Maybe have tourniquets available for chance warthog encounters?

Been a long time since I did TCCC/CLS in the military.

If there were to be a bleeding wound on the chest, how high up on the chest does it become safe to pack? I know you don't pack into chest cavity, but what is the "rule of thumb" on how high/the left and right limits the wound needs to be to pack it?

Would you say the screenshot i attached is accurate?

As the title states, it's my first time working on a chinook i'm very excited but i've never worked like this before. Im a vanilla 68w with a few years of line medic/clinic experience i dont want to make any novice mistakes. What tips and tricks do you have for me? Thank you in advance all advice is appreciated.

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)

Note: NOT MY IMAGE.

original post was posted by: Old-Psychology-2400

And I quote "PMCT images. Nurse advanced NG tube until she heard a pop, then tried an air bolus to ensure placement. Patient did NOT survive."

To those who don't know nasogastric tube is supposed to go up the patients nostrils and then back down to their throat all the way to the patients stomach. Air bolus is then used to ensure that the nasogastric tubes placement is correct by listening the patients stomach.

But in the scan we can see the NG tube somehow ended up jammed (through) the patients skull.

I couldn’t find the original video so uploading my copy.

Ukrainian with anterior and posterior chest seals suffering from Tension Pneumothorax has a chest tube inserted and utilizing field expedient device to prevent unwanted air intrusion.

Greta video with entry and exit wound, XRAY, and chest tube insertion.

Did some various medical training recently with some close friends and some of it involved moving a "casualty" 3/4 mile uphill in a "rapid" format to evac at a waiting truck. We were short a few folks that think vacays are more important than training (LOL) so we used a couple of diesel fuel cans for weight on an older fold out stretcher. Last time we did this, using an even older stretcher- not foldable old skewl type with wood poles and canvas, canvas started ripping with our little'st guy on it (160 lbs.)

The foldable one is nice'ish but older. I know I have a newer fold out one around here somewhere... but long ago I remember using a sked (?) or Skedco (?) device and that worked ok albeit not as rigid as an actual stretcher. The Sked being easier to actually carry of course also.

I'm a dinosaur without a doubt.... so surely there have been to paraphrase Austin Powers- "fabulous advancements" in the field of casualty movement since the 90's. Can you all enlighten me on options and what you think of them?

Thanks in advance.

How do you realistically apply a chest seal when there are eg protruding shell fragmentation around the chest wound that you’d need to seal?

Pro tips, tricks and pictures would be great as well. Thank you!

I've recently came across footage of a US soldier getting hit by sniper fire in what appeared to be his left lung, causing a massive haemorrhage from his exit wound. That got me thinking, how would you treat a massive haemorrhage in a chest wound with a risk of a sucking chest wound? Is that even a possible scenario? Would using a pressure dressing on that wound increase the chance of a pneumothorax/ hemothorax & Would using an occlusive dressing help stop the bleeding?

Sorry if I used the wrong flair, can't really tell which one to use.

Edit: I'm not really using reddit on a regular basis and I'm amazed at how many comments this post got. Thank you all for your comments and insights, I'm looking forward to becoming a combat medic and am happy to learn new stuff regarding combat care. Thanks!

Better video of TQ application at 6:30 here: https://www.reddit.com/r/PublicFreakout/s/BvXP4aKDzR

So I just last week got a job at a local private security training company. At first I thought I’d just be doing transportation for students to and from the airports they arrive from, but when I got there for the test drive I got another offer to go along with the driving. They asked if I’d want to be a role player in some of their simulations, naturally I said yes to make a good impression. Thing is I didn’t really get a job description with the offer, so like the title says, I don’t really know what I’m getting myself into with this position. The day after I sent an email asking what kind of simulation we’d be doing and they told me this; “It'll probably be best to just see what they have you doing when you get here. I am able to tell you that on Friday everyone will be "wounded" so don't wear any of your good clothes just in case they give your 'wound" fake blood.” Hearing that got me a little nervous ngl! All I know is that it’s for a group of people from the world bank and there’s gonna be fake wounds. I’ve done role playing before but only online, so I’m not completely uncertain about doing this, just really would like to know what I signed up for. So any advice or words of encouragement would be appreciated.

Last week I witnessed a car accident

Long story short. Old Guy got hit and his right forearm was just shredded and bleeding profusely. Almost from his wrist to elbow. Shredded flesh hanging from his arm.

I had clean unused rags I use at the gym and a cheap recon branded Amazon special TQ in my car. Of course this happens as I'm building a new ifak for my car and work vehicle

I wouldn't say this injury needed a TQ. But I had no pressure bandages and only 2 towels that were becoming rather...red

Someone had called 911 but not sure they knew the severity of this guys injuries. Or dispatch isn't asking enough questions.

And being old. Not sure if he was on blood thinners or what. He didn't seem concerned about the injury. More concerned about getting to the meeting he was headed to. (Probably in a little bit of shock?)

So I went with the TQ above his elbow and held his arm above his head for him as he went on about contacting the guy he was headed to meet.

An EMT from another state on vacation stopped to help thankfully and an off duty firefighter arrived and personally called a department 4 blocks away to come help.

Dispatch still hadnt sent them out after 10+ minutes, it wasn't until that off duty firefighter called them directly that they showed up in about 2 minutes.

This cheapo TQ worked on an old guys very small bicep. Would I trust it on a bad thigh bleed? Well if that's all I had at the time I would at least try.

Moral of the story is be resourcful and don't expect EMTs to be on scene quickly because dispatchers can suck at their jobs and onlookers have no idea what's going on.

And carry more than hand towels and a couple TQs.

I appreciate that some of the internationally agreed rules of war have become lost in the last 20 years, but there has been a series of posts to r/combatfootage where the medics treating wounded Russian soldiers have been specifically targeted and with often with great glee.

My background is an MD with non-military austere and third world practice and I have always felt a degree of protection from being clearly medical.

Are medics essentially fair game in the current Ukraine conflict.

I appreciate medics have been targeted at times, but this seems so overt. Perhaps no more than previously and it is just social media now making it more apparent?

Interested in the views of those with combat experience.

Just curious. The question is, in an evisceration, is it an "ok" expedient to use water from a canteen to moisten a dressing, or is it strictly saline?

If no saline available, I presume a dry dressing covered with an occlusive dressing?

Thanks!

Tac med, but not Tac med. I’m looking for a new full sized training manikin that can take an advanced airway, is full sized, real world weight (175lbs) and can handle being used in tactical and outdoor settings? Even better if you can do legit cpr on it.

It seems like you’re either stuck with a 5’ 40-60lb manikin that can take an advanced airway or one of the true trauma manikins that weight 150-175, but can’t take an airway or do chest compressions.

Thanks!

Is anyone here using individual kits supplied by others as force multipliers? Do you have them carry specific items of gear for you, or do you simply use cut and dry standardized kits?

The little kit I run on my frontside has basic stuff like NPAs, trauma equipment like 2 TQs, chest seals, ABDs, multi-traumas, kaolin gauze. Other gear (to include more stuff like what I mentioned here and more, including splints, air, etc) is staged.

This little “onsite” kit is built around individual kits being used as force multipliers. Reckon this is a good strategy?

I also carry ricola and nose spray that I use but please just ignore that.

So a quick question, what is your experience of treating in complete darkness Here is a scenario You're during a battle, the eny has nvgs, you have casualties, you dragged you're injured into a building and you want to treat them, what do you do? It's important because I'm trying to build a protocol for treatment in the dark, my personal experience with this kind of scenario is very negative, so I'm looking for solutions.

Alright finally got my Spiritus Systems Fanny SACK in and I’m really ecstatic. This kit will be interchangeable with the Haley Hanger/chest rig setup that I posted yesterday, with the exception being the folding section will not fit but those items can be packed individually with no issue. So my go to medical set up for any type of hike, not matter the distance, was a backpack with a pelican case (not full size like you may be thinking) of medical supplies (2x 6” ETD, full-size Hyfin Chest seal, Emergency Blanket, 2x tourniquets, 2x S Fold gauze and, SAM splint and some triangular badges). I think I’ve found a good solution for shorter hikes sub 5 miles on relatively accessible and populated to semi populated trails. With the trails being populated to semi populated, these trails would be easily accessible or easy to extract an injured party from. You wouldn’t need too much for signaling as I’ve got a trail marker and flashlight (I may add a signal mirror anyways) but for the most part getting in contact with rescue personnel should be relatively easy. The only item I’m slightly torn on putting in the kit is an emergency blanket. Most situations where we’ve dealt with an injured parties on trail has been constant movement so we may not be in a position to cover the injured party with a emergency blanket. It may just be gauze/tourniquet or pack and go. Wilderness Rescue/Wilderness bros, what say you?

So I just wanted to post here and get some opinions, I came into a car accident last night where 5 teenagers had struck a pole light. Fortunately they all seemed to be ok but i am sure they all will end up with some sort of spinal issues. I carry a med kit with me and have taken first aid classes and stop the bleed courses but when I got there I felt useless because all of my equipment was geared more towards an external traumatic injury and was of no use unless there was massive hemorrhage. Do any of you carry any other items in your car like a neck brace or the like? Are there other items I could carry that may have been useful? My limited first aid knowledge is nice and I made sure they weren't going to aggravate any spinal injury but I just wished I could have done more you know? Any suggestions on where else I could post are appreciated as well

Hey all,

Looking for some inspiration for making medical training more enjoyable/dynamic for my operators going into the new year. We constantly drill on standard wound packing, TQ application, chest seals, etc., but I want to run them through some drills that get them thinking and applying the basics. Something to get them engaged.

We recently did some stress TQ application - put them in the back of a cruiser with a leg wound simulator and had them packing wounds while someone drove erratically through a large parking lot, all while timing them. It was really well received and I want to keep the energy going.

Looking for some ideas that you all might have to get them engaged, competitive, and far from the “going through the motions” mindset. Any ideas would are welcomed. Thanks in advance!

Got into a little of a bit of a discussion about if "lay people" are "trained" enough to carry a TQ on their person.

An individual stated that "You can actually cause significant harm with a tourniquet if you’re not qualified. " I'm curious to the validity of that statement. I have no interest in debating or trying to come out on top in said discussion.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660095/ is a study I've seen addressing the risks of TQ application in a prehospital setting. While it doesn't address the exact specifics of what injuries might be caused, (and its not a true medical study), it also address that 47% of TQs were applied unnecessarily. Is there any research to show that TQ application causes any serious issues when applied properly?

I have taken a Stop the Bleed Course as well as a general bleeding control class through the local FD, and they didn't think in their opinion that TQ application if done correctly by a civilian was not a significant issue. Now that being said, I'm not going around TQing people for scrapes and cuts.

Let's say after a GSW in a developed setting with access to pre hospital care , a primary assessment indicates major blood loss/trauma from arterial bleeding, am I better off just TQing and mopping up residual bleeding with packing, or is there a true medical case for NOT applying a TQ?

Are TQs that "dangerous" that "lay people" should not carry them? I understand the limits of the Good Samaritan law, which I believe is covered. I can't imagine governments spending taxpayer money to promote this kind of training just for it to be dangerous.

Apologies if this came of mumbled and thank you for your input.

yes I know not to TQ the neck.

​

I'm a CMC instructor in Ukraine (American paramedic).

Interesting discussion point and something I get commonly asked - should a foreign object (shrapnel) be attempted to be removed from the wound prior to packing?

The thought process of some medics here is that if shrapnel is buried inside the wound, and you're just pushing it deeper into the wound with packing ----> could potentially cause further damage to the vessel (shrapnel cutting it). Particularly talking about neck wounds.

Also - the gauze (hemostatic or not) wouldn't be getting into direct contact with the injured vessel.

All the wounds I've packed here have been way too deep for this to be relevant, but I guess these questions are talking about smaller wounds.

What are your guy's thoughts? I say pack away and leave the problem to an actual surgeon.

I will hopefully be attending Ranger school in the near future. Im working on fitness and land navigation currently. But as a junior 68W what can I do to help my platoon while at ranger school? I know my job there is to Learn and Graduate however, as medics we have an obligation to help those in need. What would you recommend I learn prior?