Article written by Guest Blogger WillG, a CF Medic with multiple deployments.

One of the premier tactical light companies promotes the concept of the “The Tactical Trinity”. They basically mean a weapon light, high intensity/low intensity search light on your fighting rig and a smaller backup light in your belt kit or clipped in the pocket of your pants. This is a great concept for gunfighters and I highly recommend it for frontline medics and armed LEO medics.

When it comes to casualty care in adverse lighting conditions, additional lighting resources are required.  First of all, and it may seem self-evident, weapon lights should never be used for casualty care. While they provide a bright light source, their use would require the muzzle to laser the casualty and the medic. Not a good practice. I mention it because I have seen it, both in training and operationally. Handheld lights provide enough light but their use takes a hand away from casualty care. There are no interventions done by a provider on a casualty that require one hand. Tourniquet application is done one-handed only in self-care. A well trained operator can put a tourniquet on in the dark relying only on tactile senses. Besides, gunfighters have better things to do than hold a flashlight. They should be providing security, getting a litter ready, or calling for evac assets. For a tactical medical operator, lighting choices really come down to two options: headlamps/helmet lights and rig mounted lights. Each has its pros and cons.

Most commercial headlamps are designed for outdoor recreation. Tactical versions of these lamps are usually available in a black or camo colour version of the outdoor light. Some come with coloured lenses, usually red. All-in-all, not good for casualty care. Remember, agencies and military units purchase for the majority which are gunfighters. Blue and green lenses are available for most high quality headlamps but usually in separate kits. Helmet lights are designed to be mounted on the provider’s helmet. There are many helmet lights designed for military use. Many have options such as multiple colours of light and some even include IR settings.

Pros of headlamp/helmet light:

• Light source is always directed to the provider‘s line of sight
• Reduced shadows thrown on the casualty because of high angle
• Hands free

Cons of headlamp/helmet light:

• Increased light signature over vital zone
• Medic can ‘flash’ teammates as they update their situational awareness
• Helmet gets ‘busy’ with NVGs and headlamp
• Light source is high thus illuminating more area than required, creating a back-lighting danger

Rig mounted lights are mounted to the operator’s fighting rig. Most have swiveling heads to allow the light to be directed to the required area. Military-use vest lights usually have multiple intensity settings; some include a strobe feature. This allows the light to be used as a backup IFF/signalling device.  Most have the ability to project multiple colours of light; a few include IR wavelengths as well.

Pros of rig mounted lights:

• Light signature is over heavily armoured area
• No chance of ‘flashing’ teammates
• Light source close to subject and the ground, reducing back-lighting danger
• Hands free

Cons of rig mounted light

• Increased shadows due to lower angle
• Beam has to be aimed by body positioning which can lead to poor body mechanics

Also, there is a training aspect that must be considered with all light sources. Under stress, most people forget to turn their lights off when making movement or after use. This is a training issue and must be addressed during scenario play.

Remember, two is one and one is none. I recommend having both a helmet light and a rig mounted light. One is back-up for the other.  Head mounted lights are very useful in advanced airway techniques and interventions of fine motor function. Vest mounted lights are good for keeping light low and on the casualty. This is very important in a Tactical Field Care Bubble because light tends to draw fire.

Night is another day in tactical operations. Most tactical operations either take place in low light or, at least, begin in low light. A tactical medical operator must be prepared to treat casualties under all possible conditions.  Control the chaos. Get a light.  Better yet, get two.