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Threat suppression Hemorrhage control Rapid extrication to safety (get off the "X")Assessment by medical personnelTransport to definitive care (hospital)

These documents present tactical medicine material that may conflict with conventional civilian emergency medical services (EMS) practices. Routine civilian EMS care is not designed to address care for victims in situations where rescue personnel are exposed to an ongoing threat of violence. These documents are specially designed for law enforcement officers who will be the first responders to situations that require balancing both tactical and medical issues.

Unless otherwise indicated, drill sheets were created by the National Association of Emergency Medical Technicians. VALOR instructor and tactical paramedic David Dunafan has created the VALOR drills. All of the roll call drills have also been reviewed by Dr. Jonathan Sheinberg, cardiologist and lieutenant on the Cedar Park Police Department.

Not all drills are the same. Two popular drill types, a spotting drill bit and a center drill bit, may not appear much different from each other, but the two have very distinct purposes. Though it is possible to use a center drill where a spotting, or spot, drill could be used, and vice versa, it is not recommended.

The best method to treat hypothermia is to prevent it. When the body’s temperature lowers and hypothermia occurs, the body’s ability to clot blood diminishes. Keep patients warm, even in warm or hot environments.

A go bag is necessary to rapidly deploy medical equipment, ammo, and supplies within the perimeter of a critical incident.

Improper technique when performing drags and carries of someone wounded in the field can create a delay in care, an increase in the time personnel are exposed on the X, or worsen an injury.

This online scenario is designed to increase the capacity of law enforcement personnel to implement mitigation techniques used to deal with major hemorrhage secondary to injuries caused by gunshot and/or knife wounds, etc.

Purchase them in bulk from a vendor that supplies TCCC-approved tourniquets: Combat Application Tourniquet (CAT) Gen 7; Combat Application Tourniquet (CAT) Gen 6; Ratcheting Medical Tourniquet, Tactical (RMT - T); SAM Extremity Tourniquet (SAM - XT); SOF Tactical Tourniquet, Wide (SOFTT - W); Tactical Mechanical Tourniquet (TMT); TX2” Tourniquet (TX2); and TX3” Tourniquet (TX3).

The VALOR Officer Safety and Wellness Program (VALOR Program) has been provided by the Institute for Intergovernmental Research® (IIR) since VALOR’s inception in 2010.

You are limited to what you can carry on you while on-duty. Choose equipment wisely and carry the most critical pieces of equipment you may need to stay prepared for a critical incident at any moment.

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This federal, multidisciplinary first responder guidance translates evidence-based response strategies from the U.S. military’s vast experience in responding to and managing casualties from IED and/or active shooter incidents and from its significant investment in combat casualty care research into the civilian first responder environment. In addition, civilian best practices and lessons learned from similar incidents, both in the United States and abroad, are incorporated into this guidance.

Below are various roll call drills to utilize in your agency or to practice on your own. There are detailed instructions and required materials provided for each drill. Practicing these vital casualty care practices could save your life, the life of a fellow officer, or a civilian!

The center drill is made of a high carbide material and is used for metal working. A center drill is used for making a starter hole in cast iron, aluminum, copper, steels, and many other alloys. The center drill is good for metals because the drill does not easily move off target when pressed against the metal. It is shorter and sturdier than some other bits that may bend under pressure or slide away from the point to be drilled. A dull drill bit will not cut as nicely and can also make holes that are not accurate. It is important to use a sharp center drill when performing these tasks.

To render effective medical aid, you must have the proper equipment and know how to use it. This requires regular training with your trauma care equipment. Utilize the resources on this page to assist you and your agency with consistent and realistic casualty care training to ensure you are prepared for any critical incident!

The three most important factors to consider when acquiring a tourniquet are cost, durability, and Tactical Combat Casualty Care (TCCC)-approved.

A spot drill does much the same as a center drill, but there are two differences. One is that the spot drill is thinner and does not have the conical ends that the center drill does. The second difference is it's accuracy. The spot drill tends to be more precise in drilling a starting point. The reason is that the spotting bit does not have grooves, or spirals, that do not go all the way up the bit shaft. This gives the bit more sturdiness and is less likely to wobble.

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Where gunfire is still occurring or is likely to start again, threat suppression is the best “medicine.” If you become a victim, you are of no help to the situation. Make sure to always “get off the X” in a hot zone to ensure tactical advantage and safety.

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Always ensure that an unconscious person has an open airway to his or her lungs. One way to ensure an open airway is to use a head-tilt, chin-lift technique, lifting the tongue from the back of the throat. The unconscious person can also be shifted to either side so that his or her tongue will not block the airways.

This publication provides photos and instruction on how to use hemorrhage control medical supplies such as tourniquets, gauze, and bandages.

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Are you carrying what is necessary should you find yourself in a critical incident requiring immediate medical attention? Download this list, check your equipment with the list, and share with other law enforcement officers to make sure that you and your fellow officers are prepared!

The best method to treat hypothermia is to prevent it. When the body’s temperature lowers and hypothermia occurs, the body’s ability to clot blood diminishes. Keep patients warm, even in warm or hot environments.

Always ensure that an unconscious person has an open airway to his or her lungs. One way to ensure an open airway is to use a head-tilt, chin-lift technique, lifting the tongue from the back of the throat. The unconscious person can also be shifted to either side so that his or her tongue will not block the airways.

Your VALOR session will expire in 60 seconds. If you are still working in VALOR, please press the Continue button to extend your session.

This online training is designed to review the Tactical Combat Casualty Care-recommended tourniquets and demonstrate to officers how to apply each of these tourniquets on themselves and others to prevent major blood loss.

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This website is funded through a grant from the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. Neither the U.S. Department of Justice nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies and any services or tools provided).

The Casualty Care Resource Clearinghouse is your one-stop-shop for all VALOR casualty care resources. All the resources available on the other pages can be found here as well as a multitude of others. Check out the Clearinghouse for videos, posters, articles, and more.

Since the filming of this video the Tactical Combat Casualty Care Committee updated their list of recommended tourniquets to include the following: Combat Application Tourniquet (CAT) Gen 7, Combat Application Tourniquet (CAT) Gen 6, Ratcheting Medical Tourniquet -Tactical (RMT-T), SAM Extremity Tourniquet (SAM-XT), SOF Tactical Tourniquet – Wide (SOFTT-W), Tactical Mechanical Tourniquet (TMT), TX2” Tourniquet (TX2), and TX3” Tourniquet (TX3). Since the filming of this video, Chief David Flory has retired from Hot Springs Arkansas Police Department and is now a Senior Research Associate for the Institute for Intergovernmental Research, and a lead instructor for the VALOR Program

This roll call training is designed to reduce officer injuries and deaths through discussion and demonstration of the types and placement of medical equipment that should be carried by law enforcement officers.

Threat suppression Hemorrhage control Rapid extrication to safety (get off the "X")Assessment by medical personnelTransport to definitive care (hospital)

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Do you have any drills that you or your agency use to practice casualty care principles? Email us your drill at casualtycare@valorforblue.org to help a fellow officer or agency with their casualty care training!

How deep to spotdrill

A center drill is a good choice on more dense metals, but it would not be practical for a softer metal. A spot drill can do the job just as efficiently. Spot drills can also be used for plastics and wood products. Tight areas are benefited by the use of a spot drill. This bit can effectively make a hole without splitting or breaking the material.The spot drill will also increase the accuracy of the secondary drill, or the drill that is to be used afterward on the same hole.

A center drill is a shorter, thicker drill with a tapered, or cone shaped end that is much thinner than the shaft of the drill. This end of the drill is used to create a starting point for another drill. The center drill can also drill an indentation so that a screw will lay flush with the surface. A center drill also does not catch or grab the surface being drilled. A center drill is also referred to as a combined drill or a countersink.

You are limited to what you can carry on you while on-duty. Choose equipment wisely and carry the most critical pieces of equipment you may need to stay prepared for a critical incident at any moment.

Where gunfire is still occurring or is likely to start again, threat suppression is the best “medicine”. If you become a victim, you are of no help to the situation. Make sure to always “get off the X” in a hot zone to ensure tactical advantage and safety.

During a critical incident, where is your tourniquet? It is too late to go back to your patrol car or agency. Download, print, and share this poster to remind yourself and your fellow officers to always have their tourniquets on them!

The VALOR Program’s casualty care curriculum and resources are based off the TCCC model. TCCC approves certain brands in the market based on rigorous research and testing on the products, ensuring that they are only endorsing products that will be reliable and effective in the field. Therefore, though there are other products on the market, VALOR features only TCCC-approved products in the toolkit.