AAR: Active Response Training (Greg Ellifritz) “Tactical First Aid and System Collapse Medicine”, Manassas, VA, 02/11/17

After the fantastic experience I had in Greg Ellifritz’s “Extreme Close Quarters Gunfighting” class in October of 2016—my final class last year—it seemed fitting to begin my 2017 coursework with two more classes from Greg.  The two courses were “Tactical First Aid and System Collapse Medicine” and “Groundfighting”.  John and I chose to take these two classes together and then divide up the AAR workload.  We also thought it fitting for the person without the medical background (me) to do the AAR on the Medical class, thus coming at the topic from the perspective of the layperson.

This class was held at Elite Shooting Sports in Manassas, Virginia, the same venue where I took my first course with Greg (Basic Knife Skills for Concealed Carry).   I cannot say enough positive things about Elite Shooting Sports; it is like a Mecca of ranges, at least around these parts.  The course was hosted once again by John Murphy of FPF Training, who does a great job not just with his own classes, but also bringing in top-notch guest instructors.  Cost of the class was a VERY reasonable $175.  Neither John nor I have any affiliation with Greg Ellifritz, Active Response Training (Greg’s company), John Murphy, FPF Training, or Elite Shooting Sports, except as full-price paying customers.  I should also add that my only prior dedicated medical skills class was in November of 2013 with Dark Angel Medical (see AAR here).

The Class

The class (with about 16 students present) began at 0900 with the typical comedic introduction of Greg by Murphy, and then Murphy bowed out to move on to other pursuits.  Greg then reviewed his background for us.  It is easy to view Greg as a police officer who conducts classes, but lumping him into this category is a bit disingenuous, since he has a wealth of experience and expertise not shared by most members of the law enforcement community.  I find that Greg’s classes fit nicely into the “cracks” ignored by other training classes.  To the best of my knowledge, there are not many police officers offering knife classes, extreme close quarters gunfighting classes, groundfighting classes, or highly comprehensive medical classes to the civilian marketplace.

Greg began by asking the class what topics we would most like to cover, since he has at least three main topics that he covers in these classes but can tailor the percentage of each topic to each specific class.  He noted for us that he does everything from four-hour  to three-day versions of this class, as there is a lot of available breadth and depth to the material.  He then launched into a question and answer session about what separates first aid from “tactical” first aid.  The experiences of the United States at war for the last 15 years—and its influence on the tactical first aid community—were discussed, as were statistics on types of wounds typically dealt with on the battlefield.  Subgrouping those into preventable deaths as it relates to what we can do on the scene (i.e., not much we can do for an open skull wound, but we CAN help someone with an arterial bleed in an extremity), he related to us the current M.A.R.C.H. acronym and how it correlates with what we can do “on the street”. 

Greg showing off the features of the Israeli Bandage

I am not going to go into the details of every little thing covered in class, as I took 14 pages of notes.  The fast version is that we went through each of the elements of the M.A.R.C.H. acronym and went over the different ways that we can treat each type of those wounds.  For example, M stands for Massive bleeding, and in this case, depending on type and location, our treatment could vary from direct pressure, a pressure dressing, a tourniquet, or hemostatic agents.  Different types of pressure dressings were demonstrated along with different tourniquets and hemostatic agents.  There were enough samples on hand for all of the students to practice putting pressure bandages and tourniquets on other students as well as themselves.  Some time was also spent on improvised versions of all of these items.

Greg demonstrating how to self-apply an Israeli Bandage

My leg with Israeli Bandage self-applied

Special Notes

One thing I will note is that Greg pointed out the fallacy of utilizing tampons to plug bullet wounds in human bodies, something I see bandied about WAY too often on internet forums.  Likewise, he was able to explain not just when to use certain pieces of equipment or techniques, but also when said equipment or techniques might be contraindicated.  For example, I did not remember from prior knowledge that one should not utilize an NPA (nasopharyngeal airway) tube if a skull fracture is suspected in the victim.  Better still, Greg dropped the knowledge bombs on what evidence to look for that might indicate such fractures. 

The Class Continued

It took us the entire morning to cover massive bleeding, and we spent the first 1.5-2 hours after lunch going over the remainder of the M.A.R.C.H. protocol.  After going through M.A.R. portion, we then got to take a photo “quiz”.  Greg showed us a bunch of slides of different wounds on real people, some of which were quite gruesome, quizzing us about what we might do if we had to treat a victim of such wounds.  I liked this, as it allowed us to “practice”—in a way—what we had been taught.

Greg then moved us into the other portions of the class, the first of which overlapped with the “C” in M.A.R.C.H.:  circulation.  Here, Greg discussed wound cleaning and care, what to clean wounds with, which wounds might need to be closed (and which should NOT be closed up!), etc.  We then moved into the suturing/stapling portion of the class.  Raw chicken wings and all the fixings (you know:  sutures, tweezers, locking forceps, staplers, staple removers, gloves, etc.) were distributed.  Greg then demonstrated how to perform suturing and stapling (and removal of both), and then provided us with a chance to practice suturing and stapling.

Suturing demo.

A deft touch!

The second-to-last portion of the class dealt with how to prepare our own trauma gear (what gear to carry and options for carry).  Greg had several ankle first aid kits on hand, and it was nice to learn that he read my article here about the ankle kit that I have been using (I was wearing it in class).  He also discussed other, less-important but nevertheless useful items to have on hand in a snivel or boo-boo kit.

“Wounded” chicken wings

The final portion of the class had a tighter focus on the “system collapse” portion of the course title.  Greg pointed out that a system collapse is not just about zombies and all of that nonsense, but could be a localized but devastating emergency (Hurricane Katrina, Mumbai terror attack, etc.), that forces us to not only be our own first-responders, but also potentially providing some longer term care.  Indeed, I would lump some of the wound care aspects discussed above into part of this discussion.

This segment was chock full of knowledge, particularly for a “regular person” like me with no specific knowledge of pharmaceuticals.  In this segment, I learned a ton about useful medications to keep on hand, which medications can substitute or prolong the effects of others, and how to acquire medications that you might want to stockpile but might be difficult to access without a prescription.  Nothing that was discussed was illegal, mind you, but there were definitely acquisition means that I had never even considered.

The class ended with Greg distributing CDs of information to all of the participants. I have so far only given a cursory examination to the contents of the CD, but it includes PDF versions of medical textbooks, countless useful links (information and products), and the outline for the class.  I look forward to wading through these resources in the coming weeks/months/years!

Teaching

I have said many times on this blog that, as a teacher, I appreciate solid instruction and can recognize it when I see/experience it.  Combined with the Groundfighting class the following day, I have now taken four one-day courses with Greg.  That should be telling, for gluttony is not one of my sins.  I feel confident in lumping Greg with the best of the instructors I have experience with.  As a teacher, I appreciate that Greg’s approach is simple, giving the student everything he or she needs with no frills.  He provides MANY opportunities throughout the class to review what has so far been covered (I cannot tell you how many times he asked us:  “Okay, what do we do for massive bleeding?  And if that doesn’t work?  Okay, and what if the bleed is higher up in a spot where you can’t apply a tourniquet?”, etc.).  All instructors say they use a stair-stepped approach to delivering the material, but with Greg I always feel like I have an outline in front of me, so I know exactly what has been covered and where he is going next.  There are teachers in my school who could probably learn a TON from Greg about how to deliver a lesson.

Final Thoughts

As with the other three courses I have so far taken with Greg, I have to highly recommend this class to our primary audience of citizens practicing concealed carry.  While there is a lot to be said for working on your grip and trigger press as you shoot B-8 bullseyes at 25 yards, the fact is you are much more likely to require trauma medical skills than your pistol.  As someone who tries to remain active through hiking and mountain biking, I feel confident that one day I will need to put these skills to work.  Even my daily commute to work is rife with the danger of vehicular accidents and the like, any of which might require the rapid utilization of the skills taught in this course.  Likewise, it does not take much time reading the news to figure out situations that might require the knowledge/skills learned in the “system collapse” portion of the class.  I should also add that I am amazed at the amount of material that Greg was able to cover in this eight-hour class.   Even with the amount of information covered, there was still plenty of time for practice as well as questions from the students (and what a great job he did answering the myriad of questions!).  In short, this is another hidden gem, high-value class taught by Greg.  He is someone whose schedule I will have to continually revisit, and I look forward to repeating some coursework as well as exploring his other offerings.

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