05-01-2004, 18:19
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#1
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Top 5 Procedures to Save a Life (Battlefield)
What are your top 5 (or less) DX and TX to save a life on the battlefield and their protocols? Be specific please.
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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05-05-2004, 13:20
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#2
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Auxiliary
Join Date: Mar 2004
Location: Canada, when I have nowhere else to be.
Posts: 91
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OK, it's gone 3 days without a response from those more knowledgable than I, so I'll take a WAG based on civilian BLS level training and my expectations of common battlefield trauma (in no particular order):
1. Extremity bleeding - Stop blood loss (direct pressure, elevation, pressure point, HCAs, TQ), manage volume if needed (ALS). Evacuate.
2. Airway, Head and facial injuries - C-Spine control dependant on MOI and Pt. assessment, airway managment, control external bleeding/allow drainage, assess for concussion, assess for ICP, evacuate.
3. Thermal Burns - assess airway for injury, irrigate for 15 mins max if clean water available, wrap in sterile dressings, ALS for pain and volume loss, evacuate
4. Penetrating Chest injury - spinal immobilization dependant on MOI and Pt. assessment, occlusive dressing, Pt. positioning (injured side down), ALS call (particularly for TPT, PT, HT, HPT, volume loss, etc), evacuate.
5. Concussion/shockwave injuries (primary blast injuries) - ABCDE as needed for specific injuries. Assess for concussion, ICP, and signs/sympoms of occult injury. Evacuate.
Feel free to pick the above apart. I come here to learn.
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Maple Flag is offline
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05-06-2004, 01:08
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#3
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Guerrilla
Join Date: Feb 2004
Location: Israel
Posts: 405
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I'm far far from a medic:
oK, these started out inorder, but are now out of order..
This should be number 1
<b>Get on the radio for a medic!</b>
Make sure you're in a safe zone, or at least safe anough not to get yourself killed, i'm not saying ignore or leave the soldier, but do not focus all your energies on the patient and forget about the hositiles. Two injured are worse than one. IOW, keep your friggin head down!
Keep a note if possible, even in the sand, on his/her forhead of time, vitals, treatmant adminestered. This will help the medic/doctor/medivac get a full history and assess diagnosis.
1. Know how to stop bleeding:
KNow the pressure points, artery locations
KNow how the basics, pressure and where/how
Know when to and when not to remove objects (protruding)(such as a knofe, shrapnel etc
Know CPR, ABC-even if you're no medic, CPR could keep oxygen to the brain until a medic comes along.
Know how to id and treat acute shock
Know how and when to tornoquet (do you guys use that? we do) ALWAYS MARK WHEN IT WAS APPLIED AND NEVER REMOVE IT YOURSELF!
2. Carry a tampon, yes that's right, a tampon, works great to help stop bleeding of an open would, such as a stab/or bullet wound.
3. Do not move an injured person, unless you have to! Especially from blast injuries where multiple fractures are common.
4, Learn ICE, Isolate, Compact and Elevate for fractures. (Not life saving really)
5. Confirm, this one for me; Do not give food or water to patient as they may need surgery amd this could complicate anethesis.
remove all potentially explosive gear from the soldier..grenades etc., safety first, the last thing you wanna do,m is snag the safety pin whilest CPRing!
All i have time for now, Please feel free to correct what is BS!
Out
Hoepoe
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hoepoe is offline
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05-06-2004, 01:11
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#4
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Guerrilla
Join Date: Feb 2004
Location: Israel
Posts: 405
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BTW, great and usefull idea for a thread!
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hoepoe is offline
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05-07-2004, 17:49
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#5
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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WTH? I'm not messing around here. Where are all the would be medics? Where are the 11Bs?
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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05-07-2004, 18:51
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#6
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Moderator
Join Date: Feb 2004
Location: Central Florida
Posts: 3,045
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Okay, 20 years out of date I'm sure
1. Asses the injured party
2. Clear the airway, get them breathing again.
3. Stop the bleeding
4. CPR, resusitat
5. Imobilize fractures, etc
6. Treat for shock
3 and 4 always confuse me but it makes sense to stop a bleeder before you get the heart pumping again?
__________________
"Are you listening or just waiting to talk?"
Light travels faster than sound. This is why some people appear bright until you hear them speak.
"Fate rarely calls upon us at a moment of our choosing."
Optimus Prime
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Kyobanim is offline
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05-07-2004, 19:05
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#7
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Well yeah, but what I was thinking was more along the lines of specifics. Say:
1. Cricothyrotomy
etc.
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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05-07-2004, 19:16
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#8
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Quiet Professional
Join Date: Jan 2004
Location: Wherever my ruck finds itself
Posts: 2,972
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Quote:
Originally posted by NousDefionsDoc
1. Cricothyrotomy
etc.
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2.) Hemorrhage control
...
Note: I was waiting for others to chime in but since they are apparently not going to...
__________________
"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
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Surgicalcric is offline
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05-07-2004, 22:34
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#9
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Asset
Join Date: Jan 2004
Posts: 9
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1. Shoot back
2. Get Pt out of line of fire.
3. Airway
4. Breathing
5. Circulation
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SGT
A 2/187 INF
101st ABN (AASLT)
88-91
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rakkasan187 is offline
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05-08-2004, 10:24
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#10
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Guest
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Quote:
Originally posted by rakkasan187
1. Shoot back
2. Get Pt out of line of fire.
3. Airway
4. Breathing
5. Circulation
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so assuming 1 and 2 are done...
what problems can you see with airway and what are the treatments that NDD wants you to discuss?
likewise, what, independent of difficulties with airway, cause breathing problems that you can fix in the field and how would you fix them?
finally, circulation....what can you see and how would you treat it?
I'll fill in my own blanks if no one else does....
doc t.
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05-08-2004, 16:39
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#11
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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I guess it wasn't as important as I thought Doc.
I'll be over here practicing hand-tying sutures on the cat if you need anything.
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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05-08-2004, 17:11
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#12
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Asset
Join Date: Jan 2004
Posts: 9
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Airway:
1.Manually open airway maintaining C-spine immobilization if tactical situation permits and clinical condition warrants.
2. Clear airway of blood, secretions, teeth or other potential FBAO if present.
3. Position Pt to allow drainage of blood or secretions (recovery position) if tactical/clinical conditions allow.
4. Airway intervention to include NPA/ETT if Pt unable to protect airway or if you suspect that Pts condition may deteriorate and unable to protect airway.
5. If unable to secure airway by less invasive means due to facial trauma, swelling or FBAO perform needle or preferably surgical cric.
Breathing:
1. Be prepared to provide rescue breathing/ventilations to apneic Pt or Pt with inadequate spontaneous respirations.
2. Perform chest needle decompression to affected side if Pt presents with decreased BS, dyspnea, tachycardia, decreased BP (hemodynamic instability), cyanosis, JVD, tracheal shift secondary to penetrating trauma to thorax, abd, proximal upper extremeities or pelvis. Also indicated for blunt trauma to thorax abd etc if suspected tension pneumothorax.
3. Apply occlusive dressing (vaseline gauze wrapper, plastic wrap, Asherman, pediatric defib pad) to entrance/exit wounds. Be prepared to burp or relieve pressure from dressing if S/Sx in #2 present.
Circulation:
1. Control arterial/venous bleeding with direct pressure, elevation, pressure pts and/or tourniquet. Tourniquets reserved for extremity wounds that cannot be controlled by earlier mentioned means or that need immediate attenuation due to severity/tactical situation.
2. Place and or trans Pt in Trendelenburg if possible.
3. Gain IV access early prior to vascular collapse if possible. Resuscitate with crystalloid fluids titrating to mentation.
4. Gain second IV access site with saline/hep lock.
5. Needle decompression could be considered a circulation intervention due to clinical features of obstructive shock.
Getting the evil eye from the old lady...gotto go to the grocery store....will expound later...
rak
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SGT
A 2/187 INF
101st ABN (AASLT)
88-91
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rakkasan187 is offline
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05-08-2004, 17:23
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#13
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Quiet Professional
Join Date: Jan 2004
Location: Wherever my ruck finds itself
Posts: 2,972
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Quote:
Originally posted by NousDefionsDoc
I guess it wasn't as important as I thought Doc...
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Important indeed.
I thought I would lay off and give some of the others a chance to respond, but it appears the usual posters are not posting.
__________________
"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
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Surgicalcric is offline
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05-08-2004, 18:15
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#14
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Asset
Join Date: Mar 2004
Location: Savannah Ga
Posts: 22
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Ok, I'll take a shot
1) Establishment of airway.
2) Control of massive hemorrhage.
3) Intravascular fluid replacement.
4) Detection and treatment of hemo- or pneumothorax.
5) Immobilization of fractures
Transport
Stinney
__________________
The art of war is of vital importance to the State. It is a matter of life and death, a road either to safety or to ruin. Hence it is a subject of inquiry which can on no account be neglected.
Sun Tzu
"You don't seem to want to accept who you are dealing with. You are dealing with a man who is an expert with guns, knives, his bare hands, a man who's been trained to ignore pain, weather,to live off the land, and eat things that would make a billy goat puke."
Col Trautman
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stinney is offline
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05-08-2004, 18:42
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#15
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Guest
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Quote:
Originally posted by rakkasan187
Airway:
1.Manually open airway maintaining C-spine immobilization if tactical situation permits and clinical condition warrants.
2. Clear airway of blood, secretions, teeth or other potential FBAO if present.
3. Position Pt to allow drainage of blood or secretions (recovery position) if tactical/clinical conditions allow.
4. Airway intervention to include NPA/ETT if Pt unable to protect airway or if you suspect that Pts condition may deteriorate and unable to protect airway.
5. If unable to secure airway by less invasive means due to facial trauma, swelling or FBAO perform needle or preferably surgical cric.
Breathing:
1. Be prepared to provide rescue breathing/ventilations to apneic Pt or Pt with inadequate spontaneous respirations.
2. Perform chest needle decompression to affected side if Pt presents with decreased BS, dyspnea, tachycardia, decreased BP (hemodynamic instability), cyanosis, JVD, tracheal shift secondary to penetrating trauma to thorax, abd, proximal upper extremeities or pelvis. Also indicated for blunt trauma to thorax abd etc if suspected tension pneumothorax.
3. Apply occlusive dressing (vaseline gauze wrapper, plastic wrap, Asherman, pediatric defib pad) to entrance/exit wounds. Be prepared to burp or relieve pressure from dressing if S/Sx in #2 present.
Circulation:
1. Control arterial/venous bleeding with direct pressure, elevation, pressure pts and/or tourniquet. Tourniquets reserved for extremity wounds that cannot be controlled by earlier mentioned means or that need immediate attenuation due to severity/tactical situation.
2. Place and or trans Pt in Trendelenburg if possible.
3. Gain IV access early prior to vascular collapse if possible. Resuscitate with crystalloid fluids titrating to mentation.
4. Gain second IV access site with saline/hep lock.
5. Needle decompression could be considered a circulation intervention due to clinical features of obstructive shock.
Getting the evil eye from the old lady...gotto go to the grocery store....will expound later...
rak
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i am not sure if this is what NDD was seeking but it was what I was looking for....
A much better answer than your previous one.
doc t.
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