Department of Combat Medic Training - DCMT-Bravo Echo

03/08/2022

You keep twisting the windlass on your tourniquet, 5,6,7…11 times and you’re still bleeding… What is going on during the worst day of your life?! A portion of literature on…

11/07/2022

Please answer this and ask your Junior Medics the same, as we see a trend we want to address:

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Worse case scenario during Fresh Whole Blood training or with real casualties while deployed, the blood bags got “mixed up” and the wrong ABO was being administered to a patient (Such as “A Pos” given to “O Neg”) … ((Perhaps a Medic even intentionally chose ABO incompatible blood))
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1.) What do you expect to happen, if anything? Can they receive ABO incompatible blood ONCE and only get a reaction the second time or is one time enough? 🤔

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2.) What would your treatment considerations be, if any? Continue or stop the blood?

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3.) What do YOU do at your unit to prevent this during training and deployment? What could you add?

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We will answer later in comments but want a chance for accountability. Being wrong is okay if we learn from it! Drop our ego and our patients benefit.

23/04/2022

05/10/2021

We know how proud you are that you can start an IV using NVGs. The question is why. Either your security is poor or you haven't moved the casualty to a place to start effective TFC.





North American Rescue
Special Operations Medic Coalition
Operational Medicine
DUSTOFF Medic Podcast

21/02/2021

11/01/2021

https://jts.amedd.army.mil/index.cfm/PI_CPGs/cpgs

26/11/2020

Scenario:

You are dispatched for an adult patient, unk age and gender, struck by a train in a su***de attempt.

You arrive on scene with abundant Fire/Rescue resources. You are the supervising/directing ALS resource.

The patient is located in the driver's seat of a 4-door sedan. The patient had parked on the tracks and taken the full speed impact of the train to the driver's side. The patient is a female appearing to be between 20-25 years old. No other occupants in the vehicle. The dashboard is deformed and caved along with the driver's side door; the patients L. Hip and Leg are completely pinned. Significant trauma is also noted to the patient's L. Abdomen and Chest Wall.

Patient is GCS 2/2/4, bradypnea, pale/cold, delayed cap refill.

Head: bleeding from ears bilaterally, periorbital ecchymosis, bleeding from mouth heavily (tongue laceration)
Neck: severe bruising to L. nice, no crepitus noted
Chest: Large piece of metal impaled in L. Chest wall w/ diffusing bruising and crepitus. Object appears to be around the 5th/6th rib at the anterior axillary line. SubQ emphysema noted. R. Side of chest appears intact. Sternum appears intact
Upper Extremities: L. Arm profoundly deformed and swollen. No radial pulse to L. arm. R. Arm appears intact with some deformity to R. Hand.
Abdomen: Non-distended, pain response on palpation, L. Side difficult to assess due to vehicle, R. Side positive for Grey Turner's sign.
Pelvis: L. Side pinned, R. Side difficult to assess but crepitus noted.
L. Leg pinned, R. Leg intact with crepitus around knee.

Vitals: BP UTO, HR 132, RR 10, spO2 88% RA

No interventions have been performed as all units arrived at roughly the same time.

There is a Lvl2 Trauma Center 10min away by ground, Lvl1 Trauma Center 30min away by ground in the opposite direction. Weather is Red for flight due to wind. Assume your unit is equipped with full CCT capabilities including blood products.