Medical Guide [OOC]

Subject: Medical Guide [OOC] Fri Feb 06, 2015 3:55 pm

Introduction

This guide will cover the essentials on equipment, common wounds such as lacerations and gunshots, alongside basic medical practice. Every bit of roleplay you do as a medic is based off what you know from here and what you decide to study from your own sources (ex. Internet, books, RL experience, etc.)

Equipment

Improved First Aid Kit (IFAK):-

Every basic class combat medic will carry a standard issue IFAK, or Improved First Aid Kit while performing any and all duties in the field of fire or the field of the unknown. Your IFAK will include all of the necessary materials needed to provide battlefield first aid to your battle buddies if they fall from wounds. The following are included in your IFAK, but not limited to:

Combat Application Tourniquet:- An item tied around a limb/appendage to constrict blood flow and reduce blood loss, may also be used to surface any and all superficial veins below it’s application point. (refer to surgical equipment)

Elastic Bandage Kit:- Small various forms of bandages placed into a carrier of high elasticity, ranging from small butterfly bandages to heavy duty joint covers (knee, elbow, etc.).

4-½” Bandage Gauze:- Self-explanatory and used to dab blood, soak blood in a wound or provide a seal against the external environment (Good for infection prevention.)

2” x 6” Adhesive Surgical Tape:- In the case of needing to hold items down to a wounded persona without the need of a hand, Tape may be used for gauze, bandaging, IV tubes, and etcetera.

Nasopharyngeal Airway (NPA):- A small, circular tube that is inserted into the nasal passageway of a patient to secure an open airway for breathing.

Burn Ointment:- Applied to bandaging or burns themselves, the ointment will cool and relieve the area of any form of pain while promoting healing of the burns.

Patient Exam Gloves 100’s Pkg:- Simply a box holding 100 individual gloves for sterile examination of a patient.

QuikClot Combat Gauze:- A gauze bandage infused with kaolin in order to promote coagulation of blood in superficial wounds.

QuikClot Hemostatic Powder:- A powder form of QuikClot which provides the same effect but for wounds where the Gauze will not suffice. (refer to surgical equipment)

Surgical Equipment

Your standard surgical kit loadout (optional/dependable), regardless of how you personally deliver it, these instruments and tools are a MUST in your kit(s) at all times.

Scalpel:- This instrument is used whenever you are to make a critical procedure. These are sharp tools that are used to cut the epidermis alongside other uses. Be weary though, as the pure sharpness of the blade can easily cut an unwarranted artery or worse. Basically self-explanatory in nature.

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Surgical Shears/Scissors:- Simply stainless steel scissors implemented for medical usage. This tool is great for exposing a wound by cutting the cloth, removal of bandages and/or sutures on treated wounds. Take notice that you should cut through layers of clothing that aren't protected well or at all. Also, it does not matter where you start to use the shears, whether it's from the edge of a sleeve or in the middle of it. As long as you expose the wound, then you are good to go.

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Forceps:- A small metallic tool consisting of two prongs welded together at a single end, allowing the other end to open and close. Usually provided to extract anomalous objects from wounds, such as bullets or fragmentation.

Bandages/Gauze:- The average bandage is used to begin coverage over a wound as to keep infection at bay. When wrapping, make sure it's tight to apply pressure for assistance in coagulating the blood. The sooner you can plant some gauze on a wound, the better as major blood loss can lead to loss of consciousness and finally, death. Wait until you're in a more secure area with equipment (ex: medbay) as to focus on the wound itself than to just temporarily stop bleeding.

Needle and Thread:- Commonly used for the sealing of wound. Provided that you need to stitch a wound shut that you created, or did not, then the procedures are simple. Take the two sides of the incision, threading the needle through each end to pull them together. A normal pattern is a zig-zag or crosshatch design. Also, the thread is usually degradable -can be absorbed into the skin- as to avoid further operation for the removal.

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QuikClot:- Scientifically dubbed Calcium Zeolite, this product proves to be very useful in the coagulation of blood. Coming in a powder form, tear the packet open, grab a SMALL pinch and sprinkle into the wound. In a few seconds, the Zeolite will begin to foam as to stop blood loss, so always use a small amount as too much can lead to consequences. Now, these packets prove impractical for large wounds alongside the decent amount of burning it causes when absorbing and halting the blood in the wound. Take great heed to keep the powder in the wound only, as if you were to say, get some in your eyes, it will dehydrate them. Make sure that the Zeolite solution is washed out before wound treatment.

Painkillers (Analgesics):- Best to keep some in grasp, these reduce the amount of pain a patient feels however may even cause them to lose consciousness - not a desirable effect - and if overdosed, will be fatal to the wounded serviceman. These can be given via pill/tablet or syringe. However, you are more likely to see a syringe used in the field as it doesn't require the patient to do any work. Pills/tablets are usually provided as prescription for regular pains.

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Tourniquet:- Usually a piece of banding with two sets of sticks, a tourniquet is made to wrap around a location where major veins/arteries are as to slow blood flow. Wrap tightly around the appendage, then twist the sticks together to secure it, pull the velcro flap over for further compromise. Commonly tied for injection via syringes.

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Hemostatic Clamps:- For such a name, they are a simple tool. They are alike to the forceps, except that they hold closed like a pair of locked pliers. It is not uncommon or random to see these placed over an incision as their main use - and the biggest difference from forceps - are to apply pressure to blood vessels directly. (Hemo - blood, static - not moving. To stop blood movement.)

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Antiseptics:- Used for wound sterilization and equipment necessarily. Make sure that your choice of antiseptic kills/eliminates bacteria rather than to slow the growth. Examples include Iodine, Hydrogen Peroxide and Ethanol though a strong form of antiseptic wipe wouldn't hurt.

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Surgery

Aside from what you should hopefully have in your surgical kit as stated above, you should also have a local anesthetic(s) and a general anesthetic(s) with a blood substitute in case of severe blood loss. (kit dependable)

Local Anesthetics:- These are used to make an AREA/LOCATION numb, as for surgery to avoid providing pain to a patient but not rendering them unconscious. An example being Lidocaine.

General Anesthetics:- These are to render a patient unconscious, usually for surgeries that require great accuracy and patience. Examples include Chloroprocaine and Etomidate.

Blood Substitute:- In case of a patient losing mass amounts of blood, he may be administered a Blood Substitute in order to replace the lost blood. Substitutes can either be isotonic subs like Lactated Ringer’s Solution (LRS) or plain O Negative Blood.

Short Anatomical Definitions

Blood Vessels:- These transport blood throughout your entire blood, coming in three types, arteries, veins, and capillaries.

Arteries:- These transport blood away FROM the heart and to the body. They come with the highest pressure out of all three types, which explains why patients 'spurt' blood when they get a severed artery. Best treatment is to apply pressure if other injuries are active and require the most attention. Once the urgent wounds are taken care of, suturing the artery to prevent further blood loos and coagulation agents are advised.

Veins: These vessels move blood TO the heart. These don't have such a high pressure as Arteries do, which can prove to be difficult in the identification of a cut vessel due to the non-spurting of blood. This is treated the same way as Arteries are.

Capillaries: These are the smallest blood vessels, allowing the transportation of water, oxygen, carbon dioxide and other nutrients for transfer between the blood and tissues. Due to the sheer size of these vessels, it is near impossible and greatly impractical to try sealing with a thread and needle. Cauterization is advised.

Heart: The heart is a hollow and muscular organ, its main priority to pump blood through the four atria and to all of the body's blood vessels. Using contractions does it move the blood. That is why you are able to use defibrillators on a flat lined person by using an electric current to force the heart for pumping.

Nanites and Biogel

During the course of an Infantryman’s service, they will encounter various hostiles that will wound them in the long run; this results in injuries that take a few weeks to a few months to recover from. This problem was rectified with the creation and implementation of nanites, which only hasten the healing process, not as an immediate antidote for all wounds. Biogel is a small, paste-like compound that also promotes healing, but on a lesser level of nanites. It has fewer disadvantages in use but is expensive in bulk and individually. Both of these should not be abused, they are not the universe’s treatment to every wound and can kill a person if sprayed/applied directly into an open wound via bloodstreams.

Nanite Tank: A large, cylindrical tank that is sealed with a large vat of nanites, automated surgical tools, water, and other liquids which act as natural remedies to gunshots, lacerations, fractures, etcetera. The tank holds a breathing apparatus that is hooked up to the wounded person’s face, as to allow them to breathe while undergoing surgery. This usually takes a day or two to complete the entire process and used as an option when treating severely wounded personnel. DO NOT ABUSE THE NANITE TANK! Despite its effectiveness in treating wounds, it also has its downsides if overused.

Nanites: Small machines the size of a molecule or atom, these are the substitute workforce for your body’s wounds. They will enter the bloodstream to move to the wounded location and will work as necessary to increase platelet and white blood cell output in order to seal and heal a wound faster. They can however, not work correctly or at all as they are still experimental so do not abuse it.

Biogel Cast: This form of cast is offered to military personnel only, as it uses the expensive paste-like compound. After receiving a form of fracture, a biogel cast will be applied to promote setting, hardening, and healing of said limb. Refer to Biogel for further info.

Biogel: A paste-like substance used for medical purposes, this breakthrough in medical research is used often for most battlefield wounds, but only after the surgery has been done on a person. Despite how helpful biogel can be, it can poison and kill a person if it were used on a large, open wound. Only use biogel straight up over sutures to prevent scarring (muscular, skin sutures) or very small cuts.

Type Of Injury	Normal Recovery Time	With Biogel
Bruising/Contusions	2 wks	2 hrs
Laceration (Skin:Subcutaneous Tissues)	2 wks	6 hrs
Muscular / Ligament Strain	2 - 6 wks	10 hrs
Dislocation	3 - 12 wks	28 hrs
Fracture / Breakage of Bone	4 - 12 wks	24 - 36 hrs
Whiplash	4 - 18 wks	24 - 36 hrs
Fracture of Spine	2 - 24 wks	26 - 38 hrs
Cartilage Injury (Surgically Corrected)	2 - 4 wks	14 hrs
Major Burns	2 wks - inf	24 hrs**
Bullet Wound	12 - 24 wks	12 hrs - 48 hrs

** - ‘Depends upon scale of burns and immersion’

- Credit to Reverend for the Guide.

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