Goat-Trail Austere Medical Solutions GAMS

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Goat-Trail Austere Medical Solutions GAMS

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Rory Hill, President of GAMS, a global leader in tactical medical training. “The hobgoblin to change is resistance, but progress lies in embracing it, showcasing the ability to adapt and evolve in a ever-changing tactical environment.

09/05/2026

Test Your Tactical Medicine Knowledge – Question #8

Cardiac Output is a key hemodynamic measurement that helps us understand how effectively the heart is delivering blood—and therefore oxygen—to the body.

Question #8:

What is the normal Cardiac Output (CO) for an adult?

A. 2–4 L/min
B. 4–8 L/min
C. 8–12 L/min
D. 10–14 L/min

Think you know it? Comment A, B, C, or D below and share your reasoning.

Knowing normal hemodynamic ranges is only the beginning. The real challenge is recognizing when those numbers indicate that your patient is moving toward cardiovascular compromise.

We’ll reveal the correct answer next week.

Last Week’s Answer

For Question #7, we asked:

“A Cardiac Index less than ______ suggests cardiogenic shock.”

Correct Answer: B – 2.2 L/min/m²

A Cardiac Index below 2.2 L/min/m² is commonly used as a hemodynamic criterion for cardiogenic shock when accompanied by evidence of inadequate tissue perfusion. Cardiac Index adjusts cardiac output for body surface area, giving clinicians a more individualized picture of cardiac performance.

Did you get #7 right? Now it’s time to take on Question #8.

09/03/2026

REAL WORLD MEDICINE FOR REAL WORLD SITUATIONS.

Are you ready to take your medical skills beyond the classroom?

Join GAMS for the upcoming Tactical Austere Medical Practitioner (TAM-P) – Austere in-person training. This intensive course is built for medical professionals who need to make critical decisions and provide effective care when resources are limited, conditions are unpredictable, and help may be far away.

📅 October 28 – November 1, 2026
📍 GAMS Training Center
1546 E 1225 N, Wheatfield, IN 46392
🏷️ Course Code: TC-26-01020-09
💲 Course Price: $1,600

Train through realistic scenarios focused on austere medicine, tactical trauma management, prolonged field care, and real-world decision-making with experienced tactical medical professionals.

This isn't just about knowing what to do—it's about being prepared to do it when conditions are at their worst.

Train for the environment. Prepare for the unexpected.

Secure your spot and experience the GAMS difference.

09/02/2026

Good Medicine or Good Tactics?
Series #8: Should Every Casualty Receive TXA?

The Question
A casualty has sustained multiple gunshot wounds but remains alert, has a palpable radial pulse, and shows no obvious signs of shock. Should Tranexamic Acid (TXA) be given early, or reserved until findings suggest significant hemorrhage or hemorrhagic shock?

The Discussion
TXA can be lifesaving when used appropriately, particularly when given early to casualties with significant hemorrhage or at risk of hemorrhagic shock. However, TXA is not intended for every trauma patient. Current TCCC guidance focuses its use on casualties most likely to benefit.

Giving TXA early may support clot stabilization and help reduce ongoing bleeding, but unnecessary administration uses limited resources and provides little benefit when indications are absent. Reserving TXA for appropriate patients supports evidence-based care and preserves supplies, but requires continuous reassessment so worsening hemorrhage or shock is recognized quickly.

Bottom Line
The decision to administer TXA should be based on the casualty’s risk of significant hemorrhage, not simply the presence of traumatic injuries. Assess, reassess, and treat based on the clinical picture.

Discussion
What patient findings would convince you that TXA is indicated?

09/01/2026

CSR Decision Series #8: Is the Casualty Ready for Evacuation?

Controlling the immediate threat is only part of the mission. The next question is: Can your casualty move right now?

In the Chaos–Stabilization–Recovery (CSR) Framework, evacuation readiness means more than completing medical procedures. Before movement, providers should reassess tourniquets, confirm triage status, document care when possible, initiate hypothermia prevention, and communicate essential information to the receiving team.

Additional treatment may provide further stabilization, but every extra intervention must be weighed against the cost of delaying evacuation and keeping the casualty in the operational environment longer.

When preventable causes of death have been addressed, preparing for immediate movement keeps patient flow moving, improves continuity of care, and gets the casualty closer to definitive treatment.

Bottom Line: A casualty isn't evacuation-ready because treatment is finished. They're ready when life-threatening injuries have been addressed and the next phase of care can begin immediately.

Ask yourself throughout the mission: If transport arrived right now, could this casualty leave without unnecessary delay?

Discussion: If transport unexpectedly arrived now, could your patient leave within 30 seconds?

08/29/2026

NEW THIS WEEK FROM GAMS | Real-World Medicine for High-Threat Situations

This week, GAMS takes a closer look at two critical components of high-threat medical response: how we triage casualties and how we move them toward lifesaving care.

1. Civilian vs. Military Triage Models
Traditional civilian triage systems were designed for environments where responders have time, stability, and freedom of movement. High-threat incidents demand something different. This article examines the differences between civilian models such as START and military-derived MARCH priorities—and why a hybrid approach may better address the realities of ballistic trauma and chaotic environments.

Read the full article:
https://goat-trailams.com/post/civilian-military-triage-models-high-threat-care

2. Hasty Casualty Collection Points (CCPs)
In a high-threat incident, delaying care can cost lives. This article explores how hasty CCPs can bring triage and immediate lifesaving interventions closer to the point of injury while maintaining protection, casualty flow, and efficient extraction. It also examines the importance of MARCH, coordinated movement, and joint medical-law enforcement operations.

Read the full article:
https://goat-trailams.com/post/hasty-ccp-casualty-flow-high-threat-response

Two important discussions. One goal: improving care when time, access, and resources are limited.

Read, think critically, and join the conversation.

Goat-Trail Austere Medical Solutions (GAMS)

08/28/2026

Test Your Tactical Medicine Knowledge – Question #7

Cardiac Index gives us more than just a number—it helps show how effectively the heart is delivering blood relative to the patient’s body size.

Question #7:

A Cardiac Index less than ______ suggests cardiogenic shock.

A. 1.0 L/min/m²
B. 2.2 L/min/m²
C. 3.5 L/min/m²
D. 5.0 L/min/m²

What’s your answer?

Comment A, B, C, or D below and share your reasoning. Think about what happens to cardiac output and tissue perfusion when the heart can no longer pump effectively.

We’ll reveal the correct answer next week.

Last Week’s Answer

For Question #6, we asked:

An elevated PCWP is most commonly associated with what?

Correct Answer: C – Left Ventricular Failure

When the left ventricle cannot effectively pump blood forward, pressure can back up into the left atrium and pulmonary circulation, resulting in an elevated PCWP. This makes PCWP an important hemodynamic measurement when evaluating left-sided cardiac dysfunction.

Did you get Question #6 right? Now put your knowledge to the test with Question #7.

08/26/2026

Good Medicine or Good Tactics?
Series #7: Needle Decompression—Treat Early or Wait?

The Question
A casualty with a penetrating chest wound develops increasing respiratory distress. Gunfire, helicopters, and environmental noise make breath sounds difficult to assess. Do you perform needle decompression based on clinical suspicion, or wait for more definitive findings?

The Discussion
Tension pneumothorax can rapidly become fatal if left untreated, yet classic textbook findings may be difficult or impossible to identify in tactical environments. Providers must consider the entire clinical picture rather than rely on a single finding.

Performing needle decompression when tension pneumothorax is strongly suspected may quickly improve oxygenation and circulation and prevent further deterioration. However, an unnecessary procedure carries risks, uses limited equipment, and requires reassessment. Waiting may allow a more complete assessment and avoid unnecessary intervention, but delaying treatment could allow the casualty to rapidly deteriorate.

Bottom Line
Tactical medicine often requires decisions with incomplete information. The goal is not always diagnostic certainty—it is recognizing when the risk of delaying treatment becomes greater than the risk of acting.

Discussion
How much evidence do you need before committing to a needle decompression?

Address

1546 E 1225 N
Wheatfield, IN
46392

Telephone

+12197126731

Website

http://www.goat-trailams.com/

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