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Posted: 8/2/2007 6:12:56 PM EDT
[Last Edit: ROMAD-556]
In a recent thread a poster inquired about advanced first aid and I did some searching because I was interested as well. I didn't find too much that would be considered advanced. I did find an excellent resource for the current Combat Life Saver (CLS) training conducted by the US Army.  I was first trained as a CLS back in 1997 and was re certified a few times but it has been several years since my last re-cert. The training has been helpful to me then and ever since - sure I haven't had to stick an IV outside of a classroom but I have ended up on the scene of a couple bad accidents and the knowledge was useful and reassuring.

If you have never attended a US Army CLS course there are a couple mandatory things you *must* understand:
- These are 'advanced' first aid techniques that will help stabilize a wounded person for the Golden Hour. This means CLS will buy you some time but it wont fix the main problem - make no mistake about that! You have to seek higher medical aid right away!
- This material is intended to be taught by a 91B (combat medic) or 18B (SF medic). While all the CLS course material is available below it should not be confused as a replacement for instructor lead and graded training.
- IV fluids are not available to plain old civilians. They are considered medicine and can only be purchased by medical personnel.

ETA 06SEP08 - It appears that some but not all of the CLS links are no longer publicly available without an AKO account. I have marked the AKO only links for you.

Here is the US Army Combat Live Saver Program home page: http://www.cs.amedd.army.mil/clsp/index.htm

The most recent self study guide (edition B) can be found here: https://atiam.train.army.mil/soldierPortal/atia/adlsc/view/public/12232-1/ACCP/IS0871/toc.htm  AKO Only

The previous self study guide can (edition A) can be found here: http://www.cs.amedd.army.mil/clsp/IS0871.pdf

The course presentation material can be found here: http://www.cs.amedd.army.mil/clsp/presentations.asp
(lots of good stuff in there!)

IS0871

Combat Life Saver Training Lesson Plan
============================

Lesson 1: PERFORMING TACTICAL COMBAT CASUALTY CARE
(care under fire; tactical field care; combat casualty evacuation care)

Lesson 2: EVALUATING A CASUALTY
(breathing/bleeding/shock)

Lesson 3: OPENING AND MANAGING A CASUALTY'S AIRWAY
(CPR, inserting a nasopharyngeal airway)

Lesson 4: TREATING PENETRATING CHEST TRAUMA AND
DECOMPRESSING A TENSION PNEUMOTHORAX

(checking/sealing, Tension pneumothorax and needle chest decompression)

Lesson 5: CONTROLLING BLEEDING
(field dressing/pressure dressing/pressure points and applying a Combat Application Tourniquet)

Lesson 6: INITIATING A SALINE LOCK AND INTRAVENOUS INFUSION
(Hypovolemic shock, saline lock and initiating fluids through a saline lock)

Lesson 7: INITIATING A FIELD MEDICAL CARD
(primary/secondary info, approved abbreviations)

Lesson 8: REQUESTING MEDICAL EVACUATION (MEDEVAC)
(9 line report)

Lesson 9: EVACUATING A CASUALTY USING A SKED OR
IMPROVISED LITTER

(pick'em up and move'em out...carefully)

Appendix COMBAT LIFESAVER MEDICAL EQUIPMENT SET
(CLS bag inventory and item cost)



Follow on information:
--------------------------


Here is the current First Aid field manual with change 1 included, dated 2004
https://atiam.train.army.mil/soldierPortal/atia/adlsc/view/public/9553-1/fm/4-25.11/fm4_25x11.pdf  AKO only

Public access:
http://www.operationalmedicine.org/Army/Milmed/fm4_25x11.pdf

This manual includes specific steps for general aid giving techniques as well as specific techniques for specific situations. A great companion manual for much of the CLS info above.

Link Posted: 8/11/2007 2:32:05 PM EDT
[Last Edit: ROMAD-556] [#1]
More supplementary CLS training information

Performance Systems Medical Division makes the Israeli Bandage that is increasingly replacing the standard, decades old USGI field bandage.

Here is the PSMD provided training resources on the Israeli bandage (right click ~ Save as)

Israeli Bandage Usage Instructions: Link
Israeli Bandage Training Video (30MB): Link
Israeli Bandage Demonstration Video (107MB): Link


PSMD also makes the SOF Tourniquet  (Combat Action Tourniquet)

Here is their training resources on the SOF Tactical Tourniquet (right click ~ save as...)

SOFT tourniquet usage instructions: Link
SOFT tourniquet training video (7.5MB): Link
SOFT tourniquet demonstration video (8.25MB): Link

More CAT videos and info here


In case you have trouble playing those videos you might want to check out VLC Media Player. VLC is a free player that will play just about any video file out there (come with lots of codecs).

Link Posted: 8/11/2007 2:39:57 PM EDT
[Last Edit: ROMAD-556] [#2]
SAM Medical makes the SAM splint used in many first responder situations

Here is there SAM splint instructional PDF link

They also have a detailed instruction PDF (dead link) http://www.sammedical.com/samsplintdirections.pdf

ETA - Links fixed, SAM Splint videos appear to have been removed - I have copies of them if you need them or can host them (total of 14 .wmv files each about 6-9MB)
Link Posted: 8/12/2007 2:09:57 AM EDT
[Last Edit: ROMAD-556] [#3]
YouTube video of a live insertion of a Nasopharyngeal Airway:

Link #1 (Army)
Link #2 (Navy)
Link #3 (even the zoomies can do it!)
Link Posted: 8/12/2007 2:20:50 AM EDT
[Last Edit: ROMAD-556] [#4]
Link Posted: 8/12/2007 4:51:57 AM EDT
[#5]
I had part of this series. Didn't realize that there was that much more. Thanks.
Link Posted: 8/14/2007 10:54:07 PM EDT
[#6]
thank you!!! this needs a TACK
Link Posted: 9/20/2007 8:20:50 PM EDT
[Last Edit: BOYSCOUT4LIFE] [#7]
I agree please tack this valuable information.

BoyScout4Life...

P.S. I forgot to say Thanks, ROMAD-556
Link Posted: 10/21/2007 8:43:31 PM EDT
[#8]
Bump to circulate good info
Link Posted: 10/25/2007 6:07:42 AM EDT
[Last Edit: ROMAD-556] [#9]
Considering the fact that CLS is a short term stabilization skill that still relies on higher medical personnel, which may not always be readily available.

Where There Is No Doctor

Link

This information was intended for 3rd world NGO workers to allow them some level of medical skills and knowledge but is not focused on trauma level care. None the less the target audience for this information should be compatible with anyone seeking CLS info.


Table of Contents: Introduction, Note About This New Edition
Front matter: Cover, How to Use This Book, Acknowledgements
Brown Pages: Words To The Village Health Worker
Chapter 1: Home Cures and Popular Beliefs
Chapter 2: Sicknesses that are Often Confused
Chapter 3: How to Examine a Sick Person
Chapter 4: How to Take Care of a Sick Person
Chapter 5: Healing Without Medicines
Chapter 6: Right and Wrong Use of Modern Medicines
Chapter 7: Antibiotics: What They Are and How To Use Them
Chapter 8: How To Measure and Give Medicine
Chapter 9: Instructions and Precautions for Injections
Chapter 10: First Aid
Chapter 11: Nutrition: What to Eat to Be Healthy
Chapter 12: Prevention: How to Avoid Many Sicknesses
Chapter 13: Some Very Common Sicknesses
Chapter 14: Serious Illnesses That Need Special Medical Attention
Chapter 15: Skin Problems
Chapter 16: The Eyes
Chapter 17: The Teeth, Gums, and Mouth
Chapter 18: The Urinary System and the Genitals
Chapter 19: Information for Mothers and Midwives
Chapter 20: Family Planning- Having the Number of Children You Want
Chapter 21: Health and Sicknesses of Children
Chapter 22: Health and Sicknesses of Older People
Chapter 23: The Medicine Kit
The Green Pages: The Uses, Dosage, and Precautions for Medicines
The Blue Pages: New Information
Vocabulary: Explaining Difficult Words
Information: Addresses for Teaching Materials, Dosage Blanks, Patient Report, Information on Vital Signs, Abbreviations, Weight, Volume
Index (Yellow Pages)


Download Them All will not work on these links - I do have all the PDFs zipped up (7.6MB) if someone can host them or email me for the zip file if you can accept attachments that large.

Alternatively the same info can be found as a single pdf on this site:

http://www.mrbill.net/survival/Where%20There%20Is%20No%20Doctor.pdf

Link Posted: 10/25/2007 6:31:08 AM EDT
[Last Edit: ROMAD-556] [#10]
Continuing with the theme of advanced first aid information...Listed below is the official DOT curriculum for EMT Basic. I would encourage anyone with the interest to seek out the offical instruction from your local community college (120 class room hours) or local FD/EMS - typically they will offer this level of training for volunteer programs.

As with the CLS information above, it should not be confused as a replacement for instructor lead and graded training.

Emergency Medical Technician-Basic: National Standard Curriculum
This is the 1994 release of the Emergency Medical Technician-Basic: National Standard Curriculum. It contains the Course Guide and Instructor Lesson Plan and it is designed for instructors to teach the new EMT- Basic course.

(right click ~ save as...) PDF Link

Supplemental Airway Modules for the EMT-Basic
This is a tool designed to assist EMS instructors with teaching the airway modules found within the 1994 EMT-Basic: National Standard Curriculum. This document supports, but does not replace, sections 2.1 and 4.2 of the EMT-Basic.

(right click ~ save as...) PDF Link

More EMT information can be found here

Link Posted: 11/9/2007 7:15:05 PM EDT
[#11]
Continuing with the theme of advanced first aid information here is the FAK list and medical guide from NASA for the shuttle and ISS. Both have a lot of good information albeit some of the instructions for dealing with weightless environments wont really apply but the procedures and details in both are excellent information.  

Space Shuttle Medical Checklist
Has advance first aid care instructions and picture/diagrams
(right click ~ save as...2.2MB) PDF link

INTERNATIONAL SPACE STATION INTEGRATED MEDICAL GROUP MEDICAL CHECKLIST
Lots and lots of good info with pictures/diagrams. Dual language English and Cyrillic Russian
(right click ~ save as...23.9MB) PDF link
Link Posted: 1/2/2008 4:36:21 PM EDT
[Last Edit: ROMAD-556] [#12]
Found a copy of the Pararescue Medication and Procedure Handbook, 2nd Edition, 2001 for download. Many good sections on the normal advanced first aid subjects and some others including DIVE EMERGENCIES, HIGH ALTITUDE ILLNESS, PHARMACOLOGY (nice section with OTC information as well as antibiotics and other prescription meds)


This handbook is designed to provide concise information regarding management of patients in austere environments.  It is a ‘quick reference’ and is not meant to provide detailed discussions of physiological events. You are expected to provide the standard of care for your EMT certification, including the unique skills native to Pararescue.


Pararescue Medication and Procedure Handbook
Second Edition, 28 February, 2001
(right click ~ save as...3.4MB) MS Word .doc link
Link Posted: 1/2/2008 7:26:32 PM EDT
[Last Edit: WETSU] [#13]
Here' some more good stuff, not directly related to CLS, but good medical info to have, more along the lines of 18D stuff maybe:

Where there is no doctor

Where there is no Dentist

Survival and Austere Medicine

Chest deco power point



I have more, if interested, or let me know if I should post them elsewhere.
Link Posted: 1/2/2008 7:38:21 PM EDT
[#14]
Link Posted: 1/24/2008 6:42:16 PM EDT
[Last Edit: ROMAD-556] [#15]
Individual First Aid Kit (IFAK) use is covered pretty well in the CLS class material but here is a great video showing some of its practical practical application. Shows pressure dressing, burn dressing, tourniquet, self aid, buddy aid and TCCC in real time action shots.

USMC IFAK Video with Carl Weathers

10 min video and well worth watching.

Alternate 79MB downloadable link of the same video:
http://www.tecom.usmc.mil/gtb/videos/IFAK%20First%20Aid.wmv
Link Posted: 8/7/2008 1:23:32 AM EDT
[Last Edit: ROMAD-556] [#16]
I was doing a little link checking on my posts and it appears that most if not all of the CLS links in the FIRST POST are now AKO access only. A couple of the links are just coming up 404 so I'm not sure about those just yet. I will try to reverify those at a later time to see if they are still working.

ETA - Looks like the original stuff is back up and not 404!

ETA#2 - It appears the main CLS site comes and goes with 404...might be due to bandwith restrictions but I admit that seems odd for a .mil site. None the less, it appears the links work best at the first of the month than the end of the month . Odd for sure as they come and go. I have all the info and can upload it all if anybody has a public host for it all. The main CLS info is a couple hundred MB of PDF, PPT and DOC files with a handfull of WMV.

Here is an alternate set of CLS info:
http://www.tacmed.dk/combat_life_saver.htm

Armystudyguide.com has some decent info as well:
http://www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/index.shtml

Here is a good bit of Buddy Aid/Self Aid info:
https://rdl.train.army.mil/soldierPortal/atia/adlsc/view/public/12617-1/ACCP/IS0877A/toc.htm#toc

Word .DOC link:
http://www.accpguide.com/index.php?act=attach&type=post&id=200

Link Posted: 1/5/2009 9:27:12 AM EDT
[Last Edit: ColonelKlink] [#17]
Link Posted: 3/24/2012 11:10:28 PM EDT
[#18]
Sadly, they took out the IV portion from training. I have no clue as to why. My DS in basic still taught it to us on his own, but every time I have to get re-certified for CLS they won't touch on it.
Link Posted: 7/28/2012 4:50:21 AM EDT
[#19]
Originally Posted By zspitfire04:
Sadly, they took out the IV portion from training. I have no clue as to why. My DS in basic still taught it to us on his own, but every time I have to get re-certified for CLS they won't touch on it.


It's because after so many years of IV being the biggest part of CLS training, the Army noticed that wounded Soldiers on the battle field were dying because their buddies were focused on getting an IV into them instead of treating the trauma. The focus has now shifted to treating GSW and blast injuries, the results speak for themselves, much better survival rate for wounded Soldiers.

Still, being able to do an IV is a useful skill, especially when operating in Desert environments.
Link Posted: 6/15/2015 3:18:12 AM EDT
[#20]
CLS doesn't cover blunt trauma injuries. I was injured in  Hummer accident as a PLT SGT and the CLS guys had no clue what to do as I wasn't bleeding. Had to talk them through a head to toe survey and take my vitals.

Got ejected from the vehicle and landed on a rock with my spine. Was temporarily paralyzed for about 45 minutes. Scared the shit out of me.
Link Posted: 10/4/2021 4:19:13 AM EDT
[#21]
Its been a very long time since I attended a couple combat life saver courses, early 90's. They were very good courses. Still have a medic bag from one of the courses, wasn't thrilled when being stuck by an amateur giving me an IV
Link Posted: 4/13/2023 7:28:28 PM EDT
[#22]
Discussion ForumsJump to Quoted PostQuote History
Originally Posted By cda97:
Its been a very long time since I attended a couple combat life saver courses, early 90's. They were very good courses. Still have a medic bag from one of the courses, wasn't thrilled when being stuck by an amateur giving me an IV
View Quote

I don't blame you there. I took the combat life saver course while stationed in Baumholder, Germany in 1993. They had us doing the IVs in our partners hands. My partner had the shakes really really bad and I told him he better get it right the first time (which he did). I haven't had to start an IV since then and definitely would not want to unless there was no other choice.

I have to agree that the CLS course is well worth it especially if you have good instructors.
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