Common Infantry Tasks Testing-The Basic Requirements Applied To Survivalists

 

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This is a follow up on a line I used in a recent post which was, “Are there Infantry skills that you should master? Hell Yes!” In the past, I posted about the Army’s Common Task Testing these are the standards every soldier has to perform and show proficiency in every year. This is an Infantry only version of that same “Tasks, Conditions, and Standards” type testing. This is Level 1. Level 1 is for the Private (PV2), PFC, and Specialist in the enlisted ranks. This is the lowest and most basic level of requirements the Infantry expects from it’s Soldiers. As with the CTT post, I have selected what I believe are the realistic tasks that a Survivalist who mean to go into harms way should have a basic understanding of, if not proficiency in. To use the recommendations here, go to the link posted below and look up the block you desire to learn the tasks, conditions and standards for. Below the first block, there is an example of the tasks, conditions, and standards for “Operate Telephone Set, TA-1/PT”.

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This PDF can be found here

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This page tells how to read the charts

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This page also shows how to read the following pages

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Whether you are a “Commo” guy or not, you have to have a basic understanding  of the group radios and how they work.

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An example of the “Tasks, Conditions, and Standards” for “Operate Telephone Set, TA-1/PT”

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More commo, using the GPS, range finding, and team member movement.

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GPS, night fighting technology, and some individual tasks

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Handgun tasks

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Use and maintenance of rifle optics w/ reticle range finder, Mine/IED/Boobytrap threats

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Rifle use and mounted night fighting devices

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You might not have an Automatic Rifle (SAW) or a machine gun now, but it’s good to understand the basics and standards required to use them (they are the standards for a reason). Here’s two videos for the  M249 and M240B

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Obviously, there isn’t any Survivalist/Prepper related tasks in this block, but you need to understand that all these tasks are the tasks that the Private, PFC, and Specialist are required to show proficiency in, either at OSUT (Basic and Infantry School) or once they get to their unit.

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JCD

American by BIRTH, Infidel by CHOICE

 

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Part 2 Of “Are You A ‘Snowflake’ Or A ‘Meteor’?” Becoming A Meteor.

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Last week a group of four Combat Arms Veterans contributed to a post I wrote concerning the premise that, “on a good day, a civilian that has taken 3 or 4 SUT type classes from a Tactical Trainer won’t even be at the experienced Infantry PFC level”. Although the majority of the comments, both here at MDT, over at WRSA,  and in personal emails were positive, even though there were still those who are still unwilling to mesh reality with their delusions of grandeur, concerning their level of training, and it’s comparison to that of the experienced Infantry PFC.

I have mentioned a number of times (these highlighted links are just a few examples) a variation of this theme, “You are not a Commando/Infantry, but you do not need to be.”. I actually had a guy say, “YES! and if you had just said it this way from the beginning then you might not be getting any negative feedback.” to part of my response to another comment he had made. My actual comment to him consisted of this, “Here’s the thing, “You can’t be what we are/were without doing what we do/did (BUT YOU DON’T NEED TO BE).”.

Let’s talk about that phrase for a minute. “You can’t be what we are/were without doing what we do/did (BUT YOU DON’T NEED TO BE).”. The question I’d imagine most SAC’s (Situationally Aware Civilian) have is, 1) How do I put myself on par with a guy who has not only gone through a 4 month One Station Unit Training course (Basic and Infantry School)? 2) Do I need to put myself on par with that guy to have a chance at surviving what is coming?

This post is about some of the “What”, the “Why”, and the “How” of “Combatant/Survivalist Skills” needed for the Neighborhood Protection Team member, or Survivalist. You are not Infantrymen, you have to be much more. As I have said a number of times, “Be a Survivalist who is a ‘Jack of all Trades’, master of some (preferably the life saving and life protecting arts).”. Are there Infantry skills that you should master? Hell Yes! In this post I mentioned the Army’s “Everybody requirement” concerning Common Task Testing. This is not an “Infantry specific” requirement, but an “Everyone” requirement. Have you mastered the tasks in that post? Even the “Water Purification Specialist” in the Army has to show proficiency in those tasks.

Most of you want to pick and choose what you want to learn, and what you want to avoid, and that doesn’t cut it if you are serious about surviving a combat scenario. This is what I said in the post, “If you can’t show proficiency in the common tasks of First Aid, Commo,  Land Nav, Movement as a Buddy Team and in a patrol, and be proficient and accurate in the use of your primary weapon, when even a Dental Hygienist in the Army has to do it every year, how do you plan on functioning in an ‘Infantry’ type role?”. Remember that? Probably not huh?

Something else of note that was “made clear” in one of the comments on the last post was that we apparently don’t explain terminology well enough. The terms in question were “Offensive” (you are taking the fight to the bad guys) and “Defensive” (you are defending what you already have secured against the bad guys) in the context of operations. My response was thus, “You make out like we treat you like you are stupid, then get pissed when I don’t explain simple terms like “Defensive” and “Offensive”. Make up my mind, are you guys a bunch of illiterate, dull eyed retards, or are you rational, generally above median, adults (like I believe you are)?”.

This type of juvenile criticism is one of the reasons many of you get grief from people that are knowledgeable and experienced in the craft you wish to learn. So here’s the deal,  if it is a term that is specific to the subject I am writing about, and not in common use, I will explain and define it. If it’s something simple like the two terms above, I expect you to look it up via google, a dictionary, or any of the following Field Manuals: FM 7-8, FM 21-75, ST 21-75-2 (presently the SH 21-76), or the ST 21-75-3.

What follows is the thoughts of the same four Combat Arms Vets who contributed to the first post. They all have a unique perspective, but you will notice, once again, a recurring theme. After the last contribution is complete, I will give some thoughts in closing.

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Where You Are, Where You Need to Be, and How You Get There…One Way

 Background of the Vet:  21 plus years active duty in the USAF; retired as a Senior NCO.  Of that time, 12 years in Air Base Ground Defense (Air Force for ‘Infantry’); comprised of 5 years teaching advanced ‘infantry’ training, rated “Master Instructor”, specialized in patrolling, 5 years on a RDT (Rapid Deployment Team) for 81mm Mortar & Hostage Rescue concurrently.  5 years as NCOIC of Air Base Ground Defense at field units building and conducting local unit training.  

 In relation to the previous post regarding training and capabilities from those wishing to increase their personal skills for defense of home and community, my perspective is the following based on my own interaction with people asking for training over the last 17 years:

Where You (or the group you’re in probably) Are:

Awake to the precarious position of our society, economy (over-inflated market reports notwithstanding), and culture (the ever-increasing lack of civility and respect for individual property and natural rights). 

  • Equipped, armed, and supplied to various levels from a minimum of a pistol, a rifle, and 500 rounds for the pistol and 1,000 rounds for the rifle, 6 months to a year of food for you and/or your family to the maximum of being able to arm your family and select friends, have a couple years of supplies, cases of ammunition, and a group of likeminded friends (some of which may or may not be former military with weapons and/or combat training/experience at one level or another).
  •  Steadfastly refusing to standardize weapons, equipment, and other important factors.
  • Able to use your weapons on various ranges to various levels of accuracy without added stress during the exercise.
  • Possess disposable income or the ability to save in order to pay for more advanced skill set training than you have.
  • The proper mindset regarding what you are willing to do to safeguard those you care about to one degree or another.
  • Varying levels of physical fitness; mostly on the lower end (upper body strength, cardio, etc.); much improvement needed.
  • Deficient in knowledge and ability to apply:

o    Realistic analysis of what training provides the largest return on investment for ‘real-world’ scenarios v. ‘cool guy’ training primarily centered on CQB or squad strength offensive operations.

o    An analysis of capabilities necessary for your local neighborhood defense

o    The ability to approach and persuade willing neighbors to join the effort

o    Finding which neighbors possessing specialized skill sets for SHTF scenarios (doctors, nurses, dentists, HAM operators, etc.

o    How to establish a secure defensive ‘pocket’ or area and keep it that way.

o    Leadership skills (not a shot; most people aren’t trained in effective leadership – leadership is a learned behavior – that is founded on the ability to subordinate oneself to the mentor leader, and then the respect from your group must be earned).

o    Intimate knowledge of avenues of approach into your personal AO by various organizations or entities (marauders, etc)

o    Networking with and participation in any local emergency response initiative (yes, that means local government entities, as they will be first responders when S does HTF and can use the help, so long as you or your group isn’t posturing as ‘wannabe operators’).

 Where You Need to Be

 In a nutshell, you need to be able to personally do or complete all those bullet points above as well as others that will be apparent when you get to that point.  Then, you need to get your group to buy in and do the same. The real trick is how you get to that point the most efficient and rapid way possible.

 How You Get There (One Way)

  •  Acknowledge that you need to refocus your efforts from attempting to emulate various high profile paramilitary groups and organizations to that of a “Neighbor Hood Protection” function.  Keeping your efforts localized will help you protect that which is most important: family, friends, neighbors and your property.
  • Understand that learning never stops.  You must constantly read and study a myriad of subjects from history to teaching methodology focusing on the adult learner to military tactics and strategy to classics that underscore the importance of personal courage and honor (some people have never been taught these values, and you may have to be the example and mentor).  Buy, beg, borrow a copy of, “A Failure of Civility,” which is now out of print, and make it your personal blue print.  It lines out exactly how to do what you need to do.
  • Read and apply Dale Carnegie’s, “How to win friends and influence people.”  Doing so will go a long way in networking with your neighbors and persuading them to participate in any local preparations prior to a SHTF event.  This might mean taking off the Oakley’s and boonie hat while having a barbecue, and losing the ‘thousand yard stare’ when being asked questions.  Smile a bit.  Talk about light hearted things during social events.  There’ll be time enough during your Neighborhood Protection Meetings to be serious about setting up the defense.
  • Subordinate yourself to the most experienced/trained person in your group for training activities.  If you are fortunate enough to have someone you know that’s a former combat arms type and was at least a staff NCO in your neighborhood or group, be humble enough to let the subject matter expert lead the training selected for the group.  If you are lucky enough to be invited to a seminar given by a former SF troop (or even be involved in a social get together for coffee), especially the ‘old school SF troops (trained in unconventional warfare and force multiplication with indigenous troops) sit down, open your ears, take copious notes, and try to see how it applies to your situation.  Not everything might be useful right away, but you’ll get an education.
  • Read and apply, “Extreme Ownership,” by Jocko Willink and Leif Babin.  You’ll not be sorry, because this reference will provide you a very good set of leadership principles that work.  There are others, to be sure, but at $17, it’s the best money you’ll spend. 
  • Disregard information on anything from anyone who tells you they have, ‘the only way’ or ‘the best way’ to do something, especially if they are selling their services.  Be intelligent enough to know that there’s nothing new under the sun, and having many tools in the tool box provides more return than following one particular method because, well, ‘cool guy’.
  • Keep information on activities flowing to your group members, or ask for more information from your leadership on schedules, plans, etc.  Don’t make your people be ‘mushrooms.’ 
  • Train with your team regularly in all areas you have learned.  Make sure that some of the training involves being miserable, wet, tired, and cold if possible.  Nothing makes a team come together better than shared misery.
  • Encourage personal defense weapon standardization. Platforms and calibers are not so important as everyone having the same tools, or as close as possible.  It’s essential for increased survival odds during failed civility scenarios.
  • Get some people HAM qualified and licensed. Practice using the communications.  Get a good scanner that’s capable of listening to emergency response organizational transmissions.  You’ll be surprised what you can learn and what kind of warning you may receive on situations you might face.
  • Make sure that the scenarios you train for match your local area. If you’re not rural, you should concentrate on built up area tactics (defense, NOT kicking in doors…).
  • Understand that your training standards are absolute minimum acceptable performance measurements. There’s an old saying, “You don’t rise to the occasion, you sink to the level of your training.  Train right along side your people.  If you’re doing dry fire, then dry fire with them.  If you’re doing land nav, do the same course.
  • In planning your neighborhood protection plan, leave nothing to chance. Make sure that you know everything there is to know about your defense zone.
  • Get the group to volunteer for service projects in and around your neighborhood. Be helpful.  Be cheerful.  Be something people want to belong to, or at least, something people are glad is in the neighborhood.  One way to do this is to either join or form a “Neighborhood Watch Association” or a neighborhood association and hold events that promote preparedness without information dumping on attendees on the imminent end of the world as we know it. Got an old folks home?  Get some people to volunteer for visitations to lonely old people, clean their grounds, cut their lawn, etc.  Be service minded because that is a very good way to gain local credibility and allay any fears you and your group might be wacko.
  • Do not use rank! Use positions, innocuous names are best.  Stay away from paramilitary sounding names and/or acronyms when dealing with the public.  Don’t have multicam or military clothing making up your wardrobe.  Earth tone field clothing works, too.  Have gatherings where the ‘uniform of the day’ is business casual, such as a golf shirt and khakis.  Why?  Because you look ‘normal,’ that’s why.  Remember, you’re not a military unit, and you shouldn’t dress or act like one.  Drill and ceremonies have no place in what you’re trying to accomplish.
  • Rid yourselves of any conception that you are some sort of ‘unit.’  You’re a protection group.  End of transmission.

If you try the above, you will eventually get to where you need to be to protect your local area that you are capable of defending.  No, you won’t be, ‘Infantry’ trained, but you don’t need to be.  There are other ways – this is one way.

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Retired Infantry Captain

Apparently I was hard on PFCs, so here goes.

PFC used to mean you’d arrived at being a qualified Infantryman.  PV1, PV2 meant you were not yet fully functional.  Somewhere along the way, Recruiting Command was allowed to award rank for PT scores, bringing a friend, or making it through a semester of college without ending up with a “judicial enlistment.”  This was a mistake.

What makes PFCs are NCOs.  Full stop.  These are missing in JC’s scenario and, once upon a time, in Iraq.  Keep in mind the events below occurred concurrently, with lots of moving parts that don’t make for a logical narrative.

When I was a senior adviser to a newly formed Iraqi unit (2004-5), we had 68 guys in man dresses and flip flops.  We were issued Iraqi officers.  One company commander (Major) was outstanding and the lieutenants were surprisingly adequate.  That commander had fought Americans in Desert Storm and the first month of Operation Iraqi Freedom.  His comment to me?  “I’m tired of having

my ass kicked by you guys.  Our [Iraqi Army] problem is we have no NCOs.  We must train NCOs.”  “Yes, sir.”

Selection went something like this.  (Mob of Iraqis.) “Who here has combat experience?”  (Hands go up.)  “Great: Stand over there.  Who fought Americans?” (Iraqi vets look at the ground.)  “Ok fellas, we’re on the same side now.” (A few hands.) “Great: You guys stand over there.”  First group

was made team leaders.  Second group was squad leaders and platoon sergeants.  Brevet NCOs, pending combat performance, which was not long in coming.  The learning curve was quite steep, as the training consisted of new tasks, rehearsals, and off to the two way live fire.  Initially, Iraqi squads were sent on confidence patrols with American units commanded by friends who agreed to

help while we sorted out NCO and officer training.  (This doesn’t even begin to address the logistical issues, which were fixed with an unpretty combination of horse trading, deception, lies, outright theft, and confidence targets. That is the subject of another paper.  Suffice it to say the US Army had not given Iraqi Army logistics any thought whatsoever.)

Those who did well kept their new rank.  The less functional were promptly returned to the ranks for further assessment.  The newly blooded NCOs were then turned over to veteran American NCOs who had orders to impart discipline, skills, and organization. Once the original 68 were sorted, recruiting began.  Initially, we did all training in house.  All of it.  All. Of. It.  Iraqi NCOs were drilled in the evening on the next day’s training, then put in front of their flip flop shod recruits, with American oversight.  Emphasis on discipline, marksmanship, and

battle drills.   Keep in mind while this was going on, officers were being trained on their tasks, then integrated into collective training and combat operations.  Later, the US Army got around to setting up basic training in the middle of the desert.  It was satisfactory and wholly based on input from operational units.  The Iraqis did not get around to marching for some time.  PT was brutal, by design.

Keep in mind that medics, commo guys, drivers, supply guys, clerks, cooks, intel, personnel managers, staffs, etc. were being trained concurrently as well.  We were rebuilding an army.  Die, Bremer.  Just. Die.

Some of you will recognize the preceding paragraph as the staff formation discussion that was conducted at JC’s a few years ago.  One hopes you at least compiled the recommended manuals.

Here’s the deal:

​You must have good NCOs to have good PFCs.

Bonus, guaranteed to aggravate everyone who isn’t already ticked off: You must have good NCOs to have good company commanders.  Lieutenants are there to learn to be commanders, coordinate, and be brave.  If you have bad commanders, there are two reasons: NCOs who failed to train lieutenants, and senior officers who failed to get rid of the unwilling, untrainable, and unskilled.

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Survivalist Tactics vs. The Infantry, II

This writer held every position on a Long Range Surveillance Team up to Assistant Team Leader (ATL) and on the Line as a Fire Team Leader, Squad Leader and Weapons Squad Leader, and had three deployments, twice to Iraq and once to Afghanistan.

In my last I identified why training and working under the assumption that you are an Infantryman and can conduct yourself as such is not only foolish but is likely a death sentence for you and your people. You do not have the material nor the support, and especially not the discipline nor the people. Perhaps that last one needs touching on again; what happens when your merry band of defenders say, “No.”? How do you compel a volunteer group to actually face death? Why would you want people who are generally blowhards and/or never-has-beens to do this anyway?

You know that type I’m talking about. That’s your average militia dud with a facebook or twitter page and his whole network on display posting circle-jerk memes. Enough of them, let’s get to you. Before we go anywhere or put on our cool guy kits, lets face reality:

  1. You Don’t Have an Army Behind You.
  2. You are your Own Logistics.
  3. You Can Only Defend What You Can Support (and you need to know how to support what you plan on defending).

These three are interdependent realities. You may not have an army behind you but you do have a community; they live there and know the area better than any occupying force will. Rural communities are better at self sufficiency.  Those same communities are far more likely to properly defend what they own as a means of ensuring posterity versus the house of cards that is modern suburbia. They’re leery of outsiders too; keep that in mind. What constitutes ownership, anyway?

The ability to enforce command over that which you claim; my the third point. The community and your standing within it, known as social capital, is what lays the foundation. It is the first tactic. With nothing to defend and no consent of those defended, you will be outcasts and killed off quickly as problems and not solutions.

Infantrymen as a cohesive unit have none of these concerns. Their supply line is theirs and the responsibility of an adjacent supporting unit. Their job is to close with and destroy an enemy; the consent to function is granted by that entity which feeds, trains and arms them. Nothing more. That’s why the Afghans call us ‘tourists’.

The second is planning. You must identify the objective before you can rock a mag into that sweet Kalashnikov you just bought. Community defense is exactly that; defense. You are not offensive troops and you lack the capability or tactical sophistication to be anything other than what you are.

Without overwhelming numbers, the use of converging routes, or the means to replenish significant losses you will remain defensive if you want to live. So if we’re planning a defensive posture, our biggest ally is terrain. All people are creatures of habit. We follow patterns and take the paths of least resistance generally. Some of the more experienced calls this ‘natural lines of drift’, meaning, paths people drift along, like roads, rivers, valleys, passes, etc.

The defender then, like a hunter, uses this reality to his advantage and can create natural choke points to create the maximum number of casualties among those he’s attacking. The faster the fight is over and the less material you’ve wasted, the better off you are. Using that AR-15 like a bullet hose is a bad idea- marksmanship matters, a bunch of noise doesn’t, and marksmanship out to longer distance (3-400m) then becomes another force multiplier.

Hit probabilities to those reacting to contact at 400m and from multiple angles is far less likely than those on the attack from pre-planned hides with the inclusion of other force multipliers. Once you’re in your positions, you should have the range to your killzone already known, drawn on an improvised range card (a piece of cardboard with hand drawn target references on it with distances) and

should train on coordinating fire from those positions.

The idea of an ambush is to quickly and efficiently kill everything in the trap, but in case you don’t, have a team watching the opposition’s march in, closing the trap once they pass by. Of course I have to know they’re coming first, which

​means my contacts in the community let me know one way or another…see the pattern here (more than just you or your ‘little group’)?

So the two most important tools to learn are terrain analysis and team marksmanship, coordinated over an area. These are called intersecting fires. Is there a time for the battle drill 1 stuff? Sure, absolutely, when you’re taken by surprise. You should rehearse this for that reason; what to do on unexpected contact, because the reality is that if you’re walking about with your band o’ bubbas and happen to forget the principles of concealment or quiet movement, it might happen. But you shouldn’t be bunched up to begin with, plan converging routes for your group members to get to their positions, and should be taking the path of MOST resistance to afford the maximum cover. Don’t forget the utility of crawling.

Once more we find our plan at the heart of staying alive. In order to plan, we have to know our terrain. In order to know our terrain, we have to be familiar with the lay of the land. In order to do any of the above, we have to have consent of our community. And you do none of the above, but parade about in a show of self importance, one will learn just how important they actually are.

Effective training on tactics, from any trainer with real credentials including time actually doing it, begins with learning to plan. This is why Operations Orders and Troop Leading Procedures are emphasized from the first day of any military school. This is why you should seek out those with actual experience for training; they know the value of the basics and the consequences of forgetting them in lieu of something you learned playing airsoft. And while this may seem mundane to the uninitiated, running around shooting fast at targets makes you an easy one to the guy who knows what he’s doing.

Do not lose sight of your reason for being.

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From an 18F

Nobody said don’t take classes or train. All we said in the last post is don’t give yourself airs you neither earned nor can claim. A couple or half dozen weekend “SUT” classes (they are no such thing) may give you some confidence in weapons handling or impart some elementary level of “buddy team” cooperation [how much is debatable because the “buddy” you trained with probably lives over 100 miles away], but it will never make you a “squady.”

What whichever classes are available to you will do for you is give you a skill set that is above the skill set of the street shit you are most likely to encounter – and that is all you will need. And here is the thing… with your weekend “SUT” classes you are in a position to train others who live around you. I’ve said this many times, and it bears repeating: Be cadre.

But here is the other thing… When you are cadre, in necessity others will look to you. At first for technical guidance (weapons handling, etc), and afterward for leadership –   because you know how to handle weapons, etc.. And there, guaranteed, is where you will fall flat on your face and put everybody who has turned to you in peril.

Because of your “SUT” training, which has nothing whatsoever to do with small unit tactics and cannot help you in small unit tactical situations. So there is your dilemma. As a “SUT” trained cadre you can train a neighborhood guard to whatever standard you learned. Which will largely be sufficient against common street shit. But, inevitably, someday, somebody is going to show up with an army. What are you going to do, cadre, when all eyes turn in your direction?

And that is what separates the infantryman from the weekend “SUT” class tourist. Keep taking “SUT” classes. Learn what you can. Be cadre and help your neighbors. Fend off street shit. When somebody shows up with an army… take an oath of fealty.

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I read a post by Bill Buppert at Zero Hedge, and although I understand where he is coming from, I don’t think he has a realistic view of the average people he is talking about. He said, “There is a stream of consciousness modality currently coursing through the prepper and III% community that if you aren’t infantry, you can’t take the fight to the enemy no matter how competent you may be as men of the gun or whatever background you hail from.”

So let’s get some terminology straight. “I haven’t said “Can’t”, I’ve said “Shouldn’t”. Why is that my opinion? Reality and practicality. The majority I have encountered cannot even get their defensive preps squared away because they’re too concerned with doing the “Tacticool” “Operator” shit (CQB, Raid, Ambush). You’re first priority should be to your loved ones defense, correct? Post SHTF, Offensive Ops shouldn’t even be considered till your defensive ops are underway, and even then, probably not because most just will not have the appropriate manpower for anything but defense.

Start with the basics. Lay the groundwork for a solid defensive foundation, then MAYBE move on to the consideration of an offensive action if urgently needed. But keep in mind, depending on perspective, that offensive operation you conducted could come back to bite you in the ass legally. If you believe that’s BS, look at some examples from the former Yugoslavia, and tell me that possibility isn’t there.

Another post that WRSA put up today, reinforces the point we made in the last post about, “on a good day, a civilian that has taken 3 or 4 SUT type classes from a Tactical Trainer won’t even be at the experienced Infantry PFC level”. “SPC Slick” can shown proficiency in the CTT. Can you?

If you still wanna run Offensive Infantry Ops I’d say, “Show me your group commander and it’s NCO’s and tell me about their experience. As was said earlier by the Captain, the NCO’s are the core of the group in an operational setting, and any operation being conducted by the group is made to work by it’s NCO’s, and you don’t have any….do you?

Organization is critical. Figure out what scenarios you believe you should prepare for, and prioritize preparations according to the degree of immediate threat, the likelihood of the threat, and your realistic ability to prepare for the threat. Here is some things I posted in this post,

  • 1). Do you have general, realistic preps in place?
  • 2) Do you have a solid, well thought out and realistic plan to deal with the general and specific concerns you’ve identified?
  • 3) Are you physically and/or logistically equipped and able to carry out the planned responses to these threats.

If your answer is “No” to any one of the questions above, you need to address and correct that. As was said by at least one of the contributors, after you get training in something, pass it on to your group as soon as possible. This doesn’t mean you are now a professional trainer. What it means is that hopefully, you have the ability to take what you learned and immediately regurgitate it to your family, friends and group members (it is critical that you teach it as soon as you can, so the lessons are still fresh and clear in your mind, a three day tactical class will give you familiarity, not proficiency or mastery).

An issue I had with a couple guys who received their “Bushbastard” tabs was that they wanted to be able to confer the award to those that they taught, and I said, “Under no circumstances will that be allowed.” The comment I received was, “I thought you wanted us to go home and teach what we learned?” To which I responded, “Yes, teach what you learned, but the only people handing out “Bushbastard” tabs are me or a designee that I feel are not only trained well enough to teach the material I have put together exactly as it is supposed to be taught, but will also enforce the standards in testing that I require for the award.”

Any trainer that has an issue with a former student teaching what they’ve learned to their family and friends is probably more worried about the almighty dollars they are missing out on, than they are about helping people prepare for what’s coming.

To recap,

  • Decide whether “Preparing for doomsday” is a hobby or a conviction. If it’s a hobby, stop reading. If it’s a conviction, continue with this list.
  • Pick the Leader of your group if he hasn’t been selected already. ( or was it going to be a democracy….? Good luck with that).
  • Make a plan that covers the scenarios you’re concerned about.
  • Organize you’re logistics on hand and plan your future purchases based on the realistic needs required for the scenarios you’re preparing for.
  • Determine which logistical preps can be generalized to cover all scenarios, and make their acquisition a priority.
  • Organize the personnel in your group based on A) Abilities they already possess via employment or hobby (Former Infantry, EMT, HAM, etc.), or B) capabilities they plan on getting via training course or new hobby. Encourage furthering the education in those areas.
  • Organize the critical information about your area (maps, area sketches, etc.) into something that is detailed, easily accessible, and understandable.
  • Get as much realistic training in personal protection (both empty hand, and firearm) and area/ retreat defense from a proven source (I wrote about how to find and verify the bona fides of the non-professional ones here).
  • Get as much First Aid, TCCC, and Extended Care training as possible.
  • Do as much PT as you are physically capable of doing. You know if you are cheating yourself and those who will be counting on you.
  • Learn as much as you can about how the pioneers of the 1800’s did EVERYTHING!
  • After your group get’s organized, network with other local groups for support.

Defending your area (to include presence patrols) is a full time job and takes a number of personnel for round the clock security. I wrote about how to put together a schedule for security here. This post contains some good defensive area prep info, and in this post I wrote about the steps I recommend for the individual to get prepared. This post is in no way exhaustive, but the bottom line is that five people took of their precious free time to try and give suggestions to help you get ready for bad times. Whether you agree with them or not, take that for what it’s worth.

YOU ARE NOT AN INFANTRYMAN, BUT YOU DON’T HAVE TO BE. YOU HAVE TO BE MUCH, MUCH MORE!

JCD

American by BIRTH, Infidel by CHOICE

 

 

 

WRSA Sends More Of The Grid Down Hospital “Patient Assessment”

Grid Down Hospital: Part VI – Patient Assessment Overview

gdh-red-cross-flag

The latest from the team:

Patient Assessment Overview

Entire medical text volumes have been written about a full patient assessment, and what it should encompass. This will not be one of them, but it will serve as a reasonable overview for your efforts.

The type of assessment you perform is entirely based on time and resources devoted, which dictates the scope.

The first, and largely ignored, is the Eyeball Assessment. What you see in the first few to twenty seconds of contact with your patient.

Are they conscious? Alert? Oriented to person, place, time, and events?

Breathing? Normally?

Bleeding?

Do they have any Stevie Wonder fractures, i.e. obvious deformities?

What color is their skin, as in normal nail-bed pink, or pale, jaundiced, etc.?

In short, can they walk, talk, and basically function normally?

This is a Go/No Go evaluation, and determines the likely severity of their situation, and the scope of your further efforts.

The second, usually deployed in the Mass Casualty Event (a Mass Casualty is ANY event when demands exceeds immediate resources, and could be as little as one patient), is known in the biz as the START assessment, for Simple Triage And Rapid Treatment.

A picture being worth 1000 words, here it is:

gdh-startadulttriagealgorithm

The algorithm above embiggens. Learn it, love it, live it.

Use of this algorithm enables one person, with a handful of triage tags with four color choices (which determine rather exactly your medical future) to triage multiple patients in a few seconds apiece, and then get back to focusing on the worst first without wasting resources on those who died or soon will.

There are multiple videos on YouTube covering START Triage which explain this process. A quick survey showed that they’re all bad (in being poor quality, lousy presenters, boring as f***, but..), but pick one and follow along, because they cover the information, while unfortunately being largely unwatchable.

The next level of patient assessment is used for most contacts – the Primary Assessment.

The list is a little more involved, and from this point onwards, all assessments need to be seen as only one data point. This means while true, they don’t tell you much by themselves; the key is to do multiple assessments, and note the trend, over time. That’s where they gain their true value.

This requires adequate documentation each and every time, and completeness, each and every time, at least of the pertinent items.

You want the following:

Baseline mental ability: awake, alert, oriented times four items?
Body Temperature?
(Note that even lacking a thermometer – which you shouldn’t but…- hot/warm/cold to touch is still clinically useful.)
And skin color and moisture: pink/dry is normal. Pale/diaphoretic(sweaty) is not.
(Note also that if lacking medical terminology, plain English will suffice.)
Pulse: regularity (or not), rate (beats per minute), and quality (weak/strong/bounding).
Respirations: regularity (or not), rate, including chest symmetry, and any further medical description of the respirations (which requires more than laymen-level instruction), if appropriate.
Blood pressure: With a cuff, and where (on the patient’s body) taken.
Pulse oxygenation, if you have the capability.

The above is standard from field and ER triage desks to surgical anesthesiology, and will stand you in good stead if you equip for it, learn it, and do it. Practice now, and on patients from infants to the elderly, any time the opportunity presents itself.

Ancillary equipment in any of those environments can get you more information, but you can’t suffice with less, in most instances, nor should you try.

I repeat: Documentation, Accuracy, and Trend Over Time.

Lastly is the Secondary Assessment. It is a complete review of the body from head to toe.

I can do a pretty thorough one in two to five minutes on a prone patient, even if they’re unconscious. The checklist runs to two or three pages. (Flighterdoc, I , or some other author may devote a separate essay to same in the future.) As this is where patient assessment and other medical texts come in handy, the short summary is that you look at and palpate (touch and feel) everything from the top of the scalp to the soles of the feet, which you have to be able to get to and see – which is why the doctor always wants you in that annoying loose gown first, and why paramedics cut your clothes to ribbons nine times out of ten at an accident scene. Jeans and boots are replaceable, death is not.

You are looking for obvious deformities, bleeding and/or other fluid leaks, bruising, other wounds, skin color, movement, nerve sensation, circulation, intactness of bones, normality of reflexes, or any and all deficits in the above. Head, neck, torso, abdomen, groin, arms to the fingertips, and legs to the toes, including rolling on the side to inspect everything, particularly the spinal column, from head to tailpipe, inclusive.

If the patient is awake and responsive, it also includes hearing, eye movements, and verbal expression checks, because these give you cranial nerve function times twelve (you should look these up) without a CT scan, in about a minute.

After that, you progress to things like laboratory blood, urine and fluid tests, and diagnostic imagery (Xrays, Ultrasounds, CTs, MRIs) which probably are – but need not necessarily be – beyond your scope. For one example, you can get a bedside ultrasound machine for about the price of a thermal weapon scope. One can pick out a target at 1500 yards, and the other can diagnose internal bleeding or appendicitis. You decide whether either of those things are important, and devote your resources appropriately.

You can also, even in degraded conditions, do blood laboratory work and cultures of specimens to detect infection, if you have the equipment, training, and resources. SF 18Ds are expected to meet that standard, and did so in sandbag hooches in SEAsia amidst a war. You get what you pay and train for, and your people will bless or curse you, depending on your abilities and their outcomes.

_________________________________________________________________

JCD

American by BIRTH, Infidel by CHOICE

TOWR Commo Class Prep

The Order of The White Rose (TOWR) will be running a 1 Day Basic Introduction to Radio and Communication Class November 5th 2016 in the Greater Seattle Area.

Class will be 6 to 8 hours, cost is $50.00, location will be provided upon registration. Email us attowr@hushmail.com to register!

This class will touch on the following areas:
– Radio and Communications Basic Theory and Terminology
– Radio Capabilities and Operating Techniques
– Introduction to the Equipment, Radios, Antenna’s, Power, Connections and Cable
– What type of Radio should you buy, Walmart Walki-Talkie, Baofeng, UHF/VHF vs HF
– How Repeaters work and how radio waves act
– Use of Your Radio
– How to Program Your Radio
– Introduction to Scanners and their uses in your area
– Local and National Education Resources
– Introduction to SDR (Software Defined Radio) and Ham-Net

Our goals for this class are:
1st – To give attendees a basic information foundation in the area of Communications. However this is class is notintended to be provide attendees enough information to pass their Ham Radio License Test, its a start but not intended to do that.
2nd – To provide enough practical information that attendees can evaluate the use of Radios in establishing their own Communication networks for families, neighborhood, Group and nearby Groups.
3rd – The Order of the White Rose will be sponsoring Sparks31’s, 2 day Grid-Down/Resilient Communications Class in the Seattle area, June 2017. Our intent is to provide attendees enough information to get the maximum value from what Sparks31 teaches in that class. Without this basic foundation sometimes getting that value is like trying to get a drink of water out of a hydrant.
Sparks31 Grid-Down/Resilient Communications ClassInformation
– Email us attowr@hushmail.com and register for both classes now! The Sparks31 class WILL sell out!

_____________

JCD

American by BIRTH, Infidel by CHOICE

WRSA Sends: The Grid Down Hospital/The Library

Got reference?

_________________________________________________________________

Grid Down Hospital: Part IV – Medical Books For Your Hospital Library

red-cross-flag

Flighterdoc sends:

Medical Books

Where to get these books

Obviously, if you have the interest and budget, the easiest place to get these is from Amazon.com. Since you don’t need the latest editions of most of them, buying used books from Amazon, or from Half.com is perfectly adequate. You can also check Ebay, local bookstores (new or used) or most any other source. Public libraries probably won’t have a good collection of this level of medical books, and you can’t keep the books indefinitely. Some may be available as electronic books (legitimately or pirated). If you go this route then print them out. It may be much less expensive to just buy them, then pay for ink to print out a several hundred page book.

The time to get and study these books is before you need the knowledge in them. And since the quality of electronic versions can be spotty, plus electronic readers can fail, get the paper copies even though many of these textbooks (and others) are available

Medical textbooks are normally referred to by the primary authors’ name, and most of these books are listed that way. They are all listed with sufficient information that they can be identified on Amazon or whatever. Many are also available as illegal downloads, as well.

Generally, you don’t have to have the latest version of a medical textbook – but you don’t want one that is decades out of date, either.

Medical science does change, and things that were considered appropriate treatment even ten years ago are now known to be dangerous, or vice-versa, so try and use the most current books available and review several different books for a consensus for treatment.

Before you start

Medical Terminology

Chabner, Medical Terminology: A short course

Medicine has its own language, and words mean very specific things. You need to understand this language.

Medical Dictionary (Professional level). Any of the following dictionaries are fine, preference for one or another is purely personal.

Stedman’s Medical Dictionary
Dorland’s Illustrated Medical Dictionary
Taber’s Cyclopedic Medical Dictionary

Laypersons level

Merriam-Websters Medical Dictionary

English Dictionary

Sometimes you have to get to basics to understand the topic.

Basic Medical Texts: Common textbooks used in current Medical School curriculums, and following a more or less typical progression of courses. These give you the fundamental knowledge to be able to effectively use the specialty books and pocket guides mentioned later.

Anatomy – How the body is put together in a general sense. Keep in mind that nobody is exactly like the pictures, there is no such thing as ‘normal’ when talking about people – just ‘normal range’.

Netter (Drawings of how the body is supposed to look)
Rohen (Photos of how embalmed bodies actually look. Live people, and unembalmbed bodies, don’t look at all like these pictures.)

Gray’s Anatomy – The various commemorative reprints of early editions are not only wrong, they are in some cases dangerous. Avoid them as a reference source and only use a modern version which can be hard to determine since the commemorative reprints have current print dates….it might be better to skip this one for the others.

Embryology (How the fetus develops) Included for completeness, not a lot you can do about the process.

Langmans’s Medical Embryology

Histology (The anatomy and purpose of individual types of cells) If you have access to a good microscope and various stains, you might be able to differentiate cells to good purpose. At the very least understand that the body is made of different kinds of cells, which have specific purposes.

Junqueira’s Basic Histology
Wheater’s Functional Histology: Atlas

Medical Research, Epidemiology and Biostatistics – Being able to interpret reports is critical – aside from the baseline knowledge there is a skill to reading and extracting information from the reports, and understanding what they say and what they don’t say and why. The short version is that popular media reports are usually 100% wrong, and even the executive summary of actual studies sometimes are partially wrong.

Riegelman, Studying the Study and Testing the Test
Clinical Biostatistics and Epidemiology Made Ridiculously Simple

Psychiatry

Kaplan and Sadock’s Synopsis of Psychiatry

Biochemistry (What makes the different ‘machines’ in the body work. Understanding biochemistry and physiology is essential to understanding HOW to fix things, not just a checklist approach.)

Lippincott, Review of Biochemistry
Lehninger, Principles of Biochemistry

Physiology (how the different parts of the body are supposed to work)

Guyton and Hall, Physiology

These next two are only useful if you actually have the ability to monitor EKGs. An AED will NOT give you that capability.

Dubin, Rapid Interpretation of EKG’s
Garcia, 12-Lead ECG: The Art of Interpretation

Genetics

While this is taught in med school, it’s probably useless grid-down (it’s not terribly useful now, except in understanding and explaining what has gone wrong). Genetics is a rapidly expanding field, however, and the technology is becoming more available.

Microbiology

Understanding microbiology allows one to determine what illness a person may have, and which of the many different antibiotics are appropriate (if any) to treat that illness.

Pathology: What goes wrong in how things work in the body

Robbins, Principals of Pathology (any edition after the 5th, and any version except the pocket book).
Goljan, Rapid Review Pathology

Neuroscience (How the brain and central nervous system is built). While working on the brain grid down is probably a losing proposition, understanding the nervous system, especially the spine, is useful.

Snell, Neuroanatomy
Haines, Neuroanatomy in Clinical Context

Pharmacology

Katzung, Basic and Clinical Pharmacology
Pharmacology, Lippincott Illustrated Review

Clinical Skills, Physical Exam

Bates Guide to Physical Exam and History Taking: (Kind of basic, Barbara Bates was a nurse who wrote these books for nursing students, but a good intro). Get the big book, and then the pocket book as a memory aid.

Bates Videos: There are some truly boring videos that go with the Bates Guide. You can find them on Youtube.

Swartz, Textbook of Physical Diagnosis: History and Examination (better for PE)
DeGowin’s Diagnostic Examination (My personal favorite for PE)

Generally, STAY AWAY from the following:

The Dummies Series….your patients don’t need any dummies, and these books are just too basic.
Board Review Series (or similar) books – these are for cramming before medical board tests, and expect you to already have a grasp of the fundamentals. The “First Aid” series (First aid for the boards, First Aid for Surgery, etc) is also a book to stay away from unless you’re cramming for the medical boards.

Not quite Medical school level books that might be useful

These books are commonly community-college or EMT/Paramedic level training

Tortora, Principals of Anatomy and Physiology
Costanza, Physiology

Emergency Care and Transportation of the Sick and Injured – the classic book for training EMT basics
Prehospital Trauma Life Support

Medical Specialty Books

These are commonly used in the third and fourth year of medical school when students are exposed to the various specialties of medicine, and patients, and are also the basic books (there are many more) for each specialty.

Surgery

Schwartz, Principals of Surgery
Skandalakis, Surgical Anatomy and Technique
Giddings, Surgical Knots and Suturing Techniques: While I generally don’t recommend laypeople suturing, this is a good primer on how to.

Internal Medicine

Harrison’s Internal Medicine
Kelley, Textbook of Internal Medicine

Family Medicine

Taylor Manual of Family Practice
Singleton Primary Care
Rakel, Textbook of Family Practice

Emergency Medicine

Rosen’s Emergency Medicine
Tintinalli’s Emergency Medicine
Ma, Emergency Medicine Manual
Buttaraviolli, Minor Emergencies – Splinters to Fractures

Pediatrics (Kids are not just small adults)

The Harriet Lane Handbook of Pediatrics
Nelson, Textbook of Pediatrics

Obstetrics / Gynecology

Beckman, Obstetrics and Gynecology

Orthopedics

McRae, Practical Fracture Treatment
Hull and Bacon, Introduction to Dislocations
Chapman, Orthopedic Surgery

Dentistry

Halestrap, Simple Dental Care for Rural Hospitals
Nara, How to become dentally self sufficient
Oxford Handbook of Dental Patient Care

Disaster Medicine

Koening, Disaster Medicine
Ciottone, Disaster Medicine
Antosia, Handbook of Bioterrorism and Disaster Medicine

Ophthalmology

The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology
The Wills Eye Manual

Anesthesia

Brown, Atlas of Regional Anesthesia
Anesthesia, Longnecker
Miller, Anesthesia

Frequently Handy Books

Merck Manual of Diagnosis and Therapy– From the last 20 years or so

Gomella Scut Monkeys Guide

Tarascon Pharmacopia – Any edition from the last 5 years or so should be fine

Sanford Guide to Antimicrobial Therapy – Any edition from the last 5 years or so should be fine

Giddings and Giddings, Surgical Knots and Suturing Techniques, any edition is good

Trott, Wounds and Lacerations

Special Operations Forces Medical Handbook, 2nd Ed,

Physicians Desk Reference – one from the last 5 year or so should be fine, you can often get them for free from your physician or pharmacist. The pictures are most useful for identifying pills.

Book Series that may be useful; additional (not primary) sources:

Lippincots Illustrated Reviews Series

Medmaster Made Ridiculously Simple Series

The Washington Manual Series

The Oxford Medical Book Series

The Pocket Medicine Series

Current Diagnosis and Treatment Series

The 5-Minute Clinical Consult Series

The Ships Medical Chest and Medical Care at Sea

Auerbach, Wilderness Medicine and the Field Guide

Iserson, Improvised Medicine: Medical Care in Resource Poor Situations

Special Operations Forces Medical Handbook, 2nd Ed,

Ranger Medical Handbook

Special Forces Medical Handbook, ST31-91B This book is useful ONLY for the ideas on austere camp setups and veterinary medicine. The human medical information in it is of extremely poor quality, and consists mostly of war stories and old wives tales that were written down and put into a book. Be very careful with this one.

Buttaravoli, Minor Emergencies: Splinters to Fractures

Oxford Handbook: Acute Medicine

Oxford Handbook: Tropical Medicine

Oxford Handbook: Emergency Medicine

Coffee, Ditch Medicine

Issac, Wilderness and Rescue Medicine

Wilkerson, Medicine for Mountaineering

Flint’s Emergency Treatment & Management, 7th edition (out of print x 20 years, many around, the single best black bag book ever, covers camel bites – ‘Nair’ poisoning – and a million other things found nowhere else)

Medical Training and Education

There are a number of ways the layperson can get medical training. There is a sort of hierarchy to basic first aid training, usually named something like:
Standard First Aid – a one or two day class from the Red Cross
Advanced First Aid –
Emergency Medical Responder / First Responder
Emergency Medical Technician, I or Basic
Emergency Medical Technician, Advanced
Paramedic / Emergency Medical Technician-Paramedic
https://en.wikipedia.org/wiki/Emergency_medical_technician#United_States

Just because a person is an EMT-Advanced, or Paramedic, they don’t usually have any special authority when they are not actually on duty, and under the control of a medical doctor. Some states have scopes of practice for off-duty EMT’s…it pays to check out your local policies.

Wilderness Training

There are several wilderness first aid programs – such as Wilderness First Aid, Wilderness Advanced First Aid, Wilderness EMR, etc…

Except in Colorado, there is no actual official recognition of this level of training. That doesn’t mean you shouldn’t get it, on the contrary I recommend these sorts of classes to anyone who wants to learn more.

Wilderness first aid has to treat people with fewer resources, and fewer people, and often in difficult conditions (terrain, weather), and for longer periods. Unfortunately, the regular pre-hospital training programs all assume that more help (paramedics, hospital, etc) are nearby.

It is possible to get wilderness add-on ratings for existing EMR or EMT ratings, or take wilderness first aid classes. They usually take a few days more than a standard class, and involve a lot of practical field experience. From time to time other organizations (American Red Cross, Scouting USA, various wilderness adventure training programs) offer wilderness medical training. If they don’t provide certification from one of the following, I’d pass them by – you are investing some time and money in a course that may be quite good, or quite bad.

Wilderness Training Providers

Wilderness Medical Associates https://www.wildmed.com/wilderness-medical-courses/
National Outdoor Leadership Courses (NOLS)http://www.nols.edu/wmi/courses/
SOLO Schools http://soloschools.com/
From time to time other organizations may offer wilderness courses, if they are not certified to one of the above organizations standards I’d pass them by.

Online (Free) courses

Actual university (not really graduate) level courses in various medically related topics – free for the taking
Coursera https://www.coursera.org/
Accessed 15 May 2015

EdX https://www.edx.org/
Accessed 15 May 2015

Online Resources

These do not replace the knowledge above, they supplement it. Print the .pdf’s out while you can.

Ethicon Wound Closure: http://www.ethicon.com/healthcare-professionals/products/wound-closure
Accessed 15 May 2015

Ethicon wound closure manual: http://media.xn--benersttning-lcb.se/2012/04/Ethicon-wound-closure-manual.pdf
Accessed 15 May 2015

Stewart and Stewart, Austere Medical Sterilizationhttp://www.moljinar.com/page6/files/Sterilization%20v1-2.pdf
Accessed 1 Oct 2016

World Health Organization

Surgical Care at the District Hospital
http://www.who.int/entity/surgery/publications/en/SCDH.pdf?ua=1
Accessed 15 May 2015

Integrated Management for Emergency and Essential Surgical Care (IMEESC) toolkit
http://www.who.int/surgery/publications/imeesc/en/
Accessed 15 May 2015

International Medical Guide for Ships: Including the Ship’s Medicine Chest
http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=15&codcch=3078
Accessed 15 May 2015

Basic Hospital Equipment
http://www.who.int/medical_devices/innovation/core_equipment/en/#
Accessed 16 May 2015

Global Help

Basics of Wound Care http://global-help.org/products/basics_of_wounds_care/
Accessed 15 May 2015

Practical Plastic Surgery for Non Surgeons http://www.global-help.org/publications/books/help_practicalplasticsurgery.pdf
Accessed 15 May 2015

And many others:

US Army Medical Department Borden Institute
http://www.cs.amedd.army.mil/borden/Portlet.aspx?id=aef88463-dc77-415a-8919-2ae436bd4b30
Accessed 15 May 2015
Many different specialties, all free for the download.

Hesperian Health Guides

http://hesperian.org/books-and-resources/
Accessed 15 May 2015

Home of Where there is no Doctor, Where there is no Dentist, and others geared strictly towards very basic laypeople

Epidemiology and prevention of vaccine-preventable disease
http://www.cdc.gov/vaccines/pubs/pinkbook/index.html
Accessed 15 May 2015

The Medical Aspects of Radiation Incidents
http://orise.orau.gov/reacts/resources/radiation-accident-management.aspxAccessed 15 May 2015

FEMA / DHS publications:
These were written by AMR, the largest private ambulance company in the US…I’d recommend downloading them as soon as possible and then printing them out.

https://www.amr.net/solutions/federal-disaster-response-team/references-and-resources

Available titles include (accessed 9 October 2016)

MASS MEDICAL CARE WITH SCARCE RESOURCES

ALTERED STANDARDS OF CARE IN MASS CASUALTY EVENTS

FEMA – DESIGNING A NATIONAL EMERGENCY RESPONDER CREDENTIALING SYSTEM

FEMA EMS TYPED RESOURCE DEFINITIONS

PARATRANSIT UTILIZATION GUIDE

DISABILITY EVACUATION GUIDELINES

72 HOUR GO KIT RECOMMENDED PACKING LIST

REQUIRED GROUND AMBULANCE EQUIPMENT LIST FOR FEDERAL RESPONSE

EMS SCOPE OF PRACTICE FOR AMR-FEMA FEDERAL DISASTER DEPLOYMENTS

DHS AUSTERE EMS FIELD GUIDE

DHS TACTICAL EMS GUIDE

DHS FEMA ALS AND BLS PROTOCOLS

AMR/FEMA DEPLOYMENT HANDBOOK

CRISIS STANDARDS OF CARE

_________________________________________________________________

JCD

American by BIRTH, Infidel by CHOICE