Tuesday, February 18, 2014

The Plight and Pack of a Combat Medic

You don’t have to be John Watson to recognize that the kind of medical work a combat medic does on the field is vastly different from the kind of work a doctor does in the safe, controlled confines of a hospital. There is a whole world of difference between the two roles, though both find themselves with the same basic set of responsibilities: to care for the sick and injured when they need it most.

With that said, however, a combat medic lacks a variety of other tools and conveniences that your domestic doctor lacks. So how do they get the job done of helping and healing individuals who may have been seriously injured while on the battlefield? The kind of trauma combat medics see, after all, is above and beyond what most doctors deal with, and yet they are expected to handle those situations similarly. Worse, they must tend to their patients while sometimes in the most trying of environments, even on the battlefield itself!



















What Makes a Combat Medic So Special? 

First, it is important to know what a combat medic does not have. An armed medic, for example, does not receive the protections of the Geneva Conventions, and is considered a combatant. That means that in any conflict where both sides are observing the rules of war as set down by the Geneva Conventions, an armed medic can be shot, killed, captured, and so on under the rules of engagement.

Thus, in order to enjoy the protections they need to do their job, combat medics typically go unarmed. Additionally, they wear large, clear, identifying symbols like the red cross to identify themselves clearly across the battlefield. Unfortunately, in “asymmetric warfare” where the enemy may not observe the rules of engagement, medics are “fair game,” and in fact medics are sometimes actively targeted along with officers and radio operators. In these kinds of conflicts, medics do not wear insignia and they do go armed.

Saving Lives 101 

A combat medic’s medical kit is typically limited to a backpack called the “Unit One Pack.” While in some units medics have a standard kit to carry, others allow for medics to choose what they bring with them onto the field. However, certain medical equipment can typically be expected.

By The Numbers: Today
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First, fluid resuscitation equipment is often brought along. This includes IV fluids for patients, as well as tubing to administer the fluids, which is typically saline, sodium chloride, hetastarch or hextend, and lactated ringers. Several gauges of IV catheters are brought along, as well. Finally, a “FAST 1” intraosseous infusion kit is included as a method of quickly administering fluids when jugular venous access is unavailable owing to the patient’s injuries. On the battlefield, massive blood loss, burns, and loss of limbs is not at all unexpected in one’s patients.

Airway management supplies is also brought. Long catheters for neddle chest decompression are included, along with chest seals, nasal trumpets, oropharyngeal airways and a surgical cricothyrotomy kit.

Beyond the Basics 

While ensuring that patients receive fluids and are able to breathe are some of the primary concerns of combat medics, a variety of other supplies are brought along to deal with other issues, including bleeding and broken or fractured bones. This can include muslin and gauze bandages, band-aids and Ace bandages, tape, self-clinging wrap, a reusable splint, burn dressing, and trauma shears. Additionally, for sterility, nitrile gloves, alcohol, iodine, and other materials may be included in the kit.

A variety of drugs are also often included, such as morphine, narcan, phenegran, and epinephrine. Additionally, as combat medics are expected to care for the daily aches and pains of their charges, medication for minor ailments are included in kits. This can include paracetamol, ibruprogen, diphenhydramine, pepto bismol, and Colace. To aid in caring for others, the medic may also use diagnostic tools like a stethoscope, blood pressure cuff, and thermometer.

It can seem beyond belief that a combat medic is expected to care for some of the most seriously injured individuals in our society in intense conditions, under threat of violence, and with only these tools available to them, but we have to keep in mind that the many tools available to us in modern medical environments were, not too long ago, not even in existence! Combat medics make do with what they have, though, and they do a surprisingly amazing job of it, all things considered!

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