Doing first aid is great and all ;BUT. what do you do with the poor bastard after that? Take him to the local ER? That has you and your boy in bracelets in what? 120sec.? Then off to the greybar till officer friendly gets tired of it? FIRST AID IS NOT TREATMENT. All it dose is to stabilize the victim for transport. If you need an Airway- IV fluid- or wound closer you ether get into surgery in one hr.-or you die. What do you do after surgery? Your boy won't be back on his feet for weeks-if ever, and he knows EVERYTHING . Your names, your op-plan, lot's and lots and SHIT LOADS of actionable intel. Where you live ,who the wife and kids are, where you buried the ammo. SO WHAT THE "F" are you gonna DO. once you plug up Goober's holes? So far the only "plan" I have seen revolved around a fantasy underground network of imaginary doctors and safe houses. That is not how to win a war.
Definitely need to add a large gage pneumothorax needle to relieve tension pneumothorax resulting from chest wounds. And just as important, learn how to properly use it -- it's not difficult, just has be placed correctly. Outside of that omission, that's a pretty good basic kit.
Well anon, why don't you step up with your plan? We will have to do the best we can with what we have..... ain't no fucking ER and you know it unless you got a Dr on your team, Been done that way forever and that's that.
In reply to the first comment - perhaps in your area a network of someone to provide definitive care and a place to do it are fantasies and imaginary. It's not so in my AO. One of the first things my group has done is to identify Paramedics/trauma nurses/military medical NCOs/veterinarians and the like. Most physicians are intentionally excluded, as they are far too high profile in a resistance scenario - and would have to be suborned only in special circumstances. But with even 68Ws trained to perform a tube thoracostomy and to initiate an underwater drainage seal, definitive care when the regime has made the local ER off-limits is definitely doable. It certainly is better than your implied plan of action, which is to put a bullet in the head of anyone with a moderately serious wound. Americans don't go in for martyrdom operations.
First it IS important to remember that a needle thoracostomy is a TEMPORARmeasure, and MST be followed up with definitive care - most usually with placement of a chest tube with suction to relieve the buildup of air and/or blood that was causing the pneumothorax (if it even existed).
Seond, David - a pneumothorax is by definition caused by air, not fuid. If the pressure is cased by fluid (blood), then it is a hemothorax. If both, then it is a hemopneumothorax. Even large bore IV catheters (the CATHETER is left in place while the needle is removed) will only reliably vent air - as any fluid (blood) present will quickly clot.
I hope you guys make getting access to someone with medical training a priority - because at this point the actions you describe are unlikely to affect the outcome for your patients.
You want a plan Ok here go's; You recruit a Doc(MD.) on your team, He trains Aid Men who work with stretcher bearers. To move men too sick or wounded to walk to a central treatment point (ORP /aid station /MRP). Your MD. Treats the men that can return to duty. He then preforms an act called "Triage" deciding who will live and who won't. The ones to badly wounded for further treatment get red tagged(y'all do know about tagging. right?) and sent to "check out" to die.(its why the PFC's are outside digging a big hole) The rest get sorted by severity of injury and moved up the "chain of care" to the SUIRGON He's the guy that cleans and closes the wound (and try's to reattach all the stuff inside you that's been blown apart). Your wounded then move up the "chain of care" to RECOVERY where highly trained NURSES preform wound care, administer drugs and all that other "stuff" you need to recover from trauma. All of this takes TONs of logistics, and weeks or months of time, Transport, fuel, Med's, equipment, A large structure, food, and ABOVE ALL TRAINED PEOPLE.(it takes 40 people to care for ONE wounded man properly) A 70 year old GP from Hooterville or your local doggie doc IS NOT A TRAUMA SUIRGON a trained NURSE or an ANASISIOLAGEST. You MUST have ALL of this if you don't want most of your guys in that big hole behind the aid station. Right now The DOGGIE DOC/ PARAMEDIC/ LOCAL GPMD concept gives you the same level of care they got at Bellue Wood Or Cold Harbor. Combine that with the fact that most "militia men" have no meaningful medical training (you tube vids and weak end "combat medical" training IS NOT TRAINING). It takes month and years of real school to learn to use most of the "gunshot kit" y'all go on about.(My wife is an MD. and she doesn't carry some of this gear in her trauma bag) Most of you will kill or really fuck up the first guy you try to "treat" with your boo-boo Kit, IF you don't GO TO SCHOOL. REAL SCHOOL not "Bubbas weakend com-bat medik skool".--- I know somebody is going to bring up WW-2 Doc's preforming surgery in the open in China - I'd just like to point out that most(over 80%) of those men died. (look up Merill's Marauders. The death rate for his wounded was chilling. The NVA/ VC "tunnel Docs" had it even worse. The death rate for there wounded was around 90%)
One would think that we have a logistics trail to bring us food, ammo, choppers to whisk us off to triage and nice nurses with big tits to nurse us back to health. I guess I didn't get the memo. Hell I will wait to issued my kit.
To anonymous 8:33 Am. Well said and no defeatism. However, the medical field may soon quickly become a fed agency. On the flip side there will probably be some docs who 'flip' on the collectivists after their practice and career are destroyed.
And there is context here for dumbass anonymous (July 28, 2013 at 9:38 PM).
These are armed insurgent Americans who know they are going in harms way. Ergo, they are going on a planned op. They know where their AO will be.
At the very least, rip our a local YP and get the names of every MD and veterinarian in the AO.
You (July 28, 2013 at 9:38 PM) are a defeatist asshole who I would not want anywhere near me in a firefight, unless of course you were in my sights.
Or maybe you are an arrogant doctor who thinks men are helpless without your cooperation; a doctor who hasn't thought about what you are going to do when armed desperate men kick in your door and tell you to treat their friend? They may ask nice ONCE.
I'm actually taking the EMT-B course at my local community college. All-in costs at my local community college is $500 and it takes 4 months. 8 hours of course work per week, minimum of 1 12-hour shift with a paramedic team, and minimum of 1 12-hour shift in an ER.
That's actually a pretty big commitment for me, given I work 60+ hours per week, have a family, and will be twice the age of the average kid in the class, but it's not that big a deal. I'm not sure if I'll take it further than that, but that seems like a minimum requirement to me. I guess the bare minimum would be to buy some fancy First Aid kits and watch some videos on closing up chest wounds, etc., but I came up on a kid in a smoking car wreck and a broken neck a while back and while I wanted to help, I also realized the implications of doing the wrong thing (move him and potentially permanently damage him, or save him from a burning car). Fortunately the guy who pulled up behind me was an off-duty paramedic and focused on working the fire extinguisher everywhere I saw smoke coming out. I'm not going to short-change the next person who needs help.
12 comments:
Doing first aid is great and all ;BUT. what do you do with the poor bastard after that? Take him to the local ER? That has you and your boy in bracelets in what? 120sec.? Then off to the greybar till officer friendly gets tired of it? FIRST AID IS NOT TREATMENT. All it dose is to stabilize the victim for transport. If you need an Airway- IV fluid- or wound closer you ether get into surgery in one hr.-or you die. What do you do after surgery? Your boy won't be back on his feet for weeks-if ever, and he knows EVERYTHING . Your names, your op-plan, lot's and lots and SHIT LOADS of actionable intel. Where you live ,who the wife and kids are, where you buried the ammo. SO WHAT THE "F" are you gonna DO. once you plug up Goober's holes? So far the only "plan" I have seen revolved around a fantasy underground network of imaginary doctors and safe houses. That is not how to win a war.
Definitely need to add a large gage pneumothorax needle to relieve tension pneumothorax resulting from chest wounds. And just as important, learn how to properly use it -- it's not difficult, just has be placed correctly. Outside of that omission, that's a pretty good basic kit.
Don't forget a pneumothorax needle to relieve fluid pressure that will kill: if not done properly and timely.
Well anon, why don't you step up with your plan? We will have to do the best we can with what we have..... ain't no fucking ER and you know it unless you got a Dr on your team, Been done that way forever and that's that.
In reply to the first comment - perhaps in your area a network of someone to provide definitive care and a place to do it are fantasies and imaginary. It's not so in my AO. One of the first things my group has done is to identify Paramedics/trauma nurses/military medical NCOs/veterinarians and the like. Most physicians are intentionally excluded, as they are far too high profile in a resistance scenario - and would have to be suborned only in special circumstances. But with even 68Ws trained to perform a tube thoracostomy and to initiate an underwater drainage seal, definitive care when the regime has made the local ER off-limits is definitely doable. It certainly is better than your implied plan of action, which is to put a bullet in the head of anyone with a moderately serious wound. Americans don't go in for martyrdom operations.
In response to the second and third comments -
First it IS important to remember that a needle thoracostomy is a TEMPORARmeasure, and MST be followed up with definitive care - most usually with placement of a chest tube with suction to relieve the buildup of air and/or blood that was causing the pneumothorax (if it even existed).
Seond, David - a pneumothorax is by definition caused by air, not fuid. If the pressure is cased by fluid (blood), then it is a hemothorax. If both, then it is a hemopneumothorax. Even large bore IV catheters (the CATHETER is left in place while the needle is removed) will only reliably vent air - as any fluid (blood) present will quickly clot.
I hope you guys make getting access to someone with medical training a priority - because at this point the actions you describe are unlikely to affect the outcome for your patients.
You want a plan Ok here go's; You recruit a Doc(MD.) on your team, He trains Aid Men who work with stretcher bearers. To move men too sick or wounded to walk to a central treatment point (ORP /aid station /MRP). Your MD. Treats the men that can return to duty. He then preforms an act called "Triage" deciding who will live and who won't. The ones to badly wounded for further treatment get red tagged(y'all do know about tagging. right?) and sent to "check out" to die.(its why the PFC's are outside digging a big hole) The rest get sorted by severity of injury and moved up the "chain of care" to the SUIRGON He's the guy that cleans and closes the wound (and try's to reattach all the stuff inside you that's been blown apart). Your wounded then move up the "chain of care" to RECOVERY where highly trained NURSES preform wound care, administer drugs and all that other "stuff" you need to recover from trauma. All of this takes TONs of logistics, and weeks or months of time, Transport, fuel, Med's, equipment, A large structure, food, and ABOVE ALL TRAINED PEOPLE.(it takes 40 people to care for ONE wounded man properly) A 70 year old GP from Hooterville or your local doggie doc IS NOT A TRAUMA SUIRGON a trained NURSE or an ANASISIOLAGEST. You MUST have ALL of this if you don't want most of your guys in that big hole behind the aid station. Right now The DOGGIE DOC/ PARAMEDIC/ LOCAL GPMD concept gives you the same level of care they got at Bellue Wood Or Cold Harbor. Combine that with the fact that most "militia men" have no meaningful medical training (you tube vids and weak end "combat medical" training IS NOT TRAINING). It takes month and years of real school to learn to use most of the "gunshot kit" y'all go on about.(My wife is an MD. and she doesn't carry some of this gear in her trauma bag) Most of you will kill or really fuck up the first guy you try to "treat" with your boo-boo Kit, IF you don't GO TO SCHOOL. REAL SCHOOL not "Bubbas weakend com-bat medik skool".--- I know somebody is going to bring up WW-2 Doc's preforming surgery in the open in China - I'd just like to point out that most(over 80%) of those men died. (look up Merill's Marauders. The death rate for his wounded was chilling. The NVA/ VC "tunnel Docs" had it even worse. The death rate for there wounded was around 90%)
From the comments its clear we need more medical training.
From the comments it's clear we need spelling training.
One would think that we have a logistics trail to bring us food, ammo, choppers to whisk us off to triage and nice nurses with big tits to nurse us back to health. I guess I didn't get the memo. Hell I will wait to issued my kit.
If I get wounded severely, I'm dead..... period!
To anonymous 8:33 Am. Well said and no defeatism. However, the medical field may soon quickly become a fed agency. On the flip side there will probably be some docs who 'flip' on the collectivists after their practice and career are destroyed.
And there is context here for dumbass anonymous (July 28, 2013 at 9:38 PM).
These are armed insurgent Americans who know they are going in harms way. Ergo, they are going on a planned op. They know where their AO will be.
At the very least, rip our a local YP and get the names of every MD and veterinarian in the AO.
You (July 28, 2013 at 9:38 PM) are a defeatist asshole who I would not want anywhere near me in a firefight, unless of course you were in my sights.
Or maybe you are an arrogant doctor who thinks men are helpless without your cooperation; a doctor who hasn't thought about what you are going to do when armed desperate men kick in your door and tell you to treat their friend? They may ask nice ONCE.
Fuck you. WHAT THEN?!?!?
I'm actually taking the EMT-B course at my local community college. All-in costs at my local community college is $500 and it takes 4 months. 8 hours of course work per week, minimum of 1 12-hour shift with a paramedic team, and minimum of 1 12-hour shift in an ER.
That's actually a pretty big commitment for me, given I work 60+ hours per week, have a family, and will be twice the age of the average kid in the class, but it's not that big a deal. I'm not sure if I'll take it further than that, but that seems like a minimum requirement to me. I guess the bare minimum would be to buy some fancy First Aid kits and watch some videos on closing up chest wounds, etc., but I came up on a kid in a smoking car wreck and a broken neck a while back and while I wanted to help, I also realized the implications of doing the wrong thing (move him and potentially permanently damage him, or save him from a burning car). Fortunately the guy who pulled up behind me was an off-duty paramedic and focused on working the fire extinguisher everywhere I saw smoke coming out. I'm not going to short-change the next person who needs help.
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