Video: 10 Critical Principles of Tourniquet Use

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Video: 10 Critical Principles of Tourniquet Use

SOF-T Tourniquet

In this video, Nurse Amy steps in front of the camera to discuss important principles with regards to tourniquet use to stop massive hemorrhage.  Besides the imperative to apply pressure to stop the bleeding, Amy discusses the concept of pressure loss, the length of time the tourniquet should be placed, and when to transition the tourniquet to a pressure dressing with hemostatic agents. Nurse Amy (an advanced registered nurse practitioner) gives you strategies that will help prevent rebleeds, and other factors that make tourniquet use appropriate and generally safe.

To watch, click below:

Wishing you the best of health in good times or bad,

 

Amy and Joe Alton

Amy Alton ARNP

Find out more about stopping hemorrhage and 150 other medical topics in the survival mindset with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at store.doomandbloom.net!

7 Tips for Avoiding an Urban Terrorist Attack

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Although technically a terrorist attack can happen anywhere, it is far more likely to happen in an urban area. In addition, it is more likely to happen at a large gathering such as a concert or sporting event. So whether you live in an urban area or just visit one occasionally to see a singer […]

The post 7 Tips for Avoiding an Urban Terrorist Attack appeared first on Urban Survival Site.

Survival Medicine Hour: Nailbed Injuries, Wound Closure, Mass Casualties

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American Survival Hour #340

Nailbed Injuries

In this episode of the Survival Medicine Hour, Joe and Amy Alton discuss small injuries like those to the nail bed, and large, massive injuries like those seen in mass casualty events. What do you do if you’re the first on the scene of a bombing or other multi-injury event? These days, as the recent events in England have taught us, a mass casualty incident (MCI) can occur anytime and anyplace there’s a crowd.

Plus, Joe and Amy talk about  the factors to consider before deciding to close a wound. Wounds should only be closed in certain circumstances in off-grid settings. Find out how to use the best judgment in this week’s Survival Medicine Hour with Dr. Bones and Nurse Amy!

When to close a wound?

To Listen in, click the link below:

http://www.blogtalkradio.com/survivalmedicine/2017/06/02/survival-medicine-hour-nailbed-injuries-wound-closure-mass-casualties

 

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Dr. Bones and Nurse Amy

Joe and Amy Alt

Don’t forget to check out Nurse Amy’s entire line of medical kits and individual items at her store at store.doomandbloom.net. You’ll be glad you did!

 

By the way, do us a Yuge favor and follow us on:

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Mass Casualty Triage Basics

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mass casualty incidents

Given the horrific events surrounding the Ariana Grande concert in Manchester, UK, we have come to realize that we may never be safe in today’s world. The bombing is new evidence, however, that no target is off limits to the terrorists in our midst. We can expect more episodes of terror in the western world in the future, and many will involve mass casualties.

The Mass Casualty Incident

The responsibilities of a caregiver is usually one-to-one; that is, the healthcare provider will be dealing with one ill or injured individual at a time.  This encounter usually falls within their expertise and resources.  There may be a day, however, when you find yourself confronted with a scenario in which multiple people are injured.  This is referred to as a Mass Casualty Incident (MCI).

A Mass Casualty Incident is any event in which your medical resources are inadequate for the number and severity of injuries incurred.  MCIs can be quite variable in their presentation.

Types of Mass Casualty Incidents

MCIs can be quite variable in their presentation:

  • Doomsday scenario events, such as a nuclear weapon detonation
  • Terrorist acts, such as occurred in Manchester
  • Consequences of a storm, such as a tornado or hurricane
  • Consequences of civil unrest or battlefield injuries
  • Mass transit mishaps (train derailment, plane crash, etc.)
  • A car accident with, say, four people injured (and only one ambulance)

 Responding to a Mass Casualty Incident

The effective medical management of any of the above events required rapid and accurate triage.  Triage comes from the French word for “to sort” (trier) and is the process by which medical personnel can rapidly assess and prioritize a number of injured individuals and do the most good for the most people. Note that I didn’t say: “Do the best possible care for each individual victim”.

Let’s assume that you were at the concert in Manchester, the Christmas market in Berlin, or the Boston Marathon when a bomb went off.  You are the first one to arrive at the scene, and you are alone.  There are twenty people on the ground, some moaning in pain.  There were probably more, but only twenty are, for the most part, in one piece.  The scene is horrific.  As the first to respond to the scene, you are “Incident Commander” until someone with more medical expertise arrives on the scene.  What do you do?

Your initial actions may determine the outcome of the emergency response in this situation.  This will involve what we refer to as the 5 S’s of evaluating a MCI scene:

  • Safety
  • Sizing up
  • Sending for help
  • Set-up of areas
  • START – Simple Triage And Rapid Treatment

Safety Assessment:  An insidious strategy on the part of terrorists when they target crowds is to set off primary and secondary bombs.  The main bomb causes the most casualties, and the second bomb is timed to go off or is triggered just as the medical/security personnel arrive.  This may run counter to your instinct to help, but your primary goal is your own self-preservation. Keeping the medical personnel alive is likely to save more lives down the road.  Therefore, you do your family and community a disservice by becoming the next casualty.

As you arrive, be as certain as you can that there is no ongoing threat.  Do not rush in there until you’re sure that the damage has been done and you and your helpers are safe entering the area.  In the immediate aftermath of the 1995 Oklahoma City bombing, various medical personnel rushed in to aid the many victims.  One of them was a heroic 37-year-old Licensed Practical Nurse who, as she entered the area, was struck by a falling piece of concrete.  She sustained a head injury and died five 5 days later.

Scene at the Boston Marathon bombing

Sizing up the Scene:  Ask yourself the following questions:

  • What’s the situation?   Is this a mass transit crash?  Did a building on fire collapse?  Was there a bomb?
  • How many injuries and how severe?  Are there a few victims or dozens?  Are there “walking wounded” that could assist you?
  • Are they all together or spread out over a wide area?
  • What are possible nearby areas for treatment/transport purposes?
  • Are there areas open enough for vehicles to come through to help transport victims?

Sending for Help:  If modern medical care is available, call 911 and say (for example):  “I am calling to report a mass casualty incident involving a multi-vehicle auto accident at the intersection of Hollywood and Vine (location).  At least 7 people are injured and will require medical attention.  There may be people trapped in their cars and one vehicle is on fire.”

In three sentences, you have informed the authorities that a mass casualty event has occurred, what type of event it was, where it occurred, an approximate number of patients that may need care, and the types of care (burns) or equipment that may be needed.

Set-Up:  Determine likely areas for various triage levels (see below) to be further evaluated and treated.  Also, determine the appropriate entry and exit points for victims that need immediate transport to medical facilities, if they exist.  If you are blessed with lots of help at the scene, assign triage, treatment, and transport team leadership roles.

S.T.A.R.T.:  Triage uses the acronym S.T.A.R.T., which stands for Simple Triage and Rapid Treatment.   The first round of triage, known as “primary triage”, should be fast (30 seconds per patient if possible) and does not involve extensive treatment of injuries.  It should be focused on identifying the triage level of each patient.  Evaluation in primary triage consists mostly of quick evaluation of respirations (or the lack thereof), perfusion (adequacy of circulation), and mental status.  These are known as “RPMs” and are a (very) basic indication of the level of injury.

Other than controlling massive bleeding and clearing airways, very little treatment is performed in primary triage. Controlling hemorrhage is best done with commercial tourniquets, for example, the SOF-T, CAT, or SWAT. It’s a sad sign of the times that I recommend carrying one of these if you have to go to areas where there are large crowds and little security. Tourniquets can be improvised with belts, bandannas, and other items, but are more difficult to apply effectively.

Although there is no international standard for this, triage levels in the U.S. are usually determined by color:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.

Delayed (Yellow tag): The victim needs significant medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, an open fracture of the femur without major hemorrhage)

Minimal (Green tag): Generally stable and ambulatory “walking wounded”, but may need some medical care. (for  example, broken fingers, superficial burns)

Expectant (Black tag): The victim is either deceased or is not expected to live.  (for example, a large open fracture of cranium with brain damage, multiple penetrating chest wounds

Patients may be identified with colored tape or triage casualty cards, but you’re unlikely to have these on hand. In that case, simply mark the victims’ foreheads with the numbers 1,2,3, and 4 indicating the priority for urgent care

casualty card produced by sos products

Knowledge of this system allows a patient marking system that easily allows incoming medical personnel to understand the urgency of a patient’s situation.  It should go without saying that, in a power-down situation without modern medical care, a lot of red tags and even some yellow tags will become black tags.  It will be difficult to save someone with major internal bleeding without surgical intervention.

The surviving victims of the Manchester bombing were “fortunate”, if I may use the word, that emergency personnel were on the scene in minutes. Although the death count is currently at 22, many more of the 60 wounded would not have survived without their assistance and transport to modern medical facilities.

We live in a more dangerous world these days, something I call “The New Normal“. In the New Normal, increased vigilance and situational awareness will be needed if you want to stay safe in crowds. In future articles, we’ll explore further how to deal with mass casualty incidents as a medical asset, and also how to avoid becoming a victim of those who want to disrupt civilized society.

Joe Alton, MD

Dr. Alton

Learn more about mass casualties, active shooter, terror events, and 150 other medical topics in times of trouble in the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

Survival Medicine Hour: Blood Clotters, Wound Closure, More

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stabwound

In this episode of the Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy discuss improvised tourniquets and some TCCC guidelines regarding hemorrhage under fire or in normal times. Blood clotting agents are introduced and Quikclot/Celox are compared. Plus, when should a wound be closed and when should it be treated as a open wound from beginning to full recovery?

celox

Celox hemostatic agent

All this and more from a Survival Medicine Hour on the road, this time in Chicago, Illinois!

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2017/03/17/survival-medicine-hour-blood-clotters-wound-closure-more

 

Wishing you the best of health in good times or bad,

 

Joe and Amy Alton

AmyandJoePodcast400x200

Dr. Bones and Nurse Amy

PDF For Active Shooter Guidelines for Places of Mass Gathering.

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Yet again in the PDF (link below) the government blames law abiding gun owners for criminal access to illegal firearms. This is a lie and unfair. Law abiding gun owners have their/our firearms locked away in secure gun safes. Gun thefts from government agencies and purchases on the black market are largely responsible for criminal access to illegal guns. Simple guns are easy to make from items which can be purchased in any major hardware store. It is not rocket science, anyone with a hacksaw, a hand drill and a screw driver can make a shotgun.
Restrictions and controls made on law abiding citizens are done so for one purpose, to control the people. The last gun confiscation by the government did nothing to make the populace safer, on the contrary, home invasions have increased along with other violent crimes.
Australians are given no legal right to carry anything for use in self defence.

National Counter-Terrorism Committee

NATIONAL GUIDELINES for the PROTECTION of PLACES of MASS GATHERING from TERRORISM


Contents

Introduction                                                                                   3

Purpose                                                                                   3

Definition                                                                                        4

Security context                                                                              4

Principles                                                                                        4

Process for engaging with places of mass gathering

at risk from terrorism                                                             5

Risk management in the current environment                                             5

Roles and responsibilities of key stakeholders in the

        protection of places of mass gathering                                           6

        Role of the Commonwealth Government                                               6

        Role of the State and Territory governments                                         6

        Role of State and Territory police                                                   6

Role of the National Counter-Terrorism Committee                                     7

Role of owners and operators of places of mass gathering and event organisers       7

Role of Mass Gatherings Strategy Group (MGSG)                                 7

Role of the Business Advisory Group (BAG)                                  8

Roles of peak bodies and associations                                            8

Distribution of relevant intelligence and information/communications protocols Current security context Introduction

In November 2009, COAG SOM agreed to recommendations of the Review of the National Critical Infrastructure Protection Arrangements, including that work relating to the protection of places of mass gathering should be coordinated by the National Counter-Terrorism Committee (NCTC).

In December 2009, NCTC noted that the protection of places of mass gathering is most effectively delivered through a business government partnership, and agreed to coordinate at a national level, work associated with protecting places of mass gathering. In December 2010, NCTC agreed to establish the Mass Gatherings Strategy Group (MGSG) to operate as a national forum to share information on issues and best practice relating to the protection of places of mass gathering from terrorism.

NCTC also agreed to establish a consultative forum with business comprising national and major venue owners and operators, through a Business Advisory Group (BAG), to exchange information, and engage with law enforcement authorities to discuss Australia-wide issues relevant to the protection of places of mass gathering.

Purpose

Places of mass gathering not only present terrorists with potential opportunities for mass casualties, symbolism and high impact media coverage, they pose a broad range of security challenges for their owners and operators. NCTC noted that places of mass gathering have been specifically identified by religious and political extremists as attractive targets.  

All jurisdictions have robust and well tested arrangements for the planning and management of major and specific events. However, determining which places of mass gathering are at higher risk is not an easy task given the sheer number and variations of such places, and the limited security resources available. Once identified, they further present the challenge of what consistent risk mitigation strategies to develop and implement.

This document has been developed to ensure a nationally consistent approach is taken by all Australian jurisdictions in the development of their own guidelines for the protection of places of mass gathering from terrorism. The approach supports a systematic process identifying security risk management activities which can be integrated into existing jurisdictional emergency management arrangements. It provides a basis for:

•       identifying places of mass gathering that are vulnerable to the threat of terrorism, and

•       risk management arrangements associated with this threat, based on the roles and responsibilities shared among all private and public stakeholders.

Definition

Places of mass gathering incorporate a diverse range of facilities including, but not limited to, sporting venues, shopping and business precincts, tourism/entertainment venues/attractions, hotels and convention centres, major events and public transport hubs. This also includes significant one off events. They are characterised by having a large concentration of people on a predictable basis and often have a minimum of security controls present. Identification of places of mass gathering for the purpose of this document is based on risk and not on any arbitrary numerical threshold.

Given the pervasive threat to a diverse range of targets, the identification of places of mass gathering cannot be precise.

The identification of places of mass gathering potentially at risk from terrorism should be informed by the current security context.

Security context

The current security context for mass gatherings is provided by the Australian Security Intelligence Organisation (ASIO) and is at Annexure A.

Places of mass gathering are potential targets for terrorist attack, particularly in larger cities, as they may satisfy the following criteria:

•       provide opportunity for attack in terms of accessibility and vulnerability

•       cause high-impact imagery likely to be generated by an attack

•       have high symbolic value, and

•       have consequences in terms of mass casualties, economic impact and public anxiety in the broader community.

By concentrating large numbers of people at high density in accessible places, at regular or predictable times, mass gatherings present the opportunity for terrorists to inflict mass casualties, cause economic damage, and instil public fear.

Places of mass gathering, or the events themselves, may have symbolic value, or be representative of Western culture. Furthermore, any terrorist attack against a place of mass gathering would generate considerable media interest.

Principles

The national approach is based on the following principles:

•       counter-terrorism preparedness for places of mass gathering focuses on the protection and safety of people

•       all levels of government contribute to the prevention, preparedness, response and
recovery from a terrorist incident, including local government

•       event managers and owners and operators of places of mass gathering are responsible for taking reasonable steps to ensure the protection and safety of people

•       prevention and preparedness arrangements for protection from terrorism are
underpinned by an intelligence-led, risk management approach

•       security arrangements for places of mass gathering recognise the dynamic nature of the terrorist threat and are responsive to changes in the security environment, and

•       effective security outcomes in complex mass gathering environments require cooperation and coordination between all stakeholders.

Handling an Active Shooter Situation

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swat_team_active_shooting

police_car_active_shootingI have spent considerable time studying this issue and even more time thinking about what one should do in the event of an armed robbery or an “active shooter”. Although I have been blessed to never have been in either, I routinely think about what I would do should that unfortunate event occur. The more I think about what I would do, the more I think about how my response differs significantly from what you are told to do by government, educational, and business loss-prevention programs.

By Dan C., a Contributing Author to SHTFBlog and SurvivalCache

Almost all training programs teach you that if there is an active shooter: you are to run, hide and then only as a last resort should you try to fight. As I mentioned before, I work in a “Big Box” sporting goods store, and they teach that tactic as well. However, when asked by a fellow employee what I personally would do, I stated that I would immediately arm myself and prepare to take out the threat. My preconceived plan would include grabbing a handgun from the display cabinet that has a large capacity magazine, run to the ammo aisle, dump a box of the correct ammo into my pockets, then, while walking toward the shooter, load the magazine. Finally, upon seeing the robber or active shooter, I would do my best to stop the threat. The employee I was speaking with replied and said: “That is not what they teach you to do”.  I responded: “No, but it is the right thing to do”.

What Would You Do? 

blackhawk_helicopter_uh-60LSo that is the dilemma. What do you do? During one of these conversations, I was talking to a person and asked what he would do. His response was that he would run for cover and do his best to escape the area. I asked why he chose that response, and he said “Because my job is to come home to my family every night”. No doubt that is a noble thing to do. I then found out he was a former Blackhawk helicopter pilot with several combat tours under his belt, a true American hero. So at first I was caught off guard that a military professional with combat experience would run and hide rather than stand and fight. I clearly understood his desire to come home to his family every night.  For one thing, his goal to preserve his family and put their welfare first was noble; that is a duty he bears as a husband and father.  Also, I recognized that he had already served his country and done his tour of duty. But this combat veteran’s anticipated reaction to a robbery or active shooter at our workplace illustrates an interesting point. You never know who might be running and who might be fighting.

Related: How to Pick the Best Personal Protection Firearm

So we are back to the main point. In the case of an active shooter or an armed robber, what do you do? What course of action is safest for everybody involved. I clearly understand that some of my upcoming comments are going to touch sensitive areas in some folks’ feelings, so get ready.

Breaking Down Roles

french_flag_tragedy_active_shooterLet’s address the Active Shooter situation. First, I feel women, children and elderly should strictly adhere to the recommended methodology of running and leaving the area as quickly as possible and finding hiding place. This is where your situational awareness will save you. You must quickly identify your escape route and expeditiously move in that direction. Help others if you can along the way, but your mission should be to get out of there as quickly as you can. Run as far away as you can. Do not trust hiding, get out of there. Look what happened in Paris in the several mass shootings by terrorists in November of 2015. People thought it was safe to hide under the tables in restaurants. They just became easy targets. Run as far from the site as you can, do not stop until you can no longer hear shots being fired. Then find solid cover–the kind that can physically stop bullets or block an attacker from entering your area.

Yes, there are women that are equally trained and equipped to fight as well as any man. And if you are one of those women, then if you elect to charge the bad guy, all the more power to you. Same with any of those that may be considered elderly. Every rule has exceptions.

Men, I feel you should go after the shooter. If you are armed, then all the better, but everyone should do what they can to stop the threat.  If you are unarmed, grab anything you can carry that can be used to throw at the shooter. Throw as much as you can at them in hope it will allow you or another person to get closer to the shooter to tackle him. If you have access to them, spray the shooter with pepper spray or you can blind him with spray from a fire extinguisher, use everything you can to your advantage. Surprisingly, even if you have a weapon and someone throws something at you, you will duck and try to avoid being hit by it. It is natural instinct. So throw lots of stuff, even if the things you are throwing are not very dangerous in and of themselves.

Action

plan_active_shooterThere is an old adage well known in the world of paramilitary training. It says: “action is faster than reaction.” I feel it is imperative that you go on the offensive when there is an active shooter or armed robber who appears about to start shooting or taking hostages. If you only “go on the defensive” then you have given the bad guy the advantage and increased the odds more innocent people are going to get hurt or killed.

For active shooters, there is risk in taking action, because they have already started their killing spree. Having them stop or leave on their own, peacefully, is not a likely possibility. If nothing is done, then there is a certainty that more bad things are going to happen and those injured or killed will escalate. Is there risk to your actions? No doubt! So what should your plan be in the case of an active shooter?

First, you must have very good situational awareness. You must always be aware of your surroundings and know where your exit points are located and be prepared to act when if an adverse event should occur.

Second, quickly recognize that something bad is happening and action needs to be taken. This is so important. The bad guy has made you an active participant. Lots of times when bad things are happening those people in the area fail to recognize that fact, and thus they keep going about their way and getting trapped in the bad event. The other thing that happens is that people run from the bad event with no direction or purpose. This causes chaos and endangers the lives of many. So having a plan is essential to escaping quickly, or ending the threat quickly.

See Also: Active Shooter!

Third, make sure those around you are safe and moving in a direction away from danger. Even if that means pointing them in the direction they should run and helping them get to safety quickly as possible.

Fourth, you should start moving toward the danger. No need to run to the danger if it is close. This may cause you to run right into bad situations and get hurt or killed unnecessarily. Use tactical movement, taking cover then moving to the next cover position and so forth until you can observe the shooter(s).

Fifth, take action. That might mean engaging your adversary on sight. Or it could mean observing for a few moments to plan how to attack him, where to ambush him, what weapon to use, or how to position yourself to make your attack most effective. Your “attack” could involve anything from throwing stuff at the shooter to shooting him. Whatever it is, do it when you can and when you know it will give you an advantage. Then do your best to STOP the shooter.

Armed Robbery

What about an Armed Robbery?  In this case, you may wish to act differently, because not all armed robberies involve shooting, and not all robbers wish to become killers. You’ll likely have a bit more time to choose how to react to a robber than an active shooter.

situation_active_shooterThe first step is the same; good situational awareness. In this case, if you are with family or friends you should be able to verbally alert them to a danger. I think all families and close friends should have a code word, such as “heads up”, to alert anyone in the group that someone in the group has seen something bad and the others need to go on a heightened state of awareness. This is very important to do if you can, but you may not have the chance to do this.

If you are commanded by the robber to do something, then do it. If you are near the robber, act as if you are no threat to him. This will give you a minute to plan your attack, your escape, or whatever you choose as the best response.

Once your plan is in place and the timing is advantageous, execute your plan, which may include throwing something at the robber, tackling them, or using your firearm to stop the threat. If it appears the robber only wants to steal some property or money and make a quick getaway, letting him go without trying to stop him may appear be the safest thing. However, you never know when the robbery is going to take the robbery to the next level by shooting someone. Just because you have a gun doesn’t mean you have to use it, but being armed gives you more options, not fewer.

Fight or Flight

Naturally these are just a few thoughts on these situations. Every case is very event-specific, and the proper response must be evaluated in light of all the circumstances. But my point is this: run & hide is not necessarily the best way to deal with an active shooter or armed robber. If action is taken, there is a good likelihood that lives will be saved. If no action is taken, the bad guys can choose to kill anyone or everyone they encounter, for whatever reason(s) that may trigger that urge in them. I am also saying that a violent counter-attack is not a course of action suited for everyone, but it should be taught and encouraged more.

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13 Tips on Surviving a Protest

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closed fist protest

Anti-Free Speech?

As a Free Speech advocate, I support the people’s right to protest and make their opinions heard. Unfortunately, demonstrations in the U.S. these days are becoming more frequent and violent. From what I saw happen at UC-Berkeley, I expect them to become more extreme as times goes on.

 
I haven’t been at a protest since the Vietnam era, and that was just on the way to class. Back then, I was fit enough to hightail it out of there when the pepper gas flew. However, there is so much civil unrest in the news these days that it’s a good idea to have a riot survival strategy, whether you’re involved or just a bystander. It goes without saying that your objective should be to stay away from the where the violence is occurring.

 
Of course, if you walk smack dab into a demonstration, things can get dicey pretty fast. I’ve written a lot about situational awareness, and that mindset will serve you well. Here are some simple tips that will help you avoid injury at a protest:

 
1. Always be in a state of “Yellow Alert”. Yellow alert simply means being aware of your surroundings and the people around you. When people are behaving strangely, take note and avoid them.
2. Always mentally map out routes of escape as you walk along. Where’s the nearest side street? Is there a building or subway entrance that will get you off the street? If you don’t know the area, move away to where you know the lay of the land.

 
3. If you have to make your way through the crowd, stay on the fringes. Don’t get caught in the masses of people surging away (or towards) the violence. If you do, they are deciding your movements, not you.

 
4. Avoid confrontation with protesters. In other words, take off your “Make American Great Again” hat if it’s an anti-Trump demonstration. At Berkeley, things like this got women pepper-sprayed and men beaten.

 
5. Have a bandanna handy. This essential survival supply isn’t a gas mask, per se, but it works at riots when tear gas is sprayed. Some advocate the soaking of the cloth with lemon juice or apple cider vinegar. Avoid black bandannas, though; at Berkeley, organized masked “ninjas” in black caused most of the damage. You don’t want to be confused with one of these people.

 
6. Wear sneakers or other footwear that will allow you the most mobility. The only women wearing heals are reporters. Make sure you’re well-clothed so that your skin is protected. You’ll need to wash clothes thoroughly that have been exposed to tear gas, or throw them away.

 
7. Be aware of the movement of law enforcement officers, but don’t approach them. Their job is tough enough, and they won’t be able to hear you above the roar of the crowd.

 
8. Don’t run if you can help it. Unless everyone else is running, you will attract unwanted attention. Walk fast and purposefully around a corner, to higher ground, or other safe spot.

 
9. Be inconspicuous. This may be difficult if you’re 6 foot 7 inches tall, but otherwise, do you best to be “the gray man”.

 
10. If you’re with friends, stay together. If you can’t, agree on a meeting place beforehand in case you get separated moving through the crowd.

 
11. Avoid being caught against walls, fences, blockades, or other solid objects. People can get crushed by masses of protesters.

 
12. Carry some water, milk, or diluted liquid antacid (like Maalox) in a container if you know you’re heading into a protest area. If sprayed with tear gas, move quickly into an area of fresh air and pour the liquid on your face (especially your eyes). Drink it if sprayed in the mouth. Milk or liquid antacid are thought by some to work better than water, but there’s no hard data one way or another. The effects of the tear gas will resolve over a relatively short time in most cases.

 
13. If you’re involved in a protest, carry a basic medical kit that will help to treat injuries and stop bleeding.

 
It’s likely you’ll never get caught in civil unrest, but having a solid plan of action in these troubled times just makes common sense. We must be prepared for man-made disasters just as we should be prepared for hurricanes, tornadoes, and earthquakes.

 

Joe Alton, MD

AuthorJoe

Joe Alton, MD aka Dr. Bones

Video: Vehicular Terror

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vehicular-terrorism

In this companion video to a recent article, Joe Alton, MD discusses the wave of terror events using a car or truck to run down innocent citizens. From Nice, France to Berlin, Germany to Ohio State University, terrorists are figuring out that it’s a lot easier to own, rent, or steal a truck or other vehicle than to build a bomb. Find out more about this new blueprint for terror and  how you can use situational awareness to your advantage to stay safe.

To watch, just click below:

Wishing you the best of health in 2017,

Joe Alton, MD

joealtonlibrary4

Surviving Vehicular Terrorism

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vehicular-terrorism

CNN reports that a man in Berlin used a truck to plow through a group of people at a Christmas market, killing 9 and injuring 50 more. The tractor trailer appeared to deliberately ram through several stalls at what is estimated to be 40 miles per hour; German authorities are treating the incident, at present, as a terror event.

The attack appears to parallel the cargo truck killing of 86 people and the wounding of 434 others in Nice, France during a fireworks display on a national holiday. On a smaller scale, a Somali student at Ohio State University recently ran down a number of people before leaving his car and stabbing several others with a large knife. A pattern seems to be emerging where a vehicle is used to cause casualties in public spaces.

Ordinarily, terror attacks are associated with guns, but these items are difficult to come by in most countries. Bombs, another preferred terrorist weapon, require expertise to assemble safely. Owning or renting a vehicle, however, is much more common and requires little skill to operate. Trucks and cars can cause mass casualties if wielded as a weapon; obtaining one elicits no suspicion.

Therefore, would-be terrorists now have a new blueprint for causing mayhem among an unsuspecting public. There are few who pay much attention to traffic unless they’re in a vehicle themselves or crossing the street. The speed at which a vehicle can accelerate and turn into a crowd leaves little time for reaction. Hence, the “success” rate of this type of terror event may surpass even a gunman’s ability to cause deaths and injuries.

The increasing number of terror events around the world underlines the increasing need for situational awareness. Situational awareness is the mindset whereby threats are mentally noted and avoided or abolished. Originally a tool for the military in combat, it is now a strategy for the average citizen in these uncertain times.

The situationally aware person is always at a state of “Yellow Alert” when in crowded public venues. By that, I mean a state of relaxed but vigilant observation of what is happening around him or her. When an action or behavior occurs that doesn’t match the surroundings and situation, it’s an anomaly.

When a vehicle moves erratically or leaves the normal pattern of traffic, it’s an anomaly that requires rapid action. Mentally noting routes of escape whenever you’re in a crowd will give you the best chance of getting out of the way. Just as knowing the location of exits in a mall or theatre is good policy, a heightened awareness is now important at any outdoor event or popular public area near roadways.

For vehicular terrorists, the target will be crowds of people near the street. Their objective is mass casualties, and those pedestrians nearest the curb will bear the brunt of the attack. Consider walking on the fringe of a crowd away from the road to give yourself the most options. In the center, the masses, not your own good judgment, will dictate your movement. Take a walk along Times Square and you’ll see what I mean.

bollards

Retractable Bollards

Municipalities can protect their citizens by constructing barriers known as “bollards” which would stop vehicles from entering pedestrian areas. These can be seen outside many government buildings and airport terminals. Expanding their use to areas that attract crowds would be an important consideration for the future.

I’ll admit that the likelihood you’ll be in the path of a terrorist using a vehicle, or any other weapon, is very small. Panic isn’t the answer, but these are troubled times; the more situationally aware you are, the safer you’ll be.

Joe Alton, MD

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For more information on surviving terror events, see my other articles:

https://www.doomandbloom.net/situational-awareness-could-save-your-life/

https://www.doomandbloom.net/how-a-fighter-pilots-strategy-could-save-your-life-the-ooda-loop/

Lessons That Could Save Your Life in a Terror Event

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bombingvictim

I’ve written quite a bit lately about shooting and terror events, but recent events highlight the fact that gun violence isn’t the only way that a terrorist can fulfill their mission of making casualties out of decent citizens. Clearly, bombings, stabbings, or shootings can occur literally anytime and anywhere in the U.S.: at churches, clubs, holiday parties, schools, the mall, at 2 in the morning or in the middle of the day. They’re part of what I call the “New Normal” and we have to be prepared to act if we’re caught in one of these events.

Although I write mostly about disaster medical preparedness, a terror event is a different kind of disaster. It’s one where you can prevent becoming a casualty if you simply know what to do when danger presents itself.  Indeed, if you don’t train yourself to anticipate these events, it could be hazardous to your health and that of your family.

I’ve mentioned the concept of “situational awareness” as a way to decrease your chances of becoming a victim in future terror attacks. In these days of Pokemon Go and other smartphone distractions, you’re seeing more and more people not paying attention to their surroundings. In the past, this might get you a bump on the head for walking into a lamp post. In today’s world, however, it could cost you your life.

Situational awareness involves understanding what’s going on in your immediate vicinity that might be represent a threat to your well-being. I don’t mean second-hand smoke here; I’m talking about knowing what immediate dangers may exist that you can avoid or abolish with your actions. Especially important for soldiers in a combat zone, it’s now become just as important for the average citizen in any public space.

In an area at risk (anyplace where multitudes of people gather), simple things might save your life. Things like not having your hoodie up, which can be like blinders on a horse. Things like making a mental note of the nearest exit at the mall. Things like looking around for people who are acting strangely or, perhaps, dressed too warmly for the weather.  Someone who might be paying too much attention to an everyday object, such as a trash can (which might contain a bomb).

Behaviors normal in some settings might be an “anomaly” in others: Hopping up and down and screaming may be normal behavior at a rock concert, but not at the local mall.  By looking for anomalies in what should be normal behavior in a situation, the situationally aware person will have the best chance to plan an escape when an attack occurs. 

To do this effectively, you should always be in a state of what I call “Yellow Alert”. You’re calm and relaxed, but taking in your surroundings: Always observing how people behave, where the nearest exits are, and formulating a plan of action if you’re in a crowd or other at-risk scenario.

In the case of the terrorist who stabbed nine people in Minnesota, it’s likely that he was in a state of agitation, his hands constantly touching the pocket where he kept his weapon. These are anomalies; things you should watch for whenever you’re in a public place.

In a crowd, it would pay to be at the fringes and not in the middle. Having a wall to your back would eliminate a danger that might come at you from behind. Indoors, for example, in a movie theatre, you want a view of the exits as well as the screen. If someone is behaving strangely, move away from them. If someone is screaming at the employee at the local burger joint (I said NO CHEESE!), maybe you should leave and order a pizza instead.

Air Force Colonel John Boyd devised a situational awareness strategy, called the “OODA Loop”, originally meant for aerial combat. It has practical applications, however, for everyday life. The components of the OODA Loop as it pertains to terror events are:

Observe: Stay at Yellow Alert whenever you’re in a public place where groups of people gather.

Orient: Identify behaviors that are not appropriate for the situation. These anomalies will tell you who and what to keep an eye on.

Decide: Determine the best course of action that will allow your escape or might eliminate the danger altogether.

Act:  Initiate the plan of action and commit to those actions.

It’s difficult to instill a culture of situational awareness in a population, but doing so would save lives. Teaching your kids the basics can help keep them safe, especially if you start early. When you’re out with the kids, tell them to pay attention to what’s going on where you are. Once the family has left the area, ask them how many people were there, what they were wearing, or other details. Ask them what they would have done if something happened. Do this often enough, and it will, hopefully, become common practice. They’ll learn to pay less attention to their smartphones and more to their surroundings.

It would also benefit society if the next generation is taught what to do to help those wounded in a terror attack. In this scenario, law enforcement must pass the wounded by until the terrorist is neutralized. It may surprise you to know this, but there’s someone out there making more casualties, and the police, first and foremost, must abolish the threat. Yet, it’s thought that 1 in 5 deaths from hemorrhage might be avoided with the quick action of bystanders.

It may be time to add a fourth “R” to education. In addition to Reading, (w)Riting, and (a)Rithmatic, Reducing hemorrhage might be a useful thing for kids to learn once they reach a certain age. Indeed, I predict that there will come a time when first aid kits will occupy a space on the walls next to the fire extinguishers and automated defibrillators in schools and other public places.

All this attention to detail may seem paranoid to you, but it’s time to realize that these are dangerous times.  Incorporate situational awareness into a calm, observant mindset and you’ll gain those extra seconds that could mean the difference between life and death in troubled times.

Joe Alton, MD

AuthorJoe

Learn about active shooters, stab wound management, and mass casualty events in the new 700 page third edition of The Survival Medicine Handbook: The Essential Guide for When Help is Not on the Way.

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Video: The OODA Loop of Situational Awareness

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Are you safe here?

In this companion video to a previous article, Joe Alton, MD, aka Dr. Bones, discusses a fighter pilot strategy that might save your life in a terror event. Originally meant for aerial dogfights, the OODA loop was developed by Colonel John Boyd and has been used in everything from business to active shooter scenarios. Incorporating the OODA loop into your mindset will help instill the culture of readiness that is so important in the New Normal of the uncertain future.

To watch, click below:

Wishing you the best of help in good times or bad,

 

Joe and Amy Alton

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The Altons

How a Fighter Pilot’s Strategy Could Save Your Life: The OODA Loop

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It’s pretty clear in these uncertain times that there’s a New Normal out there. There will always be the possibility of a terror event or shooting whenever crowds of people gather. Almost daily, a terrorist or madman causes death and destruction somewhere. If you learn to be situationally aware, you won’t be a soft target for these savages.

ooda loop graphic

the OODA loop

 

The basics of situational awareness are described in what is called the OODA Loop. It was first devised by Air Force fighter pilot Colonel John Boyd. Originally meant to help in an aerial dogfight, it’s useful in all sorts of settings. The four steps of the OODA Loop are: Observe, Orient, Decide, and Act. It’s a loop because you go back to the observe step after you act, to determine if the situation has resolved or if further action is needed.

 

Observe: Yellow Alert

yellow alert image

Stay at Yellow Alert when in crowds

You’ve heard of red alert, but let’s go to yellow alert as our stance in most cases. Yellow alert is best described as “relaxed awareness.” you have your head up and scanning the surroundings with all your senses. Most people associate situational awareness with what they can see, but you also learn a lot from the sounds (or lack thereof) and even smells in the environment.

 

It’s important to stay relaxed. Staying relaxed ensures that you remain focused on the important aspects of the environment, but not to the exclusion of new factors that might arise.

 

Put yourself in a position for optimal observation. You need to be able to take in as much of your surroundings as possible. When you enter any environment, place yourself so that you can see as much of the area in question. If it’s a restaurant, have a view of the exits (maybe a table by a wall). You might not be able to choose which table to sit at, but you can pick a chair which gives you the best view of what’s going on.

 observe view ooda

Orient: Baselines and Anomalies

 

Being observant, however, isn’t enough. You have to know what you’re looking for and then put that information into context. The Orient step establishes baselines and anomalies for a particular environment and the human behaviors that match it or don’t.

 

Whatever setting you’re in, establish a baseline. A baseline is what’s “normal” in a given situation, and it’s different for different instances. For example, the baseline at Starbucks is people reading books working on their computer, or talking with friends. The baseline at a rock concert would be loud music and people jumping up and down and shouting. If someone is jumping up and down and shouting at Starbucks, that’s what we call an anomaly.

 

Anomalies are things that should happen in a situation but don’t or things that do happen but shouldn’t, and are what we need to focus on. Questions you might ask yourself in a crowd: What’s the general mood? How should people be behaving? Who is doing something that’s different from the norm?

 

For example, is someone acting in an aggressive manner? Most people are in submissive mode normally. We all want to get along, after all. If someone is at a burger joint, screaming at the guy behind the counter “I said no cheese, you idiot!”, that’s someone to keep an eye on.

 

Is someone acting too interested in something that ordinarily wouldn’t catch their attention? If you see a guy staring at the garbage can in your workplace, that’s an anomaly. If they’re too uninterested, though, that’s also something that’s not normal. Say there’s a ticking suitcase in the middle of the mall, and only one person isn’t paying attention to it, that’s an anomaly.

batman and robin

Gee Whiz, Batman! That guy looks like an anomaly!

Perhaps the most significant anomaly is someone that’s acting uncomfortable in a place where everyone is relaxed. People appear uncomfortable in many ways. One of them is constantly checking their “six”; that is, always looking nervously behind them. If someone is constantly looking over their shoulder, that’s an anomaly and deserves your attention. That’s not to say that everyone who’s uncomfortable is a threat. They might be late for work, for example, or just had an argument with a significant other. Still, you might want to keep an eye on them.

 

On the other hand, someone who’s comfortable when others are in a panic, such as videos of the Boston Marathon bombers showed, could be someone who expected the disaster to occur.

 

You might take a look at what people are doing with their hands. Law enforcement often wants to see the hands of someone they’re suspicious of. People who are constantly patting a pocket or reaching inside a jacket, especially if a jacket isn’t warranted for the weather, could be concealing a weapon or worse.

 

Decide and Act

 

Once you decided that there’s an anomaly that might represent a threat, have a plan of action to counter it. If a guy with a gun shows up at your workplace, the best course of action might be to hoof it out of there. If he’s right next to you and escape is unlikely, however, your best choice might be to act to incapacitate him.

 

To recap: Observe the situation. Orient to establish baselines and look for anomalies. Decide on an action. Act.

 

All this attention to detail may seem paranoid to you, but it’s time to realize that these are dangerous times. Incorporate a constant state of Yellow alert by putting away those smartphones and incorporate the OODA loop whenever you’re in a crowd. Do this and you’ll be situationally aware enough to gain extra time that could mean the difference between life and death.

Joe Alton, MD

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Joe Alton, MD

How to Respond to Active Shooter & Terrorist Attacks

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Written by Orlando Wilson on The Prepper Journal.

Editor’s Note: This article was generously contributed by Orlando Wilson. If you have information for Preppers that you would like to share and possibly win a $300 Amazon Gift Card to purchase your own prepping supplies, enter the Prepper Writing Contest today!


Remember!

  1. Moving targets are harder to shoot than stationary targets!
  2. Smaller targets are harder to shoot than the large target!

When I ask my students what is the most important thing they must do in a hostile incident, most reply that they should simply shoot the bad guys, get access to their weapons, shoot for the head, carry a big gun and so on.  The answer I am looking for is not to get shot by the terrorists!

You should first of all work out a plan of action that you will take in the case of an active shooter or terrorist attack.  Do this for your home, business and for when you are out and about in public. Things that need to be considered are means communication, safe areas, when to fight and when to flee and so forth. Planning is what sorts the professionals from the amateurs, if you plan how to deal with a hostile situation if it happens, you’ll know what to and how to react to it and not be confused and panic!

Plan your reaction to being shot at!

As I just mentioned, you NEED to put together a plan of action on how you will react to a shooting or a hostile incident. Over the years I have spoken to many security contractors, police and former non-British military personnel and find it amazing that when talking about their reaction fire drills most just say they would draw their weapon, if they have one and return fire…  That’s OK if you have a gun or are on a gun range but you need to take a few other things into consideration if someone is shooting at you!

This is an adaptation of the British Army individual reaction to fire drill. Some of this may apply to you and some might not- use this as a basic format. If you are serious about your security, you must put together a plan that is specifically designed for your personal situation and then practice it until it is second nature.

  • Preparation: If you have a gun it must be clean, serviceable and well-oiled. Ammunition must be of good quality, clean and your magazines full. You must be properly trained and ready to deal with the incident.
  • Reacting to fire: The immediate reaction at close quarters is to identify the threat, move to cover as you are deploying your weapon, if you have one and returning fire. If you are being shot at from a distance or do not know where the shots are coming from, you should:
    • Dash– a moving target is harder to hit than a stationary target.
    • Down– keep low and present a smaller target.
    • Cover– Get into cover from fire.
    • Locate – Observe where the threat is.
    • Return fire– if you have a firearm.
    • Winning the fire-fight, if you have a firearm: As soon as the threat has been firmly located, you must bring down sufficient accurate fire on the terrorist to incapacitate them or force them into cover so you can extract yourself from the situation.
    • Re-organizing: As soon as you have incapacitated the terrorist or are in a safe area, you must reorganize yourself as quickly as possible in order to be ready for other possible threats. You need to re-load your firearm if you have one, make sure that you or anyone with you is not injured and inform law enforcement and emergency services immediately.

There are two types of cover: 1.) Cover from view 2.) Cover from fire (bullets and shrapnel), you always want to locate the latter.

Moving targets are harder to shoot than stationary targets. It’s a fact, it’s harder to shoot a target that is moving than one that is stationary. So, if someone is shooting at you, do not stand still, run. Smaller targets are harder to shoot than large targets! If there is no cover for you, make yourself a smaller target and drop to a kneeling position. I do not recommend prone position, as it takes too much time for most people to stand up. From a kneeling position, you can quickly run and get to cover.

Use of cover

This is a very important and basic subject! In your home, business or when you are walking around, you should always be looking out for positions that you could use for cover in the event of a shooting incident. There are two types of cover: 1.) Cover from view 2.) Cover from fire (bullets and shrapnel), you always want to locate the latter. You also may want to consider which type of rounds the cover will stop. A table might be able to stop a .32 fired from a handgun, but a 7.62X39mm fired from an AK-47 would go through both the table and you. Also consider will you want to be able to shoot through the cover, such as at a criminal in your house through dry wall etc.

Guard Dog Security ProShield 2 Bulletproof Backpack

Guard Dog Security ProShield 2 Bulletproof Backpack

Cover from view includes:

  • Cardboard boxes and empty rubbish bins
  • Bushes
  • Thin walls and fences
  • Thin tabletops
  • Doors
  • Shadows

Cover from fire (depending on the firearm used):

  • Thick tabletops
  • Heavy furniture
  • Stone and concrete walls
  • Dead ground
  • Thick trees
  • Various areas of a car
  • Curb stones

One of the best-publicized examples of good use of cover happened in St. Petersburg, Russia on February 26, 1996. At 4:25 pm, two mafia gunmen in long coats entered a fashionable café. Under their coats, each man had a AKS-74. They were there to kill an opposing mafia boss, who was in the cafe with his two off duty police bodyguards. The mafia gunmen fired 60 rounds at close quarters from the AKS-74s and killed both the police bodyguards. The criminal boss tipped over a thick marble table he was sitting at and hid behind it; although wounded he was well enough to walk out the cafe making phone calls, after the gunmen had escaped. A Scottish lawyer was killed; he was just sitting drinking coffee in the café when he was hit by three stray bullets. The attack took about 40 seconds from the gunmen entering to leaving the café. The Scottish lawyer was in the wrong place at the wrong time.

When you get into cover, you should always try to have an escape route and try not to get pinned down. When using cover as a shield, always keep low and fire or look around cover- not over it. When you are in cover and need to move, first select the next piece of cover that you will move to and move fast and keep low. Keep the distances between cover positions short. When you get behind the cover, assess your situation, where the threat is, etc. Keep moving this way until you are out of danger.

Active_Shooter

Remember!

  • Always looking for and make maximum use of available cover and concealment.
  • Avoid firing or looking over cover; when possible, fire or look around it.
  • Avoid silhouetting yourself against light-colored buildings, backgrounds and lights.
  • Always carefully select a new piece of cover before leaving the cover your in.
  • Make sure you always have an escape route planned.
  • Avoid setting patterns in your movement, for example, shooting or looking from the same position at the same level.
  • Keep exposure time to a minimum; don’t look over or around cover for an extended period of time.
  • Always look up and behind you remember that positions which provide cover at ground level may not provide cover on higher floors.

Camouflage yourself

It makes me laugh when I see a lot of SWAT Teams and PSD guys wearing Tactical Black and other colors that look cool but do nothing bit make them stand out. In reality black is one of the worse colors to wear, what is black in nature, look around you now and what in your surroundings are black? I expect very little… In urban areas most walls are white, gray or cream… Light colors! The colors you wear should blend in with your background whether its day or night. Even at night dark clothes stand out when moving past light backgrounds. In the country or bush when moving through low bushes or fields the silhouettes of people in dark colors are easy to see at a distance…

Moving Through a Building

If you have to evacuate your home or business, for whatever reason, it should be done quickly, quietly and with the minimum of fuss. You should also have already worked out your escape routes and exits. If there is an incident, get as much information as possible to what the threat is, where and what the threat is. I recommend you never use obvious evacuation routes and exits, the criminals or terrorists could have blocked, booby trapped, ambushed or manned them.

If you have to walk down corridors keep low and move fast, do not walk down the center and do not walk next to the walls. Stay a couple of feet off the walls to avoid being hit by any ricochets and wall fragments if you come under fire. Doorways and frames can make good cover, even in an apparently empty corridor look for things that could be used as cover. Remember to continuously check behind you, and if you must stop, do not stand up, stay in a kneeling position. Always be aware of where you are casting shadows, you do not want this to give away your position, such as before you go around a corner. You should always keep staggered spacing from anyone who is with you; you do not want to bunch up. Remember; one bullet can go through two people; large group of people make an easier target than a lone individual. Also if you are dealing with criminals or terrorists who are using improvised pipe bombs or hand grenades, one of these devices could take out your whole group if you are close together.

With the rise of active shooter incidents in the United States, students and faculty members are highly encouraged to be aware of the policies to follow in order to promote safety precautions in case of an active shooter incident were to take place. (Photo Illustration by Cassandra Nguyen | The Collegian)

Going through doorways is very dangerous, especially if the room or area on the other side could contain a criminal or terrorist. If you must go through a doorway, try to determine if there are any threats on the other side before you enter. Use your senses of smell and hearing, in addition to sight; take a quick look into to room at a low level before entering. If you have to open a door, do so quickly, quietly and then back away from the door and listen. You want to back away from the door because if there is a terrorist in the room they will be shooting at the now opened door or moving if startled. Also consider if the wall around the door could stop a bullet; the criminal or terrorist could shoot through the wall and hit you, especially if they are armed with hunting or assault rifles. When you go through a doorway, again keep low and move fast, check the corners, when though the door move away from it and get behind cover.

You must keep a cool head as you might not be the only person evacuating the building. When you are clear of the building, get out of the area and summon support and law enforcement, ASAP.

Remember!

  • Never use obvious escape routes.
  • Use your senses of smell and hearing not just sight!
  • Move quietly, cautiously and quickly.
  • Corridors are areas of extreme danger- avoid whenever possible.
  • If you need to use a corridor, NEVER walk down the center stay a couple of feet off the wall.
  • If you must walk past an open door keep low and move fast.
  • Always check around corners before you go around them and expose yourself.
  • Continuously check behind you.
  • If you must stop do not stand up, stay in a kneeling position.
  • Avoid offering a silhouette for your opposition to shoot at.
  • Lights behind you should be extinguished.
  • Always keep a space between you and others; one bullet can go through several people.

After a Shooting Incident

You should do all that you can to avoid getting involved in any hostile situations, even indirectly. If you are somewhere where a hostile situation is developing, leave the area quickly and not by an obvious route. You do not want to be in the wrong place at the wrong time and to catch a stray bullet. So, if you see a hostile incident developing and it has nothing to with you, mind your own business and leave the area, ASAP! If you are unfortunate enough to get involved in a shooting incident, when you believe the incident is over, you should reload your weapon if you have one, prepare to deal with any other threats, give first aid to anyone with you who is injured and evacuate to a safe location. You should also call for support and police etc. as soon as is safely possible.

In developed countries, even if you believe others have already called the police, do so yourself and identify yourself to the dispatcher as the victim and you should do as the dispatcher tells you, as long as it does not compromise your safety. You must ensure that the police officers responding to the incident know that you are the victim and not the attacker. For their own safety, the police officers will assume that anyone at the scene of the incident is a threat. You should never point your gun at the police and should comply with their every request. Remember the responding police will be scared and most are not that well trained and will shoot with minimum excuse. Try to remain calm and do not argue with them- do as you are told. Make no fast movements and keep your hands where they can be seen. It would be unfortunate to survive a lethal encounter with a criminal, only to end up being shot by the police.

If you get into a hostile shooting in a country where the police cannot be trusted and going to prison would most probably mean you would catch an incurable decease to say the least, you should have pre-planned on how to deal with the situation. My advice; leave the country as quickly as possible if you are a non-resident of that country!

The Tactical Use of Lights

In my opinion, many people are over-enthusiastic in the use of flashlights. There is a big market in tactical flashlights and the companies making them wants everyone to buy one, thus making them a must have item. Flashlights have an application in hostile situations but you should remember that any light will give away your position and draw fire. Light should be used sparingly and tactically. I tell my students to get used to training in the dark and using their senses of hearing and smell in addition to sight. At night there is more chance you will hear someone before you see them! When moving in a dark environment, do so slowly and cautiously and try to make minimum noise. Try finding your way around your house or business in the dark, before you start moving around give your eyes a few minutes to adjust to the dark.

If you must use a flashlight, keep it at arm’s length and keep it on for no longer than necessary, then move quickly or get behind cover. If you want to check a room or a corridor, one option is to roll the flashlight across the doorway, corridor or into the room. Light can be used as a distraction and help to cover your movement, shine it in their general direction of your opponent and move. This will mess up their night vision and if you leave the light pointing in their direction, it will be difficult for them to see what is happening behind the light.

If possible, use remote lights, as this is more of an application for your home or business. For example, place powerful spotlights that illuminate corridors to safe rooms, stairways or doorways. If your home is broken into at night, you could move your family to your safe room and take up a position in cover behind the lights. If you hear or identify movement to your front, you turn on the spotlights; this will surprise, blind and illuminate anyone in the corridor. This will also help you to confirm that the people in your house are criminals or terrorists and give you good targets to shoot at if you have a firearm.

About the author: Orlando Wilson is ex-British Army and has been in the international security industry for over 25 years. He has initiated, provided, and managed an extensive range of specialist security including investigation and tactical training services to international corporate, private, and government clients. Some services have been the first of their kind in the respective countries. His experience has included: providing close protection for Middle Eastern Royal families and varied corporate clients, specialist security and asset protection, diplomatic building and embassy security, kidnap and ransom services, corporate investigations, and intelligence, tactical, and paramilitary training for private individuals, specialist police units, and government agencies. You can learn more about Orlando and his services at his site Risks Incorporated.

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American Survival Radio #18

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American Survival Radio

American Survival Radio is Joe and Amy Alton’s second and latest podcast, focused on current events, health, and politics. It is separate and distinct from The Survival Medicine Hour, which continues as before focused mostly on health issues as they pertain to preparedness and survival.  If you’re interested in Survival, your own and that of your country, we bet you’ll like both!

In this episode of American Survival Radio, Joe and Amy Alton discuss the just completed Republican convention, the good, the bad, and the ugly. Also, Zika virus throws health officials some curves with cases of female-to male transmission, caregiver infections, and possibly local infections being reported. A total of 400 U.S. pregnancies infected with Zika virus have been identified, with 12 babies born with birth defects so far. An equal number are being followed in the U.S. territory of Puerto Rico.

Plus, Dr. Alton talks about the truck attack in Nice, France, and how being “situationally aware” may save your life in a terror attack. What do you have to do to change your mindset and instill a culture of readiness, not victimization, in the general public and, especially, our next generation?

All this and more in (click to listen) American Survival Radio #18!

Joe and Amy Alton

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Video: Situational Awareness in Terror Attacks

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Boston Marathon

Terror events: Part of the New Normal

In this companion video to a recent article, Joe Alton, MD tell you how being “situationally aware” could save your life in a terror event. It seems that a day doesn’t go by without some heinous action by terrorist cells, and this video discusses how we can replace a culture of victimization with one of readiness for any disaster. We now know that terror events can happen anywhere, anytime: Malls, schools, nightclubs, holiday celebrations, and more. Throughout the world, no one who ventures into a crowd is safe anywhere. It pays to be aware of your surroundings. Situational awareness could save your life.

To watch, click below:

Wishing you the best of health in good times or bad,

 

Joe and Amy Alton

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Joe and Amy Alton

Situational Awareness Could Save Your Life

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On France’s equivalent of Independence Day, a large truck plowed through a large crowd in the southern city of Nice and engaged in a gunfight with police. Bystanders noted that the truck appeared to accelerate into the festive throng, killing dozens and injuring many more.

It seems that you can’t read the news without a report of a terror event somewhere, and it’s clear that there will be more to come. Although we don’t know the exact circumstances at this early stage, I believe that this is just part and parcel of what I’ve called the New Normal in recent articles.

I’ve mentioned the concept of “situational awareness” as a way to decrease your chances of becoming a victim in future terror attacks. In these days of Pokemon Go and other smartphone distractions, you’re seeing more and more people not paying attention to their surroundings. In the past, this might get you a bump on the head for walking into a lamp post. In today’s world, however, it could cost you your life.

Situation awareness involves understanding what’s going on in your immediate vicinity that might be hazardous to your health. I don’t mean second-hand smoke here; I’m talking about knowing what dangers may exist that you can avoid or abolish with your actions. Especially important for soldiers in a combat zone, it’s now become just as important for the average citizen in any large crowd.

In an area at risk (anyplace where multitudes of people gather), simple things might save your life. Things like not having your hoodie up, which can be like blinders on a horse. Things like making a mental note of the nearest exit at the mall. Things like looking around for people who are nervous or, perhaps, dressed too warm for the weather. The situationally aware person will have the best chance to plan an escape when an attack occurs.

In Nice, France, the terrorists waited for the crowd to be distracted by fireworks. Spectators who had their eyes glued to the sky wouldn’t have time to react, and this greatly increased the casualty count. The situationally aware person would always be looking around for possible threats, and these days in France, the threats are everywhere.

In such a crowd, it would pay to be at the fringes and not in the middle. Having a wall to your back would eliminate a danger that might come at you from behind. Indoors, for example, in a movie theatre, you want a view of the exits as well as the screen. If someone is behaving strangely, move away from them. If someone is screaming at the employee at the local burger joint (I said NO CHEESE!), maybe you should leave and order a pizza instead.

It’s difficult to instill a culture of situational awareness in a population, but it can be done if you start early. When you’re out with the kids, tell them to pay attention to what’s going on where you are. Once the family has left the area, ask them how many people were there, what they were wearing, or other details. Ask them what they would have done if there was an attack. Do this often enough, and they may begin to pay less attention to their smartphones and more to their surroundings.

All this attention to detail may seem paranoid to you, but it’s time to realize that these are dangerous times.  Incorporate situational awareness into a calm, observant mindset and you’ll gain those extra seconds that could have meant the difference between life and death for so many in Nice.

Joe Alton, MD

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Survival Medicine Hour: Tom Martin of APN, Shooter Issues, Summer Germs, Natural Remedies

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Summer Germs

In this episode of the Survival Medicine Hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy, Tom Martin of American Preppers Network joins us to talk about his new show, plus a serious look at the recent shooter events and when violence is the answer to stop the fatalities. Also, places you’ll be this summer that could make you seriously sick if you’re not careful. Nurse Amy continues her discussion of natural remedies that will help for orthopedic injuries. Dr. Bones also talks about what the medic’s priorities should be when under fire in hostile survival scenarios. All this and more on the latest Survival Medicine Hour.

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To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/07/08/survival-medicine-hour-shooters-summer-germs-tom-martin-of-apn-more

 

Wishing you the best of health in good times or bad,

 

Joe and Amy Alton

joe and amy radio

Don’t forget to check out our brand new Third Edition of the Survival Medicine Handbook, as well as our Zika Virus Handbook, both available on Amazon. And fill those holes in your medical supplies at Nurse Amy’s store!

Active Shooters: When Violence Is The Answer

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active shooter

As a physician, my focus is how to heal wounds rather than how to cause wounds. A terrorist, however, has quite different goals. Normally, they have a short window of opportunity, and their focus is to cause as many casualties as possible during their brief (hopefully) remaining time on Earth.

I’ve been asked quite a bit lately about what to do in active shooter situations. My standard answer has been the same as that given by the Department of Homeland Security: Run, Hide, Fight, in that order.

Just as Stop, Drop, and Roll may save the life of someone on fire, Run, Hide, Fight may save the life of someone under fire. This is the order of the actions that I have been recommending in recent articles regarding active shooter situations.

This sequence of actions is based upon the expected lifespan of the attack, and the attacker, in an active shooter event. Most active shooter events are over in a few minutes. Following the Run, then Hide, then Fight paradigm is often effective in these short-term events.

When potential victims put distance between themselves and the shooter by running, they make themselves a more difficult target than someone laying on the ground two feet in front of the gunman. When targets remove themselves from the line of sight of a shooter by hiding in a different room, preferably with a barrier against the door, the gunman may, knowing his time is short, search for easier victims. Fighting back is recommended as a last resort; it’s a superior strategy to closing your eyes and taking a bullet to the head.

Which takes us to the Orlando shooting. This horrific event took a full three hours before the threat was neutralized. This amount of time gave the gunman ample time to seek out people that were hiding, often in bathroom stalls, and make casualties out of those that would have survived if the event had been terminated more quickly.

I’m not a member of a SWAT team, just an old sawbones, so I can’t comment on the time it took for SWAT team members to abolish the threat. I assume it had to do with concern about hostages and the safety of the team, all perfectly reasonable concerns.

I have seen accounts of brave individuals helping people out of the building, which certainly saved lives, but I have yet to see any 9/11 Flight 93 “let’s roll” moments which indicated that some of the bar’s patrons tried to stop the killing by dropping the attacker.

This disturbs me, as it is thought that the gunman fired off 200 rounds, something that would have required reloading magazines into the rifle multiple times. This was a rifle that the gunman had little experience with, so there must have been a number of opportunities to intervene in the killing and end the event. This, apparently, never happened and the casualties were a record for a lone gunman attack.

The “success” of this terrorist may serve as a blueprint for future attacks. If there’s an exit to run through, it’s still the best option, in my opinion. Always be situationally aware and mentally mark where those exits are anytime you’re in a crowd. But if a gunman has three hours to find you, is hiding the next best thing? If someone was given three hours to find you in your house or your place of work, what do you think of their chances? Probably pretty good.

This leads me to think that, in the Orlando shooting, fighting back would have cut down significantly on the casualties. Why did some of the 300 young and able people in the bar not take that option? It’s not as if the objective of the gunman wasn’t clear.

It all comes down to the natural paralysis that occurs when something happens foreign to the average person’s thought process. We are all victims of normalcy bias: that is, we believe the events of the day will follow a certain pattern, because they always have. When this pattern is broken by an atrocity, the human brain processes it slowly; denial and hesitation makes for a soft target. Certainly, becoming violent is not part of the mindset of the average person in most scenarios.

Yet, there are circumstances when violence is the answer. Statistics published in the FBI Law Enforcement Bulletin indicate a significant minority of attacks which ended before law enforcement arrived were aborted by a single citizen without a firearm. In fewer instances, a firearm-carrying citizen terminated the event and, in other cases, the shooter terminated himself or law enforcement arrived to do him (and us) the favor.

I’m not saying that it’s a great idea for 300 people in a bar to be carrying loaded weapons, but an unarmed citizen can still make a difference. The patrons of the Orlando nightclub where the shootings occur were, indeed, armed. There were bar glasses, bottles, and 300 cell phones that could have been used as projectiles to hurl at the gunman, while a number charged the attacker from different directions to drop him to the ground and grab his weapon.

This guy wasn’t James Bond. He would have been disconcerted by multiple attackers and objects thrown his way. He would have ducked and flinched, and would have had to make decisions as to who to shoot. I’m not saying someone might not have been killed attacking the gunman, but the fatalities would have been held to a minimum and the event would have ended with far less loss of life.

A faulty strategy doomed to failure? Well, three unarmed men were able to stop a shooter on a train in Paris a while ago without any fatalities. It may be extreme, but sometimes violence is necessary to prevent worse violence.

I recently saw a video of lions taking down a water buffalo. A few other water buffalo charged the lions, flipping one high into the air and ending the attack. When a herd takes action, the prey has a good chance of surviving.

It’s time for us to decide that we are not going to be soft targets for these mass murderers. It’ll take a major change in mindset to do it, but it might just save some lives in the end. Your life. The lives of friends and loved ones. Prepare physically and mentally to both avoid and confront these situations with commitment, and we might see a little more reluctance on the part of those who wish harm to decent people.

Joe Alton, MD

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American Survival Radio, June 25

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American Survival Radio is Joe and Amy Alton’s second and latest podcast, focused on current events, health, and politics. It is separate and distinct from The Survival Medicine Hour, which continues as before focused mostly on health issues as they pertain to preparedness and survival.  If you’re interested in Survival, your own and that of your country, we bet you’ll like both!

In this episode of American Survival Radio, Joe Alton, MD and Amy Alton, ARNP discuss the issues of the day, which seems to include terror events and active shooters more and more as time goes on. Of course, with that, the political battle over gun control rages while, perhaps, the discussion over how to make Americans more difficult targets gets ignored. Plus, the state of California”s lawmakers pass a bill to allow Obamacare to be offered to undocumented immigrants, something President Obama himself had guaranteed repeatedly would NOT happen. Listen to how California State Senator Ricardo Lara (D) found a loophole in the law, and how, unless, they find funds to pay the premiums for these immigrants , Obamacare is still going to be unaffordable to most even if offered.

On the natural disaster front, a deadly heat wave in the West is causing problems for the 3500 firefighters trying to control multiple wildfires in the area. Yes, a heat wave is a natural disaster: A major one in 2003 on the European continent killed tens of thousands of people. Joe and Amy Alton tell you how to stay safe in the hottest weather. All this and more in American Survival Radio #14!

American Survival Radio

The Altons

Survival Medicine Hour: Expert Charley Hogwood, Cinnamon, Antibiotics, Alligators

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Charley Hogwood, Survival Group expert

In this topic-packed episode of the Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP, survival group expert and author Charley Hogwood joins us to talk about survival group dynamics as well a number of other issues that may affect your chances for survival in the uncertain future. Also, Nurse Amy talks about one of her favorite herbs, Cinnamon, and its medical uses and Dr. Alton discusses an unusual subject, driven by recent news: Alligator attacks, what to do and some common-sense prevention strategies. He also brings you up to date with the Zika epidemic ramping up in Puerto Rico, and the 3 infants born with Zika-related deformities in the United States. Finally, Dr. Alton discusses antibiotics while answering a question from a listener of the popular Survival Podcast with Jack Spirko. Dr. Alton serves as the medical expert on Jack’s Expert Council.

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image by pixabay.com

Plus, doctors say 1 in 5 trauma victims’ death are preventable. Dr. Bones and Nurse Amy discuss why and what could be done to increase your chances of surviving a mass casualty incident.

To listen in, click below:

http://www.blogtalkradio.com/survivalmedicine/2016/06/20/survival-medicine-hour-expert-charley-hogwood-cinnamon-antibiotcs-alligators

 

Wishing you the best of health in good times or bad,

Joe and Amy Alton

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Dr. Bones and Nurse Amy

American Survival Radio, June 18th

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PULSE Orlando nightclub

American Survival Radio is Joe and Amy Alton’s second and latest podcast, focused on current events, health, and politics. It is separate and distinct from The Survival Medicine Hour, which continues as before focused mostly on health issues as they pertain to preparedness and survival.  If you’re interested in Survival, your own and that of your country, we bet you’ll like both!

In this episode of American Survival Radio, the Altons explore the Orlando shootings and come to a disturbing conclusion: that there are millions of soft targets for a gunman and that a repeat of this event can and will occur again and again in the uncertain future. Indeed, Omar Mateen’s attack on the Orlando PULSE nightclub will become the blueprint for future attacks: crowded venue, no armed patrons, lots of noise, and late enough for most club goers to have had a drink or two (not the best recipe for situational awareness).

Also, President Obama is close to his goal of handing control of the internet from U.S. hands to that of a global organization. The Alton explore whether this is really a good idea, or will authoritarian regimes take advantage and make the internet a less free place? Will Congress block the move?

All this and more on American Survival Radio #13.

Wishing you the best in good times or bad,

 

Joe and Amy Alton

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Joe and Amy Alton

 

 

Orlando Shootings: More To Come, What To Do

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Active Shooters: What to Do

In the sad aftermath of the Orlando shootings that killed or injured more than 100 people, it has become clear to me that we’re in for a rough ride for the foreseeable future.

You might think that the “success” achieved by Omar Mateen in executing his terror event was a fluke. The sheer number of casualties was the most ever on American soil. The complexities of Mr. Mateen’s relationship with the community, having apparently visited the PULSE nightclub on multiple occasions, must make this a rare circumstance, right? Wrong.

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Pulse Nightclub, Wikipedia

The shooter’s assessment of his target as being a “soft” one was deadly accurate. A crowded venue, maybe all in one large room with limited exits, some allegedly padlocked. At 2 o’clock in the morning, many club goers must have had some drinks, and weren’t exactly in a condition to be situationally aware. Likely, no one was armed. It was a massacre and, worse, a blueprint for massacres to come.

Those who support Mr. Mateen’s philosophy will look at this event and marvel at how much damage a single gunman can do. This can only encourage others of like mind to do the same. How many nightclubs are there, gay or straight, that’ll be crowded on a Saturday night in the average city? How many club goers will be ready for the next gunman? How many establishments will act to boost security in the face of this horrible tragedy? I’ve answered these questions myself, and I am saddened.

The Islamic State giving credit to this terrorist will seem like a badge of honor to those who wish us harm. They see cowardly acts as courageous. They see mayhem as morality. They know that most Americans have gone soft, and that’s a hard truth.

We now know that mass shootings can occur anywhere, anytime. They can occur in churches, schools, nightclubs, and at holiday parties. They can occur at 2 in the morning and they can occur in the middle of the day. What would be your response if confronted?

The natural response for most people is to do nothing. You’ve heard me talk about “normalcy bias” before. That’s the tendency for people to believe everything follows a pattern and that the day will proceed normally because it always has. When a terrorist event breaks that pattern, however,  the unprepared brain takes time to process the new situation. People will think that the sound of gunfire is fireworks, or anything less threatening than an assassin out to kill them.

A person without a plan of action typically follows the herd. If fifty people around you drop to the floor, your natural tendency is to do the same. Cowering in fear under a table in plain view of the shooter isn’t a recipe for a good outcome. But having a plan will give you a better chance of getting out of there in one piece.

During an active shooter event, what you do in the first few seconds may determine whether you live or die. Give yourself a head start by always knowing what’s happening around you. We call this situational awareness. Know where exits are. Know where the gunshots are coming from. Know who appears nervous or suspicious in your immediate area.

Sounds simple, doesn’t it? But in this era of people immersed in their smartphones, few are situationally aware and become easy targets for the active shooter.

Run, Hide, Fight

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If you find yourself in the middle of a terrorist event, you should remember these three words: Run, Hide, Fight. Just as “Stop, Drop, and Roll” can save the life of someone on fire, Run, Hide, Fight might save the life of someone under fire. This is the order of the actions that you should be taking in an active shooter scenario.

Run

Most people will hide as their first course of action. You, however, should run away from the direction of gunfire immediately, leaving through those exits you’ve been mentally marking. This will make it less likely you and the shooter will cross paths. Forget about collecting your stuff, it will only slow you down and, let’s face it, it’s just stuff.

A kind of paralysis may occur when you first realize what’s happening. This is normal, but running away from the shooter increases your distance from them, and makes it difficult for them to hit a moving target.

A good citizen would yell for others to follow and prevent others from entering the kill zone. Don’t try to move or otherwise help the wounded, however. You have to get out of there; becoming the next casualty does no one any good. Even the police will leave the injured for after the shooter has been neutralized.

(One very important note: If you see law enforcement, don’t run up and hug them. Get your hands in the air, fingers spread, where officers can see them. They need to know you’re not the threat. Follow any instructions given and leave in the directions the officer came from.)

Once you’re in a safe area, call 911 if rescuers have not yet arrived.

Hide

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If there’s only one exit and the shooter is standing in front of it, running might not be an option. Your next choice is hiding.

You have to get out of the shooter’s line of sight, but hiding under a table in the same room as the shooter is a very bad idea. Get into another room, preferably one with a door you can lock. If there is no lock, put together a barrier with desks and chairs. Turn off the lights, silence your cell phone, and stay quiet behind an additional barrier like a table or in a closet. If you can quietly alert authorities, do so.

By accomplishing the above, you’ve just made yourself a harder target to acquire for the shooter, and he wants to do his damage as fast as possible. He’ll likely pass you by to find easier targets.

Fight

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What if you can’t run, and there is no reasonable hiding place? You just might have to fight your way out of there. This strategy isn’t always doomed to failure. You still might be able to drop an attacker even if unarmed. Three unarmed men were able to do it to a shooter on a train in Paris. It’s a last resort, but it can work; it did there.

If you don’t fight, the shooter will have a clear shot to your head and death is likely. If you fight, you’ll be harder to hit with a fatal shot. Any type of aggression against the gunman would disrupt their “flow” and possibly put you at an advantage. If you can, approach him from the side or rear, and go for his weapon.

If you have help, all should attack at the same time from different directions while hurling objects that he has to dodge. At the PULSE nightclub, there were probably drinking glasses and bottles handy, not to mention hundreds of cell phones.  The gunman is probably not James Bond: he’ll duck or flinch and not be able to handle multiple threats at once. Imagine a half-dozen people charging you while throwing stuff at your head. Makes for a pretty nervous terrorist, I’d say.

If you’ve disrupted the shooter or, better, gotten the weapon out of his hands, inflict damage on him until he is out of the fight. Tough, I’ll admit, but these are tough times; commit to your actions.

Luckily, few people will find themselves in the midst of a terrorist attack like the one in Orlando, but you can bet more are coming. Having a plan for active shooter situations is galling to some, but it’s part of life in the New Normal. Those who are prepared will have a better chance to survive terror events and many other disasters in the uncertain future.

Joe Alton, MD

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Joe Alton, MD

Find out more about what you can in active shooter situations in our brand new Third Edition of The Survival Medicine Handbook.

Surviving a Terrorist Attack: 5 Things You Need To Know

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Terrorist attacks have become a common occurrence–not just in the Middle East, but all over the world. From the notorious disaster on 9/11 in 2001 to the recent attacks in Paris and Brussels to last weekend’s murder of 49 people in Orlando, it seems terrorists have the ability to strike anywhere at anytime. The only […]

The post Surviving a Terrorist Attack: 5 Things You Need To Know appeared first on Urban Survival Site.

Some Thoughts on What to Do in an Active Shooting situation

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shootingThe shooting that occurred in Orlando Florida has been on my mind ever since I heard about it yesterday.  It clarified some thoughts that have been going through my mind for some time now.  First let me express my condolences to the families of the victims, I feel for them.  Second, let me express my contempt for the radical Muslims and the fellow travelers in our current administration who aid and abet them.

Now the next section may make some people upset with me.  But these are the thoughts that have been going through my mind.  First the government programs teach that if you are caught in an active shooter situation to run, hide or fight in that order.  I personally have some questions about this.  I think that this is the correct tactic for women and children and men who are too far away.  But for men who are within a reasonable distance of the shooter it should be fight.

In yesterday’s shooting, we saw people who texted messages as the shooter approached them.  They would have stood a lot better chance if they would have thrown the phone at him and charged.  With the number of rounds he fired, he had to have done several reloads.  Now I am 72 years old and I feel that I could travel approximated 20 feet during the time it takes to reload an AR15.  Another  factor is that regardless of how well trained an individual is, an AR15 is not a magic weapon.  It only fires in one direction at a time and only one round for each pull of the trigger.

Now my feelings for some time is that if I am involved in an active shooting situation and am within a reasonable distance of the shooter I will attack.  Now being a bit of a realist even though this is my plan, I don’t know if I would have the courage to actually do it until I am faced with the situation.  But I know that if I get the thought in my mind ahead of time I am much more likely to do it.

Now let’s discuss what happens if you charge, first there is a good chance others may join you.  People react to a leader.  If the shooter has to deal with you, it buys time for others to flee.  If you are shot, but if the suspect goes down as a result of several people charging, you will get medical help much sooner.  You won’t lie there for three hours, slowly bleeding to death.  I believe that fighting back will reduce the death toll in most situations.

I hope that if I am ever in such a situation I have the courage to die on my feet fighting, rather than hiding in a bathroom.

Howard

The post Some Thoughts on What to Do in an Active Shooting situation appeared first on Preparedness Advice Blog.

Announcing The NEW Third Edition Survival Medicine Handbook

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The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2016 Third Edition

Well, we’ve returned from an awesome week in the great state of Oregon and got to look at the final proof of the Third Edition, which arrived while we were away. It looks good on review, so we hit the publish button and it’s now available at Amazon.

 

For those who don’t know us, the third edition of The Survival Medicine Handbook is not your standard first aid book: Unlike other medical books (even some outdoor and “survival” medicine books), it assumes that a disaster, natural or man-made, has removed all access to hospitals or doctors for the foreseeable future; you, the average person, are now the highest medical resource left to your family.  It’s also for the family that lives or is traveling in rural areas where the ambulance is more than a few minutes away, or where there isn’t cell phone service.

 

To let you know what’s in the book, most of the topics are below. Every chapter has been revised to some extent. We’ve greatly increased the content on hemorrhagic wounds, adding chapters on active shooters, tourniquets, gunshot and knife wounds, discussions of ballistic trauma and body armor, and even the medic under fire. Food/water contamination, pandemic diseases, rodent issues, and disease-causing microbes also added as individual discussions. The section on respiratory infections is completely reworked as is the section on physical exams. Additional natural disaster preparedness topics include blizzards, avalanches, survival when lost at sea, mudslides, and more. Nurse Amy has added a lot of material to the medical supplies section, plus how to sterilize supplies, choosing a medic bag, and more. Soft tissue wound care and patient transport have been expanded. As always, we discuss alternative remedies wherever they may be helpful.
Here are just some of the over 150 topics (175 illustrations) covered in our 670 page book:

PRINCIPLES OF MEDICAL PREPAREDNESS-HISTORY OF PREPAREDNESS-USING ALL THE TOOLS IN THE WOODSHED-SPIRITUALITY AND SURVIVAL-MODERN MEDICINE VS. SURVIVAL MEDICINE-THE IMPORTANCE OF COMMUNITY-HOW TO BECOME AN EFFECTIVE MEDIC-LIKELY MEDICAL ISSUES YOU’LL FACE-MEDICAL SKILLS YOU’LL WANT TO LEARN-MEDICAL BAGS, KITS, AND SUPPLIES-HOW TO STERILIZE MEDICAL SUPPLIES-NATURAL REMEDIES, LIKE OILS, TEAS, TINCTURES, AND SALVES-THE MEDICAL HISTORY AND PHYSICAL EXAM-THE MASS CASUALTY INCIDENT-THE ACTIVE SHOOTER EVENT-PATIENT TRANSPORT-HYGIENE-RELATED MEDICAL ISSUES-LICE, TICKS, AND WORMS-DENTAL ISSUES AND PROCEDURES-RESPIRATORY INFECTIONS-GUIDE TO PROTECTIVE MASKS-FOOD AND WATER-BORNE ILLNESS-WATER STERILIZATION-DIARRHEAL DISEASE AND DEHYDRATION-DEALING WITH SEWAGE ISSUES-RODENTS AS DISEASE VECTORS-FOOD POISONING-PATHOGENS (DISEASE-CAUSING ORGANISMS)-HOW INFECTIONS SPREAD-APPENDICITIS AND OTHER ABDOMINAL INFECTIONS AND CONDITIONS-HEPATITIS-URINARY TRACT INFECTIONS-INFECTIONS CAUSED BY YEAST-CELLULITIS-ABSCESSES-TETANUS-MOSQUITO-BORNE ILLNESSES-PANDEMICS-THE SURVIVAL SICK ROOM -HYPERTHERMIA (HEAT STROKE)-HYPOTHERMIA-FROSTBITE/IMMERSION (TRENCH) FOOT-COLD WATER SAFETY-FALLING THROUGH THE ICE-AVALANCHE PREPAREDNESS-ALTITUDE SICKNESS-WILDFIRE PREPAREDNESS-SMOKE INHALATION-TORNADO PREPAREDNESS-HURRICANE PREPAREDNESS-EARTHQUAKE PREPAREDNESS-FLOOD PREPAREDNESS-MARITIME SURVIVAL-NEAR-DROWNING-VOLCANO PREPAREDNESS-ALLERGIC REACTIONS-ASTHMA-ANAPHYLACTIC SHOCK-POISON IVY, OAK, AND SUMAC-RADIATION SICKNESS-BIOLOGICAL WARFARE-INJURIES TO SOFT TISSUES- MINOR WOUNDS-HEMORRHAGIC WOUNDS-PHYSICAL EFFECTS OF BLOOD LOSS-HEMORRHAGE CONTROL-TOURNIQUETS-COMMERCIAL BLOOD-CLOTTING AGENTS-KNIFE AND BULLET WOUNDS-BODY ARMOR-THE MEDIC UNDER FIRE-SOFT TISSUE CHRONIC WOUND CARE-HOW TO SUTURE SKIN-HOW TO STAPLE SKIN-LOCAL NERVE BLOCKS-BLISTERS, SPLINTERS, AND FISHHOOKS-NAIL BED INJURIES-BURN INJURIES-ANIMAL BITES-SNAKE BITES-INSECT BITES AND STINGS-HEAD INJURIES-SPRAINS AND STRAINS-DISLOCATIONS-FRACTURES-PNEUMOTHORAX-AMPUTATION-THYROID DISEASE-DIABETES-HIGH BLOOD PRESSURE-HEART DISEASE-ULCER AND ACID REFLUX DISEASE-SEIZURE DISORDERS-JOINT DISEASE-KIDNEY AND GALL BLADDER STONES-SKIN RASHES-VARICOSE VEINS-HEMORRHOIDS-AIRWAY OBSTRUCTION-TRACHEOTOMY-CPR IN THE UNCONSCIOUS PATIENT-HEADACHE-EYE TRAUMA AND INFECTIONS-NASAL TRAUMA-EAR INFECTIONS-PREGNANCY AND DELIVERY-ANXIETY AND DEPRESSION-SLEEP DEPRIVATION-OVER THE COUNTER DRUGS-PAIN RELIEF-ANTIBIOTICS (and how to use them)- EXPIRATION DATES

 

We hope you’ll consider the Third Edition of the Survival Medicine Handbook for your library.

 

Joe and Amy Alton

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Joe Alton, MD and Amy Alton, ARNP

 

VIDEO: Active Shooter Bleeding Control Kit in Action

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cover celox with roller gauze

Would you be able to stop severe hemorrhage in the aftermath of a terror attack? In Amy Alton, ARNP, aka Nurse Amy’s latest video, she puts on a realistic demonstration of her First Aid Bleeding Control Kit in action after a simulated active shooter event. Each item in the kit is demonstrated as if utilized by a civilian with no training. We believe a kit like this should be available in every workplace, mall, school, and, really, any place at risk for this type of event. The items in the kit are meant to be easy to implement and effective in the control of bleeding.

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Bleeding Control Kit

To watch, click below:

 

 

 

Wishing you the best of health in good times or bad,

 

Amy Alton, ARNP and Joe Alton, MD

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Amy Alton, ARNP

Video: Active Shooter Bleeding Control Kit, Part 2

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In part 2 of a series on hemorrhagic wounds incurred in a terror or other active shooter event, Amy Alton, ARNP discusses what she believes would be a reasonable item for a bleeding control kit and why she chose specific items for the kit she designed for the average citizen in the workplace, school, or mall.

Small Bleeding Control Kit image

 

To watch, click below:

 

Wishing you the best of health in good times or bad,

 

Amy Alton, ARNP, aka Nurse Amy

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Are you equipped with the supplies you’ll need to deal with medical issues in times of trouble. Check out Nurse Amy’s entire line of kits at her store at store.doomandbloom.net

Survival Medicine Hour: The New 3 R’s, Ear Infections, 5 Second Rule, More

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ear_drum

healthy eardrum

Given the rash of bombings and shooting in recent years, should first aid 101 be taught in schools and should bleeding control kits be placed next to the fire extinguishors in schools, workplaces, and malls? Find out about the new 3 R’s of learning with Joe and Amy Alton, aka Dr. Bones and Nurse Amy. Also, does the 5-second rule really work? Hear what scientists have to say, plus how to deal with ear infections using conventional and natural remedies. All this and more on the latest Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP.

active shooter

To listen in, click below:

 

http://www.blogtalkradio.com/survivalmedicine/2016/03/28/survival-medicine-hour-ear-infections-first-aid-in-schools-much-more

 

Wishing you the best of health in good times or bad,

 

Joe and Amy Alton

American Survival Radio

The New 3 R’s: Reading, ‘Riting, Reducing Hemorrhage?

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cover celox with roller gauze

Given the spate of bombings and shootings throughout the world, most recently in Brussels but also in Paris and San Bernardino, we now realize that mass casualty incidents (also called MCIs) are becoming part of the “New Normal”. A mass casualty incident is any event in which the medical resources available are inadequate for the number and severity of injuries incurred.

 

Look at images of any terrorist attack, and you’ll see a lot of blood. These events tend to be over very quickly, but during that time, death from bleeding wounds can easily occur.

 

In a world where high level medical care is just minutes away, we have become secure in the notion that help is forthcoming. Unfortunately, it is rarely immediately at hand; the actions of individuals at the scene may make the difference between life and death. If aid isn’t administered in the first few minutes, hemorrhage can be fatal. In a mass casualty incident, the sheer number of those needing help could overwhelm the ability to attend to them.

 

Despite the urgency of the situation, law enforcement is taught not to approach the wounded until it is clear the threat has been neutralized. This is actually a wise move that avoids additional casualties, but adds a delay that may cost the wounded their lives. Therefore, the quick action needed may have to come from those involved but uninjured in the event. Of course, even these individuals should beware of continued hostile action before they rush to help.

 

How many know exactly how to stop a major hemorrhage? Just a few. Only those in the medical field or who take First Responder classes have been taught basic techniques, such as how to use a tourniquet. But although you can find fire extinguishers on the wall, there are no medical kits readily available to help these Good Samaritans. Is it time to have these items on the wall (in emergency, break glass?) and to teach bleeding control as a subject in school and workplaces? As horrible as this sounds, It’s possible we have reached that point.

 

Disasters occur regularly, not just terrorist events but natural disasters such as tornadoes, as well. If hemorrhage control first aid were a part of the curriculum, would it make a difference? Imagine a community full of people who learned to deal with injuries during their school years. Would there be lives saved, even if just by a witness to a car accident? How many lives would have to be saved for such a subject to be worthwhile to teach?

IMG_0945

Bleeding Control Kit

 

Also, is it time for basic medical kits to be placed in every teacher’s desk, workplace, and mall? Would it make people uncomfortable to see them? Probably as much as when you see a fire extinguisher.

 

Certainly, such a first aid course in schools would not be for kindergarteners, but for teenagers and teachers. Videos and demonstrations would be important to desensitize students to the topic. Of course, parents who are concerned that their child would be traumatized emotionally would protest. Perhaps, however, those who underwent the training might become a little imbued with sterner stuff than our current crop of college students, who cry out in anguish when their safe spaces are invaded.

 

These are hard times, and they come with hard realities. You might choose to live in denial of the “New Normal”, but I think you’d be grateful if the life of a loved one was saved by someone who learned Reading, ‘Riting, and Reduce hemorrhage.

 

Joe Alton, MD

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You might want to add some medical supplies for a terror event to your medicine cabinet in these uncertain times, so check out Nurse Amy’s line of medical kits and individual items at store.doomandbloom.net.

Video: Bleeding Control Kit

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Small Bleeding Control Kit image

In her latest video, Nurse Amy shows off her recently designed Bleeding Control Kit for active shooter or terrorist events. Packaged in highly visible mylar, it’s meant to be kept anywhere there are crowds that might be a tempting target for those who would do us harm. Especially useful for workplaces, schools, malls, arenas, and other locations, but also works for homes or vehicles. See it by clicking the video link below:

 

 

 

Wishing you the best of health in good times or bad,

 

Amy Alton, ARNP
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Video: Mass Casualty Triage, Part 3

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ambulances

Joe Alton, MD’s YouTube series on mass casualty triage ends with a review of the victims he posted in the comments section in part 2. What triage level is each, why, and what would their level be if there were no hospitals or emergency care units?

 

To watch, click below:

 

Wishing you the best of health in good times or bad,

 

 

Joe Alton, MD

AuthorJoe

 

Video: Mass Casualty Triage, Part 2

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ambulances

In this part of Joe Alton, MD’s series on Mass Casualty triage, Dr. Bones discusses the RPMs of primary triage, plus the various triage levels. In the comments section, you’ll find 10 victims to triage. We’ll go over these in part 3, coming up soon!

 

To watch, click below:

 

Wishing you the best of health in good times or bad,

 

Joe Alton, MD

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Guest Post: Top Ten Things To Know About Ballistic Protection

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BodyArmorJoeShirtFront

Covert body armor can be worn under clothes

 

(DR BONES SAYS: From time to time, we post articles from aspiring writers in the field of medical preparedness. This time, our guest author is Chris Taylor of SAFEGUARD body armor who gives a top ten countdown of important things to know about ballistic protection. And now, Chris’s article ).

 

 

Preparedness is no easy task; it requires an understanding of the situations you will find yourself in and the methods by which you can survive them. The most important thing to safeguard is your safety, as only by being properly protected can you keep yourself alive.

 
Proper protection can mean a number of different things, from first aid, to self-defense. However, an often overlooked method of keeping oneself safe is by employing body armor. Bullet proof vests are more accessible and protective than ever, and yet there are still a number of important things to understand before grabbing the nearest vest. Here are the top ten most important aspects of body armor everyone should know:

 

body-armor
10.) Body Armor is Available for Everyone
Body armor usually conjures up images of high-visibility protective vests worn by the Police, or ultra-protective tactical armor worn by SWAT teams and the Military. Similarly, many assume that these products are difficult to obtain, and are only reserved for these people. While there are some restrictions on how body armor may be purchased and used in some areas (check local regulations before you purchase), body armor is available for anyone to purchase and wear. Indeed, anyone who faces the threat of attack or injury should consider a protective vest, as it could help save their life.

 
9.) Body Armor covers a lot of products
As we’ve seen above, body armor refers to a wide range of protective clothing; everything from stab proof vests to helmets is considered body armor, and it can be difficult to know exactly what you need and what you are getting. The products can be loosely grouped into ‘soft armors’ and ‘hard armors’, depending on the materials they use to offer protection. However, within each of these groupings there are variations that need to be considered.

 

female body armor

female body armor

8.) Different threats mean different protection…
These variations exist in order to combat different threats, as certain weapons or attacks require different materials to provide protection. For example, bullet proof vests cannot protect against many stab wounds, which cannot protect against spike attacks like ice picks. Similarly, ‘soft’ bullet proof vests cannot protect against high-velocity ammunition. To add to the confusion, many vests meant to protect injury from sharp objects also come with ballistic protection. While this will be discussed later, it is important first to know what threats you need protection against; if you will be facing rifles, you need armor with rigid plates. If you will be facing edged weapons, you need armor with stab protection. If you are facing spiked weapons, you need spike protection. All of these protections can be found in addition to ballistic protection.

 
7.) Not completely bulletproof
However, even a bullet proof vest is not completely bullet proof. There is no such thing as complete protection against a bullet, particularly when bullets come in all shapes and sizes. A bullet proof vest will certainly increase your chances of surviving an attack involving a firearm, but it should never replace caution and diligence.

 
(DR. BONES SAYS: EVEN THE BEST VESTS WON’T PROTECT YOU FROM THE FORCE OF THE BULLET. BLUNT TRAUMA FROM IMPACT AGAINST THE VEST MAY BREAK RIBS, COLLAPSE LUNGS, AND CAUSE INTERNAL BLEEDING)

 
6.) Levels
While no vest can offer 100% guarantee against bullets, vests at different levels offer some assurance against certain ammunition types. Ballistic protection is tested and graded by the National Institute of Justice, which assigns ‘levels’ to bullet proof vests. These NIJ Levels outline exactly what threats a vest can protect against. This means that vests at lower levels cannot protect against higher caliber ammunition, whereas higher levels can offer greater protection. The highest level of ‘soft armor’ available is Level IIIa, which will protect against the vast majority of handgun ammunition. The highest level of ballistic protection available is Level IV, which is only achievable with rigid plates, and can protect against even armor-piercing ammunition.

 
5.) How it works
Many do not know exactly how a bullet proof vest provides protection, and understanding how the materials involved work helps distinguish between the different levels and types available. ‘Soft armor’ uses fabrics like Kevlar, which have an incredibly high strength-to-weight ratio. This allows them to trap bullets and disperse their energy, slowing them to a complete stop. These materials are lightweight and flexible, allowing them to be worn even under clothing. Higher levels, however, need rigid plates that use materials like Ceramics and Polyethylene, which are incredibly strong and even deflect or absorb bullets. These plates are much thicker and heavier, and yet still light enough to be worn in covert vests.

 

 

4.) Different Styles
In addition to being split along numerous protective lines, body armor can also be found in ‘covert’ and ‘overt’ styles. This means that a vest is designed either to be worn under clothes or over clothes. Covert armor offers discreet protection at all levels, and can even use rigid plates. Some covert vests are even designed to help keep the wearer cool. On the other hand, overt vests are worn over clothing and have more variety in the materials used and the extras available. For example, overt vests can use waterproof and high-visibility covers, and can be equipped with additional pockets and clips, as well as logos and insignia.

 

body-armor-hard

Overt body armor

3.) Proper fitting
It may sound obvious, but ensuring your vest fits you properly is just as important as ensuring you have the right level of protection and style. In a hostile situation, freedom of movement is very important, and you need to be comfortable in order to perform to the best of your ability. Body armor should be comfortable enough to be worn for extended periods, meaning you don’t have to worry about your protection. Armor that does not fit properly may also have gaps in protection, leaving you vulnerable. Many vests are fully adjustable, but making sure you have the right size is very important.

 
2.) Keep it clean
Just as important is keeping your armor well maintained. Many do not realize that body armor and the materials used only have a limited lifespan, and without proper maintenance, this will be reduced dramatically. Vests need to be cleaned regularly and stored correctly, just like all clothing. The carrier, which is the vest itself, can usually be machine washed and often only consists of materials like cotton. The protective inserts, on the other hand, should only be cleaned with a mild cleaning agent and a gentle sponge, to avoid causing damage to the protection. Armor should be stored out of sunlight, should not be crumpled, and should have nothing stored on top of it. Moreover, all vests should be inspected regularly, and if any damage or deformity is found, you should replace your armor immediately. Many manufacturers recommend having multiple carriers to ensure you always have clean armor to wear.

 

greek-body-armor

looks great, but not much help against bullets

1.) Wear it
The most important thing to know about a vest is that it can only protect you when it is worn. Again, this seems obvious, but all too often people are injured or even killed despite owning body armor. Choosing the right vest and keeping it well-maintained is important, but unless you wear it when it is needed, it cannot protect you.

Video: The Medic Under Fire

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medicmemorial

 

In Joe Alton, MD’s latest video, he examines the issue of providing medical care in hostile encounters, including some thoughts on the role of the medic. What should your strategy be when there’s a threat to be abolished? To all combat medics: You have my utmost respect for your dedication and courage…

 

 

To watch, click below:

 

Wishing you the best of health in good times or bad,

 

Joe Alton, MD

 

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Close those holes in your medical storage by checking out Nurse Amy’s entire line of medical kits and supplies at store.doomandbloom.net

The SWAT Tourniquet

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SWAT tourniquet

The SWAT-T

In these dangerous times, any trip to the mall (or anywhere there are crowds) could be a ticket to an active shooter event. In our recent article on what to do in these circumstances, we specifically mentioned that you shouldn’t attend the wounded until the threat is abolished, and that is still your best strategy; you aren’t doing anyone any good by becoming the next casualty. Even law enforcement won’t treat the injured until the gunman is neutralized.

 

 

ABCDE vs. CABDE

 

 

It stands to reason that those sustaining wounds are going to be bleeding. If emergency medical personnel are not on the way, you will have to take action.

 
The initial field assessment of a victim usually involves the mnemonic ABCDE:

 
• Airway: Is the airway open?
• Breathing: Is the victim breathing?
• Circulation: Is the victim bleeding?
• Disability: Can the victim feel and move extremities? Can they respond appropriately to questions?
• Expose: Can you see the full extent of the injury or injuries?

 

 

This sequence changes in the actively bleeding wound to CABDE. In these circumstances, the cause of death is more often hemorrhage, which must be abated quickly. The determination of airway, breathing, and mental status can often be done simultaneously with bleeding control, as many patients will be conscious and talking.

 
Direct pressure with a gloved hand is still the most successful method of bleeding control. However, there are many instances where pressure alone won’t deal with the issue. More aggressive methods such as tourniquets were, however, discouraged due to the risk of “necrosis” (tissue death due to lack of blood flow), nerve damage, and more.

 
Despite the legitimacy of these issues, the military, through its experience in the Middle East, began to change its thinking. They found that a percentage of preventable deaths were related to inadequate measures to control bleeding. As such, the Tactical Combat Casualty Care (TC3) guidelines for our armed forces now actively promote the use of tourniquets as the first step to stop severe hemorrhage.

 
This has carried over to civilian emergency care, especially in events like the Boston Marathon bombings and the San Bernardino shootings. Injuries at remote locations, like homesteads where rapid transport is difficult, make tourniquets a required item in the family medical kit.

 

The SWAT-T

SWAT tourniquet

SWAT tourniquet

We’ve talked about tourniquets in the past, but we haven’t mentioned what might be an ideal tourniquet for the average citizen: the SWAT-T. SWAT-T stands for Stretch, Wrap, and Tuck Tourniquet, and the instructions are, essentially, all in the name. You can see the simplicity of application in the video below:

The SWAT tourniquet is a wide elastic band that can serve as a compact, lightweight, and inexpensive tourniquet or pressure dressing. It’s very simple to use, especially with two hands: Stretch it, wrap (at least 2 inches) above the area of bleeding on the extremity, and tuck the end into itself. That’s pretty much all there is to it.

 
Some tourniquets are difficult or impossible to place effectively around the thin arms of children, but the SWAT-T gives you the ability to apply it on just about anyone’s extremities, regardless of size.

 
The SWAT-T is often carried as a backup to other tourniquets due to its versatility: It can be used as a pressure dressing as well as a tourniquet, or even just as a covering for other dressings without any significant pressure at all.  Other non-tourniquet uses include stabilizing a splint or ice pack for orthopedic injuries, holding an abdominal dressing in place, and even as a sling for an injured arm or shoulder.

 
For the medic, having a supply of tourniquets is important to save lives that would otherwise be lost due to bleeding. Even if you have other tourniquets, consider adding the versatile and lightweight SWAT-T to your medical storage.

 

 

Joe Alton, MD

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Learn more about controlling hemorrhage (or just about any other issue you’ll face in times of trouble) by getting a copy of our 3 category #1 Amazon Bestseller The Survival Medicine Handbook.

Video: Surviving the Active Shooter

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active shooter

What would you do if you were unarmed and at the scene of an ongoing active shooter/terrorist event? Joe Alton’s latest video examines your options in this situation and the strategies that give you the best chance of getting out of it in one piece. Companion video to a recent article…

To watch, click below:

 

Wishing you the best of health in good times or bad,

 

Joe Alton, MD

Amy Alton, ARNP

JoeAmyPortrait2013Check out Nurse Amy’s entire line of medical kits and individual supplies at store.doomandbloom.net, now with free shipping on all orders until Dec. 31, 2015! Also, a free goody bag of supplies for every order over $50…

The Active Shooter: Staying Alive

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machine gun

It’s hard to read the news without seeing reports of the latest shooting by terrorists or the deranged and disgruntled. Few believe that they could possibly wind up in the crosshairs of a gunman’s sight, but it can happen anytime, anywhere. What would be your response?

The natural response for most people is not to do anything. You’ve heard me talk about “normalcy bias” before. That’s the tendency for people to believe everything follows a pattern and that the day will proceed normally; they’re usually right. When a terrorist event breaks that pattern, however,  the unprepared brain takes time to process the new situation. People will think that the sound of gunfire is fireworks, or anything less threatening than an assassin out to kill them.

Another thing most citizens believe is that law enforcement and homeland security are on the case. While these agencies do the best they can to counter situations like this, most mass shooting events end in a few minutes. There is little or no chance that help will be there at the moment you need it, so you should have a plan of action.

boston

A person without a plan of action follows the herd. If fifty people around you drop to the floor, your natural tendency is to do the same. Cowering in fear under a table in plain view of the shooter isn’t a recipe for a good outcome. By having a plan, you will have a better chance of getting out of there in one piece.

You’re at the mall; what would your plan be if you heard gunfire nearby? What would you do first? Run? If so, where? If you couldn’t run, what would you do? These are things you should be thinking about, calmly and rationally, whenever you’re in an area where there are a lot of people. It may seem extreme to have to think of these things, but that’s what I call the “New Normal”.

With an active shooter, what you do in the first few seconds may determine your final outcome. Give yourself a head start by always knowing what’s happening around you. We call this situational awareness. Know where exits are. Know where the gunshots are coming from. Know who appears nervous or suspicious in your immediate area.

Sounds simple, doesn’t it? But in this era of people immersed in their smartphones, few are situationally aware and are easy targets for the active shooter.

Here’s an example: Have you ever seen a patron enter a restaurant through the door marked “employees only”, or a movie theatre through the fire exit? This is a person you’ll want to observe. In most cases, it means nothing. In rare instances, though, it could be someone that’s up to no good.

By the way, those same little-used exits might save your life: Most people will be trying to leave by the front door, just where the gunman expects them to go. Find an exit away from the direction of gunfire.

 

Run, Hide, and Fight

run hide fight vector

If you find yourself in the middle of a terrorist event, you should remember these three words: Run, Hide, Fight. Just as “Stop, Drop, and Roll” can save the life of someone on fire, “Run, Hide, Fight” might save the life of someone under fire. This is the order of the actions that you should be taking in an active shooter scenario.

Run

run hide fight

Most people will hide as their first course of action. You, however, should run away from the direction of gunfire as soon as you hear it, leaving through those exits you’ve been mentally marking. This will make it less likely you and the shooter will cross paths. Forget about collecting your stuff, it will only slow you down and, face it, it’s just stuff.

If you’re in the line of sight of the shooter, run away at an angle or zig zag to make yourself a more difficult target. I know it’s not a natural action you’d think of doing, but most shooters aren’t marksmen and will miss a moving target.

A good citizen would yell for others to follow and prevent others from entering the kill zone. Don’t try to move or otherwise help the wounded, however, despite your natural tendency to want to do so. You have to get out of there and becoming the next casualty does no one any good. Even the police will leave the injured for after the shooter has been neutralized.

(One very important note: If you see law enforcement, don’t run up and hug them. Get your hands in the air, fingers spread, where officers can see them. They need to know you’re not the threat. Follow any instructions given and leave in the directions the officers came from.)

Once you’re in a safe area, call 911 if rescuers have not yet arrived.

Hide

hide 2

If there’s only one exit and the shooter is standing in front of it, running might not be an option. Your next choice is hiding.

You first want to get out of the shooter’s line of sight. We call this “concealment”, but it isn’t necessarily “cover”. If you’re concealed, you can’t be seen but a bullet might penetrate to hit you. If you have found cover, it means that you are both hidden and protected from projectiles hurled your way. Foliage is good concealment, but a thick tree trunk might be better cover.

In a building, hiding under a table in the same room as the shooter is a death sentence. Get into another room, preferably one with a door you can lock. If there is no lock, put together a barrier with desks and chairs. Turn off the lights, silence your cell phone, and stay quiet behind an additional barrier like a table or in a closet. If you can quietly alert authorities, do so. Don’t respond to voice commands unless you’re sure the danger is over; sometimes the gunman will try to lure you out of a safe place.

By accomplishing the above, you’ve just made yourself a harder target to acquire for the shooter, and he wants to do his damage as fast as possible. He’ll likely pass you by to find easier targets.

Fight

fight

What if you can’t run, and there is no reasonable hiding place? You just might have to fight yourself out of there. This strategy isn’t always doomed to failure. You still might be able to subdue an attacker even if unarmed. Three young and unarmed men were able to do it to a shooter on a train in Paris. It’s a last resort, but it can end without a fatality as it did there.

If you don’t fight, the shooter will have a clear shot to your head and death is likely. If you fight, it might just be harder to be hit with a fatal shot.

Of course, it would be great if you knew martial arts, but any type of aggression against the gunman would disrupt their “flow” and possibly put you at an advantage. If you can, approach him from the side or rear, and go for his weapon. If you have help, all should attack at the same time from different directions while hurling objects that he has to dodge. This guy is probably not James Bond: he’ll be disconcerted and not be able to handle multiple threats at once.

If you’ve disrupted the shooter or, better, gotten the weapon out of his hands, inflict damage on him until he is dead or has stopped moving. Tough, I’ll admit, but these are tough times; commit to your actions.

Luckily, few people will find themselves in the midst of a terrorist attack like the one at San Bernardino, but I honestly believe that more are coming. Needing a plan for active shooter situations is galling to some, but it’s part of life in the New Normal. Those with a plan will have a better chance to survive this event and many other disasters in the uncertain future.

 

Joe Alton, MD

blaze tv 2

Are you prepared to survive an active shooter style terrorist attack?

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Not so ironically, I was in the process of writing an entire piece on how Islamic terrorist cells were already operating inside the United States and then the events in

Celox and Quikclot to Control Bleeding

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medic-in-action

 

No matter what survival scenario you envision, few come without a real risk of major trauma, and with it, bleeding. One of the most important medical supplies to have on hand in times of trouble would be those items that can help you control hemorrhage. In studies of casualties in the recent wars, 50% of those killed in action died of blood loss. 25% died within the first “golden hour” after being wounded. Indeed, with many injuries, a “platinum 5 minutes” may determine life or death.

 
The battle to prevent deaths from hemorrhage has been waged throughout history. The Egyptians mixed wax, barley, and grease to apply to a bleeding wound. The Chinese and Greeks used herbs like bayberry, stinging nettle, yarrow, and others for the same purpose. Native Americans would apply scrapings from the inside of fresh animal hides mixed with hot sand and downy feathers. These treatments would sometimes save a life, sometimes not.

 
In modern times, the control of major hemorrhage rightly belongs to the emergency physician, paramedic, trauma surgeon, and other trained medical personnel. Our focus, however, is when you find yourself without access to modern medical care. In these circumstances, you may be the highest medical asset left, and it pays to have some tools that will help you stop bleeding. In a recent article, we discussed one of these tools: tourniquets and their use in survival situations. Today, we’ll discuss compounds produced specifically to produce clotting.

 

 

HEMOSTATIC AGENTS

 

CeloxHemostatics

 

In the last decade or so, there have been advancements in clotting agents (also known as “hemostatic agents”). Knowledge of their appropriate use in an emergency will increase the injured patient’s chance of survival. These products are used in conjunction with direct compression on the bleeding wound. Ideally, a hemostatic agent should:

 

 

  • Stop a major hemorrhage within two minutes of application
  • Be applicable through pools of blood
  • Be packaged ready to use
  • Simple to use
  • Store well for extended periods of time
  • Be affordable
  • Have little risk of infection or embolism (blood clots that travel to other areas of the body)

 
Although there are a number of hemostatic agents available on the market for your medical storage, the two most popular are Quikclot and Celox. They are two different substances that are both available in a powder or granule form and a powder-impregnated gauze.

 

quikclot
Quikclot originally contained a volcanic mineral known as zeolite, which effectively clotted bleeding wounds but also caused a reaction that burned the patient and, sometimes, the medic. As a result, the main ingredient was replaced with another substance that does not burn when it comes in contact with blood.

 
The current generation of Quikclot is made from Kaolin, a naturally-occurring mineral that was the original ingredient in Kaopectate. It does not contain animal, human, or botanical components.

 
Contact between kaolin and blood immediately initiates the clotting process by activating Factor XII, a major player in hemostasis. The powder or impregnated gauze is applied directly to the bleeding vessel along with pressure placed on the wound for several minutes. Quikclot is FDA-approved and widely available; the gauze dressing is easier to deal with than the powder, but can be relatively expensive. Quikclot has a shelf life of 3 years or so, less if the packages are left out in the sun. It’s uncertain exactly what effect the passage of time has on the product.

 
One negative with Quikclot is that it does not absorb into the body and can be difficult to remove from the wound. The material is known to become hard when left in too long and bleeding may restart when removed. This occurs less often if you use the gauze dressing.

 
In the The Journal of TRAUMA® Injury, Infection, and Critical Care , (Volume 68, Number 2, February 2010), the kaolin gauze was found to be as safe as standard surgical gauze.

 

celox

Celox is the other popular hemostatic agent, and it is composed of Chitosan, an organic material taken from purified shrimp shells. Despite this, the manufacturer states that it is safe to use in those allergic to seafood. This product is made up of high surface area flakes. When these tiny flakes come in contact with blood, they bond with it and form a clot that appears as a gel. Like Quikclot, it also comes in impregnated gauze dressings, which are, again, relatively expensive.

 
Unlike Quikclot, Celox will cause effective clotting even in those on anti-coagulants like Heparin, Warfarin or Coumadin without further depleting clotting factors. Chitosan, being an organic material, is gradually broken down by the body’s natural enzymes into other substances normally found there. Like Quikclot, Celox is FDA-approved. This study by the U.S. government compares Celox favorably to some other hemostatic agents: http://www.ncbi.nlm.nih.gov/pubmed/18211317

 
Both Quikclot and Celox gauze dressings have been tested by the U.S. and U.K. military and have been put to good use in Iraq and Afghanistan. The US Department of Defense’s Committee on Tactical Combat Casualty Care (CoTCCC) has added CELOX™ Gauze to its guidelines for control of hemorrhage as approved hemostatic agents for military use. The Rapid version significantly cuts down the amount of compression time required. Expiration dates are similar to Quikclot.

 
One additional benefit of Celox gauze is that it serves as a reasonable gel-like burn dressing when moistened with water or saline solution.

 
To see both Quikclot and Celox in action (warning: graphic in nature):

 

 

“Celox demonstration”

 

 

“Quikclot demonstration”

 
Although effective, you shouldn’t use these items as a first line of treatment in a bleeding patient. Direct pressure, elevation of a bleeding extremity above the heart, gauze packing and tourniquets should be your strategy here. If these measures fail, however, you have an effective extra step towards stopping that hemorrhage. Be sure to include one or both in your medical supplies.

 
It’s important to make certain to avoid getting hemostatic powders into a patient’s eyes or airways. Also, removal from the wound  is usually recommended no longer than 24 hours after application.

 
Let’s not forget natural remedies that may help stop mild-moderate bleeding. Certainly, if a disaster has long-standing consequences, the supply of commercial hemostatic agents will diminish, and it’s important to know what plants may provide medicinal benefits.

 
Cayenne Pepper powder at levels above 35,000 Scoville (heat) Units has a coagulant (clotting) effect, although it may cause a burning sensation. Too much stronger, however, and it can get into the medic’s eyes and cause irritation. Black pepper has also been used in the past to help control hemorrhage. Apply either of these in a good quantity to the bleeding area and apply pressure with a gauze dressing. For major hemorrhage, however, the commercially produced products like Celox or Quikclot are superior.

 

 

The medic is most effective when they have the right tools. Accumulate a supply of hemostatic agents now and you’ll succeed, even if everything else fails.

 

 

Joe Alton, MD

JoeAltonLibrary4

Get YOUR medical supplies in gear by checking out Nurse Amy’s entire line of medical supplies at http://store.doomandbloom.net/

 

 

Feminist wants “White Guys” guns taken away

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This has got to be the most uneducated feminist on the planet. The comments coming out of her mouth; “White guys cannot be trusted to use guns responsibly. It is time to stop giving guns to white guys,” is beyond idiotic, it borders insanity. Where are the “white guys” for black on black crimes? Where are the “white guys” for gang wars that involve black gangs and Mexican gangs? Now for the most part Whites rule the roost when it comes to mass shootings, whites seem to want to get the killing done all at one time. Where other violent crimes committed by minorities are spread over time.

She then adds “I mean, it’s time to stop giving guns to everybody, but we can start with the white guys.” Very few crimes are committed with guns “given” (what I assume she meant was purchased) to them. Now if you want to focus more on tightening the background checks on who can legally purchase a gun then I am all for that.

Ryan-GirouxAn example given in the article is this guy Ryan Giroux, the shooter in Arizona. If this guy bought a gun legally which considering his history of convictions probably wasn’t the case then we do need to have a more strenuous process for purchasing a firearm. Bottom line is legal firearms and white guys (even black guys) are not the problem and people like Andrea Grimes needs to get off her high horse and realize that. Bad people come in all race and colors and those people get guns by other means.

Here is the article

http://dailycaller.com/2015/03/19/feminist-reporter-take-away-white-mens-guns/

AR Pistol Build Part 2

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I finally had a chance to sit down and write the final part to the AR pistol build. Some things have changed with the law since Part 1 was released.
Here is a linkfor you to keep yourself informed and on the right side of the law. If you don’t want to deal with the headache of changing laws, get an NFA trust and buy a sbr and a suppressor. This post will still help with assembling and sourcing parts for any AR platform build. So we are clear, an AR pistol is not a rifle, disclaimer over.

Part 1 ended with the pistol lower being completed. The next phase of this build began with planning out the upper receiver for the pistol. I prefer to support smaller companies for gun parts for many reasons, customer service being on top of that list.


I wanted a top tier billet receiver, choosing SanTantactical was a no brainer. These guys make some of the best uppers and lowers on the market. I picked a burnt bronze for the color to change it up a bit. Enough can’t be said for doing business with smaller companies and will see why throughout this post. The guys from SanTanare all about interacting with their customers on social media; little things like telling a customer how sick their build came out goes a long way. Try getting feedback on your build from Bushmaster, DPMS, or Colt.


The barrel was next on my list. Again I wanted to go with a smaller company but wanted top tier performance. AR pistols have a bit of a bad reputation for having malfunctions due to the short gas system causing short stroking and other various malfunctions. This pistol is to be used as my home defense gun and cannot afford to have a malfunction of any kind. I did some serious research into companies who have the right attitude and put out high quality components. That is when I found Ballistic Advantage.

Deciding on the length of the barrel was not easy, this pistol needed to be easy to maneuver and 100% reliable. If you are having this same issue do this: IGNORE THE INTERNET and anyone who doesn’t even gun. These people will just spew half truths from YouTube videos they’ve seen and act like they know what they are talking about. Do what I did and call someone who actually makes barrels and shoots these guns. I called Ballistic Advantage and explained my situation to the super friendly guy there and without hesitation he said, “You know what, let me get Clint to help you, he makes the barrels.” Again name one company who will do that. Clint got right on the phone, he was genuinely engaged and interested in my build and really gave me that warm and fuzzy of what customer service really is. I told Clint I wanted a 100% reliable pistol that I could trust with my life. Clint asked me a series of questions ranging from what muzzle device, BCG, and buffer weight I planned to use. He made a few suggestions on what he typically does to make his pistols run without issue. We agreed to go with their 10.3” barrel. He then mentioned that he has a line of barrels called the Hanson Series. This barrel profile was developed by Clint Hanson and this is a brief description from their page on exactly what a Hanson series barrel is.

“The Hanson Profile, just like the quality and accuracy you have come to expect from BA, the Hanson continues this pattern. This barrel is essentially shoulder-less, symmetrically limiting barrel “whip”. The Hanson is designed to return to its home position sooner than other barrels which are beneficial for follow up shots at a high rate of fire or full auto fire. It has lightweight feel without the lightweight limitations. It is truly ideal for what an AR-15 is meant to do.”



I went with the Hanson series and Clint promised me that if the pistol did not fire every kind of ammo out there without issue to send the pistol to him and he would personally go through the pistol and do what needed to be done to get it running. Again, try to get that kind of guarantee from any major manufacturer.


The next part of this build was choosing the muzzle device, this was a no brainer. I went with the Noveske KX-5. If you build a pistol you will not be disappointed with the flaming pig.

Now that the most difficult part was over I moved on to choosing a rail. I’m active on Instagram (Follow me) and when I was looking at some SanTan fitted firearms I saw this rail that looked like nothing I have never seen before. It was love at first sight. I immediately found out who makes them and was pleased to see they are a small company. I gave SLR Rifleworks a call and again a surprisingly pleasant person answered the phone. I shared my vision for this pistol and explained I wanted the rail to end at the beginning of the brake. We settled on the 10” Keymod Solo Series rail and added a couple hand stops for good measure. These guys have a connection to a company who coats their rails for them and for a small fee I was able to have my rail match my burnt bronze upper.

I wanted a BCG that would run problem free with little maintenance. I decided to go with the Spikes Tactical nickel boron coated BCG, these are a bit pricey but worth it.


Assembling the upper is really easy, just pay attention and have the proper tools. Just hop on YouTube and you can find plenty of great videos with step by step instructions.

Now came the tough part, choosing the optic. I have an Eotech EXPS 3-2 on my rifle with the Magpul Pro mbus and that combo is amazing, but I do not need something like that for this pistol. This pistol’s main purpose is to engage threats at a distance no longer than 100 yards. I didn’t feel the need for backup sights on this. For this setup I went for the Aimpoint Pro. This optic has earned a reputation for being super rugged and performing like an optic that is double the price.


I finished the assembly of the upper and all but sprinted to the range to test fire and zero the pistol. After having three fail to eject malfunctions and overall shitty function I went home crushed. This pistol that I spent this time and effort into was a dud. The next morning I called Clint at BA for some help and he dropped what he was doing to help me diagnose the issue. I explained the issues that I was having and we were able to come to the conclusion that the charging handle I was using was the culprit. It was warped and the finished was terrible. The charging handle was binding up the operation of the pistol, so I swapped the junk one out for a BCM Gunfighter mod 3. I went to the range the following day and wouldn’t you know it, the pistol ran like a sewing machine. I put 300 malfunction free rounds through the pistol and held groups far better than I was expecting for this length barrel.


I wanted to take the pistol to a course that would put it through a serious amount of stress, mud, and dirt. I used this pistol for the second day of Fighting Rifle taught by Tactical Response. The second day of this course was a brisk 45 degrees accompanied by a cold downpour all day.

Post course BCG

The only malfunction I had was due to a muddy magazine that created a double feed. We put approximately 600 rounds through the pistol that day and it ran flawlessly in the mud and rain.
Here is the link to the YouTube video I made from the course. 














Something to consider if you plan to build a pistol; a single point sling is key for maintaining a nice cheek weld while keeping that brace clear of your shoulder. All you need to do is push the pistol out and the sling tension will be more than enough to have a nice tight cheek weld.

My three favorites!


I couldn’t be happier with this build. The companies I used for this build have gotten a lifetime customer out of me based on this experience. If you have any questions about building an AR of any variation feel free to contact me and I’ll help you as much as I can.

What are your thoughts on the Pistol platform in AR and AK?
Let me hear your input!

Head over to Olmsted Risk Solutions to learn about how to run a PTR like a boss!



Say fit and keep that Warrior Mindset!

Los Angeles County Sheriff’s Department: Surviving an Active Shooter

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The Los Angeles County Sheriff’s Department has produced a video presentation on Surviving an Active Shooter. As the site ActiveShooter.lasd.org states the likely hood of being involved in a situation is low. But as we all “should” know is that it is better to prepare for the worst and hope for the best than be passive and assume everything is fine in the world. The video is at least an effort by the Los Angeles County Sheriff’s Department to try and education the populace.

Are other county sheriff offices in America done the same? If so let us know we will post it as well.

LASD_Logo

 

Turning the Tables on an Active Shooter

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I don’t need to list the most recent attacks on unarmed civilians that have taken place in the past year or even past month to get my point across. Violent attacks are clearly on the rise with attackers ranging from pissed off former employees to religious fanatics and everything in-between.



You need to come to terms with the fact that you can never be prepared enough to prevent an attack from happening. You will not be able to grab your battle rifle, plate carrier, and call the police prior to getting attacked unless you are in your home, awake, and near your gear.

 

It is more likely you will be vulnerable and wearing what you are wearing now in a crowded public place or alone in unfamiliar territory. Hopefully you have a pistol and or knife on you to give you an edge on your would be attacker/attackers. If it all possible dialing 911 should always be your first action when you get the feeling your life is in danger.


If you are in a situation where your life is in danger and you can dial 911 without sacrificing safety:

·         Dial 911

·         Put your phone to speaker

·         Put the phone in your pocket so you have use of both hands

·         Describe your surroundings to the dispatcher in great detail

·         Seek cover or a safe zone

·         Prepare to defend yourself until help arrives

Leave the square ranges for BZO
A great way to prepare yourself is to break away from relying on square ranges and bulls-eye targets as a sufficient means to becoming an effective defensive shooter. Square ranges are meant for zeroing firearms and marksmanship training, not drawing from your holster and moving to cover in order to land some well-placed shots on target. If you don’t have access to a range or facility that allows dynamic training or scenario training try some of these simple drills in the comfort of your own home. Make a room clear of all ammo and never bring ammo or loaded guns in there, practice drawing and reloading your cleared gun or blue gun for a few minutes a day so you become comfortable drawing and acquiring a target after seeking cover.


 

Dry firing is great practice but it’s just that, so once you feel you have mastered drawing your pistol, clearing malfunctions, reloading, etc. Seek out courses and training that is geared towards active shooters and concealed carry scenarios. Do your research and make sure the course is run by a professional that has a verifiable background in firearms training and is insured. This day and age there are folks who grow a beard, buy some gear and call themselves a firearms instructor. Please make sure these people have actual credentials that mean something. The NRA is a great source for finding quality instructors as well.

Airsoft is a highly underrated and affordable way to do force on force training that allows you to actually shoot people and to get shot without actually dying.

Let’s run with that idea:

·       Get the airsoft equivalent of your carry pistol and a training knife

·       Make a friend do the same

·       Get proper protective equipment

·       Find a safe private place (so people don’t think it’s real)

·       Create 5 scenarios where you are vulnerable (Entering/leaving vehicle, asleep in bed, taking a poop, walking your dog)

·       Get attacked and take note of what works and doesn’t for you

·       Start timing closing speeds of an attacker in unknown distances to evaluate what reaction fits the situation

Yup, you will look like a total freak doing these exercises but looking like an idiot when training may just be enough to give you the edge if you were to be attacked or became involved in an active shooter situation.


Physical fitness can never be stressed enough for this subject. Close quarters confrontation,  gun free, and knife free zones leave you with only your physical skillset to keep you safe and alive.

If you are legally permitted to carry a concealed firearm you should never leave your home without your pistol and a spare magazine.

My EDC, within arms reach 24/7

For some added firepower and magazine capacity consider storing a rifle in your vehicle, but be cognizant of local laws prior to doing so. Rifle manipulation in a vehicle is frustrating at best so look into acquiring an AR or AK pistol.

My work in progress AR pistol

These rifle caliber pistols are relatively new to the market and have tremendous benefits. Especially if you value maneuverability in tight places such as a vehicle or in your home.


It’s a shame the cameraman didn’t have a gun

 You can be that person who spends their last moments with their hands up begging for mercy or you can be prepared and give yourself that chance to fight back and stop a tragedy. What do you do to keep as prepared as possible?


Stay Fit and Keep that Warrior Mindset!