That takes too much time IMO. To me, there's not a lot I can do about altered mental state at the scene, so I focus on the things I can fix. Make sure everybody's yelling "Medic!" (Airway, breathing), then move right to "C". The burns weren't too bad, so not likely to be a priority. Shrapnel seems to have done the most damage, so I'm looking for bleeders.

Seems like it was bleeding out. I would check the guys with the thigh wound first, especially the through and through to the other leg, make sure it didn't get the femoral.

quick glance at the compount FX to make sure he wasn't going to go south on me. Then deal with him after I'm sure of the thighs.

Plus, the thigh wound stands a good chance of going into shock if I don't reassure him about his package ASAP.

Make sense? Just me.

pushing my luck...
 

That was not in SOAP format Sarn't.

From the Special Operations Forces Medical Handbook (2001).

Circulation: Uncontrolled hemorrhage is the leading cause of preventable battlefield deaths. Rapid identification and effective management of bleeding is perhaps the single most important aspect of the primary survey while caring for the combat casualty.


Sir, a soldier with your training is hardly guessing.

Re: pushing my luck...
 

LOL - Touche Cherry. I SOAP 'em after I get 'em dirty.

Seems like I have seen that somewhere before...

Here's a SOAP for ya:

S -VERY year-old smart ass 18Xer reports to clinic app 22:48. C/O knowing it all.

O - Pt observed floundering around worried about mental status after a large order explosion thread. Guarding and avoidance on mention of SOAP format. PERRLA. Alert, however 12 on the NDD coma scale.

A - 1. Lack of quality time with old soldiers
2. Too much time as a civie

P - 1. Refer Pt to SFAS Instructors ASAP
2. Check PRN for attitude adjustment
3. Repeat SFAS PRN

LOL - I crack myself up.:D

Just funnin' ya Crip - you know you're my favorite 18B candidate.

Back to the PTs at hand. Do you agree with my analysis?

We'll see what Eagle has to say when he comes in.

Well, in the case that was chosen, there are a few more things that should be mentioned. First, we were under fire after the blast, so there's a lot of gunfire going on. Second, the most serious injury (one closest to blast, punctured IBA, etc.) was still alive for sometime after the blast. Third, we had one medic, almost everything except the three closest to the IED was addressed using buddy aid.

You are too funny.

S- no comment

O- no comment other than shouldn't "knowing it all" fall in 'O' lol

A1- concur but working on that daily
2- what can I say...

P1- not much longer
2- James who...we have no idea who you are talking about Sarn't. No attitude here NDD
3- hopefully not

You are not baiting me with the 18B comments. I stumbled into that firing lane last time and I am not going to make that mistake twice. I barely escaped with my life last time.

care to elaborate?

Sounds like you guys and your medic did an outstanding job.

I'm sorry you lost your teammate.

With the added information, the chest wound becomes my #1 priority, followed by the through and through thigh.

Just messin' with Crip, ma'am. I didn't know you were here. I'll stop now.:o

I would agree.

I was under the impression from your wording Max the soldier with the chest injury was deceased. He would have become my first priority.

On that note, I find it difficult to treat patients sometimes without being able to physically see them and what occurred. This was a good learning tool though.

the residents have a hard enough time remembering the glascow coma score....was hoping for something more interesting....

keep messing around.... James can take it I am sure....

doc t.

Only if I actually observed you knowing something. NOW STOP! Doctor Ma'am is here - no more messin' around.

Are you still going with mental status and respiratory rate for triage?