SF Medics trained to do appys and c-sections?
 

This topic seems to crop up every once in a while.

Other people in the rest of the army seem to think SF medics can perform appendectomies and c-sections.

I can tell you during MY tenure no such capability existed. And speaking as a general surgeon now, I have a hard time believing it ever did.

VFOGs - were you guys ever taught this in the schoolhouse?

Or is this entirely an urban legend as I suspect?

I was not taught it, and it is outside the scope of practice for 18Ds. Medics are taught amputations and debridement of soft tissue injuries, as well as emergency procedures like tubal thoracostomies, surgical crocs, and venous cut downs. Depending on the year they have been taught external fixator placement as well.... but not anything dealing with general surgery of the chest, abdomen, or internal organs.

However, I have heard the urban legends as well. They are likely just that.

Well in the late 70's I was also taught amputations and debridement of wounds. Along with crics and chest tubes. Venous cutdowns were stressed for access. I did deliver a few babies but never was taught C-sections or appys; that came in my residency as a physician.

we had a medic from 3rd Group do one in haiti up north during the tropical storm that killed so many people. Swoop may remember who it was. I flew up with the Doc the following week to check stuff out. Guy did a great job.

J.P., I remember the incident but I can’t remember the name.....

Makes me wonder if the entire 18D POI may have to be rewritten as females arrive on teams, and require additional specialized care.

TR

JUst curious, do you remember anything else about this? When was it? DO you remember who the Doc was that you flew up with?

Thanks

RL

I remember hearing about a baby delivery during the 94-96 Haiti time frame but I always thought it was a regular birth. I was on the trip when the big storm hit and I don't remember c-section being mentioned as the method.

It is also possible that an 18d may have assisted a Haitian Doc or a Doc W/O Borders doc on a c-section. That would be much more plausible but who knows....

It is definitely not taught - but - page 3-101 in the SOF medical handbook it does have a complete walk through of instruction for cesarean delivery. I assisted one cesarean delivery on my rotation through Fort Polk a couple years ago and the doc made it sound like it was no big deal. However...he does them everyday.

Same goes for an appendectomy - page 4-72.

The SF medic (or even SOCM) should have the tools (physically and mentally) to perform either surgery if the emergency were to arise. Again, without assisting several before hand...I'd need a good shot of whiskey and youtube or some kind of telecomm available.

C-sections are not terribly complicated from a procedural standpoint - cut into the big bump by layers and take out the little person, close in reverse. Appendectomies are way more complicated. I have scrubbed in on a few, and I would never attempt one. Just finding and identifying it would be a nightmare.... it's not always obvious what you are looking at, everyone's viscera is different, and it's not always in the same place. Sure, if you sliced someone open chin to balls and opened everything up we could all find the appendix easily enough, but there is a lot of fascia and general stuff in the way of you are going for that small incision. I would never try it myself.

Watch one, do one, teach one
 

I think a couple of the other guys have mentioned it, but on hospital rotations you can get the opportunity to participate in some pretty odd procedures(from a combat medic POV). Depending on your motivation, knowledge and the willingness of the MD to teach, if you're in the right place at the right time you can easily find yourself scrubbed in on an interesting case. Since they are "odd" experiences guys tell their buddies about it and I can see where it can go from "I assisted on this case" to "I know a guy who was trained to do X".

-Gnome

During my OJT phase of Med training (Ft. Polk), I "did" a C-Section. The actual MD surgeon did the incisions of the abdomen and uterus, and I did everything else under his license, guidance, and probably prayers... It was a boy!

Rich, sorry I didn't see this before. If I recall correctly, it was Doc Randolph, a great guy.

Also, as memory serves, the Medic stepped in when the Haitian Doc was in the midst of killing the patient - again, this is all from memory in a world of these types of memories we all have.

In fairness, the Haitian Doc may have been the local chicken breeder up there for all we know. He may have opened her up - I now recall that there was a longitudinal scar - and the medic stepped in to fix/complete/save her.

But by all accounts the medic saved the day in a really crappy situation. Wish I could remember that cat's name.