Crisis Response Group LLC

#theoriginalblackberet #rltw #ranger #medic #tccc #tecc #battboys #crgtactical #thesethingswedo #soothersmaylive #kitup

Back to the basics. BLS recert for my EMTs today. #americanheartassociation #aha #bls #cpr #aed #firstresponders #emt #paramedic #cct #rn #trauma

MECHANICAL VENTILATION Volume Modes: Assist-Control Ventilation (ACV)... Also known as continuous mandatory ventilation (CMV). Each breath is either an assist or control breath, but they are all of the same volume. The larger the volume, the more expiratory time required. If the I:E ratio is less than 1:2, progressive hyperinflation may result. ACV is particularly undesirable for patients who breathe rapidly they may induce both hyperinflation and respiratory alkalosis. Note that mechanical ventilation does not eliminate the work of breathing, because the diaphragm may still be very active. Synchronized Intermittent-Mandatory Ventilation (SIMV) Guarantees a certain number of breaths, but unlike ACV, patient breaths are partially their own, reducing the risk of hyperinflation or alkalosis. Mandatory breaths are synchronized to coincide with spontaneous respirations. Disadvantages of SIMV are increased work of breathing and a tendency to reduce cardiac output, which may prolong ventilator dependency. The addition of pressure support on top of spontaneous breaths can reduce some of the work of breathing. SIMV has been shown to decrease cardiac output in patients with left-ventricular dysfunction. ACV vs. SIMV Personal preference prevails, except in the following scenarios: 1. Patients who breathe rapidly on ACV should switch to SIMV 2. Patients who have respiratory muscle weakness and/or left-ventricular dysfunction should be switched to ACV Pressure Modes: Pressure-Controlled Ventilation (PCV) Less risk of barotrauma as compared to ACV and SIMV. Does not allow for patient-initiated breaths. The inspiratory flow pattern decreases exponentially, reducing peak pressures and improving gas exchange. The major disadvantage is that there are no guarantees for volume, especially when lung mechanics are changing. Thus, PCV has traditionally been preferred for patients with neuromuscular disease but otherwise normal lungs Pressure Support Ventilation (PSV) Allows the patient to determine inflation volume and respiratory frequency (but not pressure, as this is pressure-controlled), thus can only be used to augment, spontaneous breathing.

TacMed-Pistol Course 9/12/2020-Sold Out ... #tacmed #pistol #careunderfire #tecc #tccc #crgtactical #ranger #medic #firstresponders #threatmitigation #ems #police #bluelivesmatter #thesethingswedo #soothersmaylive See more

Trauma Alert #trauma #ems #emt #paramedic #flightmedic #rn #cctrn #mercyair #firstresponders

Repost from @the_resuscitationist Horrific news out of Beirut, Lebanon today. I don't have the full details and won't comment on specifics. Generalized mass casualty and large destruction being reported. Moments like this are why we train. QUICK REVIEW ON BLASTS...... . BLAST INJURIES: Various causes include work place unintentional, radiation, "dirty" bombs, IEDs, chemical/biologic explosive weapons. SPALLING EFFECT: organs with air-fluid or "hollow viscous" organs susceptible to blast pressure injury Ex. Alveoli, GI tract, Tempanic Membranes INJURY CLASSIFICATION 1. Primary- direct effect from shockwave (the blast pressure itself). 2. Secondary- objects causing injury (amputations/penetration) 3. Tertiary- injury from body being thrown and/or hitting against objects 4. Quarternary- environmental such as burns, toxins, weather 5. Quinary- fallout / long term effects from bodily absorption or contamination. ORGAN SYSTEM SPECIFIC 1. HEENT: eye injuries, TM rupture, hemotympanum, auditory (ossicle) injury 2. PULM: most common fatal primary injury "blast lung", pulm contusion, pnx, ards, pneumomediastinum, hemothorax 3.CV: blunt cardiac injury,collapse, tamponade 4. MSK: fractures, burns, amputations, compartment syndrome 5. NEURO: tbi, bleeds, DAI (diffuse axonal injury) from shear forces 6. INFECTIOUS 7. FOREIGN BODIES 8. RADIATION (cell injury) . . NOTE: continue scene safety, hazmat/fire control, mass casualty triage considerations, MARCH algorithm! . Video pulled from @wildernessdoctor #ems #medic #paramedic #physician #er #emergency #hospital #teach #medical #doctor #doc #dr #rn #nurse #emt #pa #news #lebanon #beruit #explosion #video #hospital #blast #train #medical #emergency #surgeon #internationalnews

Repost from @tacticaltrainingguide Ryan Besneatte - CRG Tactical @crg_tactical... Favorite Handgun: @dynamicweaponsolutions Glock 17 @trijicon SRO @firstdefense_usa stipple job @overwatchprecision DAT trigger Favorite Rifle: @danieldefense 16 AR @jprifles trigger @clouddefensive owl Favorite Class: TacMed-Pistol Course Favorite Drill: Care Under Fire drill. Students run through tactical trauma care stress shoot using proper TacMed protocols in the Hot/Warm/Cold zones. From: Orange, California Where do you teach: Teach courses in California, Nevada, Arizona. If you have a range to host, have gun will travel. Background: Former Army Ranger with the 75th Ranger Regt. 14+ years as a Trauma RN/Critical Care Transport Nurse. Dept. of Homeland Security TacMed Instructor. High School Wrestling coach. Enjoy USPSA shooting competitions, hunting, camping, wrestling, BJJ. Huge thanks to Ryan for the help getting this post together! If you would like to take a class from Ryan, go to @crg_tactical

Happy 4th birthday to my only daughter. Riley is an awesome dog, and great protector of our family. #gsd #protector #k9 #happybirthday #goldensablegermanshepherd

Cole Range: The place nightmares are made of. I can still hear RIs yelling Hit the wood line. ... Other than the constant smoke sessions and log PT, I enjoyed the land navigation course. It was the first time we were left on our own the a map, compass and a set of grid coordinates. It was actually a fun time minus dodging all the Water Moccasins! #ranger #medic #rip #colerange #hitthewoodline #landnav #rangerbuddy #75thrangerregiment #rltw See more

Repost from @persys_medical Tactical Combat Casualty Care (TCCC) revolutionized our approach to trauma by utilizing evidence-based medicine in replacing the antiquated ABCs with the MARCH mnemonic. Not familiar with MARCH? Follow this Instagram account. Even better, get training in TCCC/TECC/Stop the Bleed and ensure you are prepared to save a life!... . . . #beready #tccc #cotccc #tecc #trauma #stopthebleed #firstaid #firstresponders #march #ebm #ems #emergencymedicine #ifak See more

Its never a bad day on the range with the boys. #crgtactical #2a #ironsharpensiron #saturdaysarefortheboys #rangedays #ranger #medic #traumarn #tacticalrn #rltw

***Public Service Announcement*** Do not shoot other people’s crappy reloads. ... While running a student through the @redbackone ORT Drill he had a catastrophic malfunction resulting in a destroyed upper and bolt carrier group. You can see the energy blow out the magwell and destroy the magazine saving the shooters face. He was apparently using reloads given to him by a friend that might have been 20-30+ years old. #catastrophic #malfunction #ar15 #dontshoototherpeople #crgtactical See more