Greetings, fellow Partisans! I’ve been very tied up with refining my local readiness setup, due to the coming storm, and that’s taken up pretty much all of my time outside of work and family. Things are certainly getting pretty weird out there! I do hope to get back to posting on fitness topics in the next few weeks. Today’s post, however, is an After Action Report (AAR) covering my most recent new training module, which was the Partisan Lifesaver Course, offered by Stuck Pig Medical / MechMedic (the course instructor) via Brushbeater Training and Consulting. The course took place over the weekend of October 15 – October 17 in North Carolina.

It had been a very long time for me – exactly 7 months pretty much to the day since I’d last participated in any new tactical training courses – the last course being Brushbeater’s Fighting Carbine back in mid-March. Driving down to North Carolina from Western New York is a 9+ hour affair, and only now, I was able to free up some time to head south for new training (and a visit or two to Waffle House, which we sadly don’t have up here). I had wanted to do the Tactical Combat Casualty Care (TC3) course some months ago, but again, I just couldn’t free up the time due to local obligations. The silver lining here was that, although I couldn’t make any of the previous 2-day TC3 offerings through Brushbeater, I was able to get a beefed-up medical training course from Stuck Pig Medical by taking the newly-offered 3-day Partisan Lifesaver (PLS) Course instead. 

The course had only four participants, a total group of five altogether with MechMedic instructing. While I was disappointed that more people didn’t participate (as the PLS course teaches incredibly vital skills), there was definitely a benefit in the small size of the group, which permitted for a great exchange of ideas, greater in-depth coverage of various relevant subjects, and a lot of camaraderie, which made things more enjoyable and interesting. We even had a seasoned dentist among us who enriched the course quite a bit with his medical-side inputs. Even before the course began, it was clear that MechMedic had gone to great lengths to bring what appeared to be damn near all of his medical gear – an entire SUV full – to display, in order to support our training. An array of small and large packs, each filled with different types of medical interventions from the individual level to the squad and platoon and vehicle levels were all brought for presentation – it was clearly a lot of work to get it all prepared, loaded, and unloaded for the class, but these pieces of medical/trauma kit were indispensable to the overall training and education. 

Partisan Lifesaver Course – Taped Pressure Bandage Application

Getting right into things, we were each given a well-organized booklet by MechMedic to refer to during and after the course, which was very helpful. The PLS Course instruction started out with MechMedic unloading a lot of combat trauma care knowledge right out of the gates, covering the realm of combat, traumatic injuries, and the very specific care that is needed for the extreme injuries we might encounter in a combat scenario (which is becoming less far-fetched by the minute). Now, I had previously been an instructor in First Aid and CPR for the American Red Cross for many years in my younger days, but really, the stuff I taught there didn’t even scratch the surface of “battlefield medicine”, as MechMedic presented it. Early on, we also go into the differences between the role of a civilian EMT/Paramedic vs. a Combat Lifesaver – the one (EMT/Paramedic) deals with a wide cross-section of the population and the illnesses/issues you might find there: diabetic emergencies; dialysis patient transport; falls; breaks; heart attacks, and so on; the other (Combat Lifesaver) deals with a much more specialized type of medicine: keeping young fighting-age men (and women) alive after experiencing the grizzly injuries that can occur on the battlefield. Let’s face it – civilian first responders probably aren’t dealing too much with gaping wounds, gushing blood, and scattered body parts (not yet, at least). The distinction was interesting, and very relevant. It also set a very somber tone for the rest of the course – I knew early on that I wouldn’t be dealing with much stuff like 350 lb. fatbodies needing transport to the ER because they were in cardiac arrest, but rather, that I might have to close holes in my own Brothers in Arms if and when the time came, so that they might live to fight again. 

Partisan Lifesaver Course- Nasopharyngeal Airway Insertion

The first day of the course covered the basics of the lifesaver’s role, but MechMedic also made sure to go well beyond the doctrinal information that is taught to the armed forces medics; whenever relevant, MechMedic filtered the information through the lens of the Partisan Lifesaver – clearly a combat lifesaver of sorts in the traditional sense, but somewhat different in our particular situation and potential needs – for example, that we might not have a big old hospital or medical system to receive our injured, and what considerations might accompany that harsher reality. We covered the basics of care, using the acronym “SMARCH”, which stands for “Shoot Back (Achieve Fire Superiority) / Massive Hemorrhaging / Airway / Respirations / Circulations / Hypothermia” – the causal order by which a casualty will die due to traumatic injury. So one by one, we went into painstaking detail (an absolute must, especially for this particular subject matter!) on each step of the immediate trauma care process. Again, as we learned these skills, I would picture in my mind the scenario necessitating this type of care – for example, sticking your fingers into holes (that shouldn’t be there) in the casualty to see where exactly they are located, and then plug them up. Like… damn. But someone’s gotta do it, and I was glad to finally be acquiring these skills. We also did some practical exercises in class that day, such as applying tourniquets, chest seals, and decompression needles. However, the real hands-on field work was saved for the final day (Sunday), which I’ll get into in a bit.

Partisan Lifesaver Course – Wound Packing with Yoga Block

As far as the instruction, MechMedic had a very receptive and friendly style about his training, and was great about answering questions, of which I usually have many – I’m a detail guy, and MechMedic was all about it! I struggled a bit to capture everything in my notes, but MechMedic was patient about helping me fill in any gaps in my notes or in my understanding, and I really appreciated MechMedic’s accommodation on this front. And once again, I really appreciated the Partisan angle on the training; MechMedic encouraged us to consider important things that might accompany a WROL scenario, like setting up field hospitals, vehicles we might consider to carry on our operations, and allies (like veterinarians and dentists) we may recruit for advanced care, which is a necessary follow-on to the initial trauma aid we provide as the Partisan Lifesaver.

For Day 2 of the PLS Course, we did a thorough review of the previous day’s oodles of new info, at which time I was able to add more refining details and get additional clarifications on the information taught the day before – very helpful, very useful. Then, we got into new information and skills, specifically, “E-PAWS-B”, which stands for “Eyes / Pain / Antibiotics / Wounds (cuts, scraps, and bruises) / Splints / Burns”. Lots of new and vital information contained in that second part of the PLS Course, and again, MechMedic went into detail on each type of care, one by one. The small class size really permitted for getting into the weeds to yield additional information on each of these areas of care, and I was very glad to be getting such a rich, in-depth look at them all – I believe it will help the participants to be better care-providers if/when we have to assume the PLS role one day. And again, the PLS Course served to subtly sensitize the participants to the ugly reality of trauma by covering stuff like eyeballs hanging out of the eye socket. Pretty grim, for sure… but such is what is possible, and the Partisan must be realistic about it.

Partisan Lifesaver Course – Avulsed Eye Bandage “Doughnut”

On Day 2, we also covered the subject of litters upon which to carry casualties (as pictured at the top of the post), which was very interesting. In fact, we necessarily covered lots and lots of critical gear for the PLS; new gear means new costs but… these medical items are vital to the PLS, and require consideration. The knowledge is powerful. MechMedic was really thorough in his coverage of all these areas of care, and really I don’t think he was ever caught off guard not knowing something. You could tell he just knew his shit.

Also on Day 2, MechMedic got into what ended up being one of my favorite modules of the PLS Course, which was a breakdown of the full spectrum of different trauma medical kits for pretty much any occasion or setting – a close look at the array of kit he hauled in. Starting with the EDC Ankle IFAK, to the Fanny IFAK (for when things start to get “spicy” and are heading towards a WROL scenario), to the Combat Lifesaver Pouch, to the Medic Pack to the Truck Bag… I was really, really digging the detailed look at the contents of these packs and their functions, especially now that we had gained a deep understanding of the purpose served by so much of that gear. Of course, there were many materials and much gear presented in the PLS Course that we as the future PLS’s may or may not know or choose to use, like blood transfusion bags, sutures, scalpels, and the like. But… at least we got a broader horizon of what’s out there and what’s possible via MechMedic’s pack display and explanations, giving us an idea of other paths we might take to enhance the PLS skills we were learning. The part of the PLS Course about medic kits really brought together a lot of the course’s concepts in a practical, consolidated way.

Day 3 of the course, the final day, started with a wide-ranging review of everything we’d covered until then. By this point, the four of us course participants were “armed” with a large amount of knowledge that was now ready to be applied in real-time. We were all quite anxious to go hands-on with our skills, and MechMedic didn’t disappoint here either! He brought “Gerald” the medical mannequin for us to work on, as well as an array of realistic props, like fake blood, clothing to cut away, and even Load-Carrying Equipment (gotta love that Type 89 Chest Rig) to strip from Gerald. All materials were available in abundance for us to practice our skills, and the level or realism was high, right down to use of blanks by MechMedic to simulate combat sounds for when we had to find our casualty, establish fire superiority, and provide follow-on PLS care.

The course participants took turns simulating the SMARCH process on Gerald after he’d experienced battlefield trauma. We had to cut away his clothes, find the bleeding, apply tourniquets, and deal with his amputation and other bleeding. We also had to sweep Gerald’s body for additional wounds, apply chest seals, get him on a litter, and haul him away to the medical treatment area while also reassessing our medical interventions along the way. MechMedic also had us check vitals several times, note down our findings to start charting Gerald’s condition, and apply other important skills that are part of the PLS’s duties. This was a good time for us as students to make mistakes and learn from them, since the care process is simple, logical, and straightforward, but does have many parts and details, as well as an order that needs to be followed. MechMedic helped us through it all, and added fine points to tighten up our PLS “game”. I believe I speak for all participants when I say that the repetition and hands-on allowed us to learn a huge amount of information and many trauma care skills in just a single 3-day period. I truly didn’t know anything about trauma care going into the course, but after having taken the course, I now feel confident that I have a good base from which to develop real proficiency and PLS skills (which, of course, absolutely need regular practice). 

Partisan Lifesaver Course – Field Exercise with Gerald the Medical Mannequin

All in all, the Partisan Lifesaver Course by Stuck Pig Medical / MechMedic was really outstanding, like every other course I’ve taken with/through Brushbeater, and worth every effort to attend. It’s just the truth. And as an added bonus, the fellowship we all enjoyed after course hours was unbeatable – just a bunch of dudes with common interests laughing it up a lot in the evening and having a good time; the atmosphere was always very relaxed and fun, and MechMedic was just as comfortable hanging out after course hours as he was on top of training in the role of the instructor. I firmly believe that a relaxed atmosphere works best when learning new skills, and so this offering really could not have been any better from any point of view!

In conclusion, I highly recommend the Partisan Lifesaver Course to ALL Partisans. Don’t waste any time – get your ass to a PLS Course or TC3 Course ASAP! You’ll be glad you did.