View Full Version : Disaster Medicine
Eagle5US
01-14-2009, 19:14
First off..we do not care about self characterizations of someone being a "Nasty Girl", even when referenced to the National Guard or "as a joke". This is not mil.com or some other BBS that supports, or condones, degradation of military service when performed honorably.
Regarding your postit appears that you are attempting to extend your scope of practice FAR beyond the boundaries of your capabilities, training, and authority. It indicates a significant lack of training and basic understanding in the field of medicine and concepts for ACLS.
What to bring:
Bring what you are provided from your Medical Platoon SGT, Medical Squad Leader, Senior Medic, or the packing list provided by your unit medical control (PA / Doc). If for some reason you have absolutely zero guidance, pack for basic trauma (splints and bandages) and non invasive airway support (NPA/OPA), collapsable BVM, pocket mask, pocket suction. Since it will be cold, I would also recommend a number of space blankets or mil casualty blankets.
MEDS
As a PFC 68W you will not need any "drugs from a civilian Doctor" to give to ANYONE...EVER.
Those medications come FROM a doctor because they require prescribing privileges...which you do not have.
You do not have the capabilities (or apparently the training) to provide ACLS care for "old people with MI's". This requires administration of medications AND MONITORING of CARDIAC ARRHYTHMIA in order to even KNOW what medications to give. Leave it to civilian EMS, provide BLS as indicated until they arrive.
Civilian EMS will be in place to handle civilian emergencies. If you happen to be a first responder in that situation, take a short history and provide BLS as appropriate.
The rest of it
You will not be the responsible party to attempt to reverse or treat drug overdoses past the point of BLS and non invasive airway support. At your level of training, your responsibility is BASIC LIFE SUPPORT.
Folks at much higher levels than you are worrying about CBRNE - if you need equipment it will be provided.
You need to review and understand the parameters that you are held to in regards to your scope of practice and your limitations when involved with the civilian population.
Save for a mass casualty incident, you cannot, and should not, start an IV on a civilian. Your role as military support is to be a first responder for BASIC life support (NOT COMBAT LIFE SUPPORT) to the civilian community until civilian EMS arrives.
If one of your SOLDIERS goes down and requires IV support or intervention, and you have the authority from your medical control to start a line, then by all means do so.
Your post is very disturbing to me.
Eagle
swatsurgeon
01-14-2009, 21:39
Your post is very disturbing to me.
Eagle[/QUOTE]
That is a very true statement........I endorse everything Eagle wrote. Practicing /providing care that is even alittle outside the bounds of your training can get you in profound trouble. Wrong question asked in my opinion.
ss
Jaw dropping !!!! But Eagle you covered it couldn't agree more with you.
swatsurgeon
01-15-2009, 11:28
I did phrase that question very poorly. I know that I have to stay within my scope of practice. That is part of what I am trying to figure out. I have no PA, no doctor, and my senior medic is a secretary at a police station and has done no medical training since graduating from Sam 3 years ago. When I asked my team leader about training and equipment he told me to do my best to get it own my own.
I asked for medical SOPs and was told that they would try to make some up. I am doing the best that I can. I am taking some additional classes from my college. I am a history major and am looking at intelligence. I am not a medic or a nurse in the real world. I am just doing the best I can to figure stuff out as I go. I just spoke with an ER nurse for advice and it was like she was speaking gibberish with cardiac drugs and EKGs, etc. I don't know anything about that stuff and so I am trying to learn on my own as fast as I can. Any polite advice you guys have would be appreciated.
As far as the drugs from civilian docs go, that was how I was told to get epipens and MDIs. I am just trying my best to help my guys...
The epipen, a far too dangerous instrument to be used without training: here is a true story. A senior paramedic in VA with > 15 years experience administers an epipen to a patient that the medic is convinced is having an anaphylactic reaction to seafood, to which he has a known significant allergy. Both the patient and the wife insist that he did not come into contact with seafood but the medic, convinced that the signs and symptoms he is "seeing" are infact anaphylaxis despite being informed of the contrary. He administers the epipen and promptly kills the patient who is CLEARLY having a heart attack.
The medic went into 'auto mode' rather than performing critical thinking and killed a patient....this is what you are reminding me of.
Take this advice if you think you should: CARRY NOTHING THAT IS NOT ISSUED, DO NOTHING THAT IS NOT BASED ON TRAINING AND COMPETENCY, IF YOU WANT TO HELP AN INJURED TEAM MEMBER, CARRY A CELL PHONE AND CALL FOR ASSISTANCE AND UTILIZE WHAT YOU HAVE AND HAVE BEEN TRAINED TO DO.....Primum non nocere, live by it and practice by it.
I am always disturbed by those that are eager to do more, carry more, perform outside their scope when in their hope to help more, they do just the opposite and cause harm....no good deed goes unpunished and jail/suit seems a high price to pay to be a 1 day cowboy.
Enough said.
ss
(deleted)
Originally Posted by galen.edwards
I did phrase that question very poorly. I know that I have to stay within my scope of practice. That is part of what I am trying to figure out. I have no PA, no doctor, and my senior medic is a secretary at a police station and has done no medical training since graduating from Sam 3 years ago. When I asked my team leader about training and equipment he told me to do my best to get it own my own.
I asked for medical SOPs and was told that they would try to make some up. I am doing the best that I can. I am taking some additional classes from my college. I am a history major and am looking at intelligence. I am not a medic or a nurse in the real world. I am just doing the best I can to figure stuff out as I go. I just spoke with an ER nurse for advice and it was like she was speaking gibberish with cardiac drugs and EKGs, etc. I don't know anything about that stuff and so I am trying to learn on my own as fast as I can. Any polite advice you guys have would be appreciated.
As far as the drugs from civilian docs go, that was how I was told to get epipens and MDIs. I am just trying my best to help my guys...
Galen.. you would do well to listen to SS, FMF and Eagle, they know what they are talking about and their advice was more than polite. What they provided you was most helpful.
swatsurgeon
01-15-2009, 11:48
This thread should have taken the theme of disaster triage. If a natural or man made disaster were to occur, it is not the equipment you carry but the knowledge and capability to perform appropriate triage with the performance of very basic maneuvers to assist you in determining how to classify patients.
If that is a topic for discussion that is desired, we'll continue.
ss
You may have good intension but not the training or supplies to back that
up. Not to mention you should never be called upon to treat anyone beyond your scope of training.
As stated above I would have my cell phone handy, have all the Emergency
contact numbers I may need for the AO, ie: ACLS, Fire, Police, Medavac,
Know the routes & locations to the nearest hospitals and there numbers
couldn't hurt. Again as stated above stick to the basics and only do what you have been trained to do.
Eagle5US
01-15-2009, 13:27
PFC Edwards,
You asked questions and received appropriate answers. By deleting your posts you prevent others from reviewing this situation and learning from it.
SS-
Nice redirect. I think that would be a good topic of discussion in our current climate of political "change" and the potential for a terrorist event resulting in a mass causalty incident.
Eagle