Tag: English

As I write this (not long after the ruzzian missile and drone attacks on Ukraine of Chrismas 2024 and New Year’s Day 2025), there are many brands and styles of tourniquets available on the market. I am a combat medic (військовий парамедик) in Ukraine, so donors often ask me which kind to buy. This letter to a friend and supporter in the United States is the answer. The executive summary: do buy the Dnipro Gen 2 or the CAT Gen 7. Don’t buy the SOF-T or the Sich. If you’re just looking to learn some new English vocabulary, you will find it in the English notes section at the end of the post. You will also find donation information there, if you would like to support our work.

Hello, my dear! You asked me what kind of tourniquets to buy for our boys and girls at the front. Thank you for asking. People like to buy tourniquets, and I get it– it is obvious, and I think obvious on a visceral level, that they are life-saving. 

There are two good options for tourniquets, and one that isn’t terrible. I will tell you the two good options:

1. The CAT (Combat Application Tourniquet) Gen 7, by North American Rescue. These typically sell for $30-35 retail, or $22 with a humanitarian discount from the manufacturer.
2. The Dnipro Gen 2, by a Ukrainian manufacturer. These go for $22 retail, or $14 in bulk. 

They are both excellent tourniquets. I carry the Dnipro Gen 2 for my own personal tourniquets. You might hear people complain about the first generation. The second generation is great–as I said, it’s what I carry for my own use. The retail prices are obviously hugely different, with the Dnipro Gen 2 being significantly less expensive. The Dnipro Gen 2 has an additional advantage: you don’t have to shlep them from the US.

The option that isn’t terrible is to buy the shittiest models that you can find. We call them “Chinese tourniquets,” which is probably unfair to China–I think the North American Rescue CATs are made in China, too. Amazon is currently selling a pack of eight of these things for $23. What you have to be aware of is that we only use them for training. For training, we really like them! The reason that we like them for training is that you can tell people that their quality is so poor that they should never, ever carry them until you’re blue in the face, but it mostly doesn’t get through. On the other hand, if they see a few of them break in a training course, they get it. So, on the medical logistics chat, you will see messages like this: “Anyone have Chinese tourniquets, the shittier the better? I need them for a training course.” So, it’s not a bad idea to bring a few of these. But, personally, I only bring them if I have a bit of space to fill in a duffle bag, and a bit of my weight allowance to spare. 

Let me tell you about a couple of other kinds of tourniquets on the market. I most definitely do *not* recommend spending any money on them. They are variants on the same design, called a SOF-T (I think it stands for “Special Operations Forces Tourniquet”). Rather than using a pair of “wings” to hold the windlass (rod) in place, SOF-Ts have a metal clip at one end that you flip over the end of the windless, locking it in place at the tip of the clip. They will most certainly stop bleeding, and with that clip and a strip of duct tape, that windlass is never going to be dislodged. But, there are three problems with them, and the third is a really big one. 

1. They are really hard to put on with one hand. It is crucial to be able to put on a tourniquet with one hand–including with your non-dominant hand–if you have a serious wound in your own arm, and you have to put on your own tourniquet yourself. It’s possible to self-apply these, but it’s pretty tough to do so even when you’re not bleeding to death in the dark. In contrast, the CAT/Dnipro design does not have that problem.
2. When put on over winter clothing, SOF-T-style tourniquets are more likely not to achieve adequate compression pressure than they are to achieve it, and they have a tendency to slip off of winter clothing. The CAT/Dnipro design is much less likely to do this. (Here’s a link to a paper on the topic of tourniquet use over winter clothing.)
3. Most people are not trained to use them.

#3 is by far the biggest of these problems. There must be dozens of thousands of people in UA who have been trained to use the North American Rescue CAT/Dnipro Gen 2-style tourniquets. (One humanitarian group claims to have trained over 100,000 people themselves.) In the US, there is a popular course called Stop The Bleed, in which anyone and everyone can get trained to use the NAR/Dnipro-style tourniquet. (If you haven’t taken that course: it’s the minimum that ANYONE should have before coming to UA.) But, it would be rare for a training course to include using the SOF-T design–personally, I have never taken such a course, and I have never heard of anyone teaching one. To me, it seems like absolute foolishness to distribute a tourniquet that the statistical equivalent of no one knows how to use, when there are excellent tourniquets that many thousands of people have been trained to use.

The issue of the SOF-T style of tourniquet comes up here a lot because there is a competing Ukrainian-made product called the Sich tourniquet. It is of the SOF-T design, and it is aggressively marketed/advertised. As a medic, I ask you not to spend donated money on Sich tourniquets–see issues 1-3 above.

Finally, a few words on colors. Tourniquets are typically available in three colors: black, orange, and blue. They work identically, and are of identical quality–only the color differs. Black is meant for situations where you don’t want to be seen, so they are what we carry. In contrast, orange is meant for when you want to be seen. The orange tourniquets are intended for civilian use. In a civilian context, they’re great, because when you get a casualty to the hospital, it is easy to see that there’s a tourniquet in place, so even if the fact that the person has had a tourniquet placed gets lost in the communicative shuffle of turn-over to hospital personnel, the very visible color brings it to the staff’s attention. Finally, blue is for training. In this context, the purpose of the color is simply to remind you that it’s one of your training tourniquets, and no one should be carrying it. (Tourniquets are single-use items, so you need separate TQs for training and for actual use. I don’t have any blue ones, so I mark mine with a Sharpie as тренування (training)). 

​Regards, and thank you for all that you do to keep us alive and kicking during this war of ruzzian aggression, 

​Your friend Zipf

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English notes

turnstile: this is a thing that is used to control access to an area. You will see them in subway stations, train stations, etc. You pay, a set of bars turns, and you can walk through the thing to get where you are going. I bring it up here because it is far and away the most common translation error that I see in Ukraine (Far and away explained in the English notes). To wit: the Ukrainian word турнікет, pronounced much like the English word tourniquet, is often translated as turnstile. So, you will often see requests like this in the medical logistics chat group: Need 10 turnstiles for a recon platoon. To an English speaker, this is uninterpretable.

There is a perfectly good reason for this common translation mistake: the Ukrainian word турнікет most properly means turnstile. There is a natively Ukrainian word for tourniquet: джгут (unpronounceable in English–it’s something like the English word jute, but with an h inserted after the j.) However, the word джгут is now used primarily to refer to the constricting band that a medic puts on your arm when drawing blood or starting an IV, while турнікет is used to refer to the tourniquets that we use to control massive hemorrhage. For the many readers of this blog who don’t speak French, I will point out that tourniquet means turnstile in French, too. Turnstile in Spanish is torniquete, in Czech it’s turniket–English is the oddball here.)

far and away: this means “by a large amount.” Merriam-Webster gives this definition for it: by a considerable margin. As far as I know, it functions as an adverb and appears with an adjectival phrase. Here are some examples of its use:

• A return of ruzzian troops to their own homes would be far and away the easiest way to end the war in Ukraine.
• putin’s assumption that Russian speakers identify as ruzzians and would welcome his invasion of Ukraine was far and away his greatest mistake. Instead, tens of thousands of them rushed to join the Armed Forces and protect Ukraine.
• ruzzia’s utter disregard for the lives of its own troops has always been, and remains today, far and away its most powerful weapon. In contrast, Ukrainians’ intelligence is far and away its most powerful weapon.

to wit: this phrase introduces a specification of something more general. Merriam-Webster defines it as that is to say or namely. Here is an example of it in use, with an analysis of the generality and the specification:

• A tug-of-war over Ukrainian identity (and history) has taken place in some fashion between Kyiv and Moscow since Ukraine’s independence in 1991 — and in earnest since Russia’s 2014 invasion. Nevertheless, this contest has intensified dramatically since the start of the Kremlin’s “special military operation.” To wit, Moscow has intentionally targeted Ukrainian schools, according to Ukrainian sources, in order to hit “soft targets” and disrupt education in Ukraine.(Paraphrased for clarity from an article by Ilan Berman.)
• The general statement: the fight over Ukrainian identity has intensified since the start of the full-scale invasion in February 2022. The specification: To wit, Moscow has intentionally targeted Ukrainian schools.

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My name is Kevin Bretonnel Cohen. I am a combat medic (військовий парамедик) in Ukraine. If you would like to support the Ukrainian Humanitarian Resistance non-governmental organization (501(c)3, EIN 99-4530777), PayPal to kevin.cohen@gmail.com works fine, as does Zelle to 303-916-2417. If you use PayPal, please be sure to choose the friends and family option, so that your donation does not get deducted from my Social Security check. However you choose to help, please be sure to add a message with your contact information, so that I can thank you!

All views expressed in this post are my own.

The future tense in English can be produced in two ways:

1. With will. For example: I will bring you a tourniquet.
2. With going to. For example: I am going to bring you a tourniquet.

Simple, right? Not in the spoken language. When these are said, many contractions are used. These are common ways of saying the future tense:

1. I’ll bring you a tourniquet.
2. He’ll bring you a tourniquet.
3. Kevin’ll bring you a tourniquet.
4. I’m goin’ to bring you a tourniquet.
5. Kevin’s goin’ to bring you a tourniquet.
6. I’m gonna bring you a tourniquet.
7. Kevin’s gonna bring you a tourniquet.

In our exercises, we will use vocabulary related to the contents of an IFAK (аптечка):

• підсумок: Pouch
• турнікет: Tourniquet. Also called TQ. The tourniquets that we use in combat are called CATs or CAT tourniquets. CAT stands for Combat Application Tourniquet.
• Гемостатична марля: Hemostatic gauze. Also called Combat Gauze or Quik Clot. (Quik is normally spelled quick.)
• Повітропровід назофарингеальний: Nasopharyngeal airway. Also called NPA.
• Пов’язка оклюзійна вентильована: Chest seal
• Голка декомпресійна: Chest decompression needle or decompression needle
• Ізраїльський бинт: Israeli bandage, or Israeli, or pressure bandage
• Марля: Compressed gauze, or Z-folded gauze, or Z-fold gauze. Also sterile gauze, or just gauze.
• Термоковдра: Space blanket or Mylar blanket or rescue blanket
• Шапочка для душу: Shower cap
• Скоч: Duct tape (sounds like “duck tape”)
• Ножиці для розрізання одягу: Scissors or shears or trauma shears

Our work in Ukraine is possible only because of the generous support of people like you. If you would like to support my work here, PayPal to kevin.cohen@gmail.com works great. So does Zelle to 303-916-2417. If you use PayPal, please pick the “friends and family” option, so that it doesn’t get deducted from my Social Security check. 🙂 And if I don’t know you personally–please, please, please add a message with your contact information, so that I can thank you!

Many foreign volunteers in Ukraine spend their time doing “hot extractions:” evacuation of civilians from the front line. That means driving into an area under fire, quickly loading little old grandmas into your vehicle, and getting out of there–fast. The typical crew will include a driver, a navigator, and a medic, and each of them has a crucial role to play in getting everyone to safety. The following list will help you make sure that your vehicle contains everything that you need. Following the list, you will find the rationale for each item, as well as explanations of obscure words (replacing our usual English notes). The driver should go through this list daily, and the team leader should verify that you did so. Have something to add? Tell us about it in the Comments section.

Daily vehicle checklist

• Oil and fluids checked
• Tires checked
• Battery expiration date checked
• Lights and turn signals checked
• Spare tire air pressure checked
• Jack in place
• Medical bag in place
• Tool kit in place
• Crew snacks and water
• Water for civilians
• Radio present
• Litter present (it’s not what you think–see below, or this video)
• Phone cables present
• Powerbank present
• Fire extinguisher present
• Jumper cables present
• Blankets present

Problems noted: Here you should document anything that you need to take care of before departing on a mission.

Roads near the areas of combat in Ukraine have typically been heavily damaged by shelling, tracked vehicles (tanks, armored personnel carriers, etc.), and the like, and are hell on the vans that extraction teams rely on. If you do not take care of yours, it will not be able to take care of you–or of the civilians for whose lives you are responsible… Hence this checklist. Here are explanations of some of the words that appear on the list.

Spare tire: This is the extra tire that you will use if your tire is damaged. “Spare” means an extra thing that you have in case you need it. “Spare tire” is also a slang word for the fat hanging off of the waist of a man. (On a woman, it’s a “muffin top.”)

Jack: This is the mechanical device that you use to raise a vehicle in order to change a flat tire. This video will help you learn this obscure English word.

Medical bag: This is an easily identifiable bag containing more than you carry in your individual first aid kit (IFAK). In my group, the medical bags include everything that goes in our IFAKs, plus a splint, eye covers, a windlass for improvising junctional tourniquets, a radiation monitor, trauma scissors, and extra gauze. Lots of extra gauze.

Litter: This is a device for carrying an injured person, or more often, an old person who cannot walk. Speed is of the essence if you want to avoid Russian artillery figuring out exactly where you are, so anyone with limited mobility needs to be moved by you, not hobble along at their own speed. This video will help you learn this obscure meaning of the word litter.

Want to support our work in Ukraine? You can send donations directly to me via PayPal using my email address, if you know me. Otherwise, I recommend these three groups. One of them is mine, and the others I have worked with very closely. Please mention that you came to them via me/the Zipf’s Law blog.
Base UA/База ЮА is a Ukrainian organization that does hot extractions, sets up mobile medical clinics, and runs tactical medicine courses and an art camp for refugee children in the beautiful Carpathian mountains. With our comrades from the US and Germany, we have evacuated thousands of civilians from Luhansk and Donetsk in the Donbas region.
Community Self Help is a Ukrainian organization that has worked with refugees from the Donbas region since the start of the Russian invasion in 2014 providing mental health care. Since the current phase of the war started in February 2022, they have also provided medical supplies, documented war crimes, and fought back against Russian propaganda and disinformation.
Global Augmentation is an American and Irish organization that sends volunteers to Ukraine (and has a group about to leave for Turkey for search and rescue operations). Global Augmentation folks are drivers, navigators, medics, trainers, and all-around fearless guys and gals. (And yes, that’s my picture on the web site.)

Photo: Paul Wall, an American veteran paratrooper, a thinker, and a man of courage, fixes a vehicle in Kyiv before leaving for a month in Bakhmut

On January 6th, 2023, two British volunteers, Andrew Bagshaw and Christopher Parry, went missing near Soledar in the Donetsk region of Ukraine. As I write this, in late January 2023, there have been no verified sightings of them, and they are presumed dead or captured. Their vehicle was found soon after their disappearance–locked. Presumably they had to abandon it and head out on foot. You should prepare and practice for this situation. The protocol that I am suggesting for you here is based on the US Navy’s procedure for abandoning a sinking ship. Air crew members: if you can add something, please tell us about it in the comments.

1. Count to ensure that everyone is present or accounted for.
2. Check that all survival equipment is on someone’s back or in their pockets: BOB, medical bag, communication tools, escape route maps, water and food.
3. Destroy all sensitive information.
4. Consider destroying or disabling the vehicle.
5. Notify someone.

Everyone present or accounted for: “everyone” means all team members and any passengers. Passengers are most often civilians who are being evacuated from the front (with attendant communication problems related to lack of a shared language), but may also be journalists (who can present their own set of challenges). If you must leave behind bodies, note their location. Take their passport, wallet, telephone, and any other personal effects or useful items (for example, individual first aid kit (IFAK), helmet, body armor, water). Consider leaving identification of some kind with them, or writing identifying information (including nationality so that the appropriate embassy can be contacted) on their clothes or body. Also consider taking a lock of their hair, some bloody clothing, or a cheek swab for later DNA matching. (Back in the day, American medics took fingerprints of bodies that would be buried overseas. See below for a link to an article on digital collection of fingerprints–no pun intended…)

Bug-out bag (“BOB”): this is an easily carryable container, typically a small- or medium-sized backpack, containing everything that you would want to have with you if you had to abandon your home (or office, or vehicle) in an emergency. You can find plenty of advice elsewhere on what a BOB should contain. Customize it for your operating environment, and update it as that changes, as the weather changes, as your crew size changes, etc.

Medical bag: this contains more things than one would have in an individual first aid kit (IFAK, or аптечка). Ours have the usual things, plus a splint, extra bandaging materials, and a radiation monitor.

Destroy all sensitive information: Destroy information on evacuees you have picked up or were on the way to pick up. Delete from your phone/destroy paper maps that show your safehouse, checkpoints, military units, humanitarian centers, routes… You should have left for your day’s mission with a separate map that shows the area that you would have to walk through to reach safety, and nothing else.

Destroying or disabling the vehicle: Even a vehicle that no longer runs is a valuable source of spare parts for the enemy in a war where logistics has been a/the major struggle for both sides. It also might contain sensitive information that you missed when you left it. I don’t know shit (to “not know shit” means to not know anything at all) about destroying vehicles–if you do, dear reader, please tell us about it in the Comments section. (In the Navy, you place explosive charges in relevant places so that the ship is guaranteed to go down.)

Notify someone: Tell them who is with you, where you are, and where you are heading.

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The British reporter Tom Mutch knew one of the two missing British volunteers. He describes them as brave guys doing life-saving work–and as under-equipped and ill-prepared for working in a combat zone. You do not have to be ill-prepared. Practice this protocol before you need it. Andrew Bagshaw and Christopher Parry: I hope we see you again some day.

Want to support my work as a medic in Ukraine? If you know me, you can send money to me via PayPal using my email address. $2.99 will buy a pack of gauze, $20 will buy a pair of tactical glasses, $30 will buy a tourniquet, $125 will buy an individual first aid kit, $400 will buy a medical bag, $800 will buy a set of body armor. If you don’t know me, you can donate through any of these organizations. I work with all of them, and they’re all quite good.
baseua.org
globalaugmentation.org/
communityselfhelp.org/

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Bryan T. Johnson & John A. J. M. Riemen (2019) Digital capture of fingerprints
in a disaster victim identification setting: a review and case study, Forensic Sciences Research, 4:4,
293-302, DOI: 10.1080/20961790.2018.1521327

Picture at top of page: van stuck in the mud in the middle of an artillery duel, east side of Bakhmut. Photo by Ori Aviram.

1. Moxifloxacin is what an American combat medic will give you if you have a penetrating wound. I have no idea how to find it in Ukraine, but your doctor can give you a prescription for it. I was very, very happy to have some with me here when a frightened cat sunk a fang very, very deep into my arm. (I was also very, very happy to have clear ballistic glasses with me when I was trying to get her out from under a bathtub while she was trying to scratch me to death, but that’s a topic for a post about ballistic glasses, right? Fang explained in the English notes at the end of the post.)
2. Do not bring aspirin or ibuprofen. US Department of Defense guidelines say not to take them for a week before entering a war zone. And, yes: since Putin deliberately targets civilian targets of no military value, all of Ukraine is a war zone.
3. Meloxicam is what an American combat medic will give you for any battlefield injury. See above regarding the situation in Ukraine.
4. Acetaminophen (sold in the US as Tylenol or in generic form) is the third thing that an American medic will give you if you are injured.
5. The antidiarrheal medication of your choice. You shouldn’t travel ANYWHERE without this anyway.
6. All medications that you normally take. Bring more than you think you will need. All problems in Ukraine are supply chain problems, so do not assume that you will be able to buy ANYTHING wherever it is that you happen to find yourself. Yes, I do understand that it is difficult to get more than your allotted quantity of prescription medications in the US, since your insurance company rations your health care.

Want to help the situation in Ukraine? Base UA/База ЮА is an excellent organization doing evacuation of civilians from the front lines (and a bunch of other stuff). I vouch for them completely. Send PayPal contributions to donate@baseua.org, and please mention that you found us through the Zipf’s Law blog.

Photo source: https://www.purina.co.uk/articles/cats/health/dental/looking-after-cat-teeth

English notes

fang: “A fang is a long, pointed tooth.” (Wikipedia) Fang often occurs with the verbs to bare and to sink into. Examples from Sketch Engine, purveyor of fine linguistic corpora and tools for searching them:

1. He sank his fangs into her shoulder.
2. Spike longed to sink his fangs into Xander’s hot flesh.
3. “Then you deserve this,” he said as he sunk his fangs into the man’s throat and drank hungrily.
4. Sink those fangs into one of our mini milk chocolate caskets.
5. How I used it in the post: A frightened cat sunk a fang very, very deep into my arm.

To bare means to uncover completely:

1. He raised his lips, baring his fangs.
2. His ears lay back and his fangs were bared.
3. But a beaten dog will bare its fangs eventually.

This message from a friend who is volunteering as a medic in Ukraine showed up in my Inbox the other day…

Yes, I’ve been in Ukraine since the beginning of May. I’m a medic, as I was in the Navy. You asked about my safety. “Safe” is a very relative concept… When I’m not in the field, my morning routine consists of making a cup of coffee, grabbing a pack of cigarettes, and then sitting on the balcony to watch the morning rocket attack on my entirely residential neighborhood. I say “morning rocket attack” because there has been one almost every day since I got here. Probably sounds horrifying, but since the only people carrying guns around here are soldiers, I actually feel safer in the city than I do in the US.  When I’m in the field, it’s a different story. I mostly do evacuations of civilians from the front. The Russians enthusiastically shell refugee collection points and clearly marked emergency vehicles, and evacuating civilians from the front means going to refugee collection points in clearly marked emergency vehicles. As it happens, I have a relatively high tolerance for danger, so although it’s certainly not “safe,” that’s fine. What’s not OK is that because the Russians hit those places and vehicles so hard, and by this point a large proportion of the people who have not yet left the front are old folks, this feels less to me like a war of one country against another than of the Russian army versus a bunch of defenseless grandmothers…

English notes

in the field: In a military context, this means being out doing whatever it is that you do. Examples:

• Your service member is headed out into the field and it looks like the entire military gear issuing office is located in your living room. No matter what their training mission might be, they will want to prepare and pack a few things for the field that will make things a little bit easier while they are “work camping.” These are things that have been suggested by actual service members who have been in the field for countless hours, days, weeks, and even months. Source: 35 things every service member needs for the field, from the Daily Mom web site.
• A good razor with a shave gel that protects throughout the day is key for a service member who is shaving in the field. Source: the Daily Mom web site.

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The picture at the top of this post shows old women sheltering in the basement of the refugee collection point in Lysychansk, in the Donbass region, during an artillery strike. My friend spent the attack outside, listening to debris bounce off of his helmet with every hit. The Russians eventually flattened the collection point.
The picture is a screen shot from this video by documentary filmmaker Marharyta Kurbanova, a member of my friend’s team.