Z06,
The Israelis came up with the BIG years ago. It works great if you stay proficient on it.

The IO used was the EZIO. Also a very easy to use IO device that is now being used by my EMS crews as first line access in 95% of all codes.

IO's have been around for years (vet care and in WW2 if I recall) It's just that they are "barbaric" so folks dont want to use them. I love em.

Show:I thought it was very well put together. Not SEAL like in trying to make them all look like Billy-Bad asses; just showing what they do and how they do it. I can't lie...I had negative views of PJ's due to some prior experiences but this changes my perspective. Not saying I won't give some a little shit next go 'round but I see them in a new light. Can't wait for next week.

IO:I don't know why more people aren't into this. It is my choice for access in a severe trauma patient. Guys on the team aren't too stoked to know this but hey, "operator feels no pain."

11Ber

Their disappointment in not being sent to help the children is obvious and troubling. You can tell they wanted to help anyone they could.

Agreed, IO is underutilized. Patients in shock/hypotensive/hypovolemic are the perfect ones for IO and since we have the luxury of choosing locations above or below the diaphram, it makes it a good RAPID access for admin of anything (meds, blood, fluid, etc).
We use it more and more in the trauma center; we have the ability to place central venous catheters but while my residents and other emergency medicine docs are spending precious time trying to get a central line, I've drilled in 1 or 2 IOs and have stuff going in 3-10 minutes before they do.
The fastest central line I've placed from start to finish is probably 60 seconds or so whereas an IO is less than 10 seconds to have in and running.

ss

I have enjoyed the series and will continue to watch. Have always had a deep abiding respect for EMTs, Firemen and others who rush to the aid of people, having been a benefactor of their skill and calm reassurance. God sent angels in the eyes of many they assist.

I had an Uncle who was an HN (Hospital Corpsman) during the Korean War. Told he was a part of the teams that came to the aid of injured soldiers and prepared them for evacution. My mother recalls the toll that experience had on her brother. I believe he carried a great deal silently until the day he died.

It's difficult to find the words to describe my admiration and heartfelt gratitude for those "who risk their lives, so that others may live." Valiant angels from above, comes to mind.. I thank God for you each day!

66 ARS
 

I was a rigger for the PJ's out at Nellis AFB back in the early 90's. Respected the hell out of those guys!

In case anyone hasn't seen these, or just wants to watch them again (without commercial interruptions ;) ), here are all the episodes.

Inside Combat Rescue - Part 1:
http://www.youtube.com/watch?v=8Rc4_2_YXuw

Inside Combat Rescue - Part 2:
http://www.youtube.com/watch?v=vae1Cr8rC_M

Inside Combat Rescue - Part 3:
http://www.youtube.com/watch?v=s7C-4P1H0yg

Inside Combat Rescue - Part 4:
http://www.youtube.com/watch?v=le1QM1PMXxg

Inside Combat Rescue - Part 5:
http://www.youtube.com/watch?v=U6j5fJ4HEVA

Inside Combat Rescue - Part 6:
http://www.youtube.com/watch?v=u9SpEn73LVg



Bravo Zulu Little Brother .... Bravo Zulu

If and when the time comes that guys need an IO instead of you spending time attempting a peripheral site their bodies will already be in pain overload and wont even notice the IO. I know. ;)

The kid with the GSW to the head in Monday's episode definitely reacted to the IO attempt.

Pedro vs Medevac
 

My primary concern is patient care. Being a Medevac crewchief in Afghanistan last year, we had numerous missions were canceled even though we were 5-10 minutes from POI. Instead, they would spool up Pedro, or Tricky(Brits). The only problem with that is Pedro, and Tricky were 30 minutes away.
So far, after watching this show, I have seen no difference in the way Pedro and Medevac operate in Afghanistan. What's more cost effective? If you haven't noticed yet, ( during the show) when you see Pedro leaving the airfield, you can see a Medevac units aircraft parked right beside them.
Another obsevation is their medical abilities have not impressed me thusfar. I am only comparing what I experienced out of FOB Edi last year, ( which was the busiest in theatre).

Problem with the PJ's IO attempt: no gun or driver. He was pushing the IO in, not twisting it in and it won't break through the outer cortex of bone that way without A LOT of pressure and that likely would cause pain. The usual pain for insertion with either the gun or driver handle is a 3-4:10 in my experience.

I watched it several times to figure out why he had an IO failure because that is truly a rare occurance......it was not a failure of IO, it was operator error, something to learn from for him and all other providers.

ss

I have not watched the episode again so am working from memory. Was the PJ attempting IO the young kid on his first deployment? I can't remember his name...
Was this possibly a factor of his inexperience and a mental vapor lock under pressure?
Do you think the error was caught and remediated at the unit level?

1) Don't know
2) Could be
3) Should have been

I was surprised to see the PJ go for a hand driven IO on this kid. He was alert to pain and moving around. I would have grabbed the drill and hammered it. But hindsight is 20/10 since we all see better than the Operator in the moment.:p

NCart: Pedro is chose usually due to the armament they bring with them and the fact that they carry up to 3 highly trained medics. No offense but a regular MEDEVAC medic can't match these guys in their knowledge, experience and training. Not trying to piss you off, it's just facts. And I know there are great MEDEVAC medics out there but they just aren't as good and their birds don't rock MK-44' and M-2's. As for your FOB being the "busiest in theatre"...Everyone tries to claim this. I helped at an FST in 2011 that rocked 100+ ATLS patients a month all summer. Sounds like you are jaded from being benched. I haven't seen them do anything that was bad medicine; they don't make the decisions, they just execute.

11Ber,
No offense taken. I respect your opinion, but I have been witness to soldiers and marines that die due to medevac taking too long. ( no fault of Pedro, or Tricky).
As far as the medical side of the house, our medics are National Guard not AD. Most of them are either paramedics, or nurses. They don't " High Five" after successful IV insertion. I do agree that the average PJ is better trained than the avg Medic, but in my case, I saw different. I have seen some aweful medics!
Patient Care is my concern! The M2's are cool and all, but I have yet to see them fire. In Medevac, we volunteer, and know the danger. That is Medevac legacy. We are not concerned about that or air cover when it's an ISAF soldier that is a CAT A.
This is just my point of view. If your not going to use Medevac, don't send us over there.

Nate