It’s always better to have proven, dedicated medical equipment in an emergency.
However, at some point in your life, you will be someplace where you simply won’t have that equipment available. In Army Special Forces, there is a PACE mnemonic used in planning: What’s the Primary plan? The Alternate plan? The Contingency plan? The Emergency plan? The Emergency Plan is sometimes referred to as the “Everything went to shit plan.” All casualties with improper improvised tourniquets evaluated at one receiving hospital in Boston after the Marathon bombing arrived with ongoing bleeding and had to have commercial tourniquets placed in the emergency department. None of those improvised tourniquets used a windlass. Likewise, many other well-intentioned “tourniquet applications” in the news are at best pressure dressings and at worst, venous constricting bands.
If you have a fire in your house, it’s best to use a fire extinguisher to attempt to put it out while waiting for the fire department. However, you’ll settle for a bucket of water if you have to, rather than standing back watching the fire get out of control and potentially burn down your house.
Average EMS response time is more than 5 minutes, during which some casualties will die if not immediately treated. Improvised techniques can save lives. The more you begin to see improvised equipment in your everyday surroundings, the quicker you’ll be able to respond and save a life without dedicated equipment.
The techniques posted here have some evidence and proof of concept to support their use in an emergency when better materials simply aren’t available.
Improvised Part 1: Water Bottle for Junctional Hemorrhage
Improvised Part 2: Sheets for Bandages
Improvised Part 3: Strips of Sheet as Tourniquet
Improvised Part 4: Wound Packing
Improvised Part 5: Pillow Case V1
Improvised Part 6: Pillow Case U v2
Improvised Part 7: Wound packing bandage magazine
Improvised Part 8: Litter & Hypothermia prevention
Improvised Part 9: Wound packing neck
Imrovised 10: axilla wound packing bandage
Adult Improvised pantleg tourniquet
Pediatric Improvised pantleg tourniquet
Improvised Junctional Tourniquet
Battlefield recover chairs as improvised litters
Improvised - Blog Posts
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Like our improvised ideas? You should see what we can teach you with dedicated medical equipment
Our Student's Experience
The Advanced TC2 class was invaluable
The Advanced TC2 class was invaluable. I’m glad this course was more than just learning about tourniquets for hemorrhage control. Having the hands-on practice of wound packing, wrapping junctional wounds, and needle decompression on real models has given me a lot of confidence in my ability to address more than just bleeding out of arms and legs.
The online course including wound packing videos was very helpful and informative. I think [our police] officers have a lot of comfort with tourniquets but because they’re only for arms and legs, and it was interesting to be given a possible solution for bleeding from other areas of the body where the tourniquet wouldn’t be appropriate.
Sergeant Jamie Beane | Beaverton Police Department, Oregon
A wealth of information designed to allow us to make good decisions when shit goes wrong.
I was in your Tactical First Aid class in June of 2016. I loved the class, both lectures and demos. A wealth of information designed to allow us to make good decisions when shit goes wrong. 734 days later, last Saturday, I was at the range for a steel challenge match and ended up addressing a 9mm ball round through a guy’s thigh. I was so glad I took that class. I was so glad that I took YOUR class. Thank you for all the help.
The guy is fine. What struck me after the fact was that I didn’t consciously decide to take action, I just hauled ass around the berm and found myself gloved up and cutting a dude’s pants. It wasn’t a matter of confidence, more a deeper sense of duty (or maybe I just relished the opportunity). Your class made me a better person simply by triggering a more worthwhile response.
Thomas Alldredge | Mechanical Design Engineer, B.E. Meyers & Co., Inc.
It is important to learn tactical care techniques as we are the first line of protection for our students.
I completed the Tactical Casualty Care course both in person and online. Being an educator at an elementary school, I think it is important to learn these tactical care techniques as we are the first line of protection for our students. The techniques can be used in any type of emergency situation earthquake, fire, and during active shooter situations. Mike is a great instructor providing information that is easy to understand, remember and replicate. I feel confident that I can help save a life!
-Ashley Parson | Extended Programs Manager | German International School
I learned more than I did in 10 years of practicing medicine
Complete Tactical Casualty Care Course
Thank you for teaching such a fantastic course! I learned more in the past week than I did in all of my education and the last ten years of practicing medicine. Thank you for what you do!
Rachel Stappler, PA-C, MHSc | Physician Assistant and Reserve Police Officer
Our School leadership team learned crucial skills in a clear and accessible manner
As a school administra
Thanks much Crisis Medicine and please keep up the good work.
Blake Peters, Head of School | German International School of Portland
I feel much more prepared after this course (on-line TC2). I am a South African Police officer…
I feel much more prepared after this course (on-line TC2). I am a South African Police officer, am certified in First Aid, and also did the Control The Bleed course (the same one you have in the US) recently.
This TC2 course really really taught me a lot. I like the style in which Mike presents it and I value his opinions. The course stimulated me to think about certain concepts and I will surely carry this knowledge with wherever I go.
MS | South African Law Enforcement
This ranks in the top classes I have taken. Maybe the best. Exceptionally well done!
I just completed the [online] TCC course and thought I’d drop you a note and let you know how much I liked the course. Actually loved the course! I am a CPA and over the years have done a ton of CPE to maintain my certification and this ranks in the top classes I have taken. Maybe the best. Exceptionally well done!
Thank you for providing this material. I hope I never have to use it, but as with CPR, you never know. I have had to use CPR a couple times, so I’ll sleep better after taking this course should I ever be in a situation where these skills are needed.
Highly researched, packed with examples, and delivered with top-notch production quality…
Tactical Casualty Care is the holy grail in crisis first aid training. Mike Shertz expertly distills his decades of experience as a Special Forces Medic and as an Emergency Room Physician into a powerful fact-filled training that leaves you confident knowing what to do in a crisis first aid event. Mike cuts through urban legends and misinformation and shows, through research and real-life situations, what works and what doesn’t. Mike has seen it, done it, and knows how to share it in a powerful presentation style that sticks. Everyone can benefit from this important information. Highly researched, packed with examples, and delivered with top-notch production quality, this online course will give you skills that can mean the difference between life and death for someone you love or anyone you may encounter who needs crisis first aid
Douglas Taylor | Global Director of Enterprise Risk Management (Retired) | Fortune 1000 Worldwide Consulting Organization
As a medical director for several fire departments, I can say it is the BEST trauma course you can take.
I have taken the 5 day TCCC class twice. As a medical director for several fire departments, I can say it is the BEST trauma course you can take.
John Heiser, MD
In seamanship, the primary rule is: keep the water out. This class could be nicknamed: keep the blood in.
In basic boating seamanship, there are a couple of primary rules and one is: Keep the water out. Dr. Shertz’s class on Tactical Casualty Care could be nicknamed: Keep the blood in. Dr. Shertz is a dynamic and crisp instructor and a compelling educator. I unlearned years of Hollywood war movie myths on what a bullet does to the body and learned what really happens when a person (or gelatin) gets shot. Most importantly I learned what I could do to help ‘keep the blood in’ and how to go about that to a reasonable degree. Both the classroom and hands-on instruction were thorough and I recommend the class to anyone who wants to become more educated in tactical casualty care, or wants to possibly be of use if found in a direct or indirect threat event with casualties and minimal equipment.