Handling the Wounded in a Counter-Guerrilla War

An incredibly useful historical context by LTC Lester Grau on how the Soviets, and later the Russian Federation, dealt with casualties and medical evacuation. Its a very interesting read, especially in how the Russians had to adapt to greater and more severe casualties as the guerrillas’ weapons became far more sophisticated.

2007165Grau

What is your own plan in an austere environment?

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About the Author: NC Scout

NC Scout is the nom de guerre of a former Infantry Scout and Sergeant in one of the Army’s best Reconnaissance Units. He has combat tours in both Iraq and Afghanistan. He teaches a series of courses focusing on small unit skills rarely if ever taught anywhere else in the prepping and survival field, including his RTO Course which focuses on small unit communications. In his free time he is an avid hunter, bushcrafter, writer, long range shooter, prepper, amateur radio operator and Libertarian activist. He can be contacted at [email protected] or via his blog at brushbeater.wordpress.com .

23 Comments

  1. WiscoDave August 26, 2020 at 09:57

    Some may find this useful. It is the last version before greater reliance was placed on having advanced equipment available. I have two copies printed and bound. It takes a ream or so of paper.
    YMMV
    http://www.mediafire.com/file/32ylkohxria2iue/Alaska_Community_Health_Aide_Manual.pdf/file

  2. Ralph k August 26, 2020 at 11:49

    Interesting read. Observation: everyone will require to carry IFAK when things go hot, the care and transport of wounded uses up lots of human resources. One takeaway was the disproportion of death from sniper fire against unarmored civilians in Grozny. Urban warfare is the worst, and in CONUS, a large portion of the population is urban. Not a great recipe. I would recommend “Special Operations Forces Medical Handbook”, a compendium of medical care originally created for SOF. Another would be Wilderness Medicine by Auerbach. From the looks of things in Kenosha, people are starting to fight back, going get ugly real quick.

  3. Daniel August 26, 2020 at 13:40

    By now most of us have seen the video of the fella in Kenosha with much of his arm blown away. Let’s assume he’s your Boog-Buddy and you’ve just gotten to his side – how do you treat him? Serious question hoping for a serious answer…

    • NC Scout August 26, 2020 at 14:35

      Got a class for that. Its coming up in November.

      https://brushbeater.wordpress.com/training-calendar/

    • DVM August 26, 2020 at 15:35

      He was OpFor, but to follow your thought exercise, if he were on our side, the following strategy is reasonable: You open his IFAK he’s supposed to have ON HIM and get his gauze or Israeli bandage and cover the damaged area (and, BTW, that WAS IMPRESSIVE for an AR, point blank), wrapping it in place with tape. A tourniquet may need to be applied before you do this. We are still in a time where transporting him to the hospital is the best option after the above is done.

      The time is coming, however, when that is not going to be an option. In that case he will be further cared for at the underground hospital. Please check out the article “Treating Gunshot Wounds in Guerrilla Fighters.” PEOPLE GET READY, THINGS ARE ESCALATING. God bless.

    • Johnny Paratrooper August 26, 2020 at 16:05

      Get him out of the line of fire. Get on top of him. He may be going into shock, or assume you are enemy and try to fight you. Try not to get shot by your own buddy. Tell him who you are and everything is gonna be OK. Be ready to shoot to disable his weapon if he tries to point it at you. And sadly, you may have to kill your buddy to save your life. He will honestly be convinced you are attacking him. He is in fight or flight mode. He may even try to run from you.

      Once you are on top of him and he isn’t a threat,

      -Put your entire weight into his brachial artery (Just below the armpit/above the bicep on the arm) using your knee/shin (doesn’t work with kneepads). You can also use your hands if you have two or more people working on him. The knee works the best. It should hurt like hell. If he complains, push harder. His adrenaline should keep him from feeling too much pain.
      -Prep HIS IFAK for use. Grab the tourniquet and put it on his arm, up to your knee. DO NOT remove your knee.
      -Tighten up the tourniquet, and strap that thing DOWN. It literally cannot be too tight. You wanna get it as high up on the arm as you can. Once the tourniquet is on, remove your knee and begin to strap the tourniquet down.
      -Prep your Gauze and your wrap bandage. You don’t have to stuff the wound with gauze, this is just to absorb some blood so your bandage wrap doesn’t leak a lot. Which it will as the blood that is trapped in his arm loses blood.

      DO NOT USE HEMOSTATIC HEMORRHAGE CONTROL CHEMICALS. IN POWDERED OR PAD FORM.

      !!!! Those require a surgeon to remove, and you don’t have a surgeon !!!!!!

      Write the time/date you put the tourniquet on your buddy. There is usually a place to do this on the TQ. If not, Write it on his Shirt in a FAT CHISEL TIP permanent marker or on his bandage. Prep your guy for shock. Wrap him in a hypothermic wrap(The silver blanket) and raise his legs. Don’t let him eat anything in cause he does find a surgeon. water should be consumed in small sips. If he is unconsious .

      DO NOT FORGET TO STRIP HIM NAKED AND LOOK FOR OTHER WOUNDS. Every medical kid should have an extra set of clothing. Because you are gonna cut his clothes off of him.

      FYI, Your boogaloo buddy is gonna lose his arm. There is too much trauma to that bicep, he will get gangrene(blood poisoning) and die.

      A GSW like that is basically a death sentence in Guerrilla War. His bicep was vaporized.

      If it is cold out, or hot out, the asphalt is gonna roast him, or suck the heat out of his body. It’s best to treat someone like this on the grass.

      NEVER STOP CHECKING ON YOUR BUDDY AND ALWAYS REMIND HIM HE IS SAFE AND EVERYTHING WILL BE OK. Observe the tourniquet for leaks. If the first tourniquet doesn’t work, put on a second one, do not remove or loosen the first. If any of your friends are body builders or are very strong, you might need two tourniquets anyway.

      Remember, just like a car crash victim, he will immediately suffer the effects of PSTD. Being seriously wounded is a very, very traumatic experience.

      Your friend may start hallucinating, and his adrenaline with make him very, very strong. Get ready for a ride if he is living rent free in LA-LA land.

      You should practice doing this now. I am sure there are a million youtube videos on the subject.

      If you friend dies after about 15 minutes, he was “walking dead” before you got too him, and his heart stopped when his adrenaline wore off.

      https://www.youtube.com/results?search_query=GSW+Treatment

      You can spend days watching these videos. In each and every video, they use different equipment and slightly different methods.
      Learn and relearn them all. Watch very carefully.

      I think that was about everything. Don’t forget to look for other wounds on his entire body. Including his buttocks, genitals, and the bottom of his feet.

      I hope I still remember this stuff…

      • Daniel August 26, 2020 at 18:23

        Many thanks, Gents. Those replies were what I was asking for.

        • Johnny Paratrooper August 26, 2020 at 19:32

          Take a class now. And you can practice safely without getting shot at.
          Also, There is a firehouse nearby, and they will give you a class. But remember, that class is oriented towards casualty care. Not Combat Trauma. Scout’s class is combat oriented. The one at the local firehouse is emergency medical. The cool thing about both classes is you will handle, and see different types of gear.

          They might even let you hop up into the ambulance and take a look around if you ask nicely. You never know when that could come in handy.

    • Johnny Paratrooper August 26, 2020 at 16:07

      FYI, Please take Scout’s Class. Combat Casualty Care is a very, very complex subject. And the finer points of blood chokes on limbs are difficult to learn. Similar to hand-to-hand combat, there are subtle details that require hands on, classroom experience.

    • johnyMac August 26, 2020 at 20:52

      Daniel, Tourniquet up high in the arm pit area and tight. Turn the tourniquet arm till the blood stops plus a half a turn.

      Fun fact, Patriotman and I carry a tourniquet as part of our daily EDC.

      Good fun question.

      73 7 God Bless

  4. Curious Passerby August 26, 2020 at 19:52

    I got a copy of my old medical manual and taught my little one on it. 7 years old and he did a great job of examining a casualty, dealing with shock, applying a field dressing, etc. Made one mistake though- I couldn’t find ketchup, so I used sriracha sauce for blood. Wow, that stuff burns worse on the skin than it does when correctly applied to your chow! Also, make little one do his own 1st aid as much as possible. He puts on his own bandaids as much as possible. He’s getting good at it, too. And he can recite what he’s supposed to do. And he knows what’s in the first aid kit. Pretty cool.

    • Johnny Paratrooper August 26, 2020 at 21:31

      Fake blood is about 9 dollars a gallon.
      Yes. I have lots of fake blood.
      Don’t ask. But you can imagine.

      Only use it outside.

      • NC Scout August 26, 2020 at 22:06

        Cornstarch, red food coloring and water.

        • Curious Passerby August 27, 2020 at 00:44

          Ohhhh now you tell me. Well, sriracha is so versatile. It’s a great condiment. It’s great blood effects. It’s a great deep muscle heating ointment. How does it know?

        • Curious Passerby August 27, 2020 at 01:06

          I saw one cool idea in checking out old Red Army equipment. Pre-WWII, they printed cravat-type bandages with a human anatomy diagram and illustrations of how to apply the cravat in various uses, such as sling, head wrap, etc. It was very informational and you didn’t need to speak Russian to use it. I think I’ve seen a German one exactly like it. If you google, “Illustrated Bandages,” you can see a variety of WWI British and US ones. And recently I saw an old pre-2003 Iraqi cravat that was very similar. It seems like a KISS idea and I’m surprised we don’t do the same thing now. If there are any current ones, sorry- I haven’t seen them in my searches. I have seen in recent years commercial survival bandanas with instructions and diagrams on them, such as how to signal for help, light a fire, make a shelter, find North, etc. An idiot’s bandage, though, seems like an idea that should never go out of style.
          Samples:
          https://ehive.com/collections/5254/objects/390448/equipment-illustrated-bandages Brit WWI
          http://quanonline.com/military/military_reference/iraq/field_gear/iraqi_bandage.php Iraqi
          https://www.antipodean.com/pages/books/24725/sanoid-c-c-co-reference-bandage-printed-illustrated-bandage 1850s-era

          Also, as an aside, a few years ago I was at a military history through the ages event at Jamestown, VA. There was a RevWar-era guy doing a medical demonstration. He had a full surgical kit on display. It was fascinating, because most of his tools were essentially unchanged from the Roman-era and are used in somewhat the same form today. Except for the de-worming syringe. That was horrifying. He had a massive pewter syringe for jamming up your butt to de-worm you. Apparently, they lit a fire in one end and blew the smoke up your rear to kill the worms, leading to our saying, “Don’t blow smoke up my rear end.”

          • NC Scout August 27, 2020 at 07:03

            Or better yet, get a class on trauma response and find out what gear we use in the modern world.

        • Johnny Paratrooper August 27, 2020 at 12:18

          That’s exactly what it says on the bottle.

          Right again Scout.

          • NC Scout August 27, 2020 at 12:22

            Eh, it’s just experience. I made some up for a CLS class I wanted to get a little more real for the bubbas going through it.

            Take a spray bottle and spray them in the face with the fake blood while they’re applying a TQ. Adds realism.

          • Boat Guy August 29, 2020 at 09:11

            The spray bottle idea below is brilliant. Absolutely stealing that one

    • Quietus August 26, 2020 at 23:49

      Seems like Stephen Stills had some lyrics about teaching your children well. Fine job on your part.

      Aside: I wonder if Stephen Stills would still come down on the commie side these days. Having heard nothing to the contrary, I assume he’s still above ground.

      • Boat Guy August 29, 2020 at 09:08

        Enough on the commies side to play at their convention

  5. Anonymous September 10, 2020 at 13:19

    5

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