Page 153 - JSOM Summer 2018

As soon as we were in the open, we were engaged by the
shooter from a concealed position with rapid automatic fire;
two SWAT officers in the team sustained injuries.
One officer who had been shot in the arm and abdomen fell
in the fire lane, and after some emotive language, motivation,
and physical assistance from Ben, the casualty was moved to
cover for assessment and treatment. Ben and I were conscious
of being split during our training, so we always made an effort
to re-group as quickly as possible to form a casualty clearing
point (CCP) and centralize our treatment and equipment.
In this serial, we set up behind a building and instructed the
SWAT team to provide security. We were in an indirect threat
zone so we moved quickly to assess both patients. One officer
had sustained a laceration to the head and a gunshot wound
(GSW) to the leg. He was confused and still in possession of
his weapon system. I elected to have him disarmed based on his
clinical presentation and level of consciousness. After applying
a tourniquet and bandaging his head, he was handed off to one
of the other SWAT members who was instructed to move him
out of the warm zone to a waiting ambulance.
The second patient has sustained a GSW to the abdomen
and arm. He was hysterical and combative and once again
required some reassurance from Ben to settle him down. Once
Ben had conducted a thorough assessment, controlled his ma-
jor hemorrhage and bandaged his abdominal wounds he was
also handed off to the waiting ambulance for immediate evac-
uation to the cold zone.
Once we consolidated in order to move, we began our han-
dover of the casualties to the rescue task force so that they
could be backloaded to the cold zone, and the K9 officer pair
advanced to contact to clear the route. Shortly after we lost
sight of the pair we heard them trigger an explosive device.
After the explosive device had been triggered, we moved in to
provide care to the injured pair. The team immediately pushed
forward and found two patients lying on the ground.
The K9 had severe torso trauma and bilateral partial ampu-
tations of the hindlegs above the knees. The K9 handler had
an amputated left leg and a severe inguinal junctional hem-
orrhage. The SOAR team had deliberately equipped us with
two tourniquets each and by this stage we had run out of With no tourniquets left in my kit, I directed the SWAT team
tourniquets. leader to source one while I provided indirect pressure above
the wound. Once he arrived at my location, a tourniquet was
applied to stem the lower limb bleeding and I moved to pack
the junctionnal wound with hemostatic gauze. This proved in-
effective, and I elected to escalate to a junctional tourniquet,
which was then successfully applied, controlling the bleeding.
A MARCH assessment was conducted that revealed a GSW
to the right side of the chest with an auxiliary exit wound.
Vented chest seals were placed on both wounds. By this time,
the SWAT team leader had called in a helicopter, which was 2
minutes out from the landing zone (LZ).
After being instructed to leave the now-stable K9 officer be-
hind with the rescue task force, we loaded the handler onto a
talon stretcher and moved toward the trailer LZ.
On the way to the LZ, we were faced with a chained and locked
Ben set to work treating the K9 using conforming gauze gate and were required to “unlock” the padlock with a breach
and pressure dressings to con- trol the massive hemorrhage. pen. We placed the casualty at a safe distance from the gate
The K9 then went into respiratory distress, leading Ben to de- and I stayed with him. Ben moved forward and used a breach
compress the K9 officer’s chest; this resulted in instant relief pen that he pulled from my kit to cut the padlock on the chain.
for the casualty. Once the breach pen had burned out, Ben kicked the now hot

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