Monday, June 10, 2019

Full Spectrum Training & Consulting TECC


Full Spectrum Training and Consulting TECC Course



I recently had the opportunity to attend the Full Spectrum Training & Consulting TECC class. TECC (Tactical Emergency Casualty Care) is an acronym similar to TCCC, and more recently better understood by many as “Stop the Bleed.” For more on those acronyms refer to the following links:
TCCC:

TECC:

Stop the Bleed:


Full Spectrum Training & Consulting:

Kevin is the lead instructor for Full Spectrum. Kevin’s background is covered in the class, but he has been in a responder role both as a Army Ranger, to now as a full time Firefighter and SWAT Medic. From this background, Kevin is able to give real examples of a variety of injuries and how following the MARCH protocols as well as with a basic trauma kit what you can do to treat it.

The course started with a quick overview of the Gen 7 CAT Tourniquet and how to properly stage it. After this, we had regular practice to apply to arms and legs (including without the use of vision, and one handed application to a leg). The practice continued through the rest of the day. 
*This method of TQ preparation is very close to what is shown on this video from Kerry Davis of Dark Angel Medical:*



Next was an overview of  TCCC/TECC and the acronym “MARCH.” MARCH is an industry standard for priority of treatment based on evidence based medicine – data compiled from injuries.
·      Massive Hemorrhage
·      Airway
·      Respirations
·      Circulation
·      Hypothermia Prevention

For the first half of the class, we covered the M in MARCH; Massive Hemorrhage. It started with a quick history of Tourniquets (TQ) – dating back to the middle ages, with modern use in the civil war and WW2, post “Black Hawk Down” TQ options, then to all the current CoTCCC recommended TQ’s.

During this class, Kevin also showed us how to make improvised TQ’s. Kevin showed how to do this with a cravat and windlass as well using the pants a subject is wearing (no, yoga pants are probably not going to work). Kevin then demonstrated how to apply the various TQ’s available, downsides and positives with various recommended TQ’s and why non-recommended TQ’s should be avoided.



Kevin broke out a Doppler unit to measure pulse and we tried various TQ options. From the improvised, to CoTCCC recommended TQ’s, then to products that continue to fail to meet CoTCCC recommendations. Kevin also showed how to make as well as use improvised junctional TQ’s including proving them on Doppler.



Doppler was eye opening in how you can take some of these options and by literally removing half a turn on a windlass lose all pressure. Also in how the non-recommended TQ’s work or more importantly don’t work and seeing the downsides to those options in a sterile classroom environment without real world implications.





Next up was pressure dressings/gauze/wound packing. Kevin showed how most commercial pressure dressings are doing what a roll of Kerlix Gauze and Ace Bandage do. Kevin proceeded to show us how to pack a wound and wrap the Ace bandage on it. Kevin also covered the history of Hemostatic agents and how we have moved to the Hemostatic impregnated Gauze options of today. This is an excellent reminder that Evidence Based Medicine is a must for the medical field, not “Instagram cool points.”



This moved into a sampling of other things that Kerlix/Ace can do. To me the biggest takeaway from this class was what all is able to be done with Kerlix/Ace. Neck/junctional bandaging, amputation coverage, pressure dressings, etc. The students took multiple turns practicing applications of the tools on each other.

Next up was “A” or Airway. This was both how to place someone in the recovery position, but also a how to apply commercial Nasopharyngeal Airway. Some stories on how to consider that a recovery position may be different for someone based on their injury helped drive home it’s a concept, not a absolute position.

Next up was “R”, Respiration. Most of us consider this as the Chest Seal phase. Kevin explained how the medical world in the US only has certain levels of care providers allowed to apply chest dart/needle decompression, but how to recognize the signs of a tension pneumothorax.  Kevin explained how as such he (and nobody else I’ve found for a civilian responder/LE responder class) will not teach how to needle decompression. Kevin showed how to try to “burp” the injury and to mitigate it.

The history/progression of Chest Seal options was shown then to the current CoTCCC recommended options. Kevin also explained what the Chest Seal is doing, and as such, how we can improvise this. To me, understanding what a Chest Seal does, therefore how to improvise one is super important. Looking at the wounding data available for CONUS mass casualty incidents, chest injuries are the biggest killer. This comes from the fact that Military/LE data have a big thing in common, we all wear body armor making the major survivable wound placement, extremity hemorrhage.

Next covered was the “C”, Circulation phase. How to do a rapid blood sweep, then how to assess mental status. In this check it was explained how we can find signs of an altered mental state which should let us know to remove our patient’s (as a cop, your brother/sister officer) weapons or anything else that may be dangerous. A severely altered mental state may cause someone to be violent that doesn’t know it and as such this makes us safer and our responding aid safer.

We them moved to reassessment of prior interventions. We should ensure our TQ’s were still in place and working, or if we needed to pack/pressure wrap an extremity wound.

Finally in the MARCH protocols was “H”, Hypothermia prevention. This is as simple as remove anything wet, apply dry clothing/blankets. Commercially available options for this were shown, but then how to apply the principles. The Lethal Triad was discussed and how coagulopathy, hypothermia, and acidosis contribute to someone’s demise.

We then moved onto patient extraction. This was both tools that make it easier, but also techniques not requiring equipment. Kevin showed us commercially available options like the Foxtrot/Skedco and Megamover. Kevin had us do 1 and 2 person movement techniques (carries and drags) where even smaller individuals were able to move larger individuals. 



To round out the classroom portion, Kevin covered Mass Casualty Incident triage ideas (MCI) and some open source info learned from some MCI’s of note. Kevin also addressed suggestions for an IFAK, daily carry trauma kit as CCW, LE on duty kit, overt tactical kit and Car/Bag options. Kevin also showed how he had worked with his agency to setup MCI response kits and the thought process and prep that went into those.

The class moved outside for scenario’s. These drove home the importance of MARCH, teamwork, environmental awareness, and other things. I won’t go into depth to give the scenarios away for future students. I will say that I appreciated how much learning was packed into the scenarios, while it didn’t cause learning overload and the inevitable brain shutdown for students getting their first exposure to a category of training.

Moving back to the classroom, Kevin covered some last terms that came up that needed clarification or further clarification – Hasty vs Deliberate Tourniquet application, how to make an improvised Pelvic Binder and why, burns, eye injuries, abdominal eviscerations, etc. Some of these were covered earlier in the appropriate MARCH category, but students wanted clarification after doing scenarios.

We did a wrap up/debrief where what was learned was covered. Kevin then answered questions from students on various trauma kits/components they currently used/had, and what options he would use for that role.

I’ve had several prior TCCC/TECC focused classes. This covered some stuff that I hadn’t previously seen in a class, and built on the things I was personally wanting to be better able to do or understand. As always when training with Kevin, there is the valuable data dump he sends after class of source materials that further your knowledge and learning.


Thursday, August 30, 2018

Running with a Gun

Lots of questions and unanswered questions online about running with a gun. Running is a next to free way to stay in some form of shape. Carrying at least your gun with you, is living the lifestyle that understands you are your own first responder.

I've found this setup works for me, a Sheriff of Baghdad Condom Holster with a Glock 43. This works the best in a pair of shorts that can cinch tight in the waistband. So far the best I've used are the Salomon Cairn.


When I go for longer runs, I wear a Salomon Sense 5 vest. This adds plenty of storage options, but not speed of access. If you just want the gun with you, a Magpul Daka pouch will hold your gun inside the back storage pouch. Pictured is not the same gun combo that I carried in the below video, but will show you potential for the size available.


Additional things to consider when running armed: ID. Some states are "Constitutional Carry" but I'd still carry my ID with me. I carry my cred's/ID and a house key always just in case. This is usually in a zipper pocket on my shorts.  Think if you are injured or hit by a vehicle, someone needs to know who you are so they can get someone to your family.

Med Kit. I will stuff a TQ (CAT or SOFT-W) in the stretch pockets on the Salomon shorts, but when those options aren't available, a RATs is better than nothing so I wear it like a bandolier. With the vest, I put a SOFT-W and Israeli bandage in one pocket with a basic first aid kit in another pocket.

See the below video for more info and maybe less reading required. 



*Shoutout to my faded but OG Raven Concealment Shirt* 


Tuesday, August 28, 2018

Camoflauge Pattern Comparison

Beyond Clothing is a local company to me, and sold some of their stuff at a Tactical Tailor "garage sale" at a steal of a price. As such the jacket I wanted to get for years, was to cheap to pass up. The Beyond Action Shirt in Orion Design Group's Lupus pattern. "Lupus" was ODG's submission in the Army's camo test of years ago in the Multicam all around category. See SSD's story's on that:  http://soldiersystems.net/tag/orion-design-group/




Since I no longer live in the high deserts of Nevada where Multicam, Multicam Arid and ATACS-AU were perfect, I was curious what Lupus would look like here in the wooded PNW. The summer is when area's are more brown that any other part of the year. As such, I took photos to compare some other patterns - Ranger Green, Tan, Multicam, ATACS-AU, Lupus, a Pakistani take on Rhodesian Brush Stroke, and Tigerstripe. 

Ranger Green
Velocity Systems Rugby Shirt

Tan
5.11 Tactical Combat Shirt

Multicam
Beyond Clothing Jungle Top

ATACS-AU
EOTAC Smock

Lupus
Beyond Clothing Action Shirt

Pakistani "Rhodesian Brushstroke"
SARCO imported shorts

Tigerstripe
Propper BDU






Monday, March 26, 2018

Full Spectrum T&C Intermediate Carbine AAR




Intermediate Carbine
Full Spectrum Training and Consulting
Instructor: Kevin Williams
Ravensdale, WA.
March 2018

Course Goals:
Refresher
·      Zero/Procedures
·      Marksmanship Fundamentals
Malfunction Clearance
Main areas of Focus:
·      Standard/Unconventional Shooting Positions
·      Reloading Techniques
·      Close Quarters Shooting
·      Multiple Target Engagement
·      Use of Cover/Barricades
·      Shooting on the move
·      Transitions

The course called for the standard equipment for a rifle class. Ammo was “300 rounds for your rifle, but bring more and we can shoot more.” Transitions were classified as a topic that would only be covered if you felt comfortable with them and pistol use, which is a good call as not everyone taking a rifle class is there with pistol use. 

Equipment used:

Weapons: My employer was kind enough to let me use my issued patrol rifle: Colt 10.5” with a Surefire RC-2 suppressor, Aimpoint T-2 and Surefire Fury. I’m using a personal SOB Tactical U-Loop sling on this rifle. For the class I fed it from various PMAGs, gen 1 to current M3 Generation. Pistol was a Glock 22 (Dirty nasty 40 S&W) with a Raven Concealment Balor and a 2 MOA T-1 on it..

I used a Raven “Roland Special” holster and Raven DSS overrun Sonny rig (2x M4 1x Glock) on my belt. A Extreme Gear Labs 3 Mag VOCR chest right with FBI Drop hanger med kit was the rest of mag/medical gear. SLIP 2000 EWL was present, Oakley eyewear prepped with Cat Crap and a pair of well worn Peltor Tactical Earpro.

Class Start:
            Start time was 0800 hours. After setting up targets as a class – mix of paper/steel, and some barricades, we had an admin briefing. This was prolonged due to the range not allowing live fire till after 0900 hours. The course overview and goals were covered. Student and AI introductions were made, and students were asked what they main thing they wanted to get out of the class. Kevin and his AI made it clear that if a student didn’t feel comfortable trying something, they should let the staff know as its better to be safe than try something you shouldn’t and get hurt.

            Medical. Kevin did a quick and to the point overview of the phased medical emergency response plan for the class. From student expectations to what responders should do. Then he did a surprise “you have 5 seconds to show me your tourniquet”drill. Of the 8 students in the class, all but one had one on them. The last student had his on his range bag. After the class was over, this student stated he will be carrying one on him all the time at the range. Kevin then distributed everyone an additional CAT for the duration of the class. After this distribution, how to stage for carry then apply one handed/two handed on arms as well as legs was practiced.

            Live fire. Everyone stated they should have had a mostly zeroed rifle. I’m limited to a 25 yard indoor range at work, put prefer a 50 yard zero. As such, I wanted to confirm my rifle zero at 50 yards. After we fired a group at 25 yards to ensure everyone’s rifle was on paper, the class moved to 50 where fine tuning was done. I found that my 25 yard rough compensate for 50 yard zero with duty ammo needed moved a half inch up and right. Considering that no paper target combo is perfect for the gun/ammo/optic/suppressor combo, this isn’t bad at all. 




            Next we covered positional shooting. This was broken down into kneeling (quick, stretch and double knee), sitting (stacked feet, crossed legs or legs in front) and prone. After a period of time engaging steel targets at 75 yards from the positions, we shot the 4 position aggregate (100 yards prone, 75 yards seated, 50 yards kneeling and 25 yards standing) and 3 position aggregate (50 yards for 10 rounds each from kneeling, seated and prone) on paper.


We story boarded from both 50 and 100 yards: 10 round groups from RDS and dry zeroed irons at 50, 10 round groups at 100 showing POI with 50 yard  zero and forced parallax (Red dot in extreme left of window). This is helpful to show that positional shooting can affect where you shoot based on how you zeroed.



            Next covered was reloads. Students had obviously been reloading already and had all taken some sort of training prior to this. Kevin was big on all our loading/unloading of the gun following the same method. As it was all building blocks that work together for administrative loading, tactical reloads, emergency reloads into simple and complex malfunction clearances.

            Kevin is a proponent of the “safety on when you can” mantra. When doing an emergency reload for example, as well as anytime you manipulate the gun – empty gun for transition, malfunction, etc. As Pat McNamara says in regards to this, “Always an enabler, never a disabler.” I started shooting when this was not the norm. It took me a while to undue the biomechanical programming of this when I first was exposed to it, and am thankful that new shooters are being taught to run the safety selector as much as possible.

            The Modified Navy Qual was shot at 50 yards on a steel target. This is typically shot on a 8” circle paper target. For this you need 3 mags of 5 rounds. The shooter is to fire 5 rounds standing, emergency reload, 5 rounds kneeling, emergency reload, 5 rounds prone. Par time for this drill is 30 seconds. I was asked to demonstrate the drill live which meant there was just a little pressure. The Surefire RC2 suppressor worked well as the shot timer couldn’t hear my shots, but one could clearly hear each of my hits on steel making me pretty happy to perform on demand. Total time was at 25 seconds.

            During the lunch break, a discussion on carbine setup was had. Also covered was a demo of how Kevin teaches malfunctions. The way malfunction clearances was covered, was the same as I’ve been taught in the other training I’ve taken on my own and from my current agency. What stood out to me though, was how Kevin really drove home the importance of ensuring everything works as a system so you have less things to think about for clearing the malfunction.


            After lunch, we started with a 5 yard drill to demonstrate the importance of knowing your mechanical offset. Next was bill drills to work recoil control and ensure the little things in holding a rifle are being followed. Also shown in this was the concept of rhythmic fire.

I learned a while ago that you can cheat and be sloppy with grip/stance on a suppressed 5.56 gun. When I was issued a .308 semi auto patrol rifle, I learned I was ignoring little things like rolling my shooting side shoulder forward into the gun then. It was good to see students in this class have that same lightbulb moment. I watched Kevin and his AI making little tweaks to shooters stance and grip as they ran this drill, and saw happiness appear on students faces as they began to shoot faster while groups got tighter and they mitigated recoil.

            Next up was transitions. Doing these dry to ensure the steps were being done right, ensured students got the hang of this. A couple times as I transitioned I felt my rifle bounce off the bulk on my support side, which is extra thick thanks to the mag pouch setup I was using. Kevin commented he had experienced the same thing a few times with the same mag pouch, which is purely for our use, training rigs. After doing this dry a few times, live fire was done. After this, anytime the rifle went down, the student were expected to transition to pistols inside 25 yards.

            To further the offset and speed up close portion we discussed shot cadence. Then there was a demo of the Half and Half drill. We then ran that as a class. Half by Half: 30 rounds total, shot on a B8 bullseye. 10 rounds at 20 yards in 10 second. 10 rounds at half of that in half the time, 10 yards/5 second. 10 rounds at half of that, 5 yards in 2.5 seconds. After seeing where we were on that, those who wanted to could run the full half by half as one drill. A par time of 17.5 seconds to get all 30 shots fired. Exploding off the line after each shot and ability to stop on a dime drive the gun and get on it was obvious.

            Shooting on the move was covered next. We did this dry fire both moving forwards and backwards as a class. Next we went 2 at a time with instructors following students to ensure a safe environment. After this a box of cones was used for ability to practice walking forward, to the right, backwards and to the left. As everyone was right handed, the only hard part was the to the left portion. I’d dry practiced the over the shoulder technique for moving to the left while engaging targets to the right before, but never live fired it. It worked well and was much easier and faster than the bend/squat lower so you can twist to the right I’d seen in prior rifle training.

            We then went back to the barricades at 75 yards where use of barricades was covered. The various odd shooting positions, braced kneeling, squatting, SBU prone, rollover prone, urban prone as well as old and worn out knees kneeling was demonstrated. Kevin then talked about being smart in when to crowd and when not to crowd your cover. We then practiced these positions dry fire, before working them live fire for a while on steel.





            Next was bilateral shooting. Discussion on when to switch shoulders and when not to was had. After this, the process for switching shoulders was done dry. After a period of dry practice standing, we did it live. After a bit of this, we started practicing bilateral kneeling around the barricades. Kevin talked about there being a time and place for when to switch your feet when switching shoulders vs just switching shoulders. Its faster to just switch shoulders and not feet, but you do loose some of the recoil control capability. As such, situation dictates the weapon manipulation.

            Next up was working ability to rapidly get into and out of cover and using the various braced cover shooting positions. This also covered when to move with your rifle in a standard ready position vs the “football” carry. We worked this by shooting a classic TMAC’s drill, “Set it Off” at 75 yards on steel. Little things like not getting into a braced position slowed shooters down vs. taking the opportunity to brace off a barricade.

            The class ended with a little work on movement around people with guns and being able to communicate. This was a fun way to end the live fire session, although by this point most of us were out of ammo having shot well over the 300 rounds we brought. As always, the only time you can have to much ammo is when you have to carry it or pay for it. ;)

            After range clean up, we had a debrief. Nobody was hurt or injured during the training. Kevin collected his collection of CAT’s despite my attempts to acquire an extra from him. The class then went around including Kevin and his AI commenting on what the main thing was that they took away. Certificates were then handed out and we all began to drive away as the first rain of the day in the seemingly always rainy PNW began.

            Takeways: Lots of things were covered in class. The same outline could of taken 2-3 days to cover everything in depth. The only way to really stay proficient and remember the techniques covered, is to dry practice them.

I had met Kevin back in 2010, when he was working with LMS Defense. I took a class on distance carbine work and malfunction clearances from him. His teaching method then, is the same as it is now. He talks through and demonstrates what he wants us to do, then makes little corrections so its not “brain overload” when corrections start. Kevin’s teaching method is more along the line of coaching than a rote “do x y z” method.  

            This class was all civilian except for the Instructors and myself. I love classes where people pay to be there, as they are motivated to learn. Being in a class of people who 1, want to be there, 2, many have suppressed rifles making the range session less harsh on the ears, and 3, care about our gun rights was a blast.