The Protectors® Podcast

#450 | Anthony Horton |Behind the Scenes of North American Rescue

September 16, 2023 Dr. Jason Piccolo Episode 450
The Protectors® Podcast
#450 | Anthony Horton |Behind the Scenes of North American Rescue
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With a wealth of experience under his belt, Anthony Horton, Director of Public Safety Programs at North American Rescue, joins us to shed light on a critical yet often overlooked issue: bleeding control in emergency situations. Ever wondered about the science and strategy behind bleeding control kits? Anthony takes us on a deep exploration, sharing his unique insights from his journey as an EMT, paramedic, firefighter, and SWAT team member, underscoring the significance of bleeding control in both civilian and public safety contexts.

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Make sure to check out Jason on IG @drjasonpiccolo


Speaker 1:

Welcome to Protective Podcast. We're joined by Anthony Horton, north American Rescue.

Speaker 2:

I'm excited to be here man, this is great doing this in person. Nice to meet you.

Speaker 1:

Now I just took a tour of this facility and it kind of reminds me of like heading into the warehouse is like the end scene of Raiders at a Lost Ark. That warehouse is amazing. And one thing that was really amazing is like so many Made in America signs. I mean it's really cool. Now, how long have you been here?

Speaker 2:

Been here for 14 years. The company's a little over 20 years old and I've been here for 14.

Speaker 1:

What do you do here?

Speaker 2:

My title is Director of Public Safety Programs, and so I sell into the public safety space really anything that's not military, so police, fire, ems, any non-conventional markets, you know, churches, schools, anything like that.

Speaker 1:

They were pretty interesting background, a lot of EMT experience, a lot of tech med type stuff. You belong to the SWAT team, all sorts of stuff like that. Where did that passion come?

Speaker 2:

from that is just a desire to help people. I've been an EMT and paramedic for the longest time in a firefighter and so the way that I got here is I just started volunteering here. The North American Rescue sponsored a SWAT competition once a year and so annually I would just come here and help set up that training and just kind of help run that event. And they were like, hey, you know, what do you do on your days off as a firefighter? You know, do you cut grass or landscape? Like most of them I said no, I really don't do anything.

Speaker 2:

And they said, would you be interested in part-time work, just kind of helping. And so I started here in product development. That lasted about six months and they were like, hey, we want you full-time. And I was like, well, hey, I'm 23 years into retirement, I can't stop. So you know I got to talk to the fire chief and so we just kind of flip flopped it and I went to part-time there and came here full-time and been here for 14 years and love it, moved out of product development into sales and that's what I do now.

Speaker 1:

And when you talk about product development too, is we took a tour of the facility and the one thing that really kind of picked me up like really was not just a stop to bleed kits and everything else that you develop there, but the litters. The litters is really cool. Like you know, all I remember the 19, when I was in the army in the 90s. The litters were like okay, if we weren't using a real litter. We're using cots.

Speaker 2:

It's kind of a long way since then, it really has, you know, because ultimately, when someone is injured to that degree, they ultimately need to be to a hospital, like to definitive care, not laying on a battlefield or laying in the street from on the civilian side, and so the casualty evacuation and movement is just as important as stop the bleeding. Yes, we need to stop the bleed as quick as we can, but ultimately they need to be in a surgical suite somewhere or a hospital, and so the litter platforms and evacuation platforms are pretty important part of that process.

Speaker 1:

Each pound is. It's worth it, Because I mean, you're thinking about someone fully kidded up, Absolutely. Even if you get rid of some of it, they're still going to have a lot on our body. You know, average soldier what 165, the two something, Right, yeah? So you don't know what you're going to get into. Then you got to carry them and you got to be able to carry them for distance, Whether it's 50 yards, 10 yards or miles.

Speaker 2:

Absolutely.

Speaker 1:

So getting that, you know that litter out there. That's some interesting development, and it's compact too, it's not like what you said, like you, know, the old days are just going to roll them up.

Speaker 2:

Right yeah, we have, you know, non-rigid litters that fold up real small, and then we have the rigid litters, like the ones we saw, that you know that have the metal poles in them, and so it really just depends on area of operation and the mission profile of which one works for that, for that, for that problem, and we just try to have a solution for each one of those situations.

Speaker 1:

Now you mentioned one word that I really want to. Really, the big reason for my trip here today was civilian. Now, coming from you know you're coming from the empty world. I'm coming from the law enforcement world. It's in the military world, but the civilian market, the civilians need to know this stuff, absolutely. They do. Like we were talking before the show. It's like I have a million. I have tourniquets everywhere. I got two teenagers at home. Do they know how to use a tourniquet? So you guys, you have the tourniquets and everything, but the big thing is stopping the bleed. So let's talk about where did this came from and how did North American rescue get into that market.

Speaker 2:

Okay, so obviously the tourniquets in our iFACs, our individual first aid kits that you used in the military and that we've been selling for years, existed before. There were active shooter events every day throughout the world. But as a result of the Sandy Hooks school shooting, a group of surgeons and doctors got together in Hartford, connecticut, and said, hey, we can't stop the threat, right, the active shooter stuff is going to happen, but let's come up with a solution that we can put into public venues to provide a solution to stop bleeding, much like we did with AEDs years ago. And so this group of surgeons and doctors it was called the Hartford Consensus because they were in Hartford, connecticut, they just happened to be where they met and they started the Stop the Bleed program or Stop the Bleed initiative. Really an unfunded mandate, really just a set of objectives. Hey, we think that everybody needs to be trained in this, or as many people as we can. We need the private sector, north American rescue and others to come up with a kit solution that has a tourniquet, a bandage, wound packing gauze, chest seals, and so through that initiative because we had it kind of got everybody's attention. The doctors and surgeons are way smarter than we are. But it got everybody's attention to go, hey, this is important. And so we got on board, started building the kits and the other part of that. Yes, we build kits and yes, there are other competing companies that build kits.

Speaker 2:

But the other part of the solution is the training, the Stop the Bleed training. So many of our folks here, many of our instructors, are certified Stop the Bleed instructors and we're constantly teaching anybody that wants a class. For Stop the Bleed month in May, we offer free classes here almost every day for the whole month. Anybody in the general public can come. I've had people from as far away as Tennessee drive all the way here. They probably passed 15 Stop the Bleed classes, but they wanted to come to North American Rescue to take the class and it's on their own dime. I mean, yeah, the class is free, but they had to drive five and a half hours and so it's important. And so we try to provide good training, because the kits without the training is not real as useless, and the training without the kits is really a two-part solution. So we try to. That's our goal, that's our partnership with the American College of Surgeons is to provide the kits and the training, and we're doing that all over the place.

Speaker 1:

It's very easy to do. I signed up for a course. I wasn't able to make it, but just going online you can sign up. There's so many local courses.

Speaker 2:

Yes, we do have an online version on our learning management system under our training. Yeah, you can do the whole course online, absolutely.

Speaker 1:

The cool thing is you mentioned up AEDs. Now we both kind of similar ages and stuff you know. I'm 50.

Speaker 2:

I'm with you.

Speaker 1:

But the thing is, too, is like you know, back in the day, an AED was like a specialized piece of equipment. You know where you find it A hospital.

Speaker 2:

A doctor's office. Now you find them everywhere, I mean everywhere.

Speaker 1:

Yeah, now I'm taking a look at a bleeding control kit here and I'm thinking about when you're talking about active shooters and stop the bleed. It's not just active shooters anymore.

Speaker 2:

It's anything Bleeding is bleeding, I'm sure.

Speaker 1:

I mean, I have myself. You know you cut yourself. You have literally seconds and minutes. So let's take a look at this bleeding control. What we're doing I mean obviously this is audio, but I want everybody to kind of we're looking at it like it's almost like a kit that you could bring either with on your person or you can have it on a wall, which is kind of cool, because we, during a tour today, you have these, the AEDs, on a wall, but then you also have areas where you have to stop the bleeding kit. So let's say, can you kind of explain what comes in one of these kits? Yep absolutely.

Speaker 2:

I talk about the location because you kind of alluded to that. The kits are usually mounted near the AEDs or at least near a fire extinguisher, Just kind of a general place in a hallway, not in a closet. It's out, visible, where people can see it. So some people are sensitive to that, especially churches, that they don't want a bleeding kit on the wall. So they want to try to hide it or not make it as visible. But the problem is is when somebody is bleeding you've got to kind of know where that kit is and so, just like today, as you're walking through public venues and airports and malls, you'll start to notice it. Now that we're talking about it, You'll notice it on the wall. But in the bleeding control kit, as I mentioned, the American College of Surgeons kind of set the standard of what should be in a kit.

Speaker 2:

There's probably 40 commercially available tourniquets on the market now. We obviously sell and promote the cat tourniquet. It's the only one we sell. So all of our kits are going to have a cat tourniquet. There are other competing companies that will have their version of a tourniquet, but the kits should have a tourniquet in it. One-handed use is ideal in case you're the one putting it on yourself.

Speaker 2:

Israeli-style pressure dressing. Our version is called the emergency trauma dressing, but it's just our version of the Israeli dressing. The Israeli dressing by name has been around a while and through the military it is a real dressing. It was made in Israel Originally. It's made in the States now, but just a pressure dressing for direct pressure. The kits should have wound packing gauze, whether it be non-hemostatic gauze or some form of hemostatic gauze, whether it be quick clot or cellox gauze or chirogaz. There's probably a half a dozen of those on the market of blood-stopping type managers.

Speaker 2:

A pair of gloves. We can't put all sizes small, medium, large and extra large. Our default size is large, but if you grab one of our kits, at least you're going to have something on your hands for personal protection. They won't fit perfect, but you'll have something. One thing that we do a little bit different in our kits is we give you the option for a chest seal. We put trauma shears in our kits as well so that you can expose the patient.

Speaker 2:

All of our kits also have an individual pictorial instruction card, much like an airplane safety card that's in the back of an airplane seat. It'll show you how to get out. Our pictures are just very basic. This is how you put the tourniquet on. This is how you use the pressure dressing. This is how you put on a chest seal. Again, the kit. Without some basic knowledge of how to use this stuff is kind of useless. We provide the instructions in the kit. We provide the online training, Like I said. Like you mentioned, there are stop-the-bleed courses offered all over the United States, just about everywhere. A two-part solution. We just want to be one of the providers of the kits and the training.

Speaker 1:

A lot of times when you have a bleed, the mergers or responders, whether it's cops or whether it's EMTs or anything. They're really the second one that's going to respond to the pain.

Speaker 2:

They are. The person that's there first is the first responder, whether that's yourself or whether someone else that's there.

Speaker 1:

It's not only imperative that you have the training, but if you're bleeding, you might have to explain this to someone else Absolutely, to be able to talk somebody through how to do it.

Speaker 2:

Hand them, hey, my kit's right here, we can grab it, or in my trunk or wherever, it is For sure. The more people we can get trained, the better off it is for everybody Because, again, it's not just for active shooter. As long as there's the religion and politics, we're going to have that. So. But aside from active shooter bleeding it can be an industrial accident, it could be a car accident, it could be a honey accident. We have a lot of second amendment gun owners. That's a huge market for us because accidental discharge, negligent discharge on the range or in a competition is a real thing. They're not planned, it's negligence or it's an accident, but you bleed the same way. That's a big market for our stop the bleed kits and tourniquets is to have those range safety officers and those folks that are exercising their second amendment right to be a gun owner to have at least a tourniquet but hopefully an entire stop the bleed kit with them.

Speaker 1:

And you know where you're finding with this. Competition shooting is everybody and anybody's doing it? Oh yeah, a lot of times the people are doing competition shootings. I'm doing it for about a year now and I've noticed that you have a very small percentile that are law enforcement and that are military there.

Speaker 2:

It's usually the general public, yeah, just picking up the sport or the hobby, however you want to look at it.

Speaker 1:

And when you roll to a range you know you're going to see maybe one stop the bleed kit, maybe two, and the ranges are allowed Right. So if you do have an issue, that's going to happen, if you don't have proper comms, someone's going to be scrambling to try to find that and that's. That's literally minutes, right.

Speaker 2:

Yeah, and and since you just said minutes, that's really what it boils down. When we're talking about a major arterial bleed, you bleed out in two to three minutes, regardless of what it whether it's an active shooter or a core extent bleeding is bleeding, and if you transect that vessel and artery, it's two to three minutes is all you saw. You've got, we've got five to six leaders in our body as an adult, and once it's on the ground, it's. It's not we can put it back in. A paramedic can't put it back in. We're not magic magicians, we're paramedics. And so the sooner we can stop that bleed with direct pressure and application but turn it, regardless of who puts it on, gives that person a chance.

Speaker 1:

Right, let's, let's. I'm not going to ask about price, but let me. Let me get my little soapbox here for a second. But let's say you have a match and you have me and a 30 80 people, sean, depending on the type of match, maybe one month, you add like five bucks to the match fee and every kit. So for everybody who doesn't know about what I believe me, I love talking about competition. Shooting is. So every every lane let's say you have seven or eight different lanes you know squads, everything. Each squad will have a box and in that box will have like Pacey so you could pace up the targets, and you know timers and stuff like that. How about? Every box has a stop to bleed kit?

Speaker 2:

Yeah.

Speaker 1:

You know I mean tourniquets and quick clot.

Speaker 2:

Right, absolutely Just something Right, something's better than what they probably have now, which is nothing.

Speaker 1:

Yeah.

Speaker 2:

A lot of your law enforcement officers now you'll notice on their duty belt as you go about your daily life. A lot of them will have a tourniquet on their duty belt. It's either personal purchase or, hopefully, agency purchased and issued. They're trained at least just to have the tourniquet. You know they already carry a lot of stuff so they don't really have room for a full kit like a SWAT vest does. But a normal patrol officer, all of our normal officers, our patrol officers around here, have it on their belt. It's agency issued and they're trained on it annually.

Speaker 1:

And there's an incredible video. I guarantee you've seen it. It's out of Las Vegas. There is a thinking officer involved shooting and he pulls the tourniquet out of his ankle holster.

Speaker 2:

Yeah.

Speaker 1:

I mean ankle holsters, I mean, there's ways. I mean, when it comes to tourniquets, you could really pretty much sash many.

Speaker 2:

That's actually how our the county we're in right now, greenville County, south Carolina that's how our agency here decided to get tourniquets. One of their deputies was in an altercation with a suspect. The suspect was able to get his finger on the trigger in the holster and pulled the trigger while the gun was holstered and the projectile went through the deputy's thigh and so he had an ankle tourniquet holster that he purchased with his own money from us. He pulled the tourniquet out and instructed a fellow deputy that was coming to his aid how to put it on. Well, that night one of our trauma surgeons here at Prisma Health went on the news and said had Brandon, that officer not had his own tourniquet, he would have bled to death.

Speaker 2:

And so, you know, the next few days the agency, greenville County Sheriff's Office, bought tourniquets for all of their officers, and then Greenville City Police Department followed suit. Because they're in the county, they bought tourniquets for all of their officers and unfortunately, unlike the military, the civilian world is a little bit more reactive than proactive because it is tied to funding, and so when bad things happen like that or accidents happen like that, it's really a reactive response to go, hey, we should probably be better prepared or we should probably be better trained. We see an uptick in business whenever an active shooter event happens in the United States or we have an officer involved event like that. We get calls the next day going hey, you know, we messed up.

Speaker 2:

We really need to be better prepared, and so it's unfortunate that we're reactive that way. It's just the way society's geared right now. It's good for business, for us, but that's really not what we want. We would rather everybody just be prepared. I would rather sell you a kit and you never use it. I just rather it right on the wall and go out of date and you just never use it.

Speaker 1:

You know, I really see the market in the civilian world and you know the reason I say market. It's really just kind of how civilians could help protect themselves and I think about a construction site and I think about like I'm just thinking about my own bleeds over the years and, like you know, I broke a toilet and I sliced my finger.

Speaker 2:

It's like you think about now?

Speaker 1:

you have construction sites you have everywhere and you might have, you know, language barriers and just how did nobody I mean yeah, we know tourniquets because we come from that community I mean, you've seen them in the movies and still, there's still that that bleeding, or if you put a tourniquet on, you're going to lose a limb, and I think it's a. It's a lawsuit, so let's get into. You know what is the reality of using it?

Speaker 2:

Okay, all right, the our tourniquet in. In many of the the commerce, other commercially available tourniquets are designed in such a way to not only be effective at controlling hemorrhage but they're safe and effective, meaning they don't generate. They generate enough pressure to control hemorrhage, but not so much pressure that they're going to damage nerves. Now, obviously, even with our tourniquet, if you put this tourniquet on and leave it on for 24 hours, yes, you could potentially have some nerve damage or paralysis or have to have the limb amputated. But in the civilian world, unlike being having to be evacuated off the battlefield, we're in the street or we're in the woods. How long does it really take to get to a trauma center? Now, are there extreme incidences where maybe you're out deer hunting and nobody finds you for hours? Yes, of course those are going to happen, but normally you're going to be in the trauma center at least for the couple of hours.

Speaker 2:

Well, the tourniquet is designed to be safe for that, for that short amount of time. So it really comes down to the science behind the tourniquet and how it's designed and how much pressure it generates. That's the problem with improvised tourniquets. You know, at the Boston Marathon bombing there were plenty of photos and news reports of people using belts or ratchet straps or shoe strings to to to make an improvised tourniquet and while again, while those are effective in controlling hemorrhage, a lot of them are too tight, especially a ratchet. If you think about a cargo strap, a ratchet strap, is it tight enough? Are you going to get it tight enough? Absolutely.

Speaker 2:

But you're going to get Amputation is better than losing your life altogether. But our tourniquet is designed and there are several other commercial, not all, but several other commercially available tourniquets have been tested. They're evidence based, they're tested by the military and just proven to be safe and effective where you're not going to cause any more damage. You're going to control the hemorrhage and buy some time for that casualty, for that patient to get to definitive care, to a surgical suite, because those injuries require a surgical repair. There's no other way around. It's not going to go back together. You have to go to a hospital for surgical repair. It's really a safe and effective tourniquet. Not just effective. We could be effective with just about anything with enough training.

Speaker 1:

Well, and you talk about training that's the next thing I want to talk about was like your facility. You have the resources here to do practical and applicable training. So you're taking your own gear and you're going out there and you're like, hey, let's see if this actually works.

Speaker 2:

Yeah, absolutely. And all of our sales staff whether we're talking about the international sales guys, the military sales guys or the public safety sales guys we all come from some kind of background within that area of operation and so we all have basic knowledge of medicine, some more advanced than others, but everybody knows. Everybody here in our company knows how to use a tourniquet and knows how to teach how to do that. Even our new employee orientation the girls in customer service or the guys in accounting if you're a new employee here because there are stop the bleep kits on every wall in this building we teach everybody how to use the kits.

Speaker 2:

It just makes sense. It makes it easier for the customer service folks who may not have the depth of medical background to talk about a tourniquet to a potential customer if they've already been trained on it. And so it's twofold we teach them how to help themselves when they're not in this building, how to use the kits that are in this building when they're here, and also how to address questions from our customers that may call in with those questions. So the training is a big deal. It's just as important as the product. Again, having a kit with nobody, that nobody knows how to use. It is just useless.

Speaker 1:

How long does it? Let's say you, let's jump right back to the civilian. If you're going to take a South to Bleed course, how long does it take?

Speaker 2:

An hour and a half.

Speaker 1:

An hour and a half An hour and a half.

Speaker 2:

Yep, the one on our online learning management system is even quicker than that. You could click through that in probably a half an hour, but an in-person course, like you and I have both taken and probably taught, is about an hour and a half.

Speaker 1:

What's this? You know I'm looking at this big bleeding control kit.

Speaker 2:

There's like a whole bunch of the eight-pack vacuum seal components that is an eight-pack kit up until your big outlier, active shooter events, like the Las Vegas shooting at the Jason Audine concert, the average cash decal and active shooter event was 6.5 casualties, based on FBI data. We can't make half a kit and so if we took 6.5 and go to seven, it's an odd number. So we did one greater than the average, which is eight. And so our largest stop the big kit that we currently market and sell as an eight-pack kit based on that FBI data of 6.5 casualties, and it's really just eight individual throw kits that could be mounted on a wall beside an AED. A lot of churches and schools use this kit because, as they're responding to an incident, whether it's a natural disaster, maybe it's a tornado at a school, not necessarily an active shooter event but if you have multiple casualties, just by grabbing this one bag you have eight identical kits. You're not having to dig through a bunch of different pouches to go oh, my tourniquet's here, my pressure dressing's here, every kit's identical, regardless of which one of those eight you pull out. They're all the same.

Speaker 2:

And then in this kit we talked about evacuation platform. In this pouch right here is a non-rigid litter to actually move that casually, because, again. I told you that was important. Stopping the bleeding is important. But now we got to move that casually to an ambulance or whatever the evacuation vehicle is to get to the hospital.

Speaker 2:

At the Aurora Movie Theater shooting, all of the victims from that active shooter event were transported in police cars and so I just responded to a SWAT call last week and the protocol here when Greenville County SWAT goes out they have a full-time SWAT team. The casualty is always put on a non-rigid litter so we can rapidly move them to an EMS stretcher, just an ESA transmission. We're not a transition. We're not having to hold ankles and arms and legs. They're already on a soft litter in the back of a patrol car and we move them from the patrol car to the ambulance, to the hospital stretcher all on the same soft litter. And so it just makes the movement of that casualty who can't help themselves, maybe heavy, maybe they're heavy and they're bleeding just makes moving the casualty so much easier and we're not causing harm to the casualty but it's an ease of transition all the way to surgery. So it works out well.

Speaker 1:

We got tourniquets, we got litters. What else does North American Rescue do with it?

Speaker 2:

Man, we do a lot of stuff.

Speaker 1:

I know I looked in a factory. That's like oh my gosh.

Speaker 2:

Lots of diagnostic equipment as far as diagnosing patients. We have surgical lights, we have field hospital beds, tons of kits. A lot of the stuff that you saw in the warehouse is different form factors of how to pack this stuff together, depending on the air vibration. Some kits are made to be mounted to a tactical vest or a military style vest. This particular kit doesn't have those straps on it. It's made to go in an eight pack kit. Same thing with a tourniquet Tourniquet holders that fit on a belt versus tourniquet holders that go on a vest or tourniquet holders that go on your ankle that we mentioned A lot of parts and pieces. We want to provide a solution to give all of our customers and all of our product users of our products a way to carry the tourniquet relative to the area they work in.

Speaker 1:

Well, Anthony, I really appreciate you coming on a show and I look forward to having you back on again.

Speaker 2:

Yeah, absolutely no-transcript.

Stop the Bleed Initiative and Preparedness
Promoting Tourniquets and Stop-the-Bleed Kits
Bleeding Control Kits and Casualty Evacuation
Different Tourniquet Carrying Solutions