Care of casualties in Iraq and Afghanistan

[Fraser.g]

I think a few of you may find this article and the following photo essay from the New England Journal of Medicine interesting.

A friend of mine sent them to me this morning.

GF

 

[Fraser.g]

From the New England Journal of Medicine
Caring for hte wounded in Iraq.
http://content.nejm.org/cgi/content/full/351/24/2476

Note the patern of shrapnel wounds on the pers who was wearing his body armour when he was hit on page 2477.

GF

 

[Adam]

Those pictures are are pretty scary.  lets hope we never see pictures like that from afganistan.

 

[Fraser.g]

Those pictures are are pretty scary.   lets hope we never see pictures like that from afganistan.

Hope yes, Be prepared for Absolutely not.

We have troops in an active theater of operations. To hope and not prepare is a foolhardy venture at the best of times.

GF

 

[Armymedic]

Those pictures are are pretty scary.   lets hope we never see pictures like that from afganistan.

Read the news, US forces are dealing with those same injuries weekly in Afghanistan, vs daily in Iraq...but they are happening.

Better to be prepared than caught unaware.

 

[medicineman]

Certainly a wake up call for those people that haven't come in contact with that stuff - almost had a flashback or two.

MM

 

[Old Ranger]

Interesting Pictures, gives an Idea of what you all deal with.

Side Question;
Do you vary what you carry in your bags overseas?
Working amongst Civi population eg. paediatric resus equip?
What do you find is Best Carried?
Do you have vehicles close to keep extra kit in?

Not sure if this has already been answered.
Sorry if it has.

 

[Armymedic]

Its covered in other threads but I'll give short answers for here...

Do you vary what you carry in your bags overseas?

yes, medics carry different stuff from what a doctor or nurse carry. Overseas we tend to carry more trauma (badages, dressings, IV fluids) then medications and bandaids because we tend to out of a base camp where the clinics are.

Working amongst Civi population eg. paediatric resus equip?

Not usually, but I did carry child and infant size airway tubes as I daily traveled along the busy roads where kids walk to school.

What do you find is Best Carried?

vague question but it is personal preference and answered on other threads here.

Do you have vehicles close to keep extra kit in?

Depends on the task/mission. Roto 3 medics had patrols that departed Camp Julien in a LAV and had the veh in close radio contact. They would carry a small thigh pack and a couple other immediate things on them as they patrolled with the big bag in the vehicle.

I had my jump bag with me all the time, but supplemented fd dressings, bandages, and IV fluids in each of the 6 G wagons my team had.

 

[Old Ranger]

Thanks, I'll check the other threads again.

Ben

 

[Dale Turner]

WOW! A picture says a thousand words!  I think that pics like that should be shown to everyone on work up training.

Thanks.

 

[kj_gully]

1st off, thanks for the many well thought out replies to my posts so far. This question is about live tissue training. Are medics getting any live tissue lab time pre-deployment? Aside from our SF medics, I mean. Speakers at a military medicine conference I recently attended spoke extremely highly of the value of both Cadaver training, and Live tissue training. It would seem that there are some "bigwhigs" at least senior medic pers on this site, and hope you would consider sending some key pers on training during predeployment. this course is representative of some of the training out there, and came to me highly reccommended from a fellow Canadian (operational overseas...)  http://www.oems.org/ I hope to attend training there at some point in my career.

 

[Armymedic]

All PAs and MOs going overseas do a predeployment stint at the trauma training center in Vancouver for 4 weeks. There they do rounds, in addition to retesting on all ATLS and ACLS skills.

 

[JANES]

What do you want to know about the course Gulley?

 

[kj_gully]

All I really want to know, is if the medic trade sends anybody, the medics in the "real" army.If not, why not, and is it as helpful as I have heard.

 

[JANES]

Conventional Canadian Army medics are not sent on the course.  The course is extremely worth it.  Stress inoculating WRT dealing with real traumatic injuries en mass scale, pentrating and blast type.  Gets you used to dealing with the real thing instead of seeing it for the first time, when is happens to your buddy beside.

 

[herseyjh]

Is the use of on scene ID prophylactic antibiotics for open trauma been explored by the CF?  Is this something that we are doing right now?  Just wondering.

 

[Guy. E]

Perhaps a graphic image warning somewhere?

When I hunt, I see that kind of stuff on the animals that I and other people kill. its just different/ unpleasant to see to see it on a person...

 

[Armymedic]

Is the use of on scene ID prophylactic antibiotics for open trauma been explored by the CF?  Is this something that we are doing right now?  Just wondering.

No, and not exploring it as of right now either, as far as I know.

 

[JANES]

TCCC working group discussed it.  They ran into problems with choosing the right type.  I appologize, I am not up to date on the specific drugs.  The US changes the type frequently.  The broad spectrum one they were using at the time the WG discussed had a confliction issue with Mefloquin.  There is no doubt that there are effective braod spectrum ones out there that dont conflict with other drugs, and have a low allergy frequency.  The US is probably using them right now.  I think the current problem is that there just isn't the staff or time to research, recommend and impliment this.  This is just the CF's priority due to poverty.  It's unfortunate.  Everyone in the US Army gets a pill pack in theatre.  When you get shot or blowed up, and you're still conscious, you pop your pill pack full of pain relief anti-inflamitories and a dose of anti-biotics that will do you for 24hrs (prophylactically as was mentioned).  Maybe one day, after we sort out the tourniquet and HSD issue we can move onto this, and try mitigate that 12%ish that DOW.

 

[herseyjh]

Sorting out which antibiotics to carry would pose an interesting problem.  I guess as long as evac times stay short this shouldn't be a major factor in patient outcomes.  Also, in our defence, the US military took time to adopt this stance.  I was just reviewing one study where the idea of antibiotics was scoffed at as research from EMS showed that their was no real benefit, and it wasn't until Mogadishu and prolonged evac times did intrest spark up again.