• Again, you can throw just about any office supply item
On a plane
• Book—use much like a laptop to strike the throat or throw. And if time permits, feel free to open this book, review the section on hijacking, and then crush the terrorist’s windpipe while yelling “SEAL survival!” at the top of your lungs.
• Rolled-up magazine—believe me, it will hurt when used with a stabbing motion to the face or throat
• Ball-point pen—can be mightier than the sword if you stab a lot
• Vodka—from the beverage cart to the eyes
• Blanket—throw over the face of an attacker to disorient and blind
Kitchen
• Knives, forks, spoons, rolling pin, pots, pans, lids—need I say more?
• Corkscrew—doubles as a fist pack with protruding point (screw) between knuckles
• Fire extinguisher—throw at an assailant’s feet/legs or engage the sprayer to blind
HOMEMADE PEPPER SPRAY
1. In a glass, add equal parts cayenne pepper and rubbing alcohol, then stir.
2. Strain the big chunks using cloth and place the liquid in a spray bottle.
3. Spray—effective on attacker for up to thirty minutes.
Garage
• Anything from a toolbox (hammer, screwdriver, box cutter . . .)
• Any sports equipment, not only for use as a weapon but for protection (like a baseball bat and hockey mask)
• Lumber
• Plumbing supplies
• Chain saw (my personal favorite)
• This list could go on and on; you name it, and you have a weapon
When I emerge from my garage for a fight, I will be donning a motorcycle helmet, chest protector, and steel-toed boots, with an idling chain saw in my right hand and a sledgehammer in my left, displaying a million-dollar smile. Welcome to my Thunderdome!
In summary, if you find yourself in a situation where someone is trying to harm you, use everything at your disposal to get out of that situation alive. If you can throw it, thrust it, block with it, spray it, crush with it . . . do it.
PART FOUR
Survival Medicine
When tragedy occurs, it always comes down like a hammer. The human body is an incredibly resilient machine capable of withstanding the unthinkable. On the other hand, we are not indestructible, and our bodies can be so unpredictably fragile that a life can be lost within moments. It’s almost guaranteed that there will be injuries when unexpected life-threatening situations occur. You may survive an initial ordeal, but if you lack the knowledge of how to stop a wound from bleeding or what to do if bitten by a snake . . . you’re done.
Whether you survive a lethal situation will often depend on whether you have some understanding of how to apply basic medical emergency techniques. The information I provide here is designed for educational use only and is not a substitute for specific training or experience. One of the very best pieces of advice I can give regarding survival is that you should go and get some medical training, because when bad things happen, people get hurt.
During an actual emergency you’ll have no time to flip through a book and learn—and being ill prepared, regardless of your other strengths or abilities, could be your death knell. Believe me, you do not want to stand by helplessly if someone you care for is in dire need of immediate care. If a dangerous situation were to occur and you were unable to help, it would haunt you and leave a mark for a long time. At a minimum, you should attend a basic first-aid class and get your CPR certification.
Several years ago, when I was considering becoming a firefighter in Los Angeles, I trained and became a nationally certified EMT. I knew how important these skills were as a SEAL. Even though I decided to go a different route, the invaluable knowledge I learned as an EMT enabled me on several occasions to save lives.
Every SEAL platoon has two highly trained medical personnel called corpsmen. When I say “highly trained,” I mean they not only perform lifesaving surgical procedures but do so while avoiding bullets and explosions all around them. It’s been proven that getting everyone out alive often comes down to how quickly lifesaving techniques are performed at the onset of an injury—and these guys are the best!
STEP UP AND HELP!
In life-or-death situations you must do everything you can to survive and to help others survive. I believe strongly that we as humans have an obligation to provide aid, or a duty to act. As I mentioned earlier in this book, I recently came upon the scene of a pedestrian who had been struck by a car. As I approached the lifeless, bleeding body, I was amazed at the group of people who were just standing there and staring. Learning medical techniques makes you a leader and lifesaver in such situations.
Good Samaritan laws were established across the country beginning in 1959 to protect you from liability if, in good faith, you attempt to render emergency care at the scene of an emergency and you are doing so as to not exceed basic lifesaving techniques or beyond your level of training. But don’t attempt to conduct certain medical procedures beyond your level of training or “scope of practice,” or you may have to deal with legal repercussions. For example: You come across an unconscious person and begin CPR and mouth-to-mouth breathing. Even if this person died, you would be protected by the Good Samaritan Law. However, if you attempted to stop bleeding in the brain by removing the skullcap and plugging the hole with a sock . . . well, that’s not in the spirit of the Good Samaritan Law and you might be in some trouble with that call.
I am bringing this up only to further stress the importance of receiving medical training. That said, each situation will be different, and you will decide what you can or will do depending on the survival scenario encountered.
Casualty Assessment
If you arrive at a scene where someone else is injured, the first and most important thing to do is a scene size-up. You must quickly identify possible hazards and decide whether it is safe to enter or stay at this location. The last thing you want to do is rush in to help, only to become one of the injured because of falling debris, an explosion, toxic fumes, or violence, for example. Maintain your situational awareness, because things can change quickly. Continually assess the scene for unusual characteristics such as sounds, smells, or things that seem odd.
As a general rule, you don’t want to move an injured person for fear they may have a spinal injury. It is best to attempt to give aid at the location at which you found someone and leave issues of transport to professional medical responders. However, if failing to move someone from a hazardous area means risk of further injury or death, then get them out of there.
A very relevant and disturbing example of the importance of scene size-up is the tactic that the “animals” (insurgents) in Iraq liked to use. This particular brand of despicable individuals would explode an IED or car bomb at a scene. They would then wait for military medics or first responders and ambulances to arrive to give aid to the injured. Ignoring all humane laws established in the Geneva Conventions, and regardless of whether the medics wore the international insignia designating that they were there only to practice medicine, these insurgents would then detonate another bomb, oftentimes a larger explosive device, killing those who were trying to help. Like I said—animals.
Get into Action
If you were injured or involved in the incident, you must evaluate your own condition and treat it before you attempt to help others. In my experience on the SEAL teams, this meant that if we were in a firefight, for instance, and I got wounded, it was expected that I would attend to and work on my own injuries. Everybody else had their hands full with the fight. I didn’t want or expect anyone to focus on my injuries when we were in an actively hostile situation. When you see a teammate injured, a guy who is closer to you than a brother, your immediate instinct is to go and help. But the priority must be to win the fight first or instead of one man down, there will be two.
SEALs say: “Self-aid, then buddy aid.”
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p; Take care of your own injuries, if possible, because the rest of the guys are taking care of the guys who gave you the injuries. This is also an example of what is now referred to as CUF (“care under fire”).
Practice scene-size up. For example, let’s say there has just been an earthquake and you hear someone screaming under the rubble of a large building. Fight the urge to run in and help, because a small aftershock may cause the rest of the building to collapse on you.
Initial Assessment
Once you have decided the area is relatively safe, you may begin the initial assessment on your patient, which is a set of procedures used to discover and treat the individual’s most immediate and life-threatening conditions. The steps of the initial assessment put in place a systematic approach and help you to make decisions about priorities and the types of care that each of the injured needs. Identify the person with the most life-threatening condition; that person must be treated immediately before you move on to the next portion of the initial assessment. For example, you must restore a person’s breathing before you attend to their broken leg or the injuries of any other breathing victim.
If you have surgical gloves (which should be in your go bag and in your vehicle), put them on before you begin treating the injured.
TRIAGE
You may find yourself at an MCI (mass casualty incident) where there are several injured people and you are the only one who can help. How do you decide whom to help first? Triage is a system used for sorting patients to determine the order in which they will receive care. This will require you to make some tough decisions, but it will also allow you to provide care for and save the ones that you can.
Triage Categories
Priority 1: The injured who need immediate care (major bleeding or very poor vital signs indicative of internal bleeding).
Priority 2: The injured whose care can be delayed (minor bleeding).
Priority 3: Those with minor injuries who need help less urgently (fracture).
Priority 4: The “expectant,” who are beyond help (deceased or fatal injury).
As a platoon commander, I confronted several situations that required difficult decisions. Generally any decision made according to the rule “The greatest good for the greatest number” was the correct one. Stopping and helping one injured man versus continuing on and saving the group from certain death isn’t the right move.
IMMEDIATE PRIORITIES FOR TREATING THE INJURED
As I said in Part One, “Whatever you do in training, you will do under stress.” It is so important to practice the following skill set because when you arrive on a scene with injuries, it will be extremely stressful. Your immediate priorities will be:
1. Restore breathing and heartbeat if absent.
2. Stop any bleeding.
3. Protect wounds and stabilize fractures or dislocations.
4. Treat for shock.
ABC
When approaching an injured person, call out to them to see if you get a response. This will give you several indications as to their current condition. For example, if a person can answer and talk, you know immediately that he is breathing and conscious. If the victim is unresponsive or unconscious, then begin your ABCs. ABC is an acronym you must remember for survival medicine; it stands for “airway, breathing, circulation.” When you begin to treat an injured person, first check that the Airway is open, that the person is Breathing, and that there is a pulse or other signs of Circulation. Periodically check with the American Red Cross and the American Heart Association for any changes or modifications to the information in this section. Methods and standards are updated annually.
A: AIRWAY
If a victim is facedown, you must carefully roll him over. Place one hand on the back of the victim’s neck and the other on his hip, and gently roll the victim over onto his back. If you suspect a back or neck injury, then try to get others to help. Keep the injured’s head, neck, and back in alignment as much as possible as you roll the person until faceup.
To open the injured’s airway, you must use a head tilt (even if you suspect back or neck injury):
1. Kneel beside the victim and place one of your hands on their forehead while you gently tilt the victim’s head back.
2. Place the fingers of your other hand on the cusp, or bony part, of the victim’s chin (not on the throat).
3. Carefully lift the chin straight up, keeping the head tilted back. Try to do so without closing the person’s mouth. If you think the victim might have a spinal injury, use the jaw thrust method.
4. Check to make sure there is nothing obstructing the victim’s throat or interfering with breathing. The tongue may have curled up at the back of the throat. Using what’s called a finger sweep, clear the mouth of all obstructions and move the tongue out of the airway if needed.
B: BREATHING
Once you determine that the airway is open, listen for any indication of breathing for five to ten seconds. This can be done by placing your ear next to the victim’s mouth or pressing your cheek against their lips in an effort to hear or feel breathing. As you are doing this, watch the chest to see if it is rising and falling.
C: CIRCULATION
Then monitor for signs of circulation by placing your index and middle fingers in the groove of the windpipe, which is located just beneath the angle of the jaw. You can also check if there is a pulse by placing two fingers on the inside of the wrist at about one inch above the base of the thumb, or under the armpits.
Rescue Breathing
If an adult stops breathing but still has signs of circulation, call for EMS (emergency medical services) and then begin rescue breathing. If a child or infant stops breathing but has signs of circulation, perform rescue breathing for two minutes before calling for EMS. Then resume rescue breathing. If the victim is not breathing and has no signs of circulation, perform CPR.
RESCUE BREATHING ON AN ADULT
1. Pinch victim’s nose closed with your fingers, and put your mouth over their mouth.
2. Exhale two full, slow breaths, each for one to one and a half seconds.
3. Then withdraw and wait for the victim’s lungs to deflate.
4. If you don’t hear air exhaling, then reposition the person’s head, mindful of possible spinal cord injury, and try the procedure again.
5. Check for any signs of breathing and circulation, and then continue the method, waiting about ten seconds between each attempt.
RESCUE BREATHING ON AN INFANT
1. Place your mouth over both the infant’s nose and mouth.
2. Blow in two gentle puffs.
3. If you feel no exchange of air, reposition infant’s head and retry.
4. Observe and listen or feel to see if there is breathing and circulation.
If the person is unconscious, yet there are signs of circulation but still no breathing, then proceed by administering one breath every five seconds for adults and one puff every three seconds for infants.
CPR (Cardiopulmonary Resuscitation)
Upon arrival, if you find an adult not breathing and exhibiting no signs of circulation, call for EMS if this has not already been done. If an AED, or automated external defibrillator, is available, begin attaching it to the victim. This is a portable electronic device that automatically diagnoses the potentially life-threatening cardiac issues in a patient and is able to treat them through defibrillation by applying electrical therapy that stops the arrhythmia, allowing the heart to reestablish an effective rhythm. If an AED is not available, begin CPR. If a child or infant is not breathing and has no signs of circulation, give CPR for two minutes immediately before calling EMS (if this has not already been done). Then resume CPR.
1. It is best to kneel a few inches to the side of the casualty in a position where you can place your hands directly on the breastbone, the part of the chest midway between the nipples. Put your hands on your ribs right now. Feel how the ends of the ribs curve up? This is where the ribs meet what’s called the sternum, or breastbone.
This is where you put your hands to perform proper CPR. The idea of doing CPR is to get blood circulating through the heart. If administering to a child, use the heel of just one hand, while placing your other hand on the child’s forehead. For adults, put one hand on top of the other, centered at the breastbone.
2. To be effective, align your shoulders above your hands and straighten your elbows. You want to create a chest compression at the very center of the victim’s chest, which is best achieved by leveraging and utilizing the weight of your upper body. You press down with the heels of your palms while moving in an upward direction. Again, the point of CPR is to force blood to enter the heart, which makes it involuntarily begin to beat again.
3. Push down and make thirty compressions at a rate of approximately two per second. It’s recommended to count aloud, which keeps a steady and regulated pace, as well as keeping your mindset focused on the job. For adults, use both hands to give chest compressions, pushing the chest down about one and a half to two inches each time. For children, use one hand to give chest compressions. Use the same rate, but press less forcibly, compressing the chest down only about one inch each time.
4. Once you have completed thirty compressions, tilt the victim’s head, pinch the nose, and place your mouth over the victim’s mouth (just as in rescue breathing). Give two breaths for an adult or child.
5. Repeat these steps four or five times.
6. At two-minute intervals assess for signs of circulation and breathing, and continue to perform CPR until breathing begins or until EMS arrives.
Seal Survival Guide Page 27
