TEMS: Rescue Task Force Tools PERSONAL PROTECTIVE EQUIPMENT, BALLISTIC PROTECTION, MEDICAL SUPPLIES Module 3/5 Prepared by B. Carr

OBJECTIVES Personal protective equipment—PPE—is designed #1 UNDERSTAND ROLE OF PPE IN TACTICAL AND IDLH ENVIRONMENT OBJECTIVES Personal protective equipment—PPE—is designed to minimize and counteract various hazards. PPE must match the range of hazards and risks presented to responders. A tactical environment can present numerous hazards. #2 REVIEW BALLISTIC PROTECTION CLASSIFICATIONS #3 REVIEW TEMS MEDICAL SUPPLIES Ballistic protection remains central to tactical EMS response. Some medical supplies provide an advantage in the tactical environment. Thanks to ease of use and design, “TEMS” equipment counterbalances challenges of wounds from ballistic injuries.

Personal protective Equipment

Personal Protective Equipment ORGANIZATIONAL PRINCIPLES BALLISTIC-SPECIFIC PPE Personal Protective Equipment Equipment worn to minimize exposure to serious injuries and illnesses. Injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Consider preplanned or in-route hazard assessment for wide range of possible hazards: impact, penetration, compression, ballistic, chemical, biological, fire, heat/cold, sonic , optical energies. Personal Protective Equipment categorized by area of body protected. Eye and Face Head Foot and Leg Hand and Arm Body Hearing Designed to provide protection against ballistic and impact-energies. Traditional “body armor” does not effectively protect wearer from stabbing or sharp-tipped objects. Body armor generally developed and tested to withstand energies from standard bullets.

Ballistic Protection Classifications Certifying and Compliance-Testing Bodies NIJ Levels of Protection and Classification Ballistic Protection Classifications National Institute of Justice (NIJ) develops standards and performs compliance testing for US law enforcement body armors. US and NATO military armor designs are tested using a standard set of test methods under ARMY MIL-STD-662 and STANAG 2920 ( 2nd ed.) Current NIJ standard for Ballistic Resistance of Body Armor (July, 2008) can be accessed using the following link. NIJ Standard SOFT BODY ARMOR Ballistic resistant fabric. (e.g. Spectra, Kevlar, Twaron) Type IIA: Usually stops 9-mm full-metal-jacketed bullets from 4-inch barrel, as well as .357 Magnum, semi-jacketed, soft-point bullets fired from 4-inch barrel. Type II: Stronger than IIA. Usually stops 9-mm full-metal-jacketed bullets from 5-inch barrel, as well as .357 Magnum, semi-jacketed, soft-point bullets fired from 6-inch barrel. Type IIIA: Stronger than IIA and II. Stops mandated 9-mm full-metal-jacketed bullet fired from 16-inch barreled carbine, as well as .44 Magnum fired from a 6-inch barrel. HARD BODY ARMOR Rigid inserts for added threat protection. Type III: Designed to protect against the common M-4/AR-15 rofle round and also center-fire rifle rounds. Type IV: Highest and thickest level of protection. Protects against armor piercing (AP) round as usually fired from hunting rifle, Garand, or similar rifle. JH F/EMS TEMS Ballistic Protection Type TITAN Assault Enhanced Carrier with Type IIIA armor inserts Ballistics protective helmet TEMS PPE CURRENTLY ON SUPPORT 19 in labeled containers

TEMS Medical SUPPLIES

Emergency Bandage (click for usage video) aka “The Israeli” COMMON PRACTICE IN UNCOMMON ENVIRONMENT “TEMS” EQUIPMENT Tactical environment doesn’t change how medical gear works. It does demand that personnel adapt equipment use to dynamic situations. Protocols and treatment guidelines generally remain active unless incident exceeds aggregate surge capacity of local hospital and necessary legal steps are taken to append or change existing care/treatment guidelines. In other words, maintain scope of practice and use equipment as directed by current guidelines. Tourniquet CAT standard application Emergency Bandage (click for usage video) aka “The Israeli” compression and absorption in single, rapid application QuikClot (click for usage video) kaolin infused gauze for packing non-compressible areas (axillae, groin, etc.) Decompression Needle rapid, easily stored method for counteracting tension pneumothoracecs Evacuation Litter carrying device to support and hasten patient extraction and movement

SUMMARY

Align PPE to hazards…assuming the worst. SUMMARY Align PPE to hazards…assuming the worst. Know limitations of PPE and ballistic protection. Maintain familiarity with standard EMS procedures and execute them as needed on TEMS environment (e.g. tourniquet use, tension pneumothorax needle decompression) Utilize TEMS medical equipment as needed to support patient care operations Practice patient carries and utilize litters as needed References National Institute of Justice, Standard-0101.06 Forthcoming (Module 4/5) Rescue Task Force Expectations: Direct Threat Care, Indirect Threat Care, Medevac Review of each care levels’ goals, principles, and guidelines