Combat Life Saver course - "stick and get stuck".

MAJ Private RallyPoint Member — Fri, 16 May 2014 07:15:49 -0400

I heard the "stick and get stuck" part of CLS was removed from BOLC. Anyone know if this is true? That was my favorite part - it was a blood bath. So many people didn't set their IV caps after placing the needle that there was blood everywhere. I remember 2 females who were afraid of blood who refused to even go close to the tables.

Response by MAJ Steve Sheridan made May 16 at 2014 9:08 AM

MAJ Steve Sheridan — Fri, 16 May 2014 09:08:06 -0400

Don't know, but can't see why they would remove that. That is a key aspect of being a CLS.

Response by 1SG Private RallyPoint Member made May 16 at 2014 9:40 AM

1SG Private RallyPoint Member — Fri, 16 May 2014 09:40:27 -0400

Not sure when it was removed from BOLC, but I took CLS in 2009 and was told it would the last class allowed to stick each other. Not usre the reasons behind the change, I definetly think they should have left it in. There is no realistic way to replicate it and it gives a Soldier the confidence to be able to do it battle.

Response by SFC Stephen Carden made May 16 at 2014 9:53 AM

SFC Stephen Carden — Fri, 16 May 2014 09:53:56 -0400

I agree that there is no real substitute for sticking a live human being. However, your Training Support Center (TSC or TAS-C) should have the Intravenous Therapy Trainer. It is an artificial representation of a human arm from about midway up the bicep to about midway down the forearm. I guess that is the next best thing. The GETTING stuck part was only an exigency of the class, as there had to be somsone to stick. I don't think getting stuck is a requirement of the POI.

Response by SSG Private RallyPoint Member made May 16 at 2014 9:55 AM

SSG Private RallyPoint Member — Fri, 16 May 2014 09:55:41 -0400

It's true Sir, I was told by a very good medic that because CLS was so focused on sticking people that first responders would go straight to the needle then treating the wound. Thats why they went away from it. I do miss it, the blood bath people freaking out over it all. Ah great times.

Response by MAJ Michael Kammerer made May 16 at 2014 10:29 AM

MAJ Michael Kammerer — Fri, 16 May 2014 10:29:14 -0400

We were told CLS Army wide has changed; it has been condensed and the IV portion has been removed. The story we received from an AMEDD REP on JBLM was that Soldiers are spending too much time trying to get an IV started and not enough time looking for other injuries. Doesn't make much sense to me either . . .

Response by LTC Private RallyPoint Member made May 16 at 2014 11:13 AM

LTC Private RallyPoint Member — Fri, 16 May 2014 11:13:53 -0400

As I understand it, IV's led to more deaths on the battlefield than prevented them due to increasing the likelihood of bleeding out. The purpose of CLS/TCCC is to eliminate preventable deaths. Pre-hospital fluids at the point of injury were bad and aggressive use of tourniquets to control life-threatening hemorrhage were good. Our best emergency medicine physicians in the Army looked at this and revised the curriculum. Controlling bleeding became our primary task at the point of injury due to what we were seeing in OIF and OEF.

I definitely do miss the "blood bath" from OBC. Seeing officers passing out left and right from the sight of blood was very entertaining to me.

Response by Maj Chris Nelson made May 16 at 2014 12:36 PM

Maj Chris Nelson — Fri, 16 May 2014 12:36:05 -0400

As a nurse and former Combat medic, I can see a couple things going along with this decission (some have been mentioned above). Here are my PERSONAL THOUGHTS:

1. Focus on IV instead of lifesaving measures such as airway
2. Over hydration in situations that do not need massive fluid bolus (lots of talk about popping clots, BUT I would say a bigger risk is dilution of the oxygen carrying blood to levels that are ineffective in carrying enough oxygen...remember IV fluids do not carry oxygen).
3. Any IV started ESPECIALLY in a classroom setting is un-necessarily increasing the risk of infection.
4. How many of you folks have carried full ruck (stupid question you may say).... Full Ruck is what 60? 80 pounds? Remember, water is 8 pounds per gallon. 4 IV bags would make appriximately 1 gallon. in a true massive fluid loss situation, 4 bags is nothing....that means that SOMEONE is carrying all their gear and at least 8+ pounds of IV Fluids.
5. medivac systems have improved greatly over time. Keep the casualty alive, let the medics push fluids and give meds.
6. for training sessions now, if they decide to continue keeping IV training as part of it, there are SIM people that will allow every aspect of treatment to include IV's to be placed without unnecessary risk. Not to mention, IV starting is an art...if you do not practice it regularly, do you really think you will hit an IV under battlefield stress? I think not.
7. Many medics now carry the Inter-Osseous system. Placed in the sternum or the Tibia, faster, more secure, and and very effective. Not as risky to place as the old IV while on the battle field.

Just my thoughts....not sure if it is the real reason or not.

Response by SSG Genaro Negrete made May 16 at 2014 2:04 PM

SSG Genaro Negrete — Fri, 16 May 2014 14:04:36 -0400

Even with it being out of the formal POI, it can still be incorporated into training (pending the approval from the BN PA).

To call someone a "tourniquet monkey" implies that, like the geico commercials, it's so easy a cave man can do it. We know that the tourniquet saves lives when used at the right time in the right way. That seemingly simple application of the tourniquet is no different than the training hours spent on how to perform SPORTS (or POPS if you are so inclined). We train to be able to do things at combat speed. That blood soaked tourniquet being applied by shaking, sweaty hands on a mangled stump that doesn't want to cooperate is no simple feat.

All in all, I'd have to say that constant, consistent, competent training is what saves lives. The details may change after years of research, but the principle is the same.

Response by CPT Private RallyPoint Member made May 17 at 2014 1:37 AM

CPT Private RallyPoint Member — Sat, 17 May 2014 01:37:16 -0400

As with most medical care, BLS>>>>>>>>>>>ALS. With most any unit I'm in, I'm sure I will be able to obtain IV supplies for my usage if I have a need to have a kit. Difference between most others and me is the licensure I hold. As a paramedic, I have a much greater appreciation for BLS>>>ALS. Too many ALS providers focus on tubing or IVs when an NPA or OPA or IO will work just fine.

Response by CW3 Kevin Storm made Aug 15 at 2015 9:36 PM

CW3 Kevin Storm — Sat, 15 Aug 2015 21:36:50 -0400

Having been a civilian Paramedic, and knowing what I had to go through, I often wondered at ther logic of CLS concept of teaching neophytes the art of sticking people without truly understanding the pathophysiology of why they were doing it. Sticking to stick was at best a horror story. I am glad to see it gone in favor of more common sense treatments.