Direct blood transfusion

[Diamondback 2/2]

Yet more proof of why the CLS program overreaches it's capability to train people to competency. I routinely removed Hextend from the CLS bags because none of my CLS trained soldiers understood how it worked.

If I am not mistaken, they pulled IV theropy from the CLS course and removed it from all the bags. Personally I think it should be in the bag and trained on, but only when a medic say's yay or nay. I have used Hextend on a few multi-amputees in the past, I always had my bags marked with red/blue tape and Hex was always red. I don't know enough about anything med to do much but basic life support stuff, but I can open/make an airway, I can stop most bleeds and I can fix up a hang over

....But yeah I agree with all of you on this stuff, I think they should just expand on the CLS course (mainly b/c there is never enough medics when shit gets fucked).

As for the thread I am simply in awww of you 18D's, I wish we had medics like you dudes in line companies. Most of the medics I have had in the past did not give me that much of a good feeling of "going to be properly taken care of" when shit gets fucked.

 

[8'Duece]

Crip-
Do you do pre-mission titering for reactive proteins for the entire team so you know who can't take the same type blood? It's not a perfect system, but it could keep guys alive when you have to go the direct transusion route without the ability to spin down and filter the blood to plasma, packed cells and garbage.

Never thought about this but as I learn more and more I'm wondering what anti-bodies you would test for ? MMR ? Hep B ? Hep C Hep A, other anti-bodies ???

Remember, I'm not in a clinical phase yet.

 

[surgicalcric]

...we need to push for the approval of treatment options like lyophilized plasma...

It is being actively pursued as well as a couple other options. However in the interim -and as a SOCM instructor of mine was fond of saying- you got what you got and you treat the patient with what you have, not what you would like to have.

Crip

 

[x SF med]

P:

I have had them done in the past but don't do them prior to every rotation. I had the idea sold to our Group Surgeon at one time -because someone has to pay for the titers right...- but there has been a change in the Med Section and our current Group SGN isn't the person we need in that position. I have recently been pushing buttons again and am hoping to make some head way on the topic -as well as a few others which I believe are important in planning for sustained operations where med support comes from my aidbag and not a CSH or FST down the road by air...

That is another topic for another time though...

Titers can change over time based on hydration, exposure to new infectors, actually having had an infection, surgery, exposure to allergens, and changes in the innoculation schedule... Primum Non Nocere says you need to know in order to reduce the chance of creating a bigger problem than you already have. A small cost for titering and reactive profiles for Teammates is much lower than replacing even one Teammate. Penny wise, pound foolish.

 

[Headshot]

For some reason I remember hearing (may be rumor) that LTC Iceal Hambleton had been shot or had several wounds during his SERE in Vietnam and it wasn't until they stuck him that he started to bleed heavily. The dehydration helped save his life is the point. Anyone else hear this, I can't find anything in his bio about it.

 

[Manolito]

The capabilites of today and the training of the medics today are beyond my comprehension. Back when the earth was still cooling BLS (Basic Life Support) was the treatment of the day. Some days you got a Doc that was on his game and you felt pretty good. Other times not so good.
To those that have gone before you and to those to follow Thank You for what you do.
Respectfully,
Bill

 

[surgicalcric]

Titers can change over time...

A small cost for titering and reactive profiles for Teammates is much lower than replacing even one Teammate. Penny wise, pound foolish.

I am in total agreement but unfortunately -for my guys- the SGN outranks me...

 

[TLDR20]

It is being actively pursued as well as a couple other options. However in the interim -and as a SOCM instructor of mine was fond of saying- you got what you got and you treat the patient with what you have, not what you would like to have.

Crip

I actually have a pretty good story about that. My pre-test in CTM, I am all stressed out and amped up as you can be, The night before I meticulously packed my bag, went over it 10 times. Well come pre test day and sure enough I forgot to re-tape my tape board, and had forgotten tape. I ran my whole clinic wit maybe 5 pieces of tape. Surgicalcric I am sure you understand how bad that sucked. I would have passed the clinic however it took me a while to figure out exotic ways to tape my procedures down. Learned a huge lesson there though. From then on I have always made a checklist and packed off of that. Because you will always have what you have, not what you wished you had.

Passed on the test day with a 13:00 min initial and rapid, and more tape then I knew what to do with :cool:

 

[surgicalcric]

[Sidebar]

...Surgicalcric I am sure you understand how bad that sucked...

Brother I know...

My trouble didn't come in the form of tape but with my BVM. As you know there is really not a good place to carry that damn thing on or in the old M5 bags they issued us so I came up with the idea of placing a small snaplink -like the ones used for keys- on the strap of the BVM and attaching it to the 550 cord on the balsawood splint contraption THE NIGHT BEFORE the pretest. Needless to say this wasnt the most intelligent of ideas but the good idea fairy had taken control.

Fast forward to the next morning... I am standing along side the rest of the guys in the first iteration when "MEDIC" is yelled. We all take off in a dead sprint for our specific cadre. I arrive at my patient with Sadiki (another student who is the assistant) to find a blast injured patient... The initial went fine: TQs, occlusives, NPA, stump dressing in place, and patient moved to poleless (Polish) litter and to a halt. Once behind "cover" previous treatments were checked, with the patients breathing becoming labored so I needle-D him and grab for my BVM only to find the 550 cord had teared thru the 100mph tape and my BVM was GONE... I can only imagine the look of fear on my face at my recent discovery. The cadre was talking with another cadre and not really paying as close attention as he should have -thank God- when another pair of students with their patient sundered by, dropping the BVM at my right knee; opposite my M5 and out of sight of the cadre. The rest of my run went very well...

I learned later that it was when I jumped the ditch at the fence that the BVM fell off.

I have a list of funny stories from SOCM/SFMS that I may put to pen one day... Good Times indeed!

Crip

 

[pardus]

I hope you brought those students a beer or two Crip, good save!

 

[Headshot]

Just noticed this thread has alot of Crip and bloods on here. Gangsta out!

In all seriousness though, good thread! This is one of those read and learn that make this site worth its salt.

 

[surgicalcric]

I hope you brought those students a beer or two...

Nope, a bottle of Johnny Walker Black Label for one and Jim Beam for the other. ;)

Crip

 

[surgicalcric]

Just noticed this thread has alot of Crip and bloods on here. Gangsta out!

Good catch on the gang reference; didnt even notice.

 

[TLDR20]

[Sidebar]
I have a list of funny stories from SOCM/SFMS that I may put to pen one day... Good Times indeed!

Crip

Yeah I do too, the look of fear in everyones eyes on cath/npa/oral gastric tube day was pretty funny. 45 stone cold killers in a circle throwing up and tearing up like a babies is a pretty funny sight!

 

[Red Flag 1]

"I am a big supporter of PHPTN and utilize it to the fullest but I know it has a point of diminishing return(s) and prepare accordingly, as I know you do."

Have used this in surgery, deliberate controlled hypotensive anesthesia. Deliberately lowering blood pressure during surgery will reduce operative blood loss. Using this technique requires direct arterial pressure monitoring, and a careful pre-op workup; not all patients are candidates for this...........

 

[Medicine-Man]

Mmmm...Good thread. ;)

 

[pardus]

Just noticed this thread has alot of Crip and bloods on here. Gangsta out!

In all seriousness though, good thread! This is one of those read and learn that make this site worth its salt.

This is a site that confirms what a wanker you are and what an uneducated newb I am to medicine...

 

[Muppet]

HEY! Do we get C.M.E.'s for this? :)

F.M.

 

[Muppet]

This is a site that confirms what a wanker you are and what an uneducated newb I am to medicine...

Uneducated newb. is not the word to use. You are more than capable to do your job and this site just adds to your tool box of skills. :)

F.M.

 

[TLDR20]

This is a site that confirms what a wanker you are and what an uneducated newb I am to medicine...

The best part of medicine is that you are always new to something, and there is always more to learn. Same goes for every job in the military. You can always improve upon your skillset.