We have repeatedly recommended the document “Law Enforcement Use of Tactical Emergency Casualty Care” by Lifehold Strategic as a vital reference on “tactical” medical intervention in the real world.
The work compiles every LEO use of TCCC/TECC interventions that could be found, since 2004, into an easy read, complete with infographics. It is well worth your time to download and check it out. In reading it, one of the things that jumps out at us as we read, and look at the numbers, is the incidences of “Drags and Carries”. This is a subject that is sometimes little touched on, and little prepared for by non-medics, but the numbers make a strong argument to change this. In LEO TECC/TCCC incidents since 2004, drags or carries have been employed 58 times. Compare this to 62 uses of hemostatic agents, 37 uses of chest seals, and only 1 use of a nasopharyngeal airway (NPA). The need is clearly there for guys and gals to be up to speed on their drags and carries. We’re going to talk about gear here, but the very first thing is to get the skills, and regularly work the skills. Not fit enough to move another human being? Work on changing that. Don’t know how to move another human being? Classes covering the ways and means are out there. Plus, the information is readily available, and a patient friend can probably help you out if no formal training opportunities are readily available (just, use caution and work carefully. If you get hurt, it’s your own fault).
Let’s ask this question: How many of us have chest seals and NPA’s in our kits, but no casualty drag equipment? We’re wagering it’s more than a few. There are plenty of commercially available drags out there. Many of them are somewhat bulky, requiring a dedicated pouch, but also offering quite a bit of length and various attachment and routing options. And no matter the size, most of the dedicated “tactical” casualty drag set-ups are expensive. Between size and expense, drags are often relegated to carry only by medical responders, packed in larger kits, and not often considered “individual equipment”. One proposed solution to this is to carry several feet of 1” “climbing” (or tubular flat) webbing in a cargo pocket, or small pouch. How much, exactly, varies depending on who is making the suggestion: Just enough to get under someones arms, all the way up to 20-feet (an approx. 7” roll). Whatever length you find works, both for carriability and being long enough to actually use, a strap of 1” webbing is not a bad idea. The only problem with it we’ve run into is that unless it’s carefully stored and carefully deployed, the two free ends can be hard to keep track of (and sometimes, hard to hang onto if one’s hands slip any). Here’s an alternative setup that we’ve been playing with for awhile:
w/ 6″ ruler, G17 mag, standard ID/CC size card, chapstick for size reference.
Climbing slings are a sewn loop of flat webbing, available in different lengths. And, in truth, the majority of climbing slings are far too short to be useful as a casualty drag. But, 6′ and 8′ loop-length slings can be found if someone looks. And most of them are cheap. The one pictured, a 72” Advanced Base Camp (ABC) sewn-sling, costs around $8 on Amazon where we got ours. To make the sling more versatile, we’ve paired them with a “quickdraw”, or two carabiners connected by a short dogbone of webbing sewn to hold the ‘biners at opposite ends. You can use two loose ‘biners, but we went with a quickdraw because it helps to retain the ‘biners in the wrapped up package, and adds some versatility in how they can be used. Quickdraws are available ready made, such as this $13 MadRock unit, or you can buy ‘draw connectors to use ‘biners you already have. Connecting two ‘biners yourself allows you to scale down a little more, like we did by using the smallest (3.7” long) ‘biners Mad Rock makes.
Although this set-up will lack some of the options of a longer strap of flat-webbing, or the purpose made casualty drags, it still offers a multitude of options for use. The greatest advantage here is the size of this setup once complete. Folded up, and secured with a rubber band or a silicone bracelet, this can be stuck in many pockets (to include jeans pockets), and certainly in a multitude of small pouches. Cost is also a significant advantage, coming in around $20 for the whole rig. You could also spend a little bit more, and get the 10′ loop-length North American Rescue Hasty Harness, which comes in at about $25, and gives you more length but will also fold up larger than the climbing sling.
To make this setup even more useful and easily carried, it can also be staged on the belt using a PHLster Flatpack to contain the sling and quickdraw. One end of the ‘draw can be attached to the sling, and the other to the ring on a riggers belt, while worn, to create a ready platform for rapid extraction.
How to best use it? The best option with any medical, or med-adjacent, skills is to get hands on training. If you can’t yet, look online for various references on casualty drags and carries, and work from there. Take some time and figure that out for yourself and your tribe, team, etc. There are multiple ways to route the sling, or attach it to equipment, and to use it to drag someone. Remember when we said that the first and best thing was to get and maintain skills at moving a casualty? Setting up and figuring out this Pocket Casualty Drag is a great opportunity to work on that.
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In the wake of the November 2015 Daesh attacks in Paris, as in the wake of any other act of mass violence, social media was filled with outpourings of sympathy, support and rage. As is often the case, many people were posting about new or additional steps they were taking “just in case” this kind of violence happens near them.
These types of posts tend to go one of two ways: First, people simply wanting to get better acquainted with the tools and training to better approach potential violence, and second, those who gleefully post their extra-steps to “being ready”. This latter group does things like add long-guns, load bearing equipment and body armor to their vehicles, stock mass casualty trauma kits, and generally “gun up” to an extreme degree. As I travel often with both a long gun, and a full-size medical pack in my truck, I cannot fault those actions, but the reality is that such things offer little in the face of terrorism or active attacker.
Violence is largely a come as you are affair, particularly mass violence. The rapidity of violence in such attacks doesn’t allow for much choice; You will deal with the situation with what you have on you.
Choices and Posture:
We all have to decide who we want to be responsible for us, and those we care about. If you’re reading this, odds are you’ve already embraced the idea that no one is coming to save you, except you. This is the way. The only help available in an emergency is the people already in the middle of it, and the one you can depend on the most (hopefully) is yourself. Everyone else is minutes to hours away. When faced with sudden violence, you are the only one capable of doing anything to change or influence your situation, and hope is not a course of action.
Perhaps the biggest action you can take to prevent violence, or at least escape it, is to pay attention. That seemingly common thing is becoming all too uncommon, and all too hard, anymore. Constant distractions are beyond plentiful, smart phones to smart watches, garish and eye-grabbing displays and advertising. Everywhere we go, and even at home, we are inundated with “immersive” user experiences designed to pull us away from the real world and into a gratified lull. Rejecting these opportunities for pleasing distraction and actually watching what’s happening around you is so rare as to be actively mocked in many settings. Yet, few actions will have as big an impact on your long term well being and safety as simply paying attention. Not just safety from violence, but safety from accident, even safety from the embarrassment of spilling your coffee all over that attractive person… that one, right there, that you just bumped into reading this on your phone while walking.
Seeing is the first step, but it is not enough. We must accept certain things as truths about the world, in order to recognize them meaningfully. Without that, we cannot act. If we fail to recognize the events unfolding in front of us, we cannot even begin to respond to them. To recognize things, we must have a place for them in our schema of reality, we must believe them to be real and possible. William Aprill of Aprill Risk Consulting refers to this as having a “parking space” in our brain; To take action when confronted with violence, we must have a parking space for violence. We must accept both that violence is possible (can happen to us), and that we can deliver violence upon others. If you cannot visualize violence happening to you, you’ll be in denial that it is, if it ever does. Similarly, if you cannot visualize harming or killing someone, your ability to do so if you need to is in jeopardy (and this state is not uncommon among armed, supposedly prepared, citizens and professionals. I was speaking with a police officer recently who was in complete shock because he had almost shot someone, and had no parking space in his head for doing so).
You must decide to be responsible for your own well-being. You must have adequate parking in your mind for both things that can threaten you, and the actions necessary to avoid or survive those threats. You must pay attention. And you must put those things together into a functional daily existence, ready and able to take care of your own.
Tools and Skills:
Fire extinguishers in the home, spare tire and jumper cables in the car, the presence of tools is the outcome of our decisions about self reliance. Many of us carry a gun for the same reasons we have fire extinguishers; Odds are, we’ll never need it, but if we do, it’s easier than putting out the fire with buckets and prayers. However we cannot be overly fixated on tools. Tools are not solutions, they are enablers. They increase our abilities to perform certain actions, if we know what actions to perform. Without skills, tools are useless.
You are not able to use something, just because you stick it down your pants every day. The common fallacy among “preparedness” types is that possession equals skill. Buy a pistol? Combat handgunner extraordinaire. Buy a tricked out Remington 700? Sniper the likes of which Carlos Hathcock could only dream of being. And so on. Thus many people, feeling the need to “do something” in the face of recent events, are buying new tools, or loading their vehicles with tools previously only kept at home. And to what end? Reality says, none.
If you cannot use a thing, it is of no use to you. And even if you can, if you cannot access it, it is of no use to you.
Violence is a come as you are affair.
Want to be better prepared to deal with violence? Better your self. Concerned about terror attacks like Paris? Your first concerns should be getting more knowledge about the skills that may be useful to you in a Paris type attack. Already have some of those skills? Find the weak places, and work on them. Find the gaps, and fill them. Then concern yourself with tools.
And what value tools that have no actual use? How popular in our communities are “EDC” (Every Day Carry) items that are nothing more than fetishes? Extremely. Social media is full of “pocket dumps” showing off single finger knuckle duster beer openers in exotic materials, beads and tops machined from unobtanium and superconductor alloys, fancy pens, and patches proclaiming bad-assery of every flavor and tribe from Mandalorian to Hello Kitty. All this stuff is very pretty, or at least appealing, but serves no actual purpose or function. Even the things that do have purpose, are often never used. That beautiful $3000 pocket knife sumdood just posted in your favorite EDC group on Facebook? It’s never been used, and never will be. He will soon trade it for another exotic custom knife, in his fervor to possess the best, without ever taking ownership of quality through actual use, and continue opening packages with his keys.
It is possible to manage a gunshot wound with no more than can be carried in a pocket, provided that pocket is not stuffed with beads, tops and patches. A tourniquet is not pretty to look at, and no one is making custom ones in exotic fabrics with zirconium windlasses, but try stopping a major hemorrhage with your superconductor CyPop (a popular single-finger knuckle duster, known to cause serious injury to users who actually hit someone with it).
Part of making choices to take responsibility for your well being, is to decide to appropriately enable yourself to act. Be an adult and take ownership of ability. You don’t wear Zegna and Canali to do yard work, you don’t eat regular meals off the finest china, and you wouldn’t put up with a phone with nothing but apps that only show pretty pictures, so don’t clutter your pockets with useless shit just because it’s pretty and cool.
You’re concerned about the state of the world, and events like those occurring in Paris recently, so lets take stock of some things that might actually be useful in dealing with such events.
Ownership of Violence (that aforementioned set of mental parking spaces for receiving and giving out violence) and Awareness (paying attention) are foundational, but before we put a chest rig loaded with magazines and an AR in the trunk, or buy another really pretty-but-useless piece of EDC “gear”, what is there to do to better ready ourselves for this type of violence?
There are some obvious things:
-Getting better at defending ourselves. Improving our fighting ability, shooting ability, skills with contact weapons. Getting better at actually carrying those tools in the first place (something many are actually very bad at, despite owning them).
-Working with our families and loved ones to develop, or improve, response plans. Practice awareness, on your own and as a game (even just people watching and commentary) with your family or friends. Talk about what to do if X occurs, be it escape, fight, and everything in between. Work together to function as a strong unit in the face of adversity.
-Get medical skills, and continue to train them. You are far more likely to use, and need, these skills than almost any other emergency preparedness skill available, and they are perishable and need frequent practice (and refreshing, as medicine continually improves).
-Improve our fitness. There is no aspect of your life that cannot be bettered by being in better physical condition. Your survivability when faced with austerity or hostility is only going to improve as you get fitter, and that’s just one of the many benefits.
A central thread to all of these things is that, while they do improve your abilities if faced with terrorist or active attack, they improve you (and your closest allies) as a whole. Being better martial artists, shooters, and family members. Being stronger, and more aware of our surroundings. Being able to handle medical emergencies, that are far more likely to confront us than any any act of violence. These are all things that benefit us no matter the emergency, and that are far more likely to matter in a terrorist attack than overloading your vehicle with supplies you’ll never get to in time.
I originally wrote this in the wake of the Daesh attack on the Bataclan theater in Paris. Events recent to this re-posting in January 2020 have made great illustration of the points made here. On December 29th, 2019, a violently unstable man wheeled a shotgun out of a long coat and began shooting inside the West Freeway Church of Christ, in White Settlement, Texas. Two parishioners were killed, one of them an armed volunteer security team member, shot while trying to draw (and possibly load) his handgun. The incident was resolved when security volunteer Jack Wilson fired a single shot to the attackers head, from an estimated ten yards. The incident lasted only a few seconds. The volunteer security team at West Freeway Church of Christ, as at most churches, are ordinary people, going about ordinary parts of their lives, carrying equipment that fits in with that. Jack Wilson came as he was, and prevailed. The other security team volunteer did too, and did not.