tactical bags and gear, but do they have million-dollar skill sets to go with it? 

To put it very directly, have your people mastered or been mastering basic fundamentals?  Notice I didn’t ask if they were trained on them but if they are mastering them.  Please skip the speech about how they all graduated AIT and do JRTC and NTC rotations.  I’m asking a simple question; do you and your people have master level performance at the most basic levels of their job description? 

This esentially means they can stop any bleed, manage and maintain any airway and perform simple interventions?  If the answer is yes, then go ahead and evaluate them again just to be sure.  If the answer is no, then how about trying to adopt a culture that emphasizes them.  I'm not against sexy gear, I'm begging all the leaders to make sure your people are proficient with it, (and without it).

The most frustrating thing I see and hear today from people is how they’ve bought some new “special operations” medical kit and they boast with bravado about abilities they think they have since purchasing the most name brand recognized gear.  Honestly, it frustrates the shit out me.  It makes me cringe to think of hearing about people who think an Israeli dressing can control a hemorrhage or they can just pack an open chest wound with combat gauze. However, that's the type of false bravado that can happen when we start letting credit cards get ahead of individual skill sets.  

Y’all, please be good shepherds to your flock.  Hear me out, “Fundamental Friday’s”.  Have your people drill the most basic parts of their jobs and demonstrate it every Friday for about thirty minutes.  Let’s see them control a bleed at the limbs, junction and throw them a wild card with one in the box just to see how they react.  Maybe the week after make some airway management interesting with some inhalation burn scenarios.  Maybe the next week see how well they understand their pain medication distribution on patients who may not be eligible to receive it. 

This all might seem laughably simple, but I promise you won’t be laughing if you wait until it's too late to find out your people were lacking in some very basic proficiency. Living and training stateside with no wars, accidents can and do still happen in the kill house. Let's not turn one tragedy into two when the medic who responds isn't as proficient at hemorrhage control as we thought and turns out to be a total dumpster fire.

Y’all should know by now I’m a “basic bitch” when it comes to battlefield medicine and trauma.  The only sexy thing I want to bring to a fight is my skillset.  I’ll make do with the equipment.  

As for the picture up top, that's not me or a medic. Just a really cool photo I've been waiting to use for a long time.

Can I get 30 minutes of a “Fundamental Friday” big sarge?