Crips weekly Question

x SF med

the Troll
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to the Mod that moved this - you are evil!! I like that!!!

Yoohoo, Crip,Crip,Crip-- come out and plaaaay!!!

But let's go with a little better - just gimme the Dx, Tx, Px for Pneumococcal Pneumonia. (the variety from H. Infuenzae is real bitch, and I need to start off slow.)

You are in a field setting, resupply takes 3 days, You have the 2 M-5's on the team for now, medevac available same timeframe as resupply - complication - Pt is febrile 103, resp incr to 125/min, grunting is noted onset 2 days ago, nausea and vomiting present, rales and decr breath sounds bilat.

go for it, grasshopper!
http://soforp.com/vb/showthread.php?t=2189
 

Polar Bear

They call me Mr Sunshine
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Well I tried to clean up the tread but lost it in neverneverland. People do not post in this thread unless you ask a question, about the question, or answer the question, any questions.

This is a Learning thread for some, refresher to others, and common knowledge to a few. Do not clutter it with crap

Thank You

Crip I lost your last post in this thread could you post again.
 

surgicalcric

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I was simply saying since we are gonna do Q&A we may as well make it beneficial to a broader populace here by discusing combat medicine as opposed to sick call/medical subjects. I believe our time will be better spent talking about scenarios centered around things guys on here may see and be able to treat such as arterial bleeding, amputations, dyspnea after blunt/penetrating trauma to chest/abdomen, and the list goes on, as opposed to talking about the difference(s) in pneumococcal, staphlococcal, myoplasmic, and streptococcal Pneumoniae just to name a few, or the difference(s) between African and American Trypanosomiasis.

Besides, of the 128 case studies every good Delta knows the two deciding factors in any med illness is a fever and a petechial rash. :rolleyes:

And with that,

Basics of Pneumococcal Pneumonia

Pneumococcal pneumonia is caused by Streptococcus pneumoniae (pneumococcus). Generally appears after an URI-V damages airway defenses which allows bacteria (staph in this case) to infect the area.

Pneumococcal pneumonia, although usually treatable, can be fatal, especially in the very young, the very old, and those people who have other severe illnesses (caveat for most disease prognosis). It can lead to pneumococcal septicemia or pneumococcal meningitis if left untreated.


C/C: Shaking and chills, with associated fever, productive cough-sputum brown, dyspnea, and chest pain w/ respiration, on the affected side. N&V and general malaise are also common.

HOPI: Preceeded by Cold or Flu generally.

Symptoms: sudden shaking chills, N&V, rapid onset fever, pluritic type C/P, SOB, productive cough w/ blood tinged sputum, malaise and myalsia.

Signs: Appears in distress, BBS decreased on affected side/lobe(s) or may have rales, hyporesonant over same, tachycardic, tachypnic, HTN. high fever (100.4-105F), SAO2 </=96% RA, cyanosis.

Labs: CXR: infiltrate/consolidation PP usually presents w/ single lobe involvement as opposed to multiple lobes.
WBC/Diff: Leukocytosis >13,000 with L shift (Bands/Segs)
Gram stain: Gram +, diplococci chains and pairs

Diff Dx1: Bronchitis
Diff Dx2: TB
Diff Dx3: Viral Pneumonia
Diff Dx4: PE

Tx: Admit to clinic if indig soldier/evac US soldier, Pen V 500mg QID x 7 days or Clindamycin 300mg QID x 7days (if treating empirically Erythromycin is DOC), supp. care, O2(if SAO2<94%). Repeat CXR/WBC/Gram stain x 7 days or PRN until resolved.

Prognosis Good (>90%) with PT compliance to treatment regime.

Well that covers the "off the top of my head" info on PP.

Crip
(long day of dental medicine...)
 

surgicalcric

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Thanks, P. Late night last night as you can see...

I would like to open the discussion to other members of the board.

Are there topics that you guys would like to discuss? I would prefer to keep it in the area of trauma. If there are, we could form a list and I will get to one or two a week, as the SFQC permits.

The floor is open.

Crip
 

Polar Bear

They call me Mr Sunshine
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I would start simple...example Auto wreak what do we look for?
Your kid falls 20 feet out of a tree?
etc....
Your studies come first though
 

surgicalcric

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...Your studies come first though

No problem there. Last written test is tomorrow morning. The real test wont come til this Nov...

So, you guys name what you want to see. Or I can work up scenarios based on current feedback from the Sandbox and I can ask the questions and give pos/neg feedback.

How many other SF or SOCM medics are on the board?

Crip
 
R

rangerpsych

Guest
no socm for me, just alot of OJT and some extra courses courtesty of various units...
 
L

Looon

Guest
Ok, if this is educational and informative, can you medical types give a laymens explanation? Im sorry, but my ignorant ass can't even understand most of what was written.:(
 

surgicalcric

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RL:

The initial question was more of x_SF_med proding me than it was meant to be educational for you guys. I will be more than glad to break down the future ones to non-med speak.

Crip
 

DoctorDoom

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I'm not Special Operations anything, but do have civilian trauma training and Army training.
 
R

RescueSig

Guest
yeah, it's old

I don't mean to bring up these old posts, but I'm a FNG to this site and like this area. I think pimping each other on our medicine is awesome. But like the responses listed, lets bring in some trauma, not just medicine. PJs are a little rusty on that, I'll have to bust out the old Paramedic books. However, we can be called out to a ship for some illness and medic questions will keep me in the know. Bring it...
 

HeloMedic1171

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I like this too. I'm not SF med, just a 68W trying to go to 300FW6... and maybe SOCM later on. bring the trauma.

what kinda scenarios you got, Crip?
 

HeloMedic1171

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I do have one question though - at DCMT @ Ft Sam they preach gatifloxacin for everything. if he gets shot, Gat. if he has an avulsed abdomen, Gat. etc... but here I got Rocephin, other guys mention Gentamycin, Erythromycin, Cipro, etc... can you give me 3-5 antibiotics to keep in my trauma bag? uses/reasoning to have them?
 
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