Medical

I do my own dentistry

First the disclaimer.  What follows is for informational purposes only.  Nothing should be construed as dental advice.  Without a proper diagnosis by a qualified dentist, appropriate treatment cannot be recommended.  If you find yourself in the midst of a dental emergency/urgency, seek care from a qualified dentist as soon as possible.  If you read this and then think you are an expert, you are the author of your own demise and it’s not my fault.

No one wants to think about dental emergencies when “out and about” but emergencies happen nonetheless.  There are many possible scenarios that qualify as dental emergencies, and unfortunately, there are some things that just simply can’t be properly treated in the field.  There are other occurences, however, that do lend themselves to “ditch dentistry” to hold you together until you get back to a dentist.

Prevention is easier – “Going For The Gold”:

I have accepted the fact that no one likes to go to the dentist, I don’t even like to go to the dentist.  When working/living/traveling in hot zones, the open ocean, jungles, or other far away places, however, it is far better to have definitive dentistry completed prior going to your gig.  The last thing you want to deal with is a dental problem especially a dental problem that could have been prevented.

Definitive dentistry does not necessarily mean that you don’t have any new cavities and you’ve had your teeth cleaned.  Definitive dentistry means utilizing crowns, inlays, onlays, bridges, etc. to treat the teeth as comprehensively as possible to get the longest lifespan possible out of the teeth and the restorations.  This treatment is more expensive and more extensive than simple fillings, but if it is done properly, it will be worth the investment.

Click Here to Keep Reading – MEDICAL: Ditch Dentistry >>>

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OK, let’s say you’ve been bustin’ your hump on an ambulance for awhile as an EMT-Basic, and you’re getting tired of driving most of the time and doing all the scut work. Well my friend, it’s time to consider advancing your career by getting more training.

As I stated in Medic 101, the National Registry of Emergency Medical Technicians has four levels of training; First Responder, EMT-Basic, -Intermediate and -Paramedic. In my opinion it’s better to skip the intermediate level and go straight to paramedic.

I say this because paramedics make more money and generally get to do more patient care interventions than intermediates do. Plus, more and more organizations prefer hiring paramedics over intermediates due to the higher level of training and wider scope of practice.

Since I went from the basic level to paramedic myself, this is what I’ll talk about. To find a paramedic course; check with your friendly, local community college first or go back to your EMT-B school and see if they offer advanced training. I went the community college (CC) route.

Click Here to Keep Reading Medic 201: How to Advance my Training >>>

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A lot of people have asked me over the years; “Hey doc, how do I, an average Joe, become a high speed medic much like yourself?”  After I stop blushing, I tell them, “It’s really pretty easy, there are basically two ways. The first is the civilian route and the second is the military route.”

Let’s talk about the civilian route first. This is how I initially got involved with pre-hospital Para-medicine way back in 1986.  First off, a little background, there’s an organization called the (NREMT) National Registry of Emergency Medical Technicians (www.nremt.org) that has, in conjunction with the Department of Transportation, set national standards for emergency medical responders.

The four levels of certification are; First Responder (FR), EMT-Basic (EMT-B, “basic”), EMT-Intermediate (EMT-I, “intermediate”) and EMT-Paramedic (AKA EMT-P, EMT-Advanced, paramedic, (“paramagic”, “medic”, etc).  These certifications are recognized by a majority of the United States (right now there are five states that do not recognize NREMT certification.  As of 31 Dec 2009 they are NY, MA, NC, IL, and WY.  When in doubt, check with your state health department to find out which certification is required.

Click Here to keep Reading Medic 101 – How to Become a Medic >>>

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How hot your zone is will determine the medical care you give or receive

There’s a lot of discussion on pages like this and forums about what you carry in your FAK (first aid kit), but not much discussion about the use of it.

I don’t necessarily mean the use of the tools in it, but rather, when is it appropriate to provide care to a team mate, and when should you expect to have to treat yourself.   So here’s the quick and dirty rules that you should expect to play by.

If you’re in the:

- Hot Zone (or Red Zone) – self-care and extrication only
- Warm Zone (or Yellow zone) – rapid assessment and treatment of immediate life-threatening injuries
- Cold Zone (or Green Zone) – Definitive care, I.V. support, packaging for transport, rehabilitation (rest/fluid replenishment)

Definitions:

- Hot Zone – direct contact with threat/ some concealment and minimal cover may be available
- Warm Zone – some cover available and good concealment but engagement with threat still potential
- Cold Zone – still in the operations area but has excellent cover/concealment and distance from threat

Click Here to Keep Reading About Medical Care in Bad Places >>>

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The Safety pin airway – Iraqi style! (Sweet unibrow dude!)

Read THIS so you can’t sue us

Treating a trauma casualty was briefly mentioned in Andrew R.’s First Aid Kit article, and we’ll make sure to post more thorough discussions here in the future on how to treat all things trauma.

In Andrew’s article he introduced EABC (exsanguinations, airway, breathing, circulation), and briefly discussed treating life-threatening bleeding. The next step in the trauma assessment is ensuring the patient has a patent airway.

Unless the airway is blocked due to a foreign object (debris, broken teeth etc), the main cause of an airway blockage is the tongue relaxing and blocking the airway. So opening an airway simply involves removing any object that is blocking the airway and making sure the tongue is out of the way.

Oral pharyngeal airways are designed to pull the tongue up and towards the front of the mouth, ensuring it doesn’t slip back and obstruct the airway. The downside with oral pharyngeal airways is that they have to be sized correctly to the patient, so you have to carry a half-dozen or so.  In addition, if the patient should regain consciousness or is semi-conscious, they can trigger the gag reflex.

[click to continue…]

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Authors FAK

I started thinking, as summer is coming up, just what I want in my first aid kit for the range and any firearms classes I will be attending. Then I tried to decide what would be a good kit for just about anything I would do outdoors that might cause a traumatic injury. I thought about what we had at work (local fire/EMS department) and what changes have come along since the wars in Iraq and Afghanistan.

With the wars in Iraq and Afghanistan we have revamped a number of things we do in treating traumatic injuries. Probably the most significant change in this care has been the reintroduction of tourniquets. What for well over 20 years had been a major No-No is now initial care. In the “old days”, care was done by ABC; Air way, Breathing, Circulation.

Now the standard is EABC. The E, standing for Exsanguination or better known as “bleeding out”, is the number one killer on the battlefield. So our first step is to stop the bleeding with direct pressure. If direct pressure will not stop the bleeding we then can go to a tourniquet. Just to clarify, we do not use tourniquets for bleeding on one’s neck, ok people.

Click Here to Read My FAK Item List >>>

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Dude, Just walk it off its not that bad

In a wilderness survival or tactical environment how can you tell if you’ve sprained or broken an ankle?  The distinction may seem minor, but the implications are dramatic.

In a wilderness environment it means the difference between wrapping the ankle and the patient can walk out, or immobilizing the limb and carrying the patient out.

Tactically, the distinction is the same, but instead of having another shooter, you have a casualty.

So here is a field expedient method to determine if an ankle is broken or sprained.  It called the Ottowa Ankle Rules.

(This isn’t completely fool-proof, so use some common sense.  If the patient’s foot/ankle is obviously deformed then it’s safe to assume it’s broken and don’t let the patient put any weight on the foot.)

Click Here to Find Out if you are Injured or just Being a Wimp >>>

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Dude, No amount of Cipro is going to fix this

Disclaimer

Wound care away from the hospital is always a problem.  And thanks to Bear Grylls, everyone thinks that any cut or scrape is going to lead to gangrene and amputation.

While antibiotics are often tough to acquire in any decent amount to treat a seriously infected wound outside of a licensed medical facility, here are some steps that you can use to prevent that field amputation.

First, wash the crap out of the wound.

Sounds easy, but a serious laceration or puncture is tougher to wash out than just using a bottle of hand sanitizer.  You need to pressure wash the wound to make sure that anything embedded (debris or bacteria) has been removed.

Two easy ways:

1: Take a standard average plastic bottle, poke a hole in the cap and squeeze.  Creates a jet of water that you can use to wash the wound

2: Take a Ziploc bag filled with water, cut a small bit of the corner off, and again squeeze to create a jet of water.

Adding some salt in the water will help to create a more aseptic solution.

Now that the wound is clean, here’s an easy Ditch medicine step to keep it from getting infected:

Click Here to Read How to Keep Your Wound From Getting Infected by Using a DIY Antibiotic Solution >>>

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The Tactical Enema – Just like maximum security prison but without the sporks

Anyone who has ever broken a sweat knows how important it is to stay hydrated. Dehydration of just 2-3% will decrease your endurance capacity by a whopping 25%.

Just sitting in front of the Xbox will cause you to lose dehydrate (mainly through respiration), and sit somewhere cold, you’ll dehydrate quickly as your body converts stored energy into free energy to shiver (plain old metabolism uses 1.5-2L of water a day, figure 2x-3x if you’re in a cold environment).

And all bets are off if you’re playing in the sandbox.

To rehydrate properly, you need a mix of salt and water, preferably in the same concentration that your body normally is – and if you can throw some glucose (sugar) in the mix for energy it’s a bonus, plus sugar makes a salt/water mix not taste like shit (actually glucose has some good hydration properties in itself and should be added in appropriate amounts, but that’s a different article).

Click Here to Learn How to Make a Field Expedient Electrolyte Drink and How to Administer a Tactical Enema >>>

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