Comments on: Save Lives Like a Combat Medic: How to Splint a Lower-Leg Fracture

By: MaddMedic

MaddMedic — Tue, 26 Feb 2013 22:14:59 +0000

As a 20 plus year EMS provider, 17 years as a medic and one whom has been teaching LEOs, FFers etc for the last 4. I think I will point a few contacts at the State Patrol Training Center to this article.
Tourniquet if bright red blood spurting…
I know all to well how that works, as I had a mishap with a machete in the BWCA a couple of years ago…Applying said tourniquet with my 18 yo son’s help saved my bacon..
Again nice write up.

By: Birch

Birch — Sun, 16 Dec 2012 14:49:18 +0000

Even If you don’t have reception, call 911 and text someone who can call for you. It may get through enough to get help on its way.

By: Cometary

Cometary — Fri, 07 Dec 2012 15:29:40 +0000

Good information. Here’s something that the Special Forces Medics train with and is available to everyone now.

http://www.dustoffmedical.com

By: Jarhead Survivor

Jarhead Survivor — Fri, 07 Dec 2012 13:20:48 +0000

Man, this brings back memories. I broke my ankle on the Appalachian Trail about ten years ago in the 100 mile wilderness up in Maine. I wrote about it here if anybody’s interested: http://www.shtfblog.com/broken-leg-in-the-100-mile-jarhead-survivors-story/

I really need to follow through and get my EMT training.

By: EMT man

EMT man — Tue, 04 Dec 2012 16:29:53 +0000

As an EMT I agree with most of this. The only part I have HUGE contention with is when to call 911. If the person is conscious, call 911 as soon as you know what the problem is! If the person is unconscious, take 10 seconds to determine if the person has a pulse and is breathing then call 911. The only time you should delay 911 is if you happen upon someone down (unwitnessed) and you do not have access to a phone or the probability of a phone will be more likely in the future I.e a person walking by etc…

I cannot stress enough how important it is to get that going ASAP. It takes a BARE MINIMUM of 3 minutes for an ambulance dispatch in a normal city environment but town or rural environments can take up to 15 minutes depending on size and
Your location!!! DO NOT WAIT. Even if you put them on speaker or call and get the words “ambulance NOW” out before you run away its worth it!

Be safe y’all.

By: Mr. Medic

Mr. Medic — Mon, 03 Dec 2012 14:15:09 +0000

I’m currently a combat medic and former EMT. The advice here is extremely useful and also very accurate (it is *how* we do
things…this is dead-on how it’s still taught). One of the things, though, is we aren’t taught MARCH anymore in Whiskey school (the MOS qualifier is 68W, or 68-Whiskey, so we call it “Whiskey school” sometimes)

We are instead taught, H-A-B-C’s which is essentially the same thing; Hemorrhaging, Airway, Breathing, and Circulation.

MARCH is still a useful way of doing things and *will* still work (and is actually more thorough since it’s inclusive of
immediately checking for head injuries)

Basically the practice of medicine; do what best works for you, the patient, and the situation based on your scope of
knowledge and what is a generally accepted method of doing things.

If you want to be highspeed, after you’re finished splinting the leg, you can be useful and gather a further patient
history for the EMT’s. Remember the acronym, SAMPLE (Patient history) and OPQRSTU (pain assessment):

S- Signs and symptoms
Basically what you see and what they are expressing
A- Allergies
For both medications and food
M-Medications they are taking
P- Past pertinent medical history
Have they broken this leg before? Any heart/breathing/diabetes problems?
L- Last oral intake
When and what did they last eat
E- Events leading up
What they were doing when this happened? Did they fall? Were they kicked? Hit by a car? etc…

OPQRSTU
O-Onset
How long ago did this happen/was it a sudden pain?
P-Provocation
What makes this feel worse? If you bend it, walk on it, etc
Q-Quality
What kind of pain is it? Sharp, dull, stabbing, achy, etc
R-Radiation
Does the pain go anywhere else?
S- Severity
On a scale form 0 to 10, 0 being no pain and 10 being the worst imaginable, how much pain are you in?
T-Time
How long has the pain been going on for
U- You
What have *you* (the patient) done to make this pain go away? Any medications, etc?

As stated in the article, just remember if you were not fully trained on specific treatments, DO NOT DO THEM. NEVER do something you saw on TV. Ever. You can end up making the situation worse and you can face legal repercussions.

By: Matt

Matt — Sun, 02 Dec 2012 21:43:26 +0000

I had a lower tib upper fib fracture in a fight in the summer, it’s been 7 months, I’m just now starting to be able to move my toes. Do Not Move the Broken Parts. It is easily life threatening, you will do a lot of permanent damage. If you can’t get cell service, either go get it, or prepare for someone to lose a limb. At 20 I almost lost my leg to a break. I’ve got a few friends with the same injury, and all the doctors said it would be at least a year before I was back to normal. I’ve got 4 screws (2 heads of the screws stick out of my bone and get bumped on everything) and a 16-20 inch metal rod hammered into my leg. By the way, they literally hammer it into your leg, and when you wake up from surgery you can tell that’s exactly what happened. They had to give me the maximum doses of 3 painkillers every 2 3 and 4 hours, to even get me to sleep because I was in the hospital, for 11 days. I also had to have 2 skin grafts because they waited too long to set the bone and the xray technician improperly handled my leg and injured it further. The only reason I didn’t lose my leg was because I was in so much pain I couldn’t pass out. My lower leg looked like it had 3 knee sized joints.

Moral of the horror story, Don’t their injury unless you’re both prepared to live with someone losing their limb.

By: Blake

Blake — Sun, 02 Dec 2012 07:23:07 +0000

As others have said a tourniquet is a last resort, it should only be used if a major artery is severed.
The trick with the nail bed is one I will remember, I can feel my own pulse in my fingers (high blood pressure) so it’ll be something for me to remember.

By: a

Fri, 30 Nov 2012 22:44:13 +0000

As a civilian medic with about a decade of street experience im just gonna say this-

Forget the tourniquet.

Unless they’re spurting bright red arterial blood, then by all means knock yourself out.

Otherwise do exactly what the man says.

By: Bone Doctor

Bone Doctor — Fri, 30 Nov 2012 22:32:12 +0000

Very good read but I agree with Marc, as an actual orthopaedic surgeon I am a little mifted at what the Army teaches their medics. In advance trauma life support airway is always the top concern. It can take hours to bleed out (unless pulsatile from neck, thigh, or elbow level) and it takes 3 mins to become brain dead. Tourniquets should only be used if you think the limb injury is a life or amputation situation, we get plenty of “medic placed” tourniquets that end up cosingt a guy his leg. The moral of the comment is Airway first unless they are exsanguinating before your eyes and only tourniquet if you think they will die. Pressure on a wound works fine unless your are dealing with a major carnage type injury (explosions, near amputations, massive crush) open fractures have very little risk of “bleeding out”.