What to Expect When Youre Expecting a SOF Casualty

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What to Expect When Youre Expectinga SOF
Casualty

• M. John McBeth
• Capt., USAF, MC

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Objectives

• Understand the latest field techniques utilized
  by SOF medics.
• Anticipate the adjuncts of field medic
  interventions.
• Gain tactile experience with the latest field
  medical devices.

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Who is the Field Medic?

• Varies greatly
• EMT basic/intermediate
• Paramedic
• IDC/IDMT
• Examples by Service
• Army 18D, 160th SOAR, 528th SOS Batt.
• Navy Independent Duty Corpsman (IDC), SEAL medic
• Air Force PJ, SOFME, CSARME

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Scope of the Field Medic

• Primarily ABCs
• Field expedient ortho stabilization
• Preparation for transport
• Pain Management
• Antibiotics
• Casevac

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Stages of Field Care

• Self-Aid Buddy Care
• Care Under Fire
• Tactical Field Care
• Casualty Evacuation

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1st Priority- Control Bleeding

• Conventional
• direct pressure, pressure point, pressure
  dressing, tourniquet
• Tactical
• Tourniquet, tourniquet, tourniquet
• In the tactical environment a tourniquet is the
  standard for primary control of severe hemorrhage
• Tourniquets improvised, Israeli, cotton web,
  ratchet, one-handed, C-A-T

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Tourniquets

• C-A-T (Combat Application Tourniquet)
• Ratchet
• One-handed
• Improvised sticks and rags
• Cotton web
• Israeli

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Airway

• OP/NP
• Combitube/LMA
• Endotracheal Tube
• Needle Cricothyroidotomy
• Cricothyroidotomy

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Breathing

• Needle thoracentesis
• Tube thoracostomy
• Occlusive dressing

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Circulation

• Access
• Peripheral IV
• External Jugular
• Intraosseus Device (FAST1, B.I.G.)
• Venous Cutdown
• IV fluids NS, LR, Hetastarch
• hypotensive resuscitation for uncontrolled
  hemorrhage
• Packed Red Blood Cells

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Circulation

• Hemostatic Dressings
• HemCon
• QuikClot
• Tourniquet Management
• Removal v. loosening
• Surgical availability

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Pain Management

• Tylenol
• COX-2 Inhibitors
• Morphine
• Fentanyl
• Demerol
• Diazepam
• Promethazine

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Miscellaneous

• Combat Pill Pack
• Antibiotics
• Oral Quinolone
• IV Cephalosporin

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Summary

• Many field medics have advanced training which
  will be reflected in their procedures
• Expect that patients will show up with adjuncts
  of advanced procedures
• We ask our field medics to do a lot with very
  little in some of the most challenging places and
  situations

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Hands-On

• TKs C-A-T, ratchet,one-handed, Israeli,
  webbing, improvised
• 14ga Catheter
• F.A.S.T. 1, Bone Injection Gun
• QuikClot, HemCon
• Combat Pill Pack