Care in the line of fire

November 3, 2011 5:45 AM

Fran Simon

Tulane trauma expert Dr. Norman McSwain has returned from Ecuador, where he led doctors and medics from 10 Latin American countries in tactical combat casualty care training. 



Dr. Norman McSwain is an expert in prehospital trauma life-support training who led doctors and medics from 10 Latin American countries through rigorous scenarios. (Photo by Rick Olivier)

McSwain, a professor of surgery, taught training techniques to a group of 25 caregivers. These, in turn, will relay the skills to front-line caregivers who, according to McSwain, “have to take care of wounded patients while the bad guys are still shooting at them.”

McSwain pioneered the development of prehospital trauma life-support training in 1981, and worked with the National Association of Emergency Medical Technicians (NAEMT) to publish the textbook on the subject. The textbook is now in the 7th edition and translated into 11 languages. Since that time, about 700,000 emergency medical technicians in 55 countries have been trained to care for injured persons until they can receive hospital care.

In 2002, the combat version of the textbook was published, providing the curriculum for training military.

Once in Ecuador, McSwain and an NAEMT colleague learned to adapt the curriculum to the specific needs of the Latin American countries, including Mexico, where combat situations might include bank robberies, battles with drug lords and hostage situations, events that McSwain says are “far more common events than we think about in the United States.”

Combat situations require basic skills for treating trauma but also require specific considerations, such as knowing how to quickly put a tourniquet on yourself while caring for the wounded. Foremost is learning skills to keep yourself and the patient out of harm’s way.

“You wouldn’t put in an endotracheal tube in that kind of environment,” says McSwain, “because the minute you turn on the laryngoscope, the light would draw fire.”



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