By Michael Carr, IPSA TEMS Committee Member
Are operating procedures and protocols ever complete? Should a TEMS provider ever be content with just being up to standard? Whether it’s your personal education or the team’s medical training, complacency is a TEMS team’s biggest enemy.
Recently, I ran my team through a firefighter survival trailer – it was completely dark. We were going through a maze of downed wires and small holes. During their endeavor, I would stop a team member mid-crawl and tell them they had a right arm injury. And not just any arm injury. This injury would incapacitate the limb to the extent that the team member would be forced to keep the right arm completely still while using the left arm to unwind a tourniquet, place it on the injured arm and then tighten in down to a painfully radial pulse stopping degree.
Once the tourniquet was applied, I examined the team member’s tourniquet application, using a flashlight because it was dark, and asked these two questions:
- How tight does the tourniquet need to be?
- What happens if the blood doesn’t stop after tightening down the tourniquet?
After my inspection, I would advise the team member to remove the tourniquet and then sent him or her on to finish the course.
One team member was taking an extremely long time placing the tourniquet. I bluntly asked, “Are you out of practice?” The team member replied, “I’m trying to place the tourniquet with my entry gloves on.”
While observing the team member struggling to place the tourniquet, I had an epiphany. After all the years of doing and teaching TEMS, why have I not made the team members train on tourniquet placement with their entry gloves on?
In our jurisdiction, officers are mandated to wear these gloves while doing any type of SWAT event, and if any operator goes down he or she will be doing buddy-aid or self-aid with the gloves on. TEMS teams must also be training mentally, physically and with the same equipment as we do our job with.
Once you believe you have a grasp on what needs to be done as a progressive TEMS provider, look at someone else’s program to learn another way. Exchanging ideas with other teams is a simple way to learn a new technique or find a new piece of equipment.
Correspond with other TEMS providers outside of your team and outside of your state. Invite another team to teach a TEMS class one month then the next month your team can return the favor. What works for one team may not always work for another, but at least you’re learning and expanding the knowledge base.
Read articles written by your peers. Authors from around the world constantly write about real world SWAT events so that others may learn what was done right and what needs to change - learn from them.
Learn how to care for injured K9s. Placing an oral airway in a dog is much easier than placing one in a human, but do you know how? Or have you ever seen it done? Contact a local veterinarian to see if your TEMS providers observe some surgeries, and make sure to watch the placement of oral airways. Pick the brains of these doctors, learn how to treat our four-legged officers. Most K9 officers have gone through a basic K9 first-aid course and has their own first-aid kit for the dog.
Reach out to individuals who serve in the military – they can offer ideas on products that have proven themselves worth the money and methods of care.
About the Author
Michael Carr is a member of the IPSA’s TEMS Committee and a 20-year Firefighter/Paramedic with the City of Noblesville, Indiana. He started Noblesville’s first TEMS program eight years ago having to write protocols and SOG’s without any training or experience. He is currently working in an administrative role on the TEMS Team. This past spring, he hired his replacement for entry on the team. It’s been bitter sweet, but a great relief knowing this individual is a good Medic and he’s passionate about the work. I continually strive to be better, make the TEMS program better and make sure my whole team goes home at the end of the call out.
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