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Medical Issues for Militia
I'm not a medic, A friend sent this to me in an email and I thought it was worth sharing with the promise of more to come.
Medical Issues for Militia
This arena of medical care presents many challenges that can be dealt with fairly effectively in most areas with some training and preparation. Nothing will be 100% in a worse case scenario but maintaining health in general and saving as many as possible of the sick and wounded will be the duty of medical personnel.
It is hoped that all Militia units will have a trained healthcare provider such as an EMT, Paramedic, Military Medic/Corpsman, LPN or RN available as a component of their medical assets. The first rule of medicine is, "Do no harm" so if the medic is not trained or certified in certain aspects such as IV administration they should not attempt it. In a non combat training environment there will be legal liabilities as well as ethical implications for medical personnel who attempt to treat casualties with techniques in which they have no training.
It is incumbent upon unit commanders and medical personnel to perform an initial health assessment and periodic checks on the health status of all troops in the unit. This assessment should include:
Age, Height/Weight, Blood Pressure, Pulse, Respirations, Sight, Hearing, A list of ALL Prescription and OTC medications taken on a regular basis, any injuries to the back, neck, joints or broken bones, all surgeries, any chronic conditions such as high blood pressure, diabetes, asthma, allergies, etc.
The screening should be used as a tool to maximize participation without jeopardizing the health of the troops. You do not want a 50 year old in poor physical condition, who has diabetes or some other condition to put on 60lbs of combat gear and go play grunt in 95 degree heat for 6 hours with no medical monitoring ... this would be irresponsible. However, screening and profiling should in no way be used to totally exclude the participation of any Patriot who wishes to contribute. Not all of us can be Rambo ... we will also need cooks, supply personnel, medical orderlies and defensive security personnel.
These guidelines should assist medical personnel to better serve the troops and aid unit commanders in utilizing their personnel within any physical limitations.
Alternative Supplies for Medical Use,
As Militia, we do not have the luxury of a central supply system with unlimited replenishment. The troops who are assigned to positions as medical support will be on their own. Medical personnel must maintain their own uniforms, weapons, ammo and rations along with a trauma/aid bag. This can turn into quite an expense unless the unit has a medical fund with all members contributing.
That being said, it is for the benefit of all members that medical personnel be adaptive and creative in utilizing alternative sources for medical supplies that will function effectively yet reduce costs and allow for competent medical care in both garrison and field environments. Availability, fast replacement and reasonable costs are all important considerations. Also, in a prolonged conflict these supplies will become more difficult to acquire so as a medic you must be aware of what you need but be able to look at what you have and adapt it to use.
For example: Battle /Compression Dressings
Military dressings on the surplus market cost between $8-10.00/ea. If you order from surplus companies it takes a week to ship them plus you have to pay shipping costs. But what do you use in a disaster when you don't have access to these suppliers?
As an alternative how about KOTEX maxi-pads? They go for $8-10.00 for a box of 48 and you can get them anywhere. They are made to absorb blood! Not sterile you say ... well 5 seconds after you take that expensive sterile dressing out of the wrapper with your unsterile hand guess what ... it's not sterile either. When a casualty is bleeding to death an infection is the least of their problems. Can't be used as a compression dressing because it has no ties you say ... cut some long strips from an old t-shirt or sheet and tape them to either end and viola ... you have ties for a compression dressing. I have used them this way.
Another example: Coagulant Medications
Everyone talks about "Quick Clot" which is about $11.00 per one dose packet. Quick Clot once applied requires surgical debridement. What if your casualty will not have access to an operating room? What can you use if you can not afford, obtain or safely apply Quick Clot? How about an old Syptic Pen .... you know those little white sticks that we men who still use blade razors grab when we nick our faces? Syptic Pens cost about $1.00/ea, contain 56% aluminum sulfate and are at Wal-Mart or anywhere next to the shaving creme.
90% of what a medic needs for an aid/trauma bag can be found at a local drug or department store for much less than all the hi-tech items being peddled from the "Survivalist" sources. Alcohol, Peroxide, Gauze dressings, roller gauze, Coban etc. are all available at less cost.
Medics ... be adaptive and creative ... think outside the box. Don't let your casualty go untreated because you do not have what you normally use. Look at what you have and how you can use it to help your patient. Your troops lives will depend on your skills and resourcefulness.
Views: 89
Replies to This Discussion
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Permalink Reply by angelofmercy on -
As a home health RN, I will tell you that all wounds are treated with 'clean' supplies. The use of sterile dressings is usually only needed in surgery. Now forceps, scissors, and re-useable equipment should be thoroughly sanitized between uses and kept in clean containers.
I frequent my local Big Lots and look in their markdown rack. They often have band-aids, alcohol, hydrogen peroxide, and numerous OTC's marked way down.
For things like 4x4's and gloves I use a site called Allegro Medical. They have some great prices if you look through their stock. I buy the bulk packages of 4x4's and then break them into smaller units and keep them in baggies. This keeps them in small units and protects them from moisture or any contamination.
Good info on the syptic pen- I had no idea such a product was made.
Small cuts can be protected and kept closed with clear nail polish. Clean the wound well and make sure the bleeding has stopped completely. Apply a few coats of nail polish and this will stop the wound from re-opening. If there are any signs of infection afterwards be sure to peel off the nail polish and soak in warm water frequently.
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Permalink Reply by Doug Sowle on -
Another way to stop excessive bleeding from small wounds is use Super Glue. Once set up it can later be peeled off also, or it will just wear off in a reasonale amount of time.
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Permalink Reply by Quinian (Scout Grp Ldr) on -
Liquid skin comes in "paint on" and spray on, it's cheap, and has antiseptic in it. I'll spend the extra couple bucks to keep my bag stocked with it over super glue. Like others have said, maxi pads, ace wraps, tampons, bandanas, even duct tape are handy to have. A tent steak and ace wrap you've got a splint. Duct tape and a popsickle stick you've got a finger splint. Another thing people over look and don't have in their bag is 550 cord. You can use it along with some branches to make a skid. A mylar blanket or tarp for the middle is good but if you have enough 550 you can make a web easy enough.
I'll try to find the Army CLS manual for you guys. Anyone who hasn't read it really needs to. If you can get in on a class DO IT it's even better with hands on, plus they teach IV -
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Permalink Reply by CamPat on
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I would like to second this. I am an ER RN and have treated lacerations on my hands that could have been sutured with super glue. Make sure you irrigate the wound thoroughly prior to closing it.
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Permalink Reply by Quinian (Scout Grp Ldr) on
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As promised... CLS Manual
http://www.me.ngb.army.mil/units/rti/resources/IS0871_Edition_C_ALM...
Disclaimer: Do NOT take this as golden advice and think you can go do this stuff. I'm only posting it so you can familiarize yourself with the symptoms, treatment, and terms before taking an actual course. -
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Permalink Reply by American Girl says NO CRACKPOTuS on -
This was good and all of you, thanks for the great suggestions. I too am an RN. Another tip that I have actually used twice: if you have NO SUPPLIES and someone has a scalp laceration, tying the hair in knots over the laceration serves to close the wound. The resulting scab further seals it when congealed blood clots in the hair. Won't leave hardly any scar too! By the time the scab breaks apart, the wound is healed.
As I said, I have used this solution twice, with no resulting infection. It may seem neanderthal, but it works in a pinch.
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Permalink Reply by Kevin M on -
Hello to the group,
Just a want to pass on some information about small wound closing, its not something they teach you in any of the books, and not even part of ANY proticols, but this might come in handy.
Super glue, Krazy glue, Eastman 910 and similar glues are all a special type of glue called cyanoacrylates. Cyanoacrylates were invented in 1942 by Dr. Harry Coover of Kodak Laboratories during experiments to make a special extra-clear plastic suitable for gun sights. He found they weren't suitable for that purpose, so he set the formula aside. Six years later he pulled it out of the drawer thinking it might be useful as a new plastic for airplane canopies. Wrong again--but he did find that cyanoacrylates would glue together many materials with incredible strength and quick action, including two very expensive prisms when he tried to test the ocular qualities of the substance. Seeing possibilities for a new adhesive, Kodak developed "Eastman #910" (later "Eastman 910") a few years later as the first true "super glue." In a now-famous demonstration conducted in 1959, Dr. Coover displayed the strength of this new product on the early television show "I've Got a Secret," where he used a single drop placed between two steel cylinders to lift the host of the show, Garry Moore, completely off of the ground.
The use of cyanoacrylate glues in medicine was considered fairly early on. Eastman Kodak and Ethicon began studying whether the glues could be used to hold human tissue together for surgery. In 1964 Eastman submitted an application to use cyanoacrylate glues to seal wounds to the United States Food and Drug Administration (FDA). Soon afterward Dr. Coover's glue did find use in Vietnam--reportedly in 1966 cyanoacrylates were tested on-site by a specially trained surgical team, with impressive results. According to an interview with Dr. Coover by the Kingsport Times-News:
Coover said the compound demonstrated an excellent capacity to stop bleeding, and during the Vietnam War, he developed disposal cyanoacrylate sprays for use in the battle field.
"If somebody had a chest wound or open wound that was bleeding, the biggest problem they had was stopping the bleeding so they could get the patient back to the hospital. And the consequence was--many of them bled to death. So the medics used the spray, stopped the bleeding, and were able to get the wounded back to the base hospital. And many, many lives were saved," Coover said.
"This was very powerful. That's something I'm very proud of--the number of lives that were saved," he said.
Ironically, the Food & Drug Administration hadn't given approval for the medical use of the compound at that point. But the military used the substance, anyway.
Although cyanoacrylate glues were useful on the battlefield, the FDA was reluctant to approve them for civilian use. In part, this was due to a tendency of the early compounds (made from "methyl-2-cyanoacrylate") to irritate the skin as the glue reacted with water and cured in the skin, releasing cyanoacetate and formaldehyde. A compound called "butyl-2-cyanoacrylate" was developed to reduce toxicity, but suffered from brittleness and cracking a few days after application. Finally an improved cyanoacrylate glue was developed for medical applications called "2-octyl-cyanoacrylate." This compound causes less skin irritation and has improved flexibility and strength--at least three times the strength of the butyl-based compound (reference 2). As a result, in 1998 the FDA approved 2-octyl cyanoacrylate for use in closing wounds and surgical incisions, and in 2001 approved it for use as a "barrier against common bacterial microbes including certain staphylococci, pseudomonads, and Escherichia coli". This latest incarnation was marketed under the name Traumaseal as well as the more popular Dermabond.
Cyanoacrylate glues also find use in medicine for orthopedic surgery, dental and oral medicine (marketed as Soothe-n-Seal), veterinary medicine (Nexaband), and for home use as Band Aid brand Liquid Bandage. It even has been explored as a potential treatment for emphysema, where it can be used to seal off diseased lung passages without the need for invasive surgery.
Is it safe to use ordinary household cyanoacrylate glue as a medical glue? According to Reference 7, most cyanoacrylate glues not designed specifically for medical use are formulated from methyl-2-cyanoacrylate, since it produces the strongest bond. Not only can such glues irritate the skin, during polymerization they can generate significant heat, to the point of causing skin burns. I gather this is a problem only if a large area of skin is affected. But to err on the side of safety, always be careful using it, there are limits.
I have 22 years as an EMT working for the "Rotten Apple" on the East Coast.
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