Op­tions for Get­ting Wounded to Safety Dur­ing a Cri­sis

RECOIL OFFGRID - - Front Page - By An­drew Schrader

Learn­ing how to evac­u­ate an in­jured per­son from a haz­ardous or re­mote lo­ca­tion, such as an ac­tive-shooter event or a back­coun­try hike gone wrong, is like pay­ing down your credit card bill rather than buy­ing new stuff ev­ery month — in your heart you know you should do it, but it’s just not as fun or as sexy as other op­tions.

We be­lieve in a holis­tic ap­proach to pre­pared­ness and rec­og­nize that it’s just as im­por­tant to know how to save the lives of oth­ers as it is to pro­tect your own. To find out more, we spoke with Eric Soder­lund, who has worked as a de­tec­tive for a large Florida county law en­force­ment agency for the last 13 years. Prior to that, he served as U.S. Army mil­i­tary po­lice­man (95B, now 31B) for eight years. He's on the board of ad­vis­ers for the Com­mit­tee on Tac­ti­cal Emer­gency Com­bat Care (CTECC) and serves on the train­ing cadre for the Florida SWAT as­so­ci­a­tion’s tac­ti­cal EMS course.

“It’s great to have a gun on you,” Eric says, “But it’s about more than just be­ing armed. Like we saw in Las Ve­gas, all of those 3,000 peo­ple in the crowd could have had a gun on them, and it wouldn’t have done any good. So we need to be a stu­dent of the game. And th­ese days the game in­cludes med­i­cal train­ing and know­ing how to move in­jured peo­ple.”

Use Your Sur­round­ings

In the event that ca­su­alty evac­u­a­tion be­comes nec­es­sary, Eric en­cour­ages trainees to first take a good look around them. This doesn’t mean to go all MacGyver and build an ul­tra­light hang-glider to es­cape out a win­dow. In­stead, keep it sim­ple and just think about what makes sense. “Look at the en­vi­ron­ment and see what’s ready to use,” Eric says. “If you have a minute to look around, see if there’s some­thing that can make your life a lit­tle eas­ier.”

If you’re in an of­fice en­vi­ron­ment and a ca­su­alty can’t walk, con­sider grab­bing one of those ever-present rolling desk chairs, plac­ing them in the chair, and wheel­ing them out. You may have to hold them from be­hind to keep them up­right, but it’ll still be eas­ier than sim­ply try­ing to drag them out with your bare hands. “You don’t nec­es­sar­ily have to be Cap­tain Cave­man, and lift and carry ev­ery­thing,” Eric adds. “Work smarter, not harder.”

Oth­er­wise, if you’re not im­me­di­ately faced with a di­rect threat and you have at least one other per­son to help you, you could im­pro­vise a lit­ter (like a flex­i­ble stretcher) out car­pet­ing on the floor. With the ca­su­alty lay­ing down, cut an out­line around them us­ing your knife. Then cut slits for hand­holds on the sides and an­other at the head, and roll your pa-

tient in­side the car­pet Cor­leone-style just like you’ve seen in all those mafia movies. This will al­low you to grab the car­pet much more eas­ily and slide the ca­su­alty along the floor with much less fric­tion than oth­er­wise. And if you de­cide that you do want to add a dash of MacGyver, thread­ing a pole or mop han­dles through the cutout slits pro­vide an even eas­ier hand­hold and im­prove the rigid­ity of the lit­ter as well.

Find Al­ter­nate Paths

For those who work in the same place ev­ery day, it makes sense to oc­ca­sion­ally look around and think about what you could use, and how you might be able to get out. “Think about your sit­u­a­tion ahead of time,” Eric says. “If you’re in a high-rise build­ing where a fire on top and bot­tom is a real pos­si­bil­ity, would you con­sider base jump­ing off the roof? That’s an ex­treme ex­am­ple, but the idea is to look at your en­vi­ron­ment and con­sider the pos­si­bil­i­ties. Think out­side the box of leav­ing the build­ing us­ing the stairs or an el­e­va­tor.”

Many wooden doors can be bro­ken down with a mule kick. How­ever, me­tal doors, as we’d find in a com­mer­cial or of­fice en­vi­ron­ment, aren’t quite so easy. But if we think out­side the box we might find that the walls ei­ther side of that door are made from dry­wall and me­tal studs. In that case, there’s a good chance you can bust through the dry­wall to ac­cess the other side.

A com­mer­cially avail­able Breach Pen cut­ting tool can be used to burn your way through pad­locks or chained doors, and is much more por­ta­ble than a bolt cut­ter. This light­weight and pack­able tool, about the size of a small flare, al­lows you to burn your way through any num­ber of bar­ri­ers. Ad­di­tion­ally, also con­sider keep­ing a fire-sup­pres­sion tool on hand, like a com­pact aerosol spray can fire ex­tin­guisher, such as those from Blaze De­fense Sys­tems, which can quickly cool red hot me­tal to hand-hold­able tem­per­a­tures.

Ad­di­tion­ally, many of­fice build­ings have drop ceil­ing tiles. If you can climb into the dropped ceil­ing space, you may well be able to by­pass locked doors and ac­cess other ar­eas.

Last, con­sider break­ing through win­dows to get out. Ten to 15 years ago it’d never be an is­sue to break glass. But de­pend­ing on your lo­ca­tion, the glass might be im­pact or hur­ri­cane-rated, so you can’t nec­es­sar­ily just throw a chair through it. To mit­i­gate this, you could con­sider us­ing a glass­break­ing tool of­fered on some fire-res­cue–style knives such as the TOPS/BUCK CSAR-T. If nec­es­sary, you might also think about shoot­ing through the glass, af­ter tak­ing a look to see what’s out­side first.

“Just re­mem­ber,” Eric says, “you own ev­ery sin­gle round that comes out of that bar­rel, re­gard­less of what kind of crazy sit­u­a­tion is go­ing on. So maybe con­sider shoot­ing out a lower cor­ner of the win­dow so you’re aim­ing at the ground, re­duc­ing the like­li­hood of col­lat­eral dam­age.”

Con­sider Af­ter­mar­ket So­lu­tions

In an ideal sit­u­a­tion, you’ll have a full-size EMS stretcher next to you, like the ones you see EMTs load into res­cues (am­bu­lances). It’s 100-per­cent rigid, so all of the force you use to push (or pull) the stretcher trans­lates di­rectly into mov­ing the stretcher. Real­is­ti­cally, of course, that’ll never hap­pen. So we trade rigid­ity for im­proved porta­bil­ity, and we use pack­able soft lit­ters in­stead of stretch­ers.

As lit­ters get lighter and more por­ta­ble, they also get more flex­i­ble, which isn’t nec­es­sar­ily a good thing. With a more flex­i­ble lit­ter, the force that would’ve moved your pa­tient is more likely to just bend your pa­tient. It’s anal­o­gous to push­ing a sturdy wooden crate ver­sus try­ing to push a can­vas sack, or worse, a thin plas­tic bag filled with or­anges.

Eric rec­om­mends train­ing with com­mer­cial prod­ucts where avail­able, be­cause hav­ing trained with good prod­ucts will help show you how to im­pro­vise a so­lu­tion when the time comes. “The more you use the com­mer­cial de­vices and for­mal­ized train­ing,” Eric says, “the bet­ter you’ll be at build­ing im­pro­vised so­lu­tions be­cause you’ll bet­ter un­der­stand the con­cepts be­hind it.”

“Con­sider a com­mer­cial tourni­quet, for ex­am­ple. If you’ve used one you’ll know that you need a strap, a wind­lass, and some­thing to clip the ten­sioned wind­lass to. So don’t es­chew the com­mer­cial op­tions just think­ing you can ‘wing it’ when you have to. Train­ing with the real gear will help you wing it.”

When it comes to com­mer­cially avail­able prod­ucts, Eric has used sev­eral from Tac­ti­cal Med­i­cal So­lu­tions (TacMed So­lu­tions) that he fa­vors. First is the Fox­trot Lit­ter. “The Fox­trot is the Cadil­lac of lit­ters, and it’s rel­a­tively in­ex­pen­sive,” Eric says. “It’s semi-rigid, strik­ing a com­pro­mise be­tween use­ful­ness and porta­bil­ity. For its size you can use a twoor four-per­son carry, or just drag it on the ground as you would in a wilder­ness sit­u­a­tion. A Skedco Sked (sled) is also cool, but usu­ally that’s not avail­able un­less you’re trav­el­ing in a large ve­hi­cle or into over­land­ing with 4x4 Jeeps.”

For the pho­tos seen in this ar­ti­cle, we used a Res­cue

Task Force (RTF) ver­sion of the Fox­trot Lit­ter, which uses some­what beefed-up ma­te­ri­als but is a sim­i­lar con­cept. We also used the Evac­u­a­tion and Rig­ging Strap (ER-S) from TacMed So­lu­tions, which is in­ex­pen­sive, small enough to be packed in­side any bag, and lets you per­form a drag, a backpack carry, or a mod­i­fied half-lit­ter carry on a ca­su­alty with a few sim­ple loops of the strap around them.

“An­other soft lit­ter is the Phan­tom from TacMed So­lu­tions,” Eric says. “It can be thrown into a backpack or bag eas­ily. The trade-off is that you can’t drag it very far or you’ll rip the sh*t out of it. It’s also su­per flex­i­ble, which ac­tu­ally makes it harder to carry when you con­sider the pa­tient nat­u­rally flex­ing their knees and bend­ing their hips.”

De­ci­sion to Move

When it comes to de­cid­ing whether or not you should at­tempt to move ca­su­al­ties dur­ing an ac­tive shooter event, the rec­om­men­da­tions are fairly sim­ple. If the ca­su­alty is dead, then there’s no need to move them. And if you’re in a “hot zone” where the shooter is a di­rect threat to you, you should worry about pro­tect­ing your­self with your own firearm if pos­si­ble or evad­ing in­stead. Oth­er­wise, if you’re in a “warm zone” where the threat is still out there, but not di­rectly in front of you, then you should at­tempt to move the in­jured ca­su­alty to safety.

Re­gard­less of whether or not you sus­pect neck or spinal in­juries, un­less you have ad­vanced tac­ti­cal med­i­cal train­ing, don’t spend time try­ing to sta­bi­lize the pa­tient's neck or spine prior to evac­u­a­tion. Chances are that you’ll just do it wrong any­way, com­pound­ing the is­sue and wast­ing in­valu­able time. In­stead, fo­cus sim­ply on get­ting the ca­su­alty to pro­fes­sional care as soon as pos­si­ble.

In a back­coun­try hik­ing or wilder­ness sit­u­a­tion, it can be dif­fi­cult, if not im­pos­si­ble, to evac­u­ate an in­jured party to safety by your­self. In most sit­u­a­tions it'll be safer for both you and the ca­su­alty if you leave him or her to shel­ter in place, and speed off by your­self to go find help. Oth­er­wise, you run the risk of run­ning out of sup­plies or dy­ing of ex­po­sure on your way out be­cause of the slowed pace when trans­port­ing ca­su­al­ties. The de­lay in med­i­cal care alone may doom the ca­su­alty. The bet­ter op­tion is to quickly alert the lo­cal au­thor­i­ties, who can de­ploy a wilder­ness searc­hand-res­cue team.

Lit­ter Use Tips

When you strap the pa­tient into an af­ter­mar­ket lit­ters, con­sider strap­ping them so that they’re lay­ing on their side as op­posed to on their back, like you see in all the movies. This makes it eas­ier for them to bend their bod­ies (or you to bend their body for them) in or­der to nav­i­gate tight cor­ners or stair­wells.

Think about it this way — if you’re lay­ing on your back it’s quite dif­fi­cult to arch your body into any con­fig­u­ra­tion be­sides straight up and down. But if placed on your side, it’s easy to bend into an S-shape or ma­neu­ver to help you fit where you need to. This also has the added ben­e­fit of the pa­tient be­ing in the “re­cov­ery” po­si­tion al­ready, re­duc­ing the chances of chok­ing on vomit or blood, and mak­ing it eas­ier for them to breathe. You can also uti­lize a backpack, jack­ets, tow­els, etc., to prop them up into the re­cov­ery po­si­tion, or use th­ese items to place in “hot spots,” bony ar­eas of the body that can take a beat­ing if dragged in a lit­ter over rough ter­rain.

To sum­ma­rize our tips: Try to use your en­vi­ron­ment to help you, con­sider other ways be­sides doors to get out, and con­sider pur­chas­ing af­ter­mar­ket lit­ters to train with and carry with you. This way you’ll be help­ing not just your­self and your fam­ily, but pos­si­bly the larger com­mu­nity as well.

“Part of be­ing pre­pared is be­ing able to en­able the layper­sons around you — show­ing them how to help oth­ers while you do it your­self,” Eric says. “So get your fam­ily in­volved, and your kids and com­mu­nity. Get them in­volved and think­ing, it'll suck to have to carry some ran­dom ca­su­alty or your wife by your­self down three flights of stairs in or­der to es­cape a threat.”


This ar­ti­cle is meant to be an over­view and not a de­tailed guide on evac­u­at­ing in­jured in­di­vid­u­als to safety dur­ing an emer­gency. Seek pro­fes­sional med­i­cal train­ing be­fore at­tempt­ing any of th­ese tech­niques.

Breach Pen is a small, por­ta­ble tool to quickly cut through locks and other me­tal

ma­te­ri­als that may be im­pass­able oth­er­wise. Like any heat

con­duct­ing de­vice, proper train­ing is im­por


Look at your en­vi­ron­ment and ask your­self

what you have at your dis­posal that could serve as an im­pro­vised gur­ney or wheel­chair to evac­u­ate some­one from dan­ger quickly.

Can't find any­thing nearby to move some­one who is in­jured? Why not carry some­thing with you? The Fox­trot Lit­ter by Tac­ti­cal Med­i­cal So­lu­tions is a por­ta­ble, light­weight plat­form that can be used to move some­one to safety when sec­onds count. It can be used to

carry a ca­su­alty in a low "bear

crawl" po­si­tion, min­i­miz­ing ex­po­sure by main­tain­ing a low pro­file

when needed.

One way to use the ER-S strap from TacMed So­lu­tions is to lay the ca­su­alty on their back and use the ER-S as a con­ve­nient drag strap, looped around the ca­su­alty's arms and chest.

Ap­plied in a dif­fer­ent con­fig­u­ra­tion, the ER-S can also be used to hoist a ca­su­alty and at­tach them to you like a backpack, which is more ap­pro­pri­ate for cer­tain con­di­tions.

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