The US Army has always taught its recruits some level of first aid for trauma.

But starting in the late 1980s, we pretty blatantly stole a program from the Israeli Army.

I don't know what the Israelis called it, but in the US Army, it is known as the Combat Lifesaver program.

The Army has a fairly robust medical establishment for its size.

And our grunts mostly love their medics.

But a lot of times, when people are hurt, there's not enough medics, and more than enough wounded. What to do?

Well, first aid, of course.

But the idea of CLS is to provide a slightly more definitive level of care.

We're not curing people, we're buying time to get to surgery

The state of the art in CLS is light years beyond what it was in my day. Virtually everything I was taught is now considered passe.

For instance, today, the VERY first step in treating bleeding on an extremity is apply the tourniquet. Hell, we didn't HAVE them.

So, the goal was, every squad and every vehicle crew would have a designated Combat Lifesaver. They'd have a nifty little bag with some medical supplies. I mean, in my day, your IFAK was a muslin bandage and one sterile compress. This gave you a little more to work with.

While the goal was to have 1 CLS in every squad, as a practical matter, the Army wants EVERYONE to be a CLS.

CLS was a 40 hour course of instruction. The first time I took it was 1989 in Germany. Our prime instructor was our battalion's Physician Assistant.

Let's talk a bit about the organization of a battalion's medical platoon in those days.

In a mech battalion, you had a Medical Platoon. The platoon leader was in the Medical Service Corps. Which, MSC, he's not a health care provider. He's trained to lead and organize medics. And you had the medics. Some good, some bad, good ones highly prized.

Doc, I sat on a cactus, and now have a near terminal cyst on my ass, and I really don't want the rest of the company giving me shit for the next year. Help me out.

Yeah, good medics are priceless.

Yes, true story.

So, the senior medical professional in the battalion medical platoon is the Physician's Assistant. Back in the steam age, he was a Warrant Officer. I think they're still Warrant Officers, but now by law also hold a commission. Weird shit. Officer shit. Not my problem.

So, 1/6IN in Vilseck Germany, first CLS class. Our BN PA is a crusty old dude. Was an SF medic in Vietnam before becoming a PA.

Guys, he says, I have certain expectations of you when you present a patient to me.

I want him under a casualty blanket, I want him butt naked under that, I want a dressing on every hole, and I want two IVs ticking at TKO when he hits my table.

If he hits the table alive like that, I'll save him.

So, as you might have kinda grasped, a part of the CLS program was learning how to administer an IV. There are some fairly technical bits about how to properly do it, to reduce infections and not kill someone with an embolism, but it's not rocket surgery. Even @tmi3rd can do it.

My CLS bad generally had one 500ml bag of Ringers Lactate, and one 500ml bag of 5% saline solution, as well as three IV tubing and needle kits.

The Army kindly provided us with plastic practice arms, but eventually, you gotta stick someone.

And this is where game theory pops up. You and your battle buddy are going to end up with him sticking you, and you sticking him.

And it's critical that you do it in that order.

Shit happens, people fuck up, fingers slip, as long as you're doing your best, I can put up with a lot of fucked up attempts at a stick.

Just remember, I get to stick you next. Me sticking you isn't going to hurt me one damn bit.

Please do your best.

By the late 80s and early 90s, the Army was working very hard on becoming a no-fun zone.

One of the interesting exceptions was, they REALLY wanted us to remain proficient at CLS skills. Carry the bag in your car, guys.

The other nice thing was, 500ml of Ringer's Lactate is awesome as Hangover Helper.

We were explicitly encouraged to dispense IVs to alleviate hangovers, just to remain proficient.

I know I went through the CLS course at least three times. I think maybe four.

One of my last trips to the field in Fort Carson in the summer, man, it was hot. Like Africa hot. And I probably had a mild cold or something.

The notional squad level mission was a TRAP, Tactical Recovery of Aircraft and Personnel.

FYI, hauling even a skinny guy on a stretcher for more than a hundred meters? Brutal.

Remember how I mentioned that our CLS bag would typically have 2 500ml IV bags and 3 sets of tubes/needles?

My unit SOP was a little more expansive.

Every troop carried a 500ml bag of 5% sodium and an IV kit. There's a velcro pouch on the top of every ALICE pack.

Now, I'm not the brightest guy, but I've had the symptoms of a heat casualty beaten into me for, by this time, six? 7? Almost 8 years? I'm having a bad day. Being a heat casualty isn't being a whimp. It's having a bad day. And man, was I cratering. Badly.

This was my second time being a heat casualty. We'll talk about the other one later.

This time, at least, I saw it coming.

What do you do with a heat casualty? Reduce heat, increase hydration.

I promptly slugged down a 1 quart canteen. And promptly vomited it right back up. Not an uncommon thing in a heat casualty.

Well, if we can't drink our way to hydration, we can IV our way.

Really? In an entire 9 man Infantry squad, and the little fucker we're carrying on a litter, I'm the only guy that knows how to administer an IV?

Skinny fuck on the litter is a medic. How the hell do you not know this?

So, I have my A-team leader call it in. We're not asking for a MEDEVAC yet, just, you know, here's a heads up. (and God bless them, they put MEDEVAC on stand-by).

So, this is in 1994? Since 1989, I've probably done 100 sticks, virtually all for hangovers.

OTOH, I've never had to stick myself. The whole "stick an IV in a dick" was entirely hypothetical. You generally don't stick an IV in a wounded appendage. Just be aware that's an option

Fortunately, we weren't quite there. But I'm a bit of a klutz, and it takes me two hands to start an IV. OTOH, I've got two feet.
I can take my boots off.

Just before I stuck my IV needle in my foot, I repeated my mantra from my first CLS class. We're not gonna hurt each other.

I think it took about 10 minutes to drain that first bag. After that, I put another 1500ml into my foot before I felt human. That took a little more time, but damn. 2 liters of juice is a lot.