Firefighters, police, paramedics and even a couple of big-wave surfers jumped into action last week at Kapiolani Community College, learning how to save as many lives as possible in tough situations.
They were participants in a Tactical Combat Casualty Care course, a trauma life-support system developed by the military for use on the scene. While violent crime is rare in Hawaii and the islands’ remote location induces a sense of security, residents face a range of hazards.
"This may not be Chicago or Detroit or whatever, but we have our conflicts here," said Barbara Brennan, pre-hospital trauma life support coordinator for Hawaii for the National Association of Emergency Medical Technicians. "I thought I have to bring this course to Hawaii."
The training is geared toward "all hazards," including active shooter situations, mass casualty events and natural disasters. It also comes in handy when hikers tumble from cliffs and oceangoers get bitten by sharks or walloped by waves,
Danilo Couto, a professional surfer who favors monster waves at Pipeline and Jaws, signed up for the two-day course in the hope of honing his rescue skills and sharing his knowledge with fellow surfers.
"We also deal with an uncontrolled environment in the ocean," said Couto, a Waialua resident who has worked hard to bring safety into his spectacular but risky sport, with annual summits to train for water emergencies. "We don’t have bullets, we have bomb waves. We want to better prepare ourselves to save each other."
The first Tactical Combat Casualty Course, hosted Monday and Tuesday by KCC’s Department of Emergency Medical Services, was by invitation only for trauma life-support instructors. It was taught by Bill Justice, associate director of the Center for Pre-Hospital and Disaster Medicine at the University of Oklahoma.
A second course on Wednesday and Thursday, open to others, was taught by graduates of the first session, who will continue passing on the techniques to others.
About 70 people from various islands took part, including police, local and federal firefighters, emergency medical technicians and doctors, water safety specialists and representatives of the FBI and National Park Service.
They grabbed "victims," pulled them to cover, and quickly assessed and treated injuries, learning to apply tourniquets to themselves with one hand, and to put them on others, trying to do each in 20 seconds.
The exercises subjected students to sensory overload, with blasts of noise and confusion, as well as sensory deprivation, where participants were blindfolded and forced to figure out what to do using just their sense of touch and hearing.
Matt Ballard, a firefighter based in Koloa, Kauai, and former Army medic, flew to Honolulu for the course along with some of his colleagues.
"With domestic terrorism being a bigger issue, it’s putting our first responders in a situation that traditionally they weren’t put into," Ballard said. "It takes our civilian first responders into a combat-type environment, so the class is applicable."
The training requires quickly assessing potential problems while dealing with hazards, giving minimal care and getting out of harm’s way.
"The three things that kill you in battle trauma are bleeding to death, No. 1; chest trauma, No. 2; and (blocked) airways, 3," said Justice, who oversaw the KCC classes. "This course hits every one of those up front, plus you get your patient to a safe place."
The other message, he added, is to have the right equipment and enough of it.
"In Boston, they had just a few of these tourniquets," Justice said, referring to the 2013 bombing of the marathon, as he held a self-fastening strap with a pen-sized tightening rod. "This year they had hundreds and hundreds of these tourniquets, for public safety and hospitals."
People don’t expect a disaster but it pays to prepare, he noted.
"The mentality is things like that aren’t going to happen here," Justice said. "The reality is things do happen. It doesn’t have to be bad folks. It’s the shark bite, the lawnmower injury. You’re hiking and someone falls off a cliff. It doesn’t matter who you are, a surfer or whoever, it’s good to know this stuff."
