FM 3.0.MH.1 Medical Handbook

Transcription

1 FM 3.0.MH.1 Medical Handbook DISTRIBUTION RESTRICITON: Distribution authorized to 3 rd Battalion, 75th Ranger Regiment Senior Leadership and Instructors to protect operational information that is of use.

2 TITLE: SPEICAL OPERATIONS MEDICAL SERGEANT ISSUED: REVISED APPROVED BY: 1LT R.CAMPBELL 1. INTRODUCTION Welcome to the 3 rd Battalion, 75th Ranger Regiment Operations Medical Sergeants Course, after completion of the Field Medic Training you will be able to: Effectively take part in a 3 rd Battalion, 75th Ranger Regiment Squad with the specialized position as Squad Medic. Effectively hold medical and personnel responsibility of your team during any exercises and combat operations. Completion of this training opens a new direction in the unit. A Squad Medic holds medical responsibility up to 10 soldiers on the field. 3 rd Battalion, 75th Ranger Regiment Squads will conduct offensive raids and intelligence missions and for that only the finest Field Medics are allowed to operate in a Squad such as that. Some of your duties as a Squad medic may include: - Ensuring Squads Medical preparation - Maintaining medical equipment and supplies - Providing examination and care to Squad members. - Developing and providing medical intelligence as required. 2. DESCRIPTION OF ROLE The Squad Medic of the 3 rd Battalion, 75th Ranger Regiment are considered to be the finest Field Medics in the world. 3. Advanced Medical System The 3 rd Battalion, 75th Ranger Regiment deploys ACE3 s Advanced Medical system. This system introduces a more realistic and immersive model for injuries and treatments, this result in a more prominent role for medical sergeants. 4. Wounds, bandages and medications There is a variety of wounds a soldier can receive in combat. Some that will affect the soldier immediately and some that will take time. It s important that all wounds are handled professionally in the field. PAGE 2

3 Abrasions (or scrapes) They occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees) Sources: falling, vehicle crashes Effects: pain extremely light, bleeding extremely slow. Avulsions Occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe. Explosions, gunshots and animal bites may cause avulsions. Sources: explosions, vehicle crashes, grenades, artillery shells, bullets, backblast. Effects: pain extremely high, bleeding extremely fast (depends on wound size) Contusions Also called bruises, these are the result of a forceful trauma that injuries internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions. Sources: bullets, backblast, vehicle crashes, falling. Effects: pain light, no bleeding. Crush wounds (crushed tissue) Occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures. Sources: falling, vehicle crashes. Effects: pain light, bleeding extremely slowly. Cut wounds Slicing wounds made with a sharp instrument, leaving even edges, they may be as minimal as a paper cut or as significant as a surgical incision. Sources: vehicle crashes, grenades, explosions, artillery shells, backblast. Effects: pain light, bleeding speed depends on length and size of wound. Lacerations (tears) These are separating wounds that produce ragged edges. They are produces by tremendous force against the body, either from an internal source or from an external source like a punch. Source: vehicle crashes. Effects: pain light, bleeding slow to medium (depends on wound size). Velocity wounds They are caused by an object entering the body at a high speed, typically a bullet or small pieces of shrapnel. Sources: bullets, grenades, explosions, artillery shells. Effects: pain extremely high, bleeding medium speed (depends on wound size). Puncture wounds Deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass. Sources: shrapnel, grenades. Effects: pain light, bleeding slowly. In order to stop the bleeding, all bleeding injuries on every body part requires treatment. This is done by either applying a tourniquet to legs or arms as a temporary solution, or by using bandages to stop the bleeding as a more permanent fix. PAGE 3

4 The picture below gives an accurate scale on what bandage which is the most effective on which wound. Most combat-engagement wounds are velocity, avulsions and puncture wounds. These are best treated with elastic bandages and quick clot. 5. Cardiopulmonary resuscitation (CPR) CPR is an emergency procedure that combines chest compressions in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. Why is this important in Arma 3 and how do you treat it? ACE 3 Advanced Medical system is set up so that if a patient does not have a pulse you must start CPR immediately. As soon as the patient s pulse stops, a timer will start. When this timer runs out, the patient will die. CPR will increase the amount of time a patient has before they die. To revive someone from this state (cardia arrest) you will need one person maintaining CPR (a fellow soldier) and you (medical sergeant) will have to stabilize their wounds. Once stable apply a Personal Aid Kit (PAK) to the patient and they will become conscious. Note: If the patient has injuries which is causing him to bleed, do not conduct CPR on him/her, close the wounds and then conduct CPR. 6. Tourniquet A tourniquet can only be applied on limbs and stops bleeding from wounds. Autoinjectors will not take effect on the patient if injected into a limb which has a tourniquet. The tourniquet should be taken of as fast as possible and applied only to give a medic more time to bandage all wounds. If not taken off it will cause pain to the patient. PAGE 4

5 7. Intravenous drips (IV s) All IV s (Saline, Plasma and Blood) restore the volume of liquid in the blood stream, as a result, blood pressure is raised for all of them. In the field saline and plasma is the only IV deployed. As blood goes bad after a period in average temperature. Use the appropriate amount depending on the situation (heavy loss of blood, blood pressure too low) (250, 500 or 1000 ml low, medium and heavy blood loss respectively) Remember IV s take time to influence the patient ml should be enough to treat someone with heavy blood loss. Just wait ant monitor their blood pressure. 8. Autoinjectors In the field we have four different autoinjectors which of we deployed. Morphine Decreases the blood viscosity, suppresses pain. Epinephrine Raises the heart rate of the patient. Adenosine Lowers the heart rate Atropine Lowers the heart rate. Note: Morphine stays much longer in the system and have a more long-lasting effect compared to the other medications. 9. Surgical Kit (SK) The surgical kit is used to completely close wounds. Each Medical Sergeant is issued one surgical kit in the field, and it can be used an unlimited amount of times. The Surgical Kit can only be used by a qualified medic and can be used anywhere. To use it a patient must be stabilized and when the field surgery is completed his wound will be stitched up and not have a reopening chance. 10. Personal Aid Kit (PAK) A PAK will fully heal the patient. It removes the injury and restores vitals to a stable state and reset the medical history. Clears all medication in the system. A PAK can only be used by a doctor and is not issued in the field. A patient must be stabilized before it can be used, and it will be removed on usage. 11. Blood pressure Blood pressure consists of two numbers, the systolic blood pressure is the number on the left, the diastolic blood pressure is the number on the right. Diastolic is the pressure that is exerted on the walls of the various arteries around the body in between heart beats when the heart is relaxed. Systolic measures the amount of pressure that blood exerts on arteries and vessels while the heart is beating. PAGE 5

6 Blood pressure is affected by the amount of blood lost as well as IV s and medication. If your patients blood pressure is within 20 of the default 120/80 start to provide blood or medication e.g. 100/60 /(low) you would fix 160/100 (High) you would fix. Hig h: 160/100 and over. Normal: 120/80. Low: 100/60 and under. Nonexistent: 0/0 12. Heart rate The heart rate (pulse) is affected by the amount of blood lost and medications. If your patients heart rate 20 over or under the default (80) you must treat them. e.g. Pulse is 60 provide epinephrine. Low: 60 and below. Normal: 80. High: 100 and above. 13. Cardiac Arrest A patient will enter cardiac arrest when: The heart rate is below 20. The heart rate is above 200. The systolic blood pressure is above 260. The diastolic blood pressure is below 40 and the heart rate is above 190. The systolic blood pressure is above 145 and the heart rate is above General patient treatment procedures Identifying a patient As a Medical Sergeant you oversee a large amounts of men medical care on the field, during heavy firefights it can be hard to identify who needs your direct assistance. The following ways in which you can be alerted to patient in need: - The patient calls for assistance. - Another soldier calls that a patient requires assistance. - Your mission objective is to treat a patient. - Your personally see or hear a soldier become injured. PAGE 6

7 These can be done on or off the radio, respond in the same means you were contacted. Once you have identified the patient that requires your help do the following: - Ask for the location of the patient. - Ask what type of injury the patient has received. If your personally identified the patient, ask those questions yourself. Moving the patient When conducting medical treatment on the patient, it s important that both yourself and the patient are in a safe area. Can you move the patient safely? Can the patient move to you safely? What can you do to make it safe? If you are not able to move to the patient and he is not able to move to you try to find a solution around the problem. Smoke screens and move to cover is one of the most used and effective maneuvers used when approaching patients that are down. If you still can t find a solution contact your direct commander. Treating a patient The Following is a step by step guide on treating a patient, you will need understand every part of this treatment procedure. Follow the steps from 1 to 6 in order unless stated otherwise. Keeping the patient s vitals stable is your priority. It s important that during this procedure you check in on other wounds time to time to make sure they do not re-open. Step 1: Is the patient responsive? Yes: Ask him if he has wounds / he is in pain and act accordingly. No: Go to step 2. Step 2: Does the patient have a pulse? Yes: Go to step 3. No: If you are alone provide CPR, if you have someone else get them to do CPR while you treat the patient s wounds. Once stabilized it is important to get a PAK to PAGE 7

8 the patient as soon as possible, this is the only device that will revive the patient. Go to step 6. Step 3: Is the patient wounded? Yes: Treat the wounds apply tourniquet to wounded limb and the treat the limb. Take off the tourniquet as soon as you have stabilized that limb. No: Skip this step. Step 4: Did the patient lose a lot of blood? Yes: Use IVs to restore the volume of liquid in the bloodstream of the patient. No: Skip this step. Step 5: Is the patient in pain? Yes: and stable pulse: Give him morphine. Yes: and unstable heart rate: Stabilize the heart rate before administering morphine. No: You re done. Step 6: is the patient awake now? Yes: You re done. No: Stabilize his pulse / make sure he isn t in pain or missing blood 15. Cheat-sheet on next page. There is also a downloadable version of the cheat sheet under Field Manuals. 3 rd Battalion, 75th Ranger Regiment rd Battalion, 75th Ranger Regiment PAGE 8

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