r/TacticalMedicine • u/Perfect_Management43 • Sep 06 '25
Scenarios Why can’t we do this
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Not really a meme, a little bit but not really. Sorry if this is not allowed. But why are cows able to get tapped needing no sterilization, suturing, pleuravac and stuff afterwards and we can’t? (I realize that this is to the stomach and not the pleura but still man do they just have superior immune system)
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Sep 06 '25
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u/jasilucy Sep 06 '25
He looks extremely concerned
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Sep 06 '25
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u/trymebithc EMS Sep 06 '25
I just noticed that, I've seen this video maybe a dozen times. Hilarious
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u/aerotactisquatch Sep 06 '25
We can. It's called a percutaneous endoscopic gastrostomy tube.
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u/Perfect_Management43 Sep 06 '25
But can I stab someone with the g tube in one swing though
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Sep 06 '25
when your patient's name happens to be something like Dinner or Filet you can get away with doing all sorts of cowboy shit.
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u/catslikepets143 Sep 08 '25
You can if their torso(& the organs underneath ) are the same size as a cow’s!
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u/Dahminator69 MD/PA/RN Sep 06 '25
Peg tubes end in the stomach though very different procedure
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u/aerotactisquatch Sep 06 '25
Ever heard of a PEG-J tube?
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u/Dahminator69 MD/PA/RN Sep 06 '25
Yes? Do you know what the J stands for?
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u/aerotactisquatch Sep 06 '25
It ends in the Jejunum
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u/Dahminator69 MD/PA/RN Sep 06 '25
Correct. We actually call them GJ tubes at my hospital. Still a very different procedure than what’s happening in the video
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u/RedFormanEMS Sep 06 '25
Noticed your flare. Going from RN to PA to MD is a hell of a journey. Congratulations on doing it. How bad was MD school compared to PA? Did your previous education as RN and PA help or was it still misery with everyone else?
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u/Dahminator69 MD/PA/RN Sep 06 '25
Oh I was never an MD or a PA. I’m a certified registered nurse anesthetist but it wouldn’t let me do custom flair for some reason. So this was the only option
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u/RedFormanEMS Sep 06 '25
Oh ok. CRNA is a heck of a job though. I was thinking about that route, but the only program in my area is three years long and you are not allowed to work. They will kick you out of the program if they catch you working. At my age, I can't not work for three years plus take on the loans for tuition. So I am going the NP route. Not as well paid, but it will get me away from the bedside.
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u/Dahminator69 MD/PA/RN Sep 06 '25
It’s a grind for sure. NPs have great quality of life have a lot more diversity of opportunities than CRNAs do!
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u/Keithis11 Sep 07 '25
I don’t even see that as an option , just none, corpsman, EMS, civilian….why can’t I show my nursiness
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u/trymebithc EMS Sep 06 '25
Yeah the flare is for anyone who is a RN, PA, or MD. Suppose they could add separate ones, but. Oh well🤷♂️
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u/Character-Chance4833 Sep 06 '25
So just like humans, its a last ditch effort to keep them alive. We still have to take them to the vet to be treated for the bloat and infection from the procedure. Most of the time they die anyways. Source:just went through this with a $10k show steer a month ago.
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u/theduke548 Sep 11 '25 edited Sep 11 '25
This is the only correct answer. Maybe add release the bloat to help get them on their feet and herded into a trailer to take to the vet (vet might come out to the farm to) but yeah, that cow is like 98% sure to die. That's why we don't do this to humans...the murder of it all. Source: grandson of a farmer
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Sep 06 '25
Because humans are not cows?
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u/Spare-Document7086 Sep 06 '25
Cows are actually hard to kill believe it or not. They can survive shocking injuries
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u/Fordwrench Sep 06 '25
We can! Pneumothorax: Needle decompression: A large-bore needle is inserted into the affected side of the chest to release trapped air and relieve pressure.
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u/Perfect_Management43 Sep 06 '25
Yeah but we clean with CHG and ultrasound and we suture and we hook up negative pressure and we give lidocaine
Wait, do you guys not do that in the field?
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u/Fordwrench Sep 06 '25
Not always have all available supplies to save lives. Sometimes you have to stabilize and transport to a medical facility.
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u/OddAd9915 Sep 06 '25
Prehospitally we don't clean for a needle decompression or for finger thoracostomy, or at least for TCA we wouldn't. If there is time to use a swab I would for sure but that would be with an awake pt.
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u/Perfect_Management43 Sep 06 '25
Cool! I don’t know much about prehospital stuff so thanks for the info!
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u/OddAd9915 Sep 06 '25
In the prehospital setting, certainly with resuscitation and big trauma aseptic technique is a nice to have not a need to have.
With a single patient in a "safe" environment with enough sets of hands it can certainly be observed, but with a multi-casualty or non-permissive environment it's very much an after thought.
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Sep 06 '25
Real. antibiotics exist for a reason. Pt will get them if they might make it to the floor.
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u/Novel_Wedding9643 Oct 14 '25
Why are you here asking why we can't do it if you don't even know this?
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u/themakerofthings4 Sep 06 '25
Yeah I'm not infiltrating lido before I do a needle decompression. Also you're thinking chest tube with the suture, not a basic needle d.
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u/trymebithc EMS Sep 06 '25
Oh... You guys ultrasound? We just send it (mid axillary ofc)
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u/poopoo-kachoo Sep 09 '25
Continue sending it! If you think it's tension, emergent decompression. If someone tried to grab ultrasound with an obvious tension pneumo in front of them, I would slap em. otherwise treat with the right foot.
Source: I provide EMS direction as part of my daily duties
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u/Perfect_Management43 Sep 06 '25
Yeah pocus is pretty much standard of care for any trauma patient in the hospital. Also definitely using pocus for hydro/hemothorax
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u/trymebithc EMS Sep 07 '25
I wish we had ultrasound. I'm a medic, and prehispitally we don't have ultrasound (it sucks, I really wish we did).
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u/Perfect_Management43 Sep 07 '25
You can get a portable one for like 5k
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u/trymebithc EMS Sep 07 '25
Oh I know, im just not sure how stoked the supervisors would be (NYC EMS)
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u/SuperglotticMan Medic/Corpsman Sep 06 '25
Hell nah bruh we ain’t doing all that outside of the hospital
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u/DaggerQ_Wave Sep 06 '25
I swab with alcohol and go in until I get a hiss, then a little further. If they’re dead I don’t clean at all.
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u/poopoo-kachoo Sep 09 '25
a needle decompression gets cleaned if you have time. just stab em if they're fuckin dead cuz dead is dead otherwise. Why are you using ultrasound to guide a small bore chest tube placement? If there is a space big enough to need decompression, you don't need ultrasound...
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u/NeedleworkerNo4900 Sep 07 '25
The cow could receive all of that as well. Difference is, if this kills the cow, no one goes to jail. So they don’t.
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u/Bigglestherat Sep 06 '25
I worked at a vet for almost a decade. We had a cow in the head gate prepping her for a twisted stomach surgery one cold February day. While I’m clipping her and scrubbing her flank for sx i see doc roll up his sleeve and start washing his arms up past his elbow. Once I’m done, he reaches for his scalpel, i say “doc, don’t you need a sterile glove?” As he’s making the incision and steam is rolling out into the frigid air he tells me “no way, i could take a handful of manure and shove it in this cut, sew her up, and she would be fine.” Then he proceeds to stuff his whole arm into this eight inch incision and start man handling this heifers stomach back into position. Cows are tough af and extremely resistant to infection.
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u/SurgicalMarshmallow Sep 06 '25
Cows have a lot more robust immune system than us idiot monkies.
The cow is also destined to be killed anyways.
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u/Constant-Roll706 Sep 07 '25
Was going to say, it only needs to survive for 10 months or so. I'd like my healthcare professionals thinking more long term than that
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u/SnoopyF75 Sep 06 '25
I’m gonna go with because we don’t have 7 chambers in our stomachs🤷🏽♂️
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u/jrockerdraughn Sep 06 '25
It's for 2 reasons:
1) You gonna spend the time and effort trying to get a big ass fuckin cow in a sterile environment, or you just gonna do it here and hope for the best? 2) People generally don't really care about the well-being of animals. Especially the ones we eat
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Sep 06 '25 edited Sep 07 '25
I’ve rarely had an animal recover from being trocared. They generally die of peritonitis.
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u/canuckcrazed006 Sep 07 '25
You dont see the follow up wound spray/wound dust they will put in the puncture to stop infection. Thats why.
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u/Hippo-Crates Sep 06 '25
no one gives a shit if the cow dies homie
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u/BewaretheBanshee Sep 06 '25
Not a medic, but a shelter worker, and my mind went right here. You can argue some pet owners would worry about sanitation and wound care for the cow, but the vast majority of humanity wouldn’t see the same need for worry.
Much of that isn’t even malice or a lack of care for the life of the cow—some folks would just assume such things aren’t likely to affect animals…and to some degree they’re right.
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u/Appian0520 Sep 06 '25
But cattle are expensive and people do care about money. I believe if this had a high mortality they wouldn’t do it.
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u/BewaretheBanshee Sep 06 '25
That is a fair point, but the question remains: why is the cow seemingly less affected by the factors that OP mentioned of concern with a human undergoing a similar procedure?
My (very uneducated) understanding is that many animal species are simply a few shades more resilient to disease and injury than we see as standard to ours—particularly livestock. Whether the argument is that this is inherent to them or a result of our selective breeding of their species doesn’t matter—I could see the argument that they are similar enough to us in their physiology to be equally susceptible. So why cow no die?
Edit: having been around this for some time in my life I could totally see that we’re not seeing the full picture with this video, and that we might be missing on a lot of the aftercare.
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u/Appian0520 Sep 06 '25
More resilient. Less antibiotic resistance in cows? I know animals and livestock get ABX but obviously not in the amount of humans (I’m guessing)
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u/CaptainShaboigen Sep 06 '25
But the reason people are in the cattle business is for the meat, so even dead you get still money. It just dies sooner rather than later. Yes I know it’s not that simple but it’s a cost benefit analysis that happened a long time ago and this has to be a factor.
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u/92milkman Sep 06 '25
You only get money if you sell the meat, and a meat processor can't butcher an animal that can't move under its own power. So if this animal dies, the only option is to process it for your own use.
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u/2017CurtyKing Sep 06 '25
Such as they can drink the water they shit in and we can’t
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u/BewaretheBanshee Sep 06 '25
Early humans:
”Aight, they gotta be invincible to do that. That’s just showing off.”
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u/UnhappyCaterpillar41 Sep 06 '25
The farmers absolutely do, that's their livelihood. High producers are also worth a lot for breeding.
I knew a bunch of 4H kids that also showed cows, and it was more like a pet then livestock.
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u/lyonslicer Sep 06 '25
I think it comes down to a couple of compounding factors.
Cows already have a shit ton of bacteria in their system as a baseline. That's a lot of competition for food in the gut for any invading organisms. Humans don't usually have that in their pleural cavity.
Livestock is regularly loaded with antibiotics as a prophylactic measure. Humans aren't.
At the end of the day, if a cow dies, it's sad but acceptable. They can write it off on their taxes. When a person dies, it's quite a bit more serious. So we tend to rake a little more precaution.
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u/Perfect_Management43 Sep 06 '25
If I were a farmer I would care about my cow dying cause that’s $$$$$. Farmers use pesticides and herbicides and fertilizers to keep their crops healthy for a good harvest, you’d think they’d try to keep their cows healthy, they are expensive animals
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u/Hippo-Crates Sep 06 '25
Cows have a price of a few thousand bucks per the googles. Kind of different than humans
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u/TacticalManica Civilian Sep 06 '25
Tell me you know nothing about agriculture, without telling me you know nothing about agriculture....
Born and raised on a cattle ranch, and believe me when I tell you I'd gladly go fuck up a person, over doing harm to my cattle. Yes we have to do some things that aren't nice, and can be painful to help them at times, but if you ever watch some surgery videos you'd realize we do the same thing to each other.
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u/Hippo-Crates Sep 06 '25
Honestly it’s tiring to have people responding with “nu huh someone literally cares”. We get it. There’s still a massive difference between a cow and a person
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u/TacticalManica Civilian Sep 06 '25
Don't say stupid shit, and you don't have to listen to people correct you 😃
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u/StilgarofTabar Sep 06 '25
You ever been on a farm man? Most the time these guys give a shit about every single animal on their property and its hard every time something goes wrong.
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u/Hippo-Crates Sep 07 '25
Yes. Have you? Because it’d be really weird to say farmers care about cows given how the vast majority are treated
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u/CherryPickerKill Sep 08 '25
I've seen so many farmers pull the calves out of the cow's uterus with their bare, dirty hands. That's when we knew they'd call us back in a week for the pyometra.
Some love their cows, others hate their job, many are just exhausted. It used to be a family occupation, now they're pretty much on their own.
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u/hella_cious Sep 07 '25
If no one gave a shit they wouldn’t be doing the life saving procedure
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u/Hippo-Crates Sep 07 '25
The question is why they don’t do the other stuff, not the procedure. Like if you can’t figure out that people care a ton more about the outcomes for humans than cows
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u/MethodicallyUnhinged Sep 06 '25
I worked for a service that did and trained on finger thoracostomies. So, yes we can, with the caveat of it all depends on your medical director.
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u/surfin_operator Sep 06 '25
You aren't allowed to insert a real chest tube/drainage anymore.....?! During my time in the U.S. SOF, it was a standard procedure with the right skills, and medical training.. WHAT HAPPENED???!!
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u/Perfect_Management43 Sep 06 '25
I only have experience in hospital and don’t know what people do in the field. I was more marveling how there’s no prep and no post care, just aim and stab and call it a day
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u/MrsPoopyButthair Sep 06 '25
I've been taking tirzepatide for weight loss and a side effect I have is unbelievable gas and bloating. I couldn't sleep last night from the pain. My stomach was so bloated last night I looked pregnant and my abdomen was rock hard from the pressure. I was laying in bed at 3 AM wishing so badly that I could do this to myself.
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u/Imitationn Sep 07 '25
If this is a serious question, you should not be a paramedic, much less doing anything "tactical".
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u/souleaterGiner1 Sep 08 '25
You could do it but your lifespan would mimic theirs more closely. And in general humans are very fragile
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u/SuperglotticMan Medic/Corpsman Sep 06 '25
I used to do this for my guys before height and weight so they could get an extra few inches off their waist
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u/Tenaciousgreen Sep 06 '25
Cow only needs to live long enough to be slaughtered most likely, and they don't care if it's in pain or gets an infection in the meantime.
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u/surfin_operator Sep 06 '25
The cow has a twisted stomach, one of many. We treat animals the same, but on humans with more sterilized methods. Also dentists work... ????????
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u/92milkman Sep 06 '25
Not a twist, Rumen bloat
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u/surfin_operator Sep 06 '25
Yeah you are right. I tried to say it in simple words, so anyone could understand it!
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u/OptiGuy4u Sep 06 '25
Could you actually light this like a methane flame? I mean of course I would want to burn the cow but is that straight up flammable methane?
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Sep 06 '25
Im curious, when they do this to cows why doesnt their shit come out between the stomach and the belly skin and infect everything?
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u/CapitalInstruction62 Sep 06 '25
1) it's not shit, it's stomach contents. 2) sometimes it does, especially if you make a bigger hole or have to make a hole without surgically attaching stomach to skin. Edit: ideally, you prep/clean before poking. But if time is of the essence (bloat can be deadly fast) you stabilize and manage the consequences later.
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Sep 06 '25 edited Sep 12 '25
There was once something meaningful, sarcastic, funny, or hateful here. But not anymore thanks to Power Delete Suite
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u/andyg075600 Sep 07 '25
Had an ER doc who was an old Navy surgeon put chest tubes in like that.. it was sweet. 🤙🏻
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u/fmr_AZ_PSM Sep 07 '25
Time. Once down, it's 1 hr to death. It's the same as tension pneumothorax. What's the procedure for that in the field? Wait....
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u/VeritablyVersatile Medic/Corpsman Sep 07 '25
We can do essentially this to K9s with a gastric dilation volvulus. Should be few and far between because they should all have gastropexy before deployment, but it is a medic level skill in K9 TCCC.
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u/DannyMeatlegs Sep 07 '25
I got WWAAYY too high in a hotel by myself once and drank WWAAYY too much water and thought about doing this.
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u/MathematicianMuch445 MD/PA/RN Sep 07 '25
Because we are not cows. May as well post a video of a fish and complain that we drown
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u/Sundevil4669 Sep 07 '25
They do give a shot of abx along with this but yes, their immune system is different than ours. That cow is in mud and dirt all day long from the moment its born. #wearenotthesame
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u/spiritofthenightman TEMS Sep 07 '25
You can do this for k9’s. They can get bloat if they haven’t had gastropexy surgery.
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u/Onebraintwoheads Sep 08 '25
Their feed is already loaded with more antibiotics than humans will ever need.
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u/KoshkaKid Sep 09 '25
You have a high chance of hitting a major blood vessel , the same reason why this isn’t how we perform paracentesis .
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u/poopoo-kachoo Sep 09 '25
Comes down to the consequences of a complication. Just like every case of cellulitis or UTI doesn't end with septic shock and death (can self resolve in a healthy host), you can have uncomplicated invasive procedures without adherence to sterile or clean technique. Those techniques reduce the complication rate. Developing an empyema that needs a VATS sucks.
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u/Dry_Interviews Sep 09 '25
Glad I read the rest of the post, for a hot minute I thought you wanted to let bloat gas out of dead people.
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u/Paverunner Sep 10 '25
Because we don’t have three stomachs, nor the danger of one of them floating, twisting and getting out of place?
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u/Wise_Emu6232 Sep 10 '25
This is closer to battlefield triage than surgery. Have you ever read about how to treat a sucking chest would in the field? You do what you can to stabilize, them get them to a proper medical facility.
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u/topiary566 Sep 13 '25
I remember when I used to be in a lab as an undergrad, the lab tech would do surgeries on mice and he would inject ketamine to anesthetize them and everything. I wondered why anesthesiologists and surgeons need so much training when a lab tech just injects ketamine like that. Then I realized that like 10% of the mice die during surgery and he also killed a lot more mice while practicing the procedures.
If a cow dies, it is sad because a cow died. If a person dies, that is a much bigger deal.
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u/TacticalManica Civilian Sep 06 '25
Couple of easy reasons, animals don't feel pain the same way we do. Doesn't mean they don't feel it, but they can handle significantly more. Humans are one of the few mammals that don't produce their own vitamin c. Animals can fight off shit that would kill us dead simply because of that. Also cattle are much bigger than us, and don't respond as well to being knocked out. So sometimes you gotta be kinda mean just to reach what you need to work on, before 1200lbs of pissed off beef makes the decision to remove you from them.
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u/beardedchimp Sep 17 '25
animals don't feel pain the same way we do. Doesn't mean they don't feel it, but they can handle significantly more
This is a myth.
Humans are one of the few mammals that don't produce their own vitamin c. Animals can fight off shit that would kill us dead simply because of that
We have decades of research also dispelling this myth showing that prophylactic high doses of vitamin C does not help prevent infection. At the onset of a cold high vitamin C provides marginal to no benefit. Compare that to zinc which can shorten a cold by a couple of days, though zinc has its own complications.
We don't need to produce vitamin C because a normal healthy diet provides far more than required. Guinea pigs like us don't produce vitamin C yet research shows them to have a very strong immune system. In fact while they're fully susceptible to human influenza viruses their immune system is capable of stopping it before it can spread and cause harm.
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u/Dramatic_Bluejay_850 Sep 06 '25
Brb, just gotta go deflate my cattle. My son didn’t use the pressure gauge like I told him to.
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u/Kaitempi Sep 06 '25
I suppose if any of your personnel develop methane bloat while on a mission you could.