As a fire captain, paramedic and reserve police officer, Blaine Murrell never knows what he will encounter on his shift each day.
To expand his emergency response skills, Murrell recently received specialized training on how to control massive bleeding and the use of tourniquets.
Murrell was one of 12 who attended a four-day Tactical Combat Causality Care course put on by Secfor International in Carlsbad, California.
This course, he said, originally was geared toward battlefield care of military personnel, but it is open to anyone, even those without medical training.
"It was one of the best medical classes I've been to," said Murrell, who indicated the guidelines were a "little different" for combat medics than civilian EMS.
The class, he said, "wasn't anymore in depth really, but ... the quality of instructors, the (special) effects they had ... It was everything I wanted it to be."
The course, according to Murrell, included classroom instruction, however, the majority of it was hands-on.
"The first day, we spent half a day in the classroom, then after that pretty much it was going over skills that we were going to do in the final," Murrell explained.
Those skills included lifting, moving and carrying patients, as well as "bleeding control, how to stop massive, active hemorrhaging" and how to pack wounds, Murrell said.
"Tourniquets were a big deal, probably the biggest deal in the whole class," Murrell said.
The training also included instruction on needle decompressions, said Murrell.
"When you have air in the chest cavity, you put a catheter in the chest to decompress it, to let the air out," said Murrell, who indicated he also learned about surgical cricothyrotomies.
An example, Murrell said, is someone not having a good airway as the result of shotgun blast to the face.
"We can open an airway up in the trachea" for the person using "surgical crics," he said.
The skills taught were "all stuff that was within my level of (medical) training," said Murrell, who described it as an "eye-opening" experience for his classmates who didn't have a medical background.
Murrell said a written test was taken on the final morning, then "we went to the safety training center, and we had a Hollywood makeup artist that actually came out and did moulage on us," stimulating various wounds.
"They smoked up the building and had loud music and people screaming ... over the loud speakers," he said. "It was pretty intense."
The instructors, he said, called the experience "stress inoculation."
The simulated wounds were "pretty realistic," he said. "They didn't pull any punches.
"We put tourniquets on, and we put tourniquets on. There wasn't any half doing it. We cranked them down until the pulse stopped."
Although the makeup was not quite the same as "having someone actually laying there" with the injuries, "I would rather see that stuff (in training) and know that I can" handle it, Murrell said.
"Being able to keep your cool and deal with (the stressors), that is a part of what this class is about," Murrell said.
The instructors, he said, were all military or former military and included two U.S. Navy corpsmen, who had been attached to Marine recon units and "saw a lot of action in Iraq," and an U.S. Army Ranger.
"Lot of the guys (instructors) have seen actual combat (and) seen a lot of these types of wounds," Murrell said.
Taking the class, Murrell said, is something he has wanted to do for a long time, so much so he sought his POST (Peace Officer Standard and Training) certification a few years ago.
The tactical combat training, Murrell said, looked "pretty cool. I started talking to the guys at the police department," asking if they would "use this if it was something I had."
The officers, he said, indicated it was, but when Murrell asked if he could "carry a gun. They said no."
The Poplar Bluff Police Department doesn't have a SWAT team per say, but local officers serve both arrest and search warrants, and when they do, Murrell wants to be available to "help those guys out, to have a medical presence there in case something did happen" instead of having to wait for the area to be secured for an ambulance to go in.
In the past, as paramedics and emergency medical technicians, he said, they always have been told they can't enter a scene until it has been secured.
"Now, they are starting to lean toward getting EMS in as quick as they can to start giving care," Murrell said. "Honestly, if I'm going to have to do something like that, I would rather be able to defend myself."
Having the training, he said, is about "being able to get there and take care of the police officers I might be working with at the time.
" ... I hope we don't have to ever (use it but) I would like to be available to help if" something ever did happen.
The training, he said, also could be beneficial in today's world of people shooting at public safety officers.
It doesn't matter, he said, if its a police officer, firefighters, paramedics or EMTs.
According to Murrell, the training doesn't really figure into much of what Murrell does with the fire department since it doesn't run EMS calls; however, if, as a firefighter, he is working a crash scene where someone is bleeding profusely, there are "other things we can do to help take care of that" until medical personnel arrive.
Murrell will have to retake the training in four years.
"I'm not sure I will get to go back out there," said Murrell, who expressed his appreciation to his employer, Butler County EMS, for helping defray the cost of his attendance.
"The moulage and the stress inoculation part of it was more intense that what I think you'll get around here locally" in similar training, Murrell said.