Field Surgery

I have to say that the best decision I did was to take an EMT class. There is a point that they make in it that was very true in my case... They say that you go to EMT training and the person who's llife you save will more than likely by someone you know and love.

My first three victims were relatives. I have become the go to guy in the family because of this knowledge. It is worth it! Even if nothing happens and we don't have to Bug Out... The knowledge will save you, or someone you know and love.

I have to say that the best decision I did was to take an EMT class. There is a point that they make in it that was very true in my case... They say that you go to EMT training and the person who's llife you save will more than likely by someone you know and love.

My first three victims were relatives. I have become the go to guy in the family because of this knowledge. It is worth it! Even if nothing happens and we don't have to Bug Out... The knowledge will save you, or someone you know and love.

reply to post by Jkd Up
And that alone is a good reason to have at least the basic knowledge. During sitX the skills will be invaluable.others were arguing about leaving it to the professionals. What if the professionals are the ones who need help?

reply to post by Anuubis


There might be a lot of people out there that are more than happy to "leave things to the professionals" but I am not one of them. And as you very well stated... What if a doctor is the one who needs help. Not only that... But doctors are specialized in training. I, as an Emercency First Responder, know how to bandage and transport, a doctors training assumes that that is already done.

Heck, for just under $200 I learned a whole bunch of fun stuff... Even how to keep traction!

reply to post by Jkd Up
But i believe people should be able to perform basic field surgery. Just the basics so they don't try to remove a bullet and end up slicing open a major artery.

reply to post by Anuubis


Absolutly! And really... Even if you don't take a course, books are available at the ibrary so at least you can have the knowledge. But I recomend starting with anatomy. You'll learn a ton from just knowing where everything is located in the body.

Absolutely a terrible idea...anyway you cut it... no offense.

You're right about needing to know medical stuff....

Take a course in First Aid... then Wilderness First Aid... then take an EMT or First Responder class. EMT is the longest of the ones I listed, and takes about 3 months (3 nights/wk, ~4 hrs/night).

You also need the right equipment and the experience.

A GSW to the leg can be managed with some gauze and tape. GSW to the chest requires a piece of plastic wrap and some tape. (In general, of course)

Hypothetically...

Scenario #1:
You have an otherwise healthy young adult who was shot in the lower leg with a small-caliber rifle. His leg is not broken. ("It's just a flesh wound!") You find one entry wound, but cannot find the exit, and therefore presume the bullet is lodged in his leg. Flush it well with clean water, apply sterile gauze, and tape or wrap it, and get him to a Doc within a day or two.

Scenario #2:
Same patient, same injury. You prep the site according to pg 32 of your manual, sterilize your insturments, and establish a sterile field. After washing up, donning a facemask and sterile gloves, you anesthetize the site with a local anesthetic. You attempt to visualize the bullet using a pair or two of forceps and extract the bullet without damaging any blood vessels. You then irrigate the wound, and suture it closed. Since it wasn't a sterile environment, and this is your first time, the wound is mis-aligned, and becomes infected. After it splits open, it goes downhill from there, and your only choice is to bandage the wound and go see a Doc! (Assuming you do the surgery right!)

Look at all the equipment needed.... do you really wanna carry all that #???


X
-Paramedic, Wilderness Paramedic, EMS Instructor

[edit on 7-12-2008 by xavier36]

[edit on 7-12-2008 by xavier36]

[edit on 7-12-2008 by xavier36]

Since surgery is a specialized MEDICAL field and I am "just a nurse", I would not like to have to perform surgery on anyone. I know DOCTORS that don't want to perform surgery (not their specialty).

That said, in a field situation where it was do or die, I would try to save the person any way I could. Sterilization and fluid/electrolyte balance would be a big consideration.

If you're on the run or hiding from TPTB then going to a hospital would be out of the question. You'd have to rely on whatever skills your group possessed.

My main consideration in such a scenario would be the repurcussions that could arise if the surgery did not go well. If someone died because I didn't have the skills or equipment to keep them alive, would the rest of the group turn on me like a pack of dogs?

Surgery is a crap shoot even if you have a trained and skilled surgeon, are in the best facility, have excellent nurses, etc. In short, surgery wouldn't be my first choice of treatment but I would try it if there were no other options to keeping someone alive.

As a nurse myself, I would be very reluctant to perform a major surgery, even with said manual alongside me.

Even in the safe sterile confines of a hospital operating theatre with loads of professionals around, things can and do go wrong and people can still get infections. Take the same procedures outside 'into the field' as it were and the complications will be 100 times worse and very likely.

Surgery is for Surgeons - It is not something that amateurs can 'have a go at'. Surgeons do not do loads of years training and residencys to be able to perform something that can be just 'picked up from a couple of lines in a book'.

As for the line that you can learn A&P from a book, well yes you can, but more often than not, the body doesnt look quite like the pictures in the book, or sometimes things are not in the 'right' place, especially if your injured victim has had prior surgery in the past.

In the first place, there's been many a man who lived for two-score years with bullets in them. If it's easy to retrieve, you go for it.

If not, you clean the wound, patch him up, and the bullet will likely work its way to the surface. Eventually.

I've had shrapnel work its way to the surface over the years time and again. I just cut the skin when it starts to reach a "head" and pull it out.

Bone setting will be critical, and it's really not all that hard on the person doing the setting. A lot harder on the person with the broken bone unless you have some anaesthetic. And huffing freon cans won't quite get it done. Fortunately, they usually pass out shortly after you begin.

I once found myself in the wrong place at the wrong time, got caught up in an emergency baby birth, scared me half to death, and ended up tying off the umbilical cord with a strip of leather boot lace. It was all I had handy, and it worked. Jeez. The things you will do.

Know your pressure points. Know that heat and salt can do miracles. I would recommend emergency survival field medicine books, and the one provided to Special Forces is one fine start.

You can usually order these online if you do a bit of searching.

Basic tools, supplies, and a bit of study will get you through a lot of emergencies. Often, time and care will get folks through. The human body is pretty resilient, and you'd be surprised how it will compensate for not having a full medical facility catering to it.

In fact, physicians themselves are dangerous. More so than guns.

Not a very comforting thought, is it?

reply to post by dooper


Great, sound advice! You got caught in a suprise child birth as well huh... I don't think you can ever get used to that

If you get a bullet in you that fragments, then it will cause a lot of damage from simple movement. I would rather myself or someone else cut it out of me.

Abdominal wounds will kill most people unless you can find a surgeon.
infection will get them. there is little that can be done in the field.

Wounds in the arms and legs all you can do is pack the wounds to control bleeding and check for blood flow distal from the wound.
no blood flow will cause wide spread infection distal to the wound. (gangrene)
once that starts amputation is called for.

Never try to close a bullet wound most high velocity wounds will need to be debrided to remove tissue killed by the shock of the bullet going though the tissue.
If they don't need to be debrided they will still need to heal from the inside out so that infection can drain and not form a septic absess.

In a sit-x the best you can do for some cases is to make there passing a painless as possible.