2. Self Aid / Buddy Aid This Program is the results of advances in Military Medicine on the Battlefields of Iraq and Afghanistan. All Branches of US Military now teaching some form of Self Aid / Buddy Aid and providing first aid supplies to individual deployed soldiers.

3. Self Aid / Buddy Aid Because of the new nature of warfare in the Middle East (snipers, roadside bombs, etc), research by Military Medical personnel determined: 15% of deaths resulting from traumatic injury can be prevented by treatment at the scene by oneself or buddy.

4. Self Aid / Buddy Aid BATTLEFIELD DEATHS Most combat deaths occur on the battlefield before the casualties reach a field hospital. Most of these deaths are inevitable (massive trauma, massive head injuries, and so forth). However, some conditions such as bleeding from a wound on an extremity (arm or leg), tension pneumothorax, and airway problems can be treated on the battlefield. This treatment can be the difference between a combat death on the battlefield and a recovering soldier. It has been estimated that proper use of self-aid and buddy-aid skills can reduce battlefield deaths by up to 15 percent (mostly from methods to control bleeding from the extremities).

5. Self Aid / Buddy Aid BATTLEFIELD DEATHS In combat, the combat medic may not be able to reach the casualty in time to save the casualty's life, especially if the casualty is losing a great deal of blood quickly. The combat medic may even become a casualty and require aid himself. In such a situation, quick self-aid (the injured soldier treating himself) or buddy-aid (the injured soldier being treated by a fellow soldier) is needed. For example, over 2500 soldiers died in Viet Nam caused by hemorrhage from extremity wounds even though the soldiers had no other serious injuries. Proper application of pressure dressings and tourniquets by fellow soldiers could have saved most of these casualties.

6. Self Aid / Buddy Aid DEATHS CAUSED BY GROUND COMBAT 31%--Penetrating head trauma 25%--Surgically uncorrectable torso trauma 10%--Potentially correctable surgical trauma 9%--Exsanguination (bleeding) from extremity wounds 7%--Mutilating blast trauma 5%--Tension pneumothorax 1%--Airway problems 12%--Died of Wounds after being evacuated to a medical treatment facility (usually from infections and complications of shock)

7. Self Aid / Buddy Aid Military combat casualty situations are similar in some respects to some law enforcement incidents. Officer injuries by firearms Delayed medical care in some cases Rural nature of some law enforcement operations

8. Self Aid / Buddy Aid Concepts of US Military SABA are now being applied to law Enforcement in order to reduce death and serious injury of police officers…..

9. Self Aid / Buddy Aid Basic concepts of SABA training provided to Law Enforcement consist of: Control of Bleeding Treatment of pneumothorax Maintaining Airway and Breathing

10. Bleeding from extremity wounds Adults have about 5 Liters of blood in their body or about 10-12 pints. When you donate a pint of blood, there is usually little effect and the body generates replacement blood within 1-2 days. Blood Pressure drops with 20-30% loss or loss of 2-3 pints

11. Bleeding from extremity wounds A 40% loss - about 4 pints will usually result in death. How quickly this occurs obviously depends on where and how the damage occurs, but… Bleeding out and death can occur in 3 to 5 minutes in the worse case.

12. Where will you be if it happens?

13. Controlling Bleeding Direct Pressure or Pressure Bandage Tourniquet

15. Or what is handy!

16. SABA kit tourniquets SABA kit tourniquets Belt as tourniquet Belt as tourniquet

32. Individual SABA Trauma Kits

33. Contents and Style of SABA Kits Vary At Minimum, kit should contain: Tourniquet Pressure Bandage Plastic patch or ziplock bag for use with Tension pneumothorax Tape of some kind Gloves

34. Important: Many times contents are packaged in manner that makes opening components difficult, especially if having to use only one hand. Officers should prepare components for easy opening under fire. Open and prepare tourniquet for application. Make a slit in the packaging for the pressure bandage (not into sterile area). Repackage and carry on person.

35. Source for SABA Training and Kits: Texas Tactical Police Officer Association STS Consulting—Tactical EMS Training Rescueessentials.com

36. If your department cannot afford to provide officers with SABA Kits, consider purchasing your own…. Knowledge of lifesaving methods will enable you to use improvised materials if actual materials are not available.

37. PERFORMING CARE UNDER FIRE Care under fire is rendered at the scene of the injury while you and the casualty are still under effective hostile fire. In such a situation, you should perform the following actions.

38. PERFORMING CARE UNDER FIRE 1.Return fire if required before providing medical treatment or rescue of a down officer. Reducing or eliminating enemy fire may be more important to the casualty's survival than the treatment you can provide. Your own survival and the survival of other officers or innocent individuals may also depend on elimination of the ongoing threat. Call for Emergency Medical Assistance as soon as possible.

39. PERFORMING CARE UNDER FIRE 2.Remove the officer from the threat zone if you can safely do so. a.If not possible to safely remove the officer from the threat area: (1.) Determine if casualty is alive or dead. (2.) Use cover or concealment (smoke, vehicle, etc.) to conceal the casualty, if possible. (3.) If the casualty is able, direct him to return fire, move to cover, and administer self-aid (control bleeding). (4.) If the casualty is unable to move and you are unable to move the casualty to cover, have casualty "play dead.“ (5.) Try to keep the casualty from sustaining additional wounds. Reassure the casualty. Administer only life-saving hemorrhage control while still under enemy fire.

40. PERFORMING CARE UNDER FIRE 3.Once the casualty is out of the line of fire, treat for life threatening injuries, and evacuate as possible to allow for quick medical access.

41. SABA Training Can Save Your Life Officers are encouraged to seek additional training including practical exercises and practice using a tactical tourniquet to improve their ability to function under fire.