On February 3rd, 2017, I met Hugh Coffee of Ditch Medicine for the first time. Hugh met me on the range to set up his “trauma theater” for the C-2 Tactical Combat Casualty Care the next day. I had heard great things about Hugh from Chase Jenkins (Talon Defense), and various other people in the medical field said that he was an excellent instructor. I’d seen pictures from C-2 courses that Hugh and Chase had taught together in the past. I noticed that everyone was covered in fake blood and had tape all over their arms. As Chase has been known to throw everything from rocks to fire ants on people, I assumed that all the unpleasantness was due to him. Hugh Coffee has the face of your kindly uncle; he set off zero warning bells in my head. I’m usually not fooled by folks, but Hugh snuck by my radar.
C-2 focuses on the use of the pistol for defense under any conditions. For instance, you might be upright with perfect stance. You might be lying on your side behind a barricade for cover. You may also be kneeling on someone’s femoral artery to get stop gap pressure and slow the bleeding, having carried a 300 pound person ¼ mile out of the woods on an improvised stretcher, while shooting with only your support hand, trying to clear a double-feed malfunction, with fake blood streaming into the only eye that hasn’t been taped over to deprive you of your normal range of vision – all while your buddy attempts to get a tourniquet on and stop the bleeding.
So I’ve spoken about Chase and his skill sets. I’ve been to four of his classes now and have continually been impressed by his knowledge base and his ability to manage a range. Each time I’ve come away with some teaching points to take back to my agency and my own classes. That said, we’ll focus on Hugh.
If you read Hugh’s bio, here, you’ll see that he’s got more than 30 years of experience in the medical field. He’s written a book, patched holes in horrible places and under horrible conditions, and has an extensive history with tactical medicine. Beyond that, Hugh is a historian and an actor. Part of his teaching style is to relate moments from history to the student and try to bring them into the moment. Some people like it, some don’t. Regardless, his knowledge over his subject matter is obvious. He also has a quiet presence and grace when you speak to him. At slightly over 5 feet tall, many people wouldn’t think that he has the type of work experience that he does. That would be a mistake.
So getting back to the 3rd of February, I’m helping Hugh stage the range. We assembled an easy-up awning in a clearing of the woods. We then wrapped it in tarps to enclose it, then doubled it up to cut all the light out. From there, he began dragging generators, smoke machines, a boom box, strobe lights, fire alarms, and props out of the truck. When it was all assembled, we had a 12’ x 12’ enclosed shelter filled with smoke, noise, flashing lights, and every other manner of distraction available. We tested it out at the end and I couldn’t see anything in front of my face. It was amazing how well that tent cut you off from your senses.
The next morning, we had a class of law enforcement officers and one highly qualified civilian on the line. Chase Jenkins gives, hands down, the best safety briefing I’ve ever witnessed. It outlines the difference between a safe range and a dangerous range filled with safe shooters. To paraphrase: Good training is inherently dangerous. To make it safe, the shooters need to be safe. You can be safe or you can spectate. I can’t do it justice here, so you’ll just have to believe me that it’s awesome and gets everyone on point.
The group was split up, with half of us starting with Chase while the other group began with Hugh. Having written up Chase’s “Gunfighter” courses, you can be sure that the same type of shooting exercises were performed. Dominant hand, support hand, malfunction clearing, and positional shooting. Muzzle discipline was ingrained through constant repetition of moving with the firearm around other people.
After two hours, we moved on to Hugh’s portion. He began with the MARCH pneumonic. With simple props (1 liter bottles filled with red water / beef roasts shot with hollow-points), Hugh outlined just how fast blood loss begins to affect the human body. He outlined the stages of shock. He gave us information on how to slow blood loss while applying tourniquets. Also, Chris Richards of Compression Works was on hand to demonstrate their product, the Abdominal Aortic Junctional Tourniquet (AAJT), which was just approved for use by EMT/Paramedic staff in Alabama.
Hugh moved us through tourniquets of various types and their strengths. He had approximately 20 different types of manufactured and improvised tourniquets on hand, but recommended the CAT and the SOFT-T from personal experience and also due to TCCC guidelines and testing. We also worked with chest seals, gauze for wound packing, splints, bandages, and everything else that you might find in a field med kit. Each piece of gear was explained and then demonstrated. The students then performed every task they’d been shown to Hugh’s specifications with commercial and improvised medical tools.
After two hours, we swapped back out and went back up to the range. Chase gave us another two hours of work on the range, cycling through exercises of increasing complexity. Building on the morning’s work, we lost the ability to use both hands on the gun. Tennis balls came out. As the shooting evolutions became more complex, the shooter needed to regulate his pace to avoid mistakes. Mistakes by one shooter generally equate to burpees for all shooters. It doesn’t (and does) help that he’s trying to get you to go too fast so that you can figure out your working speed. By the time we left, we all had a pretty good idea of how well we could run the guns.
Two hours later, we’re back with Hugh for the last medical block. This time, Hugh has us improvising stretchers, dragging dummies, carrying each other, and applying medical tools as we go. It was this point that I was pretty sure I’d messed up. Hugh had been on his feet, moving and running for six hours. He showed no signs of tiring and continued to outpace people half his age during the periodic runs from position to position. He never stopped smiling, said please, thank you, and called everyone brother. By the end of that round, people were tired. We’d also performed every medical procedure covered in the first block under stress. That brought us to the end of Day 1.
Day 2 started bright and early. We went with Uncle Hugh directly to the tent for “Trauma Theater.” Joining us that day were Jesson Bateman and Jay Paisley of Crisis Application Group. Jesson Bateman is the 2016 National TacMed Competition winner (apparently a pretty big deal). The other was Jay Paisley, former Green Beret / 18Z who sat on the committee for TCCC for a number of years while it was being developed (again, apparently a big deal). First things first, we began with a bunch of running and crawling around to get everyone tired. Jesson likes working out – a lot. From there, blindfolded, we crawled one by one to Uncle Hugh’s tent, while Jesson and Jay put noise distraction devices out around us to add some smoke and noise. Upon reaching the tent, Uncle Hugh began yelling at us, tore off the blindfold, hit us with a wave of fake blood, and threw us into the tent to perform medical procedures in a smoky, dark, loud, disorienting, wet place. And there was stage blood. Lots of it. Uncle Hugh LOVES that stuff. You’ll have to experience it for yourself. The Wizard’s Curtain is different for everyone, but not knowing what to expect made it that much better. You want to peek behind, you can see a trailer here.
So… after emerging from the tent covered in red, we went back to Mr. Jenkins for more of the same. Chase’s block built on the previous day, only now we were working around a partner. Reloads, malfunctions, and movement were all conducted in confined spaces with other warm bodies next to you. The barricades, the ground, or your body could be used to accomplish your tasks. You’d also need to get tourniquets and such on yourself while staying behind cover and keeping your gun running. Believe me when I say that the shooting aspect was much less stressful than the medical side of the house.
After we’d completed Chase’s shooting evolutions, we had a break prior to the final scenario testing. This was a downed officer drill. The teams needed to locate the injured officer, render emergency medical aid, evacuate the patient to a cool zone for transport using improvised carry techniques, perform a variety of shooting tasks, and then render self-aid. In true Jenkins fashion, I found myself without the use of my dominant arm and my left eye.
We spent the better part of 45 minutes dragging a nearly 300 pound human around, applying medical devices, shooting, carrying a stretcher, communicating, setting perimeter positions, and loading all 8 people into a compact car. There was smoke. There were flashbangs. There was a gallon of fake blood per person. We applied tourniquets to ourselves and our buddies, then continued to shoot and move with them. We needed to evaluate and check on the patient throughout. We probably carried the injured person (always the heaviest guy) about ½ mile, which doesn’t sound bad until everyone is down to using only one arm and you’re on broken terrain. Pro tip: Get on a group of skinny kids. The biggest guys always get to be the wounded.
At the end, it was excellent to be able to relax, take off our filthy clothing, and watch the other group go through their scenario. I spent my time washing my Glock and duty gear in a bucket until the water stopped being pink. We had an after-action briefing, talked about what we’d learned and what we wanted more of, and then everyone left. A note on situational awareness. I actually went into Barberitos just like this and stood in line for three minutes before the person next to me noticed how I looked. That was an excellent teachable moment.
Due to some pretty epic procrastination on my part, I’m writing this AAR after completing the Tactical Medical Instructor program at FLETC – Glynco. The review appears on the website as well, here. Tac Med Instructor was an excellent course. Students had approximately $500,000 in props, equipment, buildings, and prosthetics available. The instructors are all from law enforcement or military backgrounds. Many of them have seen combat and have treated these conditions in the field. That said, there was nothing in that course that I hadn’t encountered during C-2. With the ability to use all five senses and both hands, the scenarios at Tac Med Instructor were straightforward and my response to each stimulus was immediate. However, by design, Tac Med Instructor spent more time cultivating the understanding of the medical protocols of TCCC in each student. My one criticism of the C-2 class is that with 8-10 people in the final scenario, not everyone was able to work through the medical aspect. However, it did reinforce the need to work as a team in a way that the Tac Med Instructor course couldn’t.
Obviously, this class appeals to a specific audience. It’s not a class where you leave feeling like you’re a rock star or that you’ve got everything figured out. Instead, you get to see where you are in terms of your physical limitations, your firearm handling, and your medical knowledge. You get to see how you perform under the stress of fatigue, diminished sensory input, and a highly confusing environment. Truthfully, I leave these classes understanding just how much more work there is to be done. It’s humbling.
That’s a pretty amazing accomplishment for two guys using tennis balls, duct tape, red water, and a smoke machine.
Posted on Sun, February 5, 2017
by Clark Sparrow