SELCO: Trauma Assessment and Treatment in Adrenalized Situations
by Selco Begovic
Would you know what to do if someone in your group was injured in the middle of a chaotic event, screaming for help?
It seems like a subject change but after many articles, assessments, and discussions about events that are happening around us during the last period of time, it makes sense to step away from looking at big events. We need to step out of the big circle and step back into our small circle of survival. Our personal circle.
Or in other words, let’s go back to the basics of survival.
It does not make much sense to monitor big events or to participate in them, if you, for example, do not know how to start a fire, shoot a weapon, or treat the most common injuries.
No matter how large and complicated the event, look to yourself and your circle. Most probably it is the simple things and situations that will kill you. A “small circle” personal particular event will cause trouble for you. Lack of food, lack of hygiene, or the lack of a particular skill will be the end, not something dramatic happening seven states away.
So we need to go back to basics, often.
Treatment in the field
Treating a wound in the field is much different than in your comfortable home with your handy supplies. I saw this video online and wanted to discuss it with you.
Watch the video and see if you think they’re treating the injury correctly.
Doing something like treating a wound in a real environment is a highly adrenalized situation, and when you under the effect of it you’ll make mistakes unless you have trained many times on what you have to do in that situation.
Without undermining those folks’ wish to help, it must be said that they overreacted in treating a wound that looked absolutely like a wound that does not require the use of a tourniquet.
In the survival movement (and not only there), a tourniquet is seen as a magical device that saves lives, and that almost should be used whenever blood occurs.
In reality, the explanation when you should use a tourniquet is very simple – whenever you can not stop the bleeding in any other way. The bleeding in the video looks like it could have been stopped by good old direct pressure without any problems. However cool the use of the tourniquet may look, there is (or there should be) common sense in using it.
Again, you use it when you can not stop massive bleeding in any other way because by using the tourniquet for example, on a leg like in the video, you are obstructing blood flow to the leg. From the point of application of the tourniquet, in other words, the leg is not getting blood and eventually, it will “die”.
That is the reason why you should use it only when other means are not stopping massive bleeding. You use a tourniquet only in life-threatening situations.
Now, you as a prepper add to the fact that in the world without a running system (and hospitals) you should be extra careful when to use it, because “help is on the way” might not be an option. By applying an unneeded tourniquet on the leg, for example, you might turn a small wound into a situation when complicated surgical procedures might be needed.
That might be tricky in the collapsed world.
So, a tourniquet is a great device, it saves lives, but only if you learn how and when to use it.
Watching the video, there are a couple of more thoughts about basic trauma assessment and treatment in the field, so you need to think about this too.
Assess the situation and try to see what s happening. Try to assess if there is any possible danger to you if you want to treat the injured person, because otherwise, you might find yourself in a situation where you also get injured, and then there might be two of you injured with nobody to help. If bullets are flying, you may have to wait to perform the treatment.
What’s going on? How many are injured? What kind of injuries do they have? Are there more serious injuries than those injuries that are visible…?
Trauma is an adrenalized event. You need to be sure what is happening, otherwise, you might easily find yourself in a situation where you treat the wound that looks horrible but it is not life-threatening and you forgot to check and see that there’s also a life-threatening wound.
In all that chaos, you need to find yourself in your “zone” if you already there and helping.
Expose the patient and check for other possible wounds more serious then the visible one.
Give orders, obey orders, or go away.
Again, trauma is a highly adrenalized event. It can be chaotic, and you can make a lot of mistakes with other people trying to help, too.
In all that wish to help, chaos will make you in the best case to do nothing, in the worst case, it will push you to make mistakes.
Learn to recognize who is who (in the matter of knowledge, skills, and guts) among people and find your place.
If there is a clear situation where you have the most and best knowledge among the people there, do not hesitate to take lead, and to give orders, People will usually listen to you. If there is a person with greater knowledge then you, do not hesitate to obey. If you are just blindly dancing around the victim, with other people you are not helping.
One important note here: know that there is a responsibility there, so in first place, decide carefully if you are gonna go there, and if you are gonna take responsibility.
Remember a bunch of people wanting to help blindly is not actually helpful. On the contrary, it can mean more harm to the injured man.
And this video kinda pushed me to mention one more thing.
You need to control the situation, and that also means you need to control the patient. If he is clearly overreacting, you need to help him get a hold of himself. Sometimes that means simply saying, “Shut the f**k up, you wimp. It is nothing.”
It works in those situations, trust me.
About the Author
Selco survived the Balkan war of the 90s in a city under siege, without electricity, running water, or food distribution. In his online works, he gives an inside view of the reality of survival under the harshest conditions. He reviews what works and what doesn’t, tells you the hard lessons he learned, and shares how he prepares today. He never stopped learning about survival and preparedness since the war. Regardless what happens, chances are you will never experience extreme situations as Selco did. But you have the chance to learn from him and how he faced death for months. Read more of Selco's articles here. Buy his PDF books here. Take advantage of a deep and profound insight into his knowledge by signing up for his unrivaled online course. Real survival is not romantic or idealistic. It is brutal, hard and unfair. Let Selco take you into that world.