Super-sticky-medic-thread

[Royal]

Cable ties....quick thinking there.

Indeed - improvise adapt & overcome

I believe they did away with the "J" Tube, not sure why though.....

Oro-pharyngeal Airway?



I was certainly still carrying them last time I got my boots dirty - which, admitedly, is a while ago now

[HarleyDoc]

The oro-pharyngeal is out in the new standards. Here are the current airway requirements:

1) Naso-pharyngeal airway. 20-24 F/ 6.0 diameter lubricated with viscous lidocaine if available, surgi-lube or saliva otherwise. Aim the airway down and rotate toward the ear. A safety pin can be used to adjust length and secure in place.

2) Surgical airway (cricothyroidotomy). -Trained use only. An emergency cric set can be fashioned by cutting an IV drip chamber in half. Find the anatomical landmark of cricothyroid membrane below "adam's apple." Make a longitudinal incision through the skin and visualize the membrane. Take top half of cut IV drip chamber, remove cap on spike that usually goes into IV bag. Insert spike through cricothyroid membrane. If patient needed a surgical airway, there will be a rush of air. The drip chamber needs to be secured in place with 100 mph tape or tac sutures. An ambu-bag can be attached to the drip chamber and the patient ventilated.

3) Suction device. (easy suction device). Also use gravity to facilitate drainage of blood and secretions. This is a reason c-spine is not as stressed in new TCCC standards, since it helps to turn the patient head so they don't drown.

[loganinkosovo]

According to the new CLS (Combat Lifesaver Course) I took a couple weeks ago everyone will be issued a CAT in the new first aid pouch. It'll have some other stuff in it too but I forget. Doc Strauss, one of the medics teaching the class, said that every CLS and soldier for that mater should carry tampons of different sizes so we can plug the holes. I felt like an idiot for buying them but if that's what needs to be in my CLS bag then so be it.

From what I've read SEALs and other people who have to travel light have carried them for years.

What ever works.....use it.

Monistat 7 cream works wonders on Athletes foot and I even cured a case of reoccurring jungle rot with it. Boy, that was a very hard sell to get my Master Sergeant to use it.

Just rub the cream between your Affected toes for a week or until the infection goes away.

This stuff is the Sh!t!


http://www.monistat.ca/english/cure_trust.html

[HarleyDoc]

OK guys, let's have a class on tampons. Tampons work very well for what they were designed to do: stop blood from exiting the ****** and running down a womans' leg. They absorb blood, they do not stop the uterus from bleeding. When they are saturated, they are replaced, and the uterus continues to bleed until the lining has been shed and the 28 day cycle repeats. A tampon was not designed to tamponade a severed artery from a bullet wound. If you stick a tampon in a bullet wound, it will absorb blood. This is very different from STOPPING bleeding. You may think the bleeding is stopped, but in reality you just can't see it for a while. In the meantime, the patient continues to exanguinate and slips further into hypovolemic shock.

If you want to stop arterial bleeding, pack the wound with the latest QuickClot tea bags, and/or pack it full of Kerlix gauze or you may have to cut the wound edges open so you can get down to the artery and apply continuous direct pressure, and then pack it with a hemostatic agent like QuickClot and/or Kerlix.

[HarleyDoc]

Civilian ATLS and military TCCC are different systems designed for different environments. Let's talk c-spine control. In civilian ATLS, which was designed to a large degree to deal with blunt trauma from motor vehicle accidents, a medic is trained to secure the airway with c-spine control. In TCCC, we have to consider a GSW or frag injury to the neck. The spinal cord has the consistency and durability of jello. If a GSW hits the vertebral column, it will most likely also sever the cord, and the neurological deficit will be apparent if not outright fatal. Thus a penetrating injury to the neck that has not yet severed the spinal cord, is unlikely to do so in the future. A patient may be harmed more if immobilization of the c-spine that prevents fluids from being drained from the airway. Remember that just putting a c-collar on is NOT spinal immobilization! The patient needs to be secured with head blocks on a long spine board. How many medics carry all the equipment for complete spinal immobilization? Not many, and nor should they. Here's why:

How to rule out c-spine immobilization

No c-spine immobilization is required if:

1) No mechanism of injury
-axial load (hit on top of head)
-traction (hanging type injury)
-flexion-extension (whiplash injury)
-lateral stress
-rotation

2) No pain
3) No tenderness
4) No step-off of vertebral column
5) No distal neurologic deficit
6) No distraction (i.e. drug or alcohol impairment or other very painful injury)
7) No pain when the patient attempts range of motion movements.

[Sabre]

Good posts HarleyDoc. Tampons are fit for purpose only for menstrual bleeding. It's akin to the old 'put on a second/third field dressing if the first bleeds through' mentality. It may treat the medics hypertonic sphincter, but it wont stop the artery from bleeding.

As for C spine control, again good points. Consider of course the mechanism of injury, this may well be an RTC out on ops where civvy street immobilisation would be indicated, but how often do military medics carry spinal boards? Don't compromise the MARCH algorithm for c spine control, although do consider the circumstances (permissive environment etc).

Regarding the 'J tube' or OP airway, it's still in for the UK armed forces. I would imagine the reason why it's 'out' over the pond could be due to personnel putting them in (however correctly) and assuming the airway is safe. Of course, they are just adjuncts and not definitive airways, and as such require just as much monitoring as the airway is still at risk. They are also not well tolerated unless the patient is completely out, in which case they probably need an ET tube. So I would imagine they have been left out in order not to confuse the issue.

[Creeper]

HarleyDoc wrote:

Remember that just putting a c-collar on is NOT spinal immobilization! The patient needs to be secured with head blocks on a long spine board. How many medics carry all the equipment for complete spinal immobilization?

I would like to add to the act of actually securing the Pt's head to the lsb< One should use appropriate blocks(velco) if those are not available take 2" tape across the forehead AND WRAP AROUND THE BOARD fully. Again- wrap around - in a continuous length min. 3X - do same again for the lwr jaw/chin if possible.
This insures - fully that the head / spine is SECURE and IMMOB'D.

just my .02 Euro.

[GiladS]

Here is what an IDF medic carries in his vest (most guys I know, including me, carry spares and extra equipment though):

- 2 silicon/rubber arterial tourniquets
- A 'Russian' arterial tourniquet
- 4 field dressings
- Triangle bandages
- 2 oropharyngeal airways
- An emergency blanket
- Alcohol prep pads
- Gauze dressing pads
- Elastic adhesive bandages
- A Metalline burn dressing
- 4 venflons
- IV set+saline solution bag

Other equipment included are medic scissors (trauma shears) and a angle head flashlight or a head flashlight.

Of course this is what's carried during the routine. In a war a medic or an assistant to him carries a whole backpack.

[DocEbola]

TCCC qualified guys only as far as I know know. The Medics were getting alot of guys coming into the role 3 hospitals with 4 and 5 tournequets on one limb for minor wounds and multiple chest needles in. Guys in the field while meaning well were doing more harm than good in some cases. The TF surgeon put an end to that with the TCCC program.

I'm deploying for the next 2 rotos and as far as our Medics said it's the 2 TCCC guys per section only.

Edit: My wife just got back and she said she was alos issued Quick Clot, a CAT and an Isreali bandage so who knows, maybe it's mid-change or maybe the Medic was wrong. I know that supposidly only TCCC guys carry chest needles and NPAs.

What is TCCC? In the states we use something almost the same, but I want to make sure it means the same.

[Sabre]

There's a few medic threads knocking about at the moment, maybe we should try and combine them into a 'Super-sticky-medic-thread'?

EDIT

"Ask and ye shall receive!"

Thanks Royal, now I just have to think of something to post in it. Perhaps this will work best as an occasional Q&A/update thread.

[Roy Batty]

What is TCCC? In the states we use something almost the same, but I want to make sure it means the same.

Tactical Combat Casualty Care

[LRPV]

There's a few medic threads knocking about at the moment, maybe we should try and combine them into a 'Super-sticky-medic-thread'?

Good idea. Perhaps some kind mod will make it a 'sticky'. It certainly is a thread worth the reading time.

[Royal]

Good idea. Perhaps some kind mod will make it a 'sticky'. It certainly is a thread worth the reading time.

Done - but with warning

Leave the crap out - if you have a relevant comment or info post it - if not put it somewhere else.

PM me with a link, if you know of any other threads that should be merged into this one.

[Sloppy Joe2]

What is TCCC? In the states we use something almost the same, but I want to make sure it means the same.

i dont know, but my unit has been using TC3 for while now, it is the future!

[Noodverbandje]

What is TCCC? In the states we use something almost the same, but I want to make sure it means the same.

Stages in Tactical Combat Casualty Care(source: Military Edition PHTLS, sixth edition)
Casualty managment during combat missions can be divided into three distinct phases: Care Under Fire, Tactical Field Care, and Casevac Care.
1. Care under fire refers to care rendered at the scene of the injury while both the medic and the casualty are under effective hostile fire. The risk of additional injuries being sustained at any moment is extremely high for both casualty and rescuer. Available medical equipment is limited to that carried by each operator and the medic.
2.Tactical field care is the care rendered once the casualty and his unit are no longer under effective hostile fire. It also applies to situations in wich an injury has occured on a mission, but hostile fire has not yet been encountered. Medical equipment is stil limited to that carried in the field by mission personnel. Time to extraction may range from a few minutes to many hours
3. Casualty evacuation care(Casevac) is the care redered while the casualty is being evacuated by an aircraft, ground vehicle or boat to a higher echelon of care. Any additional personel and medical equipment prestaged in these assets will be available during this phase.