What measurement or technology, knowing BP measures aren’t always best, and mental status and peripheral pulses aren’t reliable, would be reasonable to field medics as a measure of resuscitation? Would a cost-efficient field lactate monitor be worthwhile?
Due Outs are issues that we have identified without complete or perfect answers. This is our attempt to crowd source ideas and solutions from as many different perspectives as possible. If you are a medic, this is your opportunity to speak up and let your surgeons or director know what could work for you. If you are a provider and have had success with something, please let us know. Our medics are Continue reading Sustainment Training and Continuing Education
The following was originally recorded on the white board at the warehouse during the SOMSA training scenario with input from the entire group. If anything was left out be sure to add it in the comments. As always, you can read it in full here or download it now and read/reference it later.
Eye emergencies are one of the big 3 concerns; life, limb or eye sight. This will be the first of many installments on PFC specific eye recommendations, Open Globe Injuries. It is presented in a Power Point presentation for easy down load and printing for future reference. This was submitted out of the blue while we were at SOMSA 2014 by a PFCWG partner and a welcomed addition to our reference material.
Here is a message from one of our brothers serving in Germany. I copy and pasted verbatim so that you don’t miss any nuances. My thoughts will be pasted as a new comment after the post to get some discussion going. Please speak up and let us know what we forgot!
During a break from the lectures at the last SOMSA one of the first issues identified was the lack of knowledge of PEEP and the absence of PEEP valves on BVMs. Within a few weeks the paper Why we need PEEP valves on BVMs was written, edited and posted for distribution. Our unit ordered the extremely inexpensive valves and they were distributed down to the medics. It is now standard to be using PEEP valves and considered less-than-best practice without.
This script is a customizable situation that any provider should be able to pick up and immediately understand. I will post a link to download it in full as well as the text of it here. This will allow you to download it to your eReader or tablet right now or read through it and make comments and suggestions at the end. Please read it and please comment! What other scenarios do you want to see? Do you have any for us? Are yours different? How so? Are we missing something? Was this page easy enough to access? If you are not able to answer questions with positive feedback we have failed in getting the proper information to the end user, the medic on the ground in the worst place in the world in the worst situation of his life.
Carl sustains a Blunt LUNG injury from a fall from height. He complains of rib pain, but no obvious fractures. Other than tachycardia, his initial vital signs are within normal parameters. Four hours into the situation, he has an obvious decrease in his pulmonary status (i.e. increasing RR, decreasing SpO2, increase work of breathing, etc.). Continue reading Case Discussion #3: Fall With Lung injury
I usually start any PFC lecture I give with a common case such as this in order to drive home the realities of the operational context; a small team operating in the middle of nowhere dealing with a critically ill patient with little to no support.
Remember the “Rules”