Editor’s Note: A tourniquet on a fellow officer’s belt was quickly put to use on May 18 when retired HPD Officer John Barnes, who was acting as a Santa Fe school district officer, was seriously wounded when he confronted the active shooter in the hallways of Santa Fe High School. Barnes’ fellow officer, Gary Forward, used his tourniquet and saved Barnes’ life. The following is a reprint of a 2013 Badge & Gun story of HPD’s implementation of medic trauma training and use of tourniquets.
By TOM KENNEDY
Senior Police Officer Rodney Jaime quickly gets to the key points of HPD’s innovative Medic Trauma Training course, a year-old endeavor that has already trained 350 officers to treat serious wounds sustained in high-risk policing scenarios.
Jaime was instrumental in the development of the course and reflects the passion of a Houston officer who has policed the streets most of his 20-year career.
‘Do Know Harm’
“If you look at this way: if you’re an officer, you would rather die in a trail of blood than die in a pool of blood.
“If you are wounded, you want somebody to do something. Get me out of here. And provide a fighting chance that knowing the type of wound and proper medical procedures will enable the officer with you to do something!
“As police officers, we’ve seen blood and guts. But we haven’t had our hands in blood and guts, sometimes our own. Let’s say you are hit in the femoral artery (the large one in your thigh). If you don’t stop the blood, you could bleed out in a few minutes. HFD is on the way but might not get there in time.
“You must act fast, remembering that tactics come first – suspects aren’t giving up. You take care of the bad guy first. Medical problems solved with tactical solutions. That’s easier said than done. Good medicine can be bad tactics.”
The two-day in-service course has prioritized TACT units, gang units, warrant execution teams and Crime Reduction Units.
As Jaime put it, heretofore in Houston, officers can get “stuck in a loop.”
He said, “We never want to see our partners hurt. But if they are, we must control our emotions. They find their partner wounded and know that HFD paramedics are trained to handle these emergency situations. Often, however, by following this routine, the trauma victim greatly suffers or could even die while the ambulance is on the way.
The course teaches officers how to “break the loop and take action.”
Jaime uses the tactical medic’s motto: “Do know harm – do no harm.”
The course, taught by five veteran HPD officers with close to 100 years’ experience on the oftimes dangerous Houston streets, details the proper medical tactics that work hand-in-glove with proper policing tactics.
This entails how to pinch an artery from a gushing bloody neck wound and addressing associated complications.
The drills and equipment used answer the crucial questions:
What if a fellow officer is hit by a gunfire – or even cut by a sharp object – when in pursuit of a suspect?
What if this is a severe car accident during a chase or just during everyday patrol?
What if the wounds are life-threatening and HFD paramedics are too far away to save his/her life?
What if the threat is still active? HFD paramedics are proficient in trauma care, not chasing bad guys.
Officers learn the proper way to deal with three major possibilities that could happen to officers in harm’s way, say, in the line of fire:
- Hemorrhage control
- Sucking chest wounds
- Airway complications
And this is why officers who take the class learn to apply a tourniquet — known as a Combat Application Tourniquet or CAT – to an arm or leg in 20 seconds as well as the proper way to apply a chest seal or “nose hose.”
This training is straight from the military’s tactical combat casualty care. Medical procedure and equipment are constantly being improved from the battlefields. The Department is lucky to have returning military veterans who have been through the combat lifesaver’s course. They are already trained and some on their own carry the same life-saving equipment as officers who have completed this course.
The trainers, led by Sgt. Bryan Garrison, put participants through one day of classroom instruction at the academy, followed by another day of realistic drills, where they learn to treat their own “wounds” suffered in realistic drills, as well as multiple gunshot that impair colleagues in tactical situations.
Garrison said, “The overall concept is that we are all servants to our students to ensure we can pass along information we have obtained to make these officers better equipped to conduct their mission and, more importantly, to go home to their families when the job is accomplished.
“We’re not any better than the people we train – we’re merely blessed to be in a position to create and implement coordinated training and do our best to properly pass it on to those still on the tip of the spear.”
Officers fire live rounds in some of the drills but start each one with dry fire, thus always training for success.
“We’re big on dry fire,” Jaime explained. “The more you dry fire, the more you iron out your kinks and concentrate on you and not the target. You get your mechanics correct.”
These mechanics are now built into your muscle memory.
The drills start out basic but get more complicated as each plateau is completed. The first drill, for example, simulates an officer getting hit in his weak arm and taking cover so he can apply a tourniquet to his own wound in 20 seconds and continue tactical operations.
The trainers allow you to “take your time” the first few efforts but ultimately put on the time pressure.
Subsequent drills get more complicated, with an officer needing to apply a tourniquet to his partner’s arm and leg and a chest seal to block air from entering into the chest cavity sustained from a gun shot.
“You know it (tourniquet) is on right if it hurts,” Sgt. Garrison explained. “Those tourniquets should be tight. When you put your partner’s tourniquet on, he should be cursing you.”
Another trainer, Officer Steve Zakharia, addressed what is literally a “touchy” subject. A chest wound necessitates removal of the shirt and protective vest.
“The chest seal must be applied to bare skin,” Zakharia explained. “You’ve got to get the vest and shirt off to apply a chest seal.”
There were two female officers participating in the session, so Zakharia and the others answered the obvious questions.
In the drills, officers merely simulated the removals.
In a real-life situation involving a wounded policewoman, officers are urged to “be as modest as possible under the circumstances,” while bearing in mind that saving a life is the ultimate goal.
The officers got detailed individual attention, as each of the trainers has only four or five officers under his supervision.
The HPD dean of the bunch is Officer Kent Winebrener, who said, “In May, it’ll be 30 years for me.” Winebrener has seen many changes over those three decades but couldn’t be more pleased with the Department’s emphasis on better training – especially when it’s not in a classroom viewing PowerPoint presentations day in and day out.
Winebrener has spent most of his 30 years on Patrol, seeing enough to be an extra strong advocate for Medic Trauma Training.
“What we originally designed and pushed for was to train everybody in Patrol. People’s lives are at stake every day. But to do Patrol first was too big a chore. We do want to put 2,000 or 3,000 (medic trained officers) on the street.”
Each of the trainers was steadfast in crediting the people in the Department who worked hard – some as long as three or four years – to see the program’s implementation. Winebrener identified Sgt. Heath Bounds as the earliest advocate for this training program for the department.
Jaime said Sgt. Bounds of the North Shepherd TACT “initiated the idea of this training and equipment several years ago.”
A key turning point came when Jaime, Bounds and others learned that Executive Assistant Chief K. A. Munden was envisioning the same kind of program. They combined efforts, while the Houston Police Officers Union paid Jaime’s tuition in an advanced military-style medic trauma training program held in 2009 in Nacogdoches.
Jaime said the program was conducted by Combat Shooting and Tactics (CSAT), which
provides training based on Tier 1 experience quality instruction to law enforcement officers and government agencies. CSAT was founded and is run by Paul Howe. Howe has more than 20 years in the U. S. military service and 10 years in the Army’s Elite Special Operations. In addition, he served as a team medic.
Jaime and another Medic Trauma Training officer, Rich McCusker, went back to CSAT for a six-day tactical medical integration course, which Jaime described as “the cornerstone for tactics in a medical situation.”
Training programs like this one readily attract the attention of Police Chief Charles McClelland, who has made training one of his top priorities. In addition, Capt. Dwayne Ready, who heads the academy “provided guidance, advice and helped purchase training equipment. Lt. Spence Coker also was a strong support; Coker oversees cadet training and the Tactical Training Unit.
Jaime also singled out Senior Police Officer Erica Fuentes, who works with the Houston Police Foundation while serving under Executive Assistant Chief Tim Oettmeier. “She made the process easy,” he said, while also crediting Chief Oettmeier for his full support.
Jaime credited Lisa Spivey of the Southeast Texas Regional Advisory Council, which provides support to agencies for preparedness training for trauma, stroke, cardiac care and pediatrics’ services. SETRAC also administers federal and state grant money for stakeholders such as Houston/Harris County. Funding was provided to the Tactical Training Unit.
“Lisa is passionate about getting law enforcement on the same page with the medical community right now and not when catastrophic events happen,” Jaime said.
Like many of his fellow officers who are determined to give credit where it is surely due, Jaime identified three others for their work and dedication. They were:
Joe Fenwick of the Academy, a “jack of all trades who provided assistance with overall development of the class”; Sgt. Stuart Harris of Planning and Development, who dealt with vendors and worked closely with Chief Munden’s office; and Cat Godden of Emergency Medical Solutions, who “provided moral support and training.”
Funding, as always, was problematic, although the Houston Police Foundation provided the funds needed to pay for the $115-120 tactical first aid kits issued to each graduate of the course to take on the streets.
“Thank God for the foundation,” Winebrener said. “If it wasn’t for them, we still wouldn’t have kits on the street. With those kits on the road everybody out there will be safer and have a much better chance of surviving.
“We teach getting the tourniquet in place in 20 seconds from the time we say go. The tourniquet must be out, in place and tied down. In a real-life situation, you are running, your heart rate is elevated and you’re going to pump out faster.
“You may lose consciousness in less than a minute. You may not be able to perform the functions to get it in place. We’re shooting for 20 seconds.
“It’s something you do with urgency. We’re not talking about a minor cut. We’re talking about massive hemorrhaging. This is very freighting.”
All five of the trainers show their own particular passion for the program. The fifth member of the team is Senior Police Officer Rich McCusker, an 18-year HPD veteran and resident expert in tactical skills, combat mindset and leadership. As you might expect, he’s a former SWAT officer.
Jaime likely won’t be please until every gun-toting HPD officer has the Medic Trauma Training course under the belt and carries the tactical first aid kit. He received his first medical training while in the military. He said at the time he was in the service a tourniquet “was a last resort. This was the standard military practice right up until about 2004.”
Then, while off-duty and on his way home out of uniform on the night of May 18, 2010, he was the first person to arrive at the scene of a one-car automobile accident on the North Freeway access road, near Troy Road.
An HPD patrol car had struck a guardrail and it looked to him like the driver’s door was open when it was actually pushed into the passenger seat.
Jaime found fellow Officer Eydelmen Mani trapped inside and seriously injured. Mani “was fighting me” in the shock and panic of the traumatic accident as he was bleeding internally.
Rescue crews extricated Mani from the vehicle and transported him to Memorial Hermann Hospital, where he died early May 19.
Ever since this tragedy, Officer Jaime has been passionate about the medical trauma training he and his four fellow trainers administer at the academy.