PPE Ideas

Everyone is aware of the PPE problem. What to do about it? What are some strategies? What are others doing? I’ll share some examples. To be honest, I don’t know exactly what is best. The experiences are all over the place. I’ll share a few things with you to help you make your best decision, if your organization doesn’t decide for you. If this continues to explode as I suspect, then Medics should learn from the civilians on the front line already developing strategies now. START FOLLOWING THIS NOW.

First, we need to understand a few foundational things about how diseases spread.

Fomitesobjects or materials which are likely to carry infection, such as clothes, utensils, and furniture.

When we come into contact with an infectious agent and then touch objects, the object becomes a fomite. If anyone touches the fomites and then touches their mouth, they transmit the disease. So, PPE is important. Good discipline is important. Washing hands often- also important. Be careful of infectious surfaces, or even your phone! This was the number one reason that the experts were warning against wearing masks at the beginning- because you could inoculate yourself if removing a mask improperly- and because of severe shortages. I think we are changing our minds not this now.

WHAT PPE Should we be Wearing?

This is the million dollar question. I already shared in a previous post that ” it’s not airborne, but its borne in the air ” – a great article. Go check that out if you have not yet read it. It’s a great article that really highlights the difficulty that we are having. The virus seems to be concentrated in droplets and so it spreads 6 feet or so when sneezing/coughing. However, we know that it takes approximately 3 hours to settle and that it has been found in air vents, etc. So, should we be taking airborne precautions? We don’t really know how much of the virus is needed to inoculate us, or how much it would take for us to be asymptomatic carriers. We just don’t know.

“There is much to learn about the newly emerged COVID-19, including how and how easily it spreads. Based on what is currently known about COVID-19 and what is known about other coronaviruses, spread is thought to occur mostly from person-to-person via respiratory droplets among close contacts.”

Centers for Disease Control, COVID 19 Website for Healthcare Providers https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html

And Why is This Different from H1N1?

**CHECK OUT THIS FANTASTIC ARTICLE BY AN AMERICAN FAMILY PHYSICIAN WHO TOOK CARE OF PATIENTS IN CHINA WHEN THIS ALL STARTED. LESSONS LEARNED!**

What Are Most HealthCare Systems Doing Now for PPE?

  • Some are using surgical masks on all healthcare workers.
  • Some are using N-95s, but limiting the workers to only receiving one per day
  • Some are using surgical masks routinely all day, but switching to N-95 for aerosolizing risky procedures
  • Some are even giving out masks to all patients who enter. – this is what was recommended by a physician in Italy.

I will share some screenshots of a social media group I am a part of and the different innovations that they have been discussing. Healthcare workers are concerned. They are getting creative. Forgive the image quality of screenshots, but this is the easiest way to share the information.

USING SURGICAL DRAPES TO MAKE COVERS FOR N-95 MASKS
USING SILK TAPE TO SEAL MASK

SOME INTERESTING PROPOSALS

MAYBE WE CAN SUBSTITUTE ANOTHER DEVICE?

MAYBE WE CAN RE-USE THE N-95 IF WE USE A COVER?

PERHAPS WE CAN USE UV LIGHT?

THE NEBRASKA MEDICINE PROTOCOL

Check out this link to a fantastic website from Nebraska Medicine. They have developed an entire protocol! Click HERE. Also, recommend to not use alcohol on the outside of the mask as it may degrade the mask.

Can We Re-use a Mask after 5-7 days? Maybe!

Some discussions have been circulating around social media from medical professionals/healthcare workers about this very subject. We think that the longest time that the virus has been detected is 9 days. Most studies are showing 3-7 days, at most. Theoretically, we could issue 10 masks to a provider and have them place the mask each day into a numbered brown paper bag (plastic not recommended). Then, the worker would rotate daily to a new mask and theoretically the virus will have died from the previous days. (Reference here)

MEDICS SHOULD CONTINUE TO TRAIN! PREPARE NOW

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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.

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.

COVID-19 Reputable Info

Consolidated Reputable and Cited Info on COVID-19 that can help leaders make informed decision based on what we know (As of 18 MARCH 2020)


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SUMMARY: The SARS-COV2 virus has infected over 200,000 people of whom we are aware. The virus is thought to be “silent” in numerous individuals and cause mild symptoms in others. However, the transmission rate is very high and the impact on our healthcare system is the most worrisome problem- this should be our chief concern.  Because the virus has the potential to infect so many at one time, a high number of individuals will die. Onset from exposure to symptoms is approximately 5 days, but viral shedding occurs prior to symptoms. In fact, it is now reported that symptoms spread the most in the first week.


The result of an overburdened system will result in children with broken limbs or other trauma waiting longer at Emergency Rooms. Strokes will go undiagnosed resulting in higher morbidity and mortality. “Heart Attacks” will not receive rapid intervention from cardiac catheterization that could save their lives. Motor vehicle accidents will have a higher mortality. Bed space will be at a premium. Riskier decisions will need to be made. Mistakes will be made. Many tests will not be available without significant wait times due to time needed to properly disinfect the machines. 

Further, healthcare workers are 3-5 x more likely to have severe illness and death compared to others, even among young individuals.. We hypothesize this could be due to viral load of intimate exposure and the wide dispersion of the virus during emergent care requiring ventilation procedures. 

These outcomes are very likely based on a comparison to China and Italy.  San Francisco, Seattle, New York, and Boston are showing us what may happen in our own areas soon.  However, based on our geographical layout of our country, we may have pockets of areas that are hit hardest.  This will also cause a disproportionate burden on resources. Concentrated clusters of people in bigger cities may spread the virus more. Sparse resources in small towns may cause serious burdens and higher mortality. 

Social distancing plays a big part in this fight.  We are slowing the transmission by splitting up into cohorts and limiting exposure to other people. After all, we do not know who has the virus.  This is not the flu. It is not Ebola. It is not a hoax. This is different. I am now part of a social media group of over 100,000 Physicians, PAs, NPs, and CRNAs that are sharing information on what is happening with their own patients as well as tips and strategies to combat this.  This is a real thing. 

Our only hope is that an unknown external factor helps us in this fight.  Perhaps warmer weather will positively affect this virus like influenza (unknown). Perhaps we will solidify pharmaceuticals which will mitigate the severity and mortality.  There are studies underway now on ideas that work, in theory. And perhaps social media will continue to hasten the way towards a cure with the instant transfer of information between specialists.

COLLECTED CONTENT

  1. The Nasopharngeal test has at least a 20% false negative rate.
    1. Swabs which are not performed accurately (appropriate depth) as well as early disease duration may lead to higher false negative tests. 
    2. SOURCE: radiol.2020200642
    3. SOURCE: https://emcrit.org/ibcc/covid19/#labs
  2. Virus General Info
    1. The virus is believed to be stable in the air for 3 hours, copper for 4 hours, cardboard boxes for 24 hours, stainless steel for 48 hours, and Plastic for 72 hours (New England Journal of Medicine)
      1. https://www.nejm.org/doi/10.1056/NEJMc2004973?fbclid=IwAR1RAJb083TQ2KJAsuPB4cTW7PkcooCS9SKvyPChcRNziZqmflODHrwtHI8
    2. Is the Virus Airborne?  (sorta)
      1. The virus is aerosol, but it appears to linger in the air. Suggestion is at least 6 feet separation, but we’re not 100% certain. 
      2. Information on mask choices and why:
      3. Source: https://www.wired.com/story/they-say-coronavirus-isnt-airborne-but-its-definitely-borne-by-air/
    3. Two different Major Strains identified with 278 mutations
      1. One major strain is more virulent (worse symptoms) than the other
      2. Hypothesized that the weaker strain is more prevalent currently, potentially due to human pressures to suppress it
        1. https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463?searchresult=1&fbclid=IwAR3x883cnvbgMPcztj8UKlIXV6z8fwSgePny3aMDFG65sOVA83CK7oLnBxg
  3. Why Social Distancing Matters
    1. We do not have the bed space to care for everyone. Social distancing slows the spread.
    2. If we flatten the curve to 6 months duration, we project 274 percent potentially available capacity) and 295,350 ICU beds (508 percent potentially available capacity). Strokes, heart attacks, injuries to kids, and others will not have a bed for admission when at 274 % of capacity. THIS IS A PROBLEM. 
      1. Source: https://www.healthaffairs.org/do/10.1377/hblog20200317.457910/full/?utm_source=Newsletter&utm_medium=email&utm_content=COVID-19%3A+US+Hospital+Capacity+And+Projected+Need+For+Coronavirus+Disease+Care%3B+Paid+Sick+Leave%3B+Politics%2C+Partisanship%2C+And+The+ACA&utm_campaign=HAT+3-17-20&fbclid=IwAR1nBOliwFZythaq6lT0F-vExBKnoUiBQdTvDdlfoRj8Lbjl4ErN0yRYaBg&
    3. “Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.
      1. Undocumented Infections defined as: “These undocumented infections often experience mild, limited or no symptoms and hence go unrecognized, and, depending on their contagiousness and numbers, can expose a far greater portion of the population to virus than would otherwise occur.”
      2. Source: https://science.sciencemag.org/content/early/2020/03/13/science.abb3221?rss=1&fbclid=IwAR0ChPtRbw0NyJ-O2z2cn_oEwIoyLRSM5XIaFtvfKwjwklYu9bCfsyZ3UQg
  4. Can N-95 Masks be re-used?
    1. There is no way of determining the maximum possible number of safe reuses for an N95 respirator as a generic number to be applied in all cases. Safe N95 reuse is affected by a number of variables that impact respirator function and contamination over time
    2. Source: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html?fbclid=IwAR1gl5crMKxQlSqm81Bcs85no0aFwUHB7kzZ_slgXaPECbeznwx3dbq7diI

Very Early relevant reports not yet substantiated:

  1. Ibuprofen may be harmful in COVID-19. Suggesting Tylenol for fever control may be better. Max 3 grams daily for adults without any contraindications.
    1. WHO now recommending against choosing ibuprofen based on reports of otherwise healthy individuals who developed severe symptoms and pneumonia after using ibuprofen. GROWING EVIDENCE TO AVOID NSAIDS
    2. Source: https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center?utm_content=bufferc15e0&utm_medium=social&utm_source=facebook&utm_campaign=buffer&fbclid=IwAR13lRxR8ow6zVSSoRBjxXUKrsp3rFjaSv_EDsOcGmM6xZCA_O6aZhJqRmQ
  2. ACE inhibitors (a type of blood pressure medicine) may worsen disease. Current guidance by American Heart Association and others is to continue medicine at this time due to lack of evidence. 
    1. Source: http://www.nephjc.com/news/covidace2?fbclid=IwAR3fiZdL1JMx6by6kpDbJP93zyUtYhX1KKqtgE2o04N5iZEKAWubfukgqCc
    2. Source: https://www.bmj.com/content/368/bmj.m810/rr-2?fbclid=IwAR1jUM8J76jryzlfDbG_BJ3yYxAlFgf_gkiKTY-_SG_FZb2uN2PIzlly5Y0
  3. Pregnant women hypothesized to not be at increased risk, but suggested caution due to limited evidence and numbers so far. Earlier pregnancies may be riskier, but unknown. Limit visits in person and use telehealth, when possible. 
    1. Source: Center for Disease COCA Group webinar
  4. There may be a correlation between disease severity and blood type
    1. Blood Type A may be more likely to get the virus as well as have harsher symptoms. Early reports and not yet peer reviewed. No reason given between possible link. 
    2. Source: https://www.medrxiv.org/content/10.1101/2020.03.11.20031096v1?fbclid=IwAR3g8rZRKsJNmbbyAa3f-3TZc1qkB1Yn595ziRQYzKrhbQUAzuPCECQJPw4

WEBSITES FOR MORE INFO

  1. HARVARD University Website on COVID-19, and FAQ (Highly recommended)
    1. https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center?utm_content=bufferc15e0&utm_medium=social&utm_source=facebook&utm_campaign=buffer&fbclid=IwAR13lRxR8ow6zVSSoRBjxXUKrsp3rFjaSv_EDsOcGmM6xZCA_O6aZhJqRmQ#Questions
  2. CDC Website for Cleaning and Disinfecting Against the Virus; Laundry
    1. https://www.cdc.gov/coronavirus/2019-ncov/prepare/cleaning-disinfection.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcommunity%2Fhome%2Fcleaning-disinfection.html
  3. EPA Website for list of Disinfectants for use against SARS-COV2
    1. https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

FOR PROVIDERS: 

One of the best collected sources for current information is from EM Crit. Link Here.


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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VISIT BLOG OR TABLE 8 INFO

COVID-19 for Medics

What do you need to know if you are asked to help the Nation care for these patients?

I can envision a scenario in which US Army Medics, Flight Medics and PJs, Air Force Medical Technicians, and Hospital Corpsmen from all components are placed into field hospitals to help the Nation care for critical patients. One only needs to look at Italy to see how it is “all hands on deck.” Even if it never gets bad enough here, reading up on all of these topics is certainly worthwhile.

POSSIBLE USES OF MILITARY PERSONNEL

  • Army Medics, Technicians, and Corpsmen – assisting in the E.R., assisting inpatient, assisting in the ICU, assisting in patient triage, performing patient evacuation, assisting with patient transport, performing nasal swabs to test for COVID-19, and completely running sick call.
  • Flight Medics, SF/SOCOM medics, and PJs – Assisting in critical care/ ICU, as well as patient transfer to higher level of care

As I write this, I am also studying to prepare myself. Teaching is a great way to learn, and to cement ideas.

I believe that we need to focus on several topics. We need to re-educate medics on using ventilators. We need to help them familiarize themselves with vents to be able to assist in the care of these patients. We need to educate and/or re-educate on the science/physiology behind respiration/ventilation. We need to review the proper PPE procedures. We need to enable Medics to do other skills also in order to free up providers to handle the most critical patients.

I hope to post relevant info as the situation evolves, and as time allows in order to assist medics. I encourage medics to imagine where they can be helpful, and to learn and study on those topics now. I’ve posted a few links at the bottom of the page to some previous posts that have a TON of helpful short videos. You will find videos on patient assessment, respiration, triage, and others. If I were a senior medic, I would be assigning medics to watch a few videos a day to refresh NOW. Better to prepare and not be needed than to be caught off guard and unprepared.

VENTILATORS THAT THE U.S. ARMY CURRENTLY USES, or MAY USE

PERFORMING A NASOPHARYNGEAL SWAB

Medics may be required to assist with performing swabs of patients suspected of having SARS-COV2 (COVID-19). Use this video below to know how to perform the swab to standard.

HOW TO CORRECTLY DON AND DOFF PPE

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TAKE TIME TO REVIEW A FEW TOPICS

Respiratory System – Knowledge and Skills Videos, Podcasts, and Lung Sounds Refresher

Triage Skills, Patient Assessments, and Other Videos

Medical Assessment and Treatment Skills Videos

IV Access and Medication Administration Skills Videos

SOAP Notes (How to think when assessing a patient)

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.

Shoulder Dislocations

Ever wonder how to reduce a shoulder? Maybe you’re down range and you need to do a shoulder reduction without being able to evacuate the patient- this is for you. Come back to this page and review the video if you’re about to try it downrange. Don’t do this in urban America where Emergency Rooms and clinics are available.

A good distal Neuro and vascular exam should be completed before and after reduction. If possible, its best to try to get a post reduction X-ray to confirm the joint is reduced, especially in cases where a clunk cannot be fully appreciated. The axillary nerve should be checked after reduction also by feeling the deltoid area of the shoulder for sensory.

Post reduction, the patient should be in an immobilizer or similar to avoid dislocating again.

Extra Credit for Next Level Medics

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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.

Contact me by Email: admin@nextlevelmedic.com

Achilles Tendonitis

A common injury in Ranger School, or in a Pre-Ranger course, is Achilles Tendonitis. It is an overuse injury. Achilles Tendonitis is minor annoying pain of the achilles tendon and can often be treated with some stretches and exercises. This post will elaborate on that topic.

In the acute phase as it starts hurting, the only real options are NSAIDs, Ice, rest, possibly foam rolling, and stretches. First, we must try to rule out a rupture by performing the Thompson Test. The two videos below will discuss the special tests to perform, as well as some other knowledge on the topic.

Once rupture is ruled out, we can consider some rehabilitation exercises. The eccentric achilles tendon exercise on the second video has been around since the mid 1980s, and has some data to support its efficacy. I’ve heard it said that a surgeon originally discovered this technique serendipitously when he experienced tendonitis. The surgeon was actually attempting to rupture his achilles tendon so that he could obtain surgery sooner in his country of socialized medicine, and discovered the eccentric exercises worked! I give these exercises out to all of my patients with tendonitis. Check out these videos below to learn more about rehab and stretching of the achilles tendon.


Extra Info on Achilles Tendonitis on OrthoBullets.Com

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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.

Check Out Other Recent Blog Posts:

Contact me by Email: admin@nextlevelmedic.com

Minor Nagging Knee Issues

The purpose of this post is to give stretches and other rehab exercises to address minor or chronic knee injury issues that did not result from trauma. My primary audience would be those who are deployed to austere environments whom are looking for ways to rehab their guys while awaiting a good time to see a provider or physical therapist. The secondary audience would be for those Soldiers, Sailors, Marines, or Airmen who have been diagnosed, but are unsure/forgot the exercises they need to perform.

As a disclaimer, knee issues can be more difficult to diagnose, and to treat. Any injury with trauma should be evaluated. Moreover, pain that occurs suddenly while in exercise should be evaluated. This post is not to address sudden or traumatic issues. I certainly am not pushing anyone to avoid a provider or a physical therapist.

Instead, use these stretches to “stay in the fight” or to start rehab until you can see a provider or therapist. There will be a download button also at the bottom to keep these for yourself. These documents were passed to me from a physical therapist, and obviously originated at Evans Army Community Hospital at Fort Carson.

KNEE STRETCHES, PAGE 1
KNEE STRETCHES PAGE 2

EXTRA CREDIT FOR NEXT LEVEL MEDICS

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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.

Contact me by Email: admin@nextlevelmedic.com

Ankle Rehab

If you find yourself with an ankle sprain and it is situationally difficult to get to a physical therapist, try these ankle rehab exercises for the first few days.

I was fortunate to receive these cheat sheets from my physical therapy friends. I now give these sheets out to Soldiers when they get hurt over the weekend, or when I know they can’t make it to physical therapy any time soon. This would be awesome for when down-range.

Assessment of the injury is important. If Ottawa Ankle Rules are negative and the injury is minor, it may be appropriate to give out this handout for ankle sprain rehab.

PAGE 1 OF PHASE 1 ANKLE REHAB
PAGE 2 OF PHASE.1 ANKLE REHAB

DOWNLOAD THE ANKLE REHAB PROGRAMS HERE


  • If you want to read more on the subject, check out ORTHOBULLETS
  • More information on Lower Extremity Evaluation and Ottawa Ankle Rules

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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.

Lower Extremity Evaluation

This post will include a PowerPoint lecture on “Lower Extremity Evaluation” taught by Dr. Anne Resty, DPT. She is a Physical Therapist that I have worked with and I highly respect. I greatly appreciate her assistance here. I recommend you also the watch videos further down on how to perform these special tests that she covers in her presentation (videos have already been posted to the blog covering knee exams-click here to go to this post). Additionally, the “When to get an Xray” video further down should be educational for any and all medics or corpsmen.

Lastly, there are a few links sprinkled in on this post that highlight products that I use for my patients, or have used in the past with success. There is a link to a cheaper version of the “Game Ready” ice compression machine, sold on Amazon. I’ve purchased this much cheaper alternative in the past, and it works. Patients love it. Additionally, I’ve linked to the ankle brace on Amazon.com that I give out to students – I call it the “Cadillac ankle brace” because it completely stabilizes the ankle and helps Soldiers continue on once we determine the injury is just a sprain. Soldiers can wear it under their boots or with their running shoe. I’m sharing the things that have worked for us.

Click Here for “Doc Medic Shirt” sold on Amazon.Com with free prime shipping

This video by Dr. Resty, DPT, will cover the following:

  • Ankle Exam
  • Knee Exam
  • When to get an X-ray for an Ankle Injury
  • When to get an X-ray for a Knee Injury
  • IT band Syndrome
Dr. Anne Resty, DPT

ANKLE SPECIAL TESTS


WHEN WE NEED TO GET AN XRAY

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Extra Credit for Next Level Medics

Link to “Ankle Sprain” Outline created by Orthopaedic Residents on “OrthoBullets” website. Gives Anatomy, Diagnosis criteria, Imaging, Surgical options, and Rehab Timelines.

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.

Forearm Injuries

When thinking about open wounds to the forearm or even open fractures, do you use Kerlix? Do you understand the risks of wrapping it circumferentially? Watch this video to learn more!

Not everything about this video is perfect, but the point is to not create more problems by creating a compartment syndrome. The secondary point is to cover the wounds of a suspected open fracture with guaze (with saline) as soon as possible. You can usually suspect (or rule out) an open fracture based on mechanism of injury.

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.

New! Table 8 Training Aids

If you’re an Army Medic, then you are familiar with the TC 8-800 – the training guide for 68W Sustainment. It underwent an update a few years ago, and I’m a fan. The TC became more TCCC oriented, and it added some basic exam skills. It also did away with the CPR portion in Table 6 (already receiving it in BLS), and added “Force Protection.”

However, allotting training time for 68Ws remains a challenge. It’s hard to explain the training to line unit leaders; they don’t understand it. The medics are usually outnumbered and often lack an advocate to fight for their training time and resources. This problem is exacerbated more in units that only drill once a month, as time is further crunched.

That’s who can benefit the most from this, in my opinion -The National Guard units. Perhaps this would also benefit some active duty units and reserve units if the medic sections are small.

Everyone in the Army Lies

There was a paper written a few years ago that was entitled “Lying to Ourselves: Dishonesty in the Army Profession.” It detailed how everyone cuts corners and lies; they have to do so. The amount of hours required in training exceeds the amount of available time, and yet units report training is complete. Here is a link to the Army Times coverage of this paper. I read through the actual paper a while back, and I loved it. It showed in actual data what we all knew to be true. I wish we didn’t live in this world, but we do.

I’m not telling anyone to lie about their training. I’m not saying to cut corners and reduce your training time. Train as much as you can, and more than is required- if possible. Attending a formal (protected time) instructional program is probably best. However, if your team is already cutting corners, then this may be a way to bridge the gap and better meet the intent.

Use This as Periodic Refresher Training

Ideally, this material would only be used to conduct individual or collective periodic refresher training in between formal instructional periods. Medics can slowly refresh on a few videos during “sergeants time” or while sitting in a FLA pulling coverage somewhere. This is excellent for “filling holes” in training or deficiencies.

Check it out! I’ve completed Tables 1-6, and 7 will be posted soon. Here is the link. It’s also posted on the homepage and in the menu.

Please send me any feedback or recommendations for any changes. I’ll listen.

Contact me by Email: admin@nextlevelmedic.com

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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