When conducting sick call using Algorithm Directed Troop Medical Care (ADTMC), it is important to have an understanding of upper respiratory infections (URIs). These are very common complaints for day-to-day sick call. Additionally, URI knowledge is an essential task in the ADTMC competency checklist. This lesson will be more lengthy due to the complicated nature of the topic. I recommend breaking it up and completing the review in stages. Additionally, I recommend returning to this topic often for review because there is so much info.
Start Here – Files to Download And Review
Videos to Break it all Down
The videos above describe the URI types and sources. Most often these illnesses are caused by viruses. However, in military populations who sleep close to each other in open bays for prolonged times, we can often see a higher prevalence of atypical pathogens (mycoplasma) that require antibiotics (Z-pack often helps). Therefore, in my experience, it is probably more appropriate to be more liberal with prescribing antibiotics in military training populations.
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Extra Credit- Complications seen in URIs
Peritonsillar abscesses can be seen in military age patients. Several of these present each year within basic trainees. The drainage of such abscesses is typically performed by either an ER physician or a ENT physician. Medics should not attempt to drain these, especially without training for a multitude of reasons (including the carotid artery in the area). Retropharyngeal abscesses (second video) are less likely in occurrence. There are more complications than just these two, but I felt these are two worth reviewing.
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All content is intended to be educational only. Medics should operate under the supervision of a medical provider and abide by all local laws while stateside. Medics should only practice at the level credentialed, and only at the level allowed. This content is not intended to treat or give a substitution for any credentialed provider. Content is intended to aid in a deployed prolonged care setting. Take guidance from your leaders. Utilize these posts as preparation and as a supplement to your provider’s direction and teaching.
This content is the author’s opinion alone and does not necessarily reflect the opinion, official position, or stance of the Department of Defense, or any other branch of the United States Military.
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