Search Results for: trauma

The ABCs of Trauma, by Dr. Mountaintop

…Blunt Trauma: Without an ability to do imaging, or blood work, or a long experience doing physical exams, it’s hard to know what’s going on with blunt trauma. If there is a blast injury (explosion) all bets are off. Don’t underestimate a blast injury. In many blunt traumas, but particularly blast injuries, there are lung injuries you can’t see initially. This will cause the lungs to fill up with fluid and the patient will drown. If you have oxygen, some ability to use an airway, or diuretics (like ferosemide / lasix), this is the time. Otherwise, don’t over-hydrate the patient if you suspect a lung injury (big chest bruising / gurgling / coughing up fluid). For abdominal blunt trauma, here’s what to consider: is the spleen or liver bleeding? What to look for: Is there a big welt on the skin below the ribs? Does the patient look pale and…


Mass Casualty Trauma Kit, by Thomas Christianson

…Medical, “The Mass Casualty Trauma Kit is designed to be a self-contained bag that can treat 2-6 critically injured people during a mass casualty incident.” They comment further, “During a mass casualty incident, you may have a large number of injured parties in varying parts of your facility. Instead of stocking a single large backpack style bag with medical trauma components, we recommend smaller self-contained pouches (like the Mass Casualty Trauma Kit) which can be distributed to trained individuals and taken simultaneously to the injured parties.”   They recommend stocking as many of the kits as are needed based upon the facility’s peak occupancy, with roughly one kit for every 50 people up to 200, with an additional kit for every 100 people thereafter. Contents The kit includes two TacMed SOF-T Tourniquets, two Dynarex 4″ “Israeli Style” High-Pressure Dressings, four pair of Blue Nitrile Gloves, one pair of Compact Trauma…


The First Aid Kit as a Multi-Layered Medical Resource, by Hambone

…1 #10 sterile scalpel blade 2 foil packets triple antibiotic ointment 2 foil packets ‘burn gel’ (lidocaine) 2 packets electrolyte tablet ( 2 tabs per packet) The next level module is for major trauma.  Housed in a surplus M-3 Medic bag, it has supplies for dealing with major trauma, heavy bleeding, crushing injury.  At this stage any injury you treat will require professional medical care found at a hospital or trauma center.   Designed to provide pre-hospital treatment of large lacerations, avulsions or deep penetrating injuries which may result in a tension pneumothorax or those resulting in evisceration. These kits are normally built based on the advice of a trauma physician and include items not covered in training at a level below P-EMT.  As such, I will just list some items to provide an idea of the level of care that might be provided – 4 sets latex or nitrile gloves…


Pat’s Product Review – Infidel Body Armor Goes Soft

…Trauma Max panel.   Due to the FedGov shutdown, I wasn’t able to access the NIJ web site, in order to see how many rounds are used to test the various types and threat levels of body armor hits they will take during testing. I don’t think they fire more than a few rounds into soft body armor panels in their testing, though. I was very impressed with the way the Trauma Max IIIA panel stood-up. I know I could defeat this armor – and I will get out for some more testing, to see just how many more rounds of handgun ammo this panel will take before it fails – and all body armor will fail if you shoot it enough times. But just for fun……..   Now for the good news, if you purchase one Trauma Max panel from Infidel, it’s only $160 and if you purchase two…


Introduction to Tactical Combat Casualty Care, by W.H.

…TCCC procedure to address circulation in the MARCH sequence is to check the patient for shock. While there are many different types of shock, an easy definition for non-medical professionals is the inability of the body to transfer blood to its tissue (also known as profusion). In the case of traumatic injury, this is usually due to blood lose and the change in hormones following a traumatic event. As the body comes down from its amped up state, immediately following an injury, it realizes that it cannot keep up its current state and begins to shut off blood flow to the outer, less essential areas. However, a patient can suffer shock without sustaining a traumatic injury, usually after a person witnesses a horrific event. One of the easiest and most timely ways to check for shock is to check the patient’s radial (wrist) pulse. If there is a radial pulse,…


Letter Re: Kevlar Helmets and Head Protection

…exposed? Helmets are also excellent for lessening blunt trauma, though you should be aware that any impact on the head is a serious threat that causes some level of injury – no armor makes you invulnerable. The blunt trauma protection of a helmet is often not given enough weight. Think about it – in a high-threat confrontation you would often be coming under fire and moving as fast as possible, perhaps in the dark. Very likely you would be hitting trees, walls, cars, the cover you are diving for, etc., etc. in your haste to get to cover. Any helmet (even a bike helmet) is desirable so that crashing into hard objects is less of an impact on the brain, possibly saving you from being knocking disoriented or unconscious. Helmets are excellent ballistic protection from pistol-caliber threats (and Fragmentation) but, sorry to say, rifle protection helmets are not on the…


Musings of a Law Enforcement Paramedic – Part 1, by LEO Medic

…at local community colleges, or through special EMS schools. The EMT idea was devised by the National Highway Transportation Safety Administration in the 1960’s as a way to deal with the increase in vehicular trauma. Trauma is what EMT is about. EMT covers basic anatomy and physiology, recognition and treatment of shock, recognizing and treating basic problems with the ABC’s, and basic wound care. It is first aid on steroids. This is not a knock. It is the basics, but the basics with a very high level of comfort and skill. A good EMT can do amazing things. Once you have your EMT certification, most communities offer free continuing education (CE) classes to meet annual requirements. EMT’s have limited pharmacology, and a few systems allow them to start IV’s and carry limited medications. In the same way the EMT idea was designed to deal with vehicular trauma, paramedics or ALS…


Musings of a Law Enforcement Paramedic – Part 3, by LEO Medic

…encourage you to buy an extra and play with it. Become familiar with it. In addition to penetrating trauma, chest trauma of any type can cause a pneumo. If anyone with chest trauma, such as a broken rib, is having difficulty breathing, be alert for a pneumo. The field solution to a tension pneumothorax is a needle decompression. Needle decompression is not covered under any good Samaritan laws and is being presented as a informational study only. So when do you do it? In addition to overall patient deterioration, you will notice lung sounds are greatly diminished or absent on the injury side, as well as a drop in oxygen saturation. This means a lung has collapsed or is in the process of collapsing. (You do have a pulse oximeter and a stethoscope, right?) Do not wait for tracheal tug to alert you to the presence of a tension pneumo,…


A Medic of Last Resort – Part 3, by Tunnel Rabbit

…American Rescue (NAR) 4″ and 6″ trauma dressings. (Get as many as affordable.) Brown in color 3″ and 6″ wide nonsterile rolled gauze 4 Multi-trauma dressings, sterile, 10 x 30″ Several large lap sponges, sterile 10 ABD/Combine Gauze pads, sterile, 5 inch x 9 inch Box of 100 5×7″ BZK antiseptic wipes (Benzalkonium Chloride) Box of Betadine antiseptic packets Box of povidone wipes Various sizes from extra large to smaller adhesive bandages (band aids, a convenience item) Surgical face masks (keeps spittle from getting into the wound) Eye Pad 2″ Surgical Tape Several rolls of Guerrilla tape (fixes anything) Disposable Razors Stethoscope Digital thermometers Curved and straight forceps Tincture of benzoin Moleskin in bulk Coban or Coflex, or other brand, self adherent elastic wraps, 3 and 6 inch wide Prepackaged, compressed, and sterile Emergency/Trauma bandages and gauzes of various types and sizes. Penlight (for inspecting pupils) Headlamp (for first aid…


Survival To Go, Revisited- Part 1, by JMD

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…over in Iraq and was now an EMT. We asked him if he’d be willing to help us put together a decent trauma kit and teach us how to use it. We offered to pay him for his time. He jumped at the chance, and when he showed up at our house a few days later, he even brought a bunch of practice supplies and a trauma practice dummy. We spent several hours going through what we needed and what we could carry (given my pack size), and he gave us pretty detailed hands-on training on how to use all of it. He even gave us some copies of the training materials he used when he was getting his EMT license. He also agreed to come back in six months or so to give us a refresher. I highly recommend making some friends at your local fire department or EMS…


Letter Re: Wounding Patterns

…Concerns, C- Circulation, H- Hypothermia, R- Recovery Position, V- Vital Signs, S- Stabilize, and Package for Transport. Our assertion is that destroying the threat first, and immediately evaluating massive hemorrhaging and determining immediate tourniquet application to extremities is STILL the way to go in an austere environment. In TEOTWAWKI, few of us will have plenty of oxygen, surgical supplies, and 24 bags of IV fluids cached. (24 bags plus blood products is the average for ANY GSW trauma patient.) Thus, it will be critical to provide immediate aggressive treatment in the field in order for a trauma patient to have a remote chance for survival. There will be no 911, paramedics, trauma centers, or definitive care available only ten minutes away. There will only be the Patriot and his or her patient. I’m not knocking the Study, just ensuring the readers have more data to make informed decisions. – S4H…


Letter Re: Soft Body Armor and Blunt Trauma

…possibly some broken ribs and internal organ damage, even when soft body armor does its job of stopping the bullet.  This is why I have a raid vest with steel plates to go over my soft armor.  If you are in the market for body armor and can afford it, get both soft and hard.  The ceramic is a little lighter and will generally stop AP better than steel, but it breaks when it absorbs the hit, so if Uncle Sugar isn’t buying you a replacement plate, I’d go for steel with an anti-spall coating.  Get on YouTube and watch the body armor tests, research the NIJ ratings and find out more than just what certain levels will stop.  If you are planning on being in a gunfight, expect to get shot, and even if you’re wearing body armor, expect a [blunt force trauma] injury from the impact. – Carl C….


Trauma School, by John M.

…us once used this litter to carry a rather heavy individual and it made the trip much easier. This also makes a great straight jacket for your friends experiencing TEOTWAWKI psychosis until they can calm down a bit. While carrying your pal out of enemy territory, you’re probably going to be shot at and possibly even take a bullet or two. Assuming you don’t get shot anywhere really bad like the guts, heart, lungs, brain, spine, etc., you may live! Bring out those fish antibiotics and open wide, friends. I’m not going to cover the “sucking chest wound” or anything that would require a wound vac, a chest tube with suction, or any other heroic medical measures, because it is a very precarious situation to find yourself in a level one trauma hospital, let alone TEOTWAWKI. I’ll just say that if you get shot in the arm or leg or…


Adapting Traditional Medical Care to the Austere Environment, by A.P.T.

…This category is rarely used outside of large MASCAL incidents. The idea is to treat those with the best chance of survival and do the most good for the most people. Major trauma such as head injuries with increasing intracranial pressure; internal hemorrhage; spinal injuries; and chest trauma will all likely be placed in the expectant category. Yes, you can perform needle decompression for a GSW to the chest, but then what? Jerry-rig a Pleura-Vac with a chest tube? What about surgical intervention and the dedicated personnel for continuing care of this patient? Even if the first 1-2 hours of care can be accomplished, the definitive and continuing advanced care will not be possible. On the other hand, if your assessment revealed an obstructed airway (foreign body or positional) or an external hemorrhage’ then these conditions could be corrected, and definitively cared for in an austere environment and should be…


The Jump Kit, by Skyrat

…wound. Should you shop gun shows or surplus stores for your equipment, be wary of old dressings. They present potential issues of failed sterility as well as mustiness or mildew occasioned by improper storage or imperfect packaging. The contemporary Israeli Battle Dressings are available from Cheaper Than Dirt or from Gall’s for $9.00 or $10.00 each. Another wound care product is QuikClot . This is a mineral product, bound to a dressing, which enhances clotting, and thereby slows and limits blood loss in the bleeding patient (common in trauma, surprisingly enough!) One article (QuikClot Use in Trauma for Hemorrhage Control: Case Series of 103 Documented Uses. Journal of Trauma-Injury Infection & Critical Care. 64(4):1093-1099, April 2008.) reflected the occurrence of burns in several patients, but the manufacturer’s web site reports that changes in packaging and delivery system have addressed this issue. An alternative you might consider is Celox. It appears…