Why is it necessary to train in Tactical First Aid?

In a deteriorated/instable security environment linked to the escalation of armed violence situations and the risk of attack, the International organizations staff and other development actors, defense and security forces and rescue/emergency services are increasingly confronted with situations that degenerate, even damaging their physical integrity.

Anyone deployed in a dangerous theatre of operations must be reassured and have acquired the right reflexes in the event of a threat 

In recent years, the Saharo-Sahelian band has experienced a number of extremely violent terrorist attacks. In each of these tragedies, a significant number of victims, seriously injured or killed by firearms, knives or by an explosion on direct or collateral targets (first responders and reinforcements) were reported despite rapid intervention by emergency services. Such a situation requires appropriate behavior and the individuals concerned must master first tactical emergency actions essential to sustaining life. Thus, within ten minutes of an injury, any person must be able to perform life-saving procedures that will effectively relay the intervention of a doctor before evacuation from the attack zone. Since the victims' chances of survival decrease as a function of response times, it is estimated that 25% of deaths are preventable, including 80% of deaths due to hemorrhage and nearly 5% for injuries requiring an airway approach.

In such a context, it is more than necessary that any individual deployed in at-risk/hazardous areas become a responsible actor/first responder for their own safety, and not exclusively dependent on procedures imposed by their employer or the know-how of more experienced colleagues due to lack of experience. It is therefore important that everyone be able to effectively apprehend and assess the various threats emanating from a hostile environment, to train individually in safety and security practices adapted to the threats they could potentially face, to develop their own skills and abilities to deal with situations that potentially could affect their vital prognosis, for their colleagues or collateral victims.

Tactical first aid training consists of the acquisition of specific skills to provide assistance and/or help ourself

Controlling rescue actions in a tactical situation involves implementing techniques and protocols that make it possible to prevent death or aggravation of injuries in an emergency/crisis situation. Anyone exposed to an environment linked to new threats and other situations of violence must be able, after acquiring the specific skills in both theoretical and practical training sessions, not only to "rescue themselves" and/or a colleague or third party but taking into account the tactical situation they are facing and observing, but also to not cause additional and unnecessary accidents /injuries in the panic. 

The first rule that must apply while accessing the scene is the following: Treat first what kills first !

Appropriate training exists, which makes it possible to assess not only the risks and dangers of the intervention area/scene and to know how to deal with them while preserving as much as possible their safety, but also the condition of a victim by adopting the actions to be taken according to their injuries, through reflex actions and adapted equipment (which must always be within reach of people on mission in dangerous areas, in the form of a first aid kit (IFAK), ideally allowing you to carry it yourself.(time is life)

These training courses must meet the following minimum objectives:  

• Assess the risks and dangers on the scene and the situation of violence or attack, through observation of the immediate environment; STEP OBSERVING
• Act safely to treat vital physical damage, during a situation of violence or attack STEP ACTING/TREATING

• Be able to apply to yourself and/or a third person first aid gestures caused by an injury of firearm, a knife or an explosion/blast;
• Follow a well-structured casualty care protocol derived from combat first aid been taught in the army and elsewhere combat field. The most commonly used protocols are MARCH-RYAN, which is directly derived from military doctrine, and the c-ABCDE civilian model, including protocols for the management of one or more injured persons/casualties in a current or terminated tactical environment, including the following three phases:

1. Care Under Fire (hot zone)
2. Tactical Field Care (warm zone)
3. Tactical Evacuation Care (cold zone)

All of the above shows that tactical first aid is an adaptation of conventional first aid to the symptomatic situations of armed conflict. It is closely linked to the environment, the security context and the specificities of the physical damage suffered. Any individual on mission in complex theaters of operation where security risk is high must now be aware of his own tactical responsibility if he is confronted with acts of violence involving his physical integrity and/or of his close surrounding. The impact on the person is therefore twice more positive: on the psychological level, it will allow him/her to suffer less by being an actor of his/her own safety and/or of his/her immediate environment. On the physical level, it will allow him/her to save his/her life or others life as well.

Jean-Michel CLAIR CEO AACCES