GET OFF THE “X”!!!
This is a term that many of us are familiar with. What is the “X” and why do we need to get off of it? We’re going to talk a little bit about proper care under fire and casualty evacuation so that if the time comes, there is no confusion on what to do. The “X” is the area in contact, whether it’s an ambush, several active shooters or just one active shooter and our goal is to get out of that area as quickly and as efficiently as possible while preventing ourselves, friends, loved ones or team mates from sustaining any injuries. Once off of the X and behind cover, we must evaluate and treat any injuries sustained. If contact has been made and injuries have been sustained, counter that contact with suppressive fire. This will allow the casualty, if able to move, to move quickly and laterally out of the cone of fire and behind cover where they can render self-aid.
SUPPRESS THE THREAT!!! The main concern at this point is not the casualty but suppressing any incoming fire and neutralizing the threat. Mission accomplisment is always primary. If this threat is not neutralized then you increase the chance of sustaining more casualties and your team becoming combat ineffective.
FIX YOURSELF!!! If you are injured and can still press your trigger, you must have the proper mindset and continue to lay down fire to suppress or neutralize the threat while moving to cover
in order to render self-aid.
FIX YOUR MATES!!! If you can safely move to an injured team mate who is unable to move themselves, move to them under suppressive fire and evacuate them to cover and begin
evaluating them and treating injuries as necessary.
What are you looking for? Talk to them as you approach them. If they’re talking, yelling or otherwise, we have Airway and Breathing covered for the moment. If they are saying that they’re
hit, then we also have a good assessment of their neurological function as they are aware of what’s going on. Use all of this info as a baseline for further reassessments later. If they are
pulseless, not breathing and have no signs of life, move on to the next victim.
Once the threat has been neutralized and you are behind cover:
- If you suspect c-spine or back injuries do not move the casualty unless it is a life-threatening
- Check for life-threatening hemorrhage and control it immediately.
- Check Airway and open it.
- Look, listen and feel for breathing.
- Check pulses, skin color and temperature, capillary refill and control bleeding.
- If life-threatening bleeding occurs at any of these stages of assessment, control it and then move back into your assessment.
- Check the neuro status of the vicitm. Are they alert? Do they respond to verbal stimuli, painful stimuli or are they unconscious? Reassure the victim and give comfort.
- Expose them and check for further injuries and ensure that you re-cover them to keep them warm.
- Watch for any symptoms of re-bleeding, mental status degradation or other signs and symptoms of shock.
If you have multiple casualties you must do the greatest good for the greatest number. Don’t fixate on injuries for which you cannot do anything and move on to those whom you can help. You must maintain the warrior mindset that you will prevail and that the mission will be accomplished. Just because you’ve been hit doesn’t mean that the fight is over. It means that the fight has just begun and you’ve got the rest of your life to fix it.
SIMPLICITY UNDER STRESS