CPT David Crawford MAJ Joanna Branstetter Insert catheter into thrombosed vessel proximal to area of thrombus. The vessel should be clamped proximal to catheter insertion. Inflate the balloon once distal to the thrombus and remove catheter and thrombus. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or … Read more
CPT David Crawford MAJ Joanna Branstetter I. Patient Preparation A. Always prep to allow access for proximal vascular control 1. upper extremity: subclavian artery 2. lower extremity: common femoral artery B. Preparation should include access to uninvolved limb in case vein graft is needed to be harvested C. Systemic heparinization (50-75 … Read more
CPT David Crawford MAJ Joanna Branstetter Cutdown for vascular access: Locate the saphenous vein along the anteromedial distal tibia. Incise skin overlying the vein and insert 18-G catheter. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical … Read more
COL Richard Pope MAJ Michelle Fontaine CPT Charles Grooters I. Soft Tissue Coverage in Austere Environment A. Normally best performed in controlled environment with availability of microscope or loupe magnification B. In rare circumstances, surgeons may need to perform soft tissue coverage procedures in austere environment when evacuation to higher echelon of care not feasible … Read more
Dr. Brandon Horne Dr. Benjamin Kam, LtCol, AF E. Demonstrate the ability to determine extremity care logistical needs for a health care operation I. Introduction A. Logistical needs for extremity care run gamut from surgical supplies for extremity trauma to inpatient musculoskeletal nursing and therapy to outpatient clinic supplies and durable medical equipment to prostheses … Read more
II. Battlefield/Austere Environment Trauma Systems (continued) Dr. Brandon Horne Dr. Benjamin Kam, LtCol, AF F. Describe the fundamentals of safe transport of patients with extremity wounds I. Stabilization II. Critical Components of Safe Transport of Extremity Wounds A. Cessation of bleeding B. Prevention of further injury 1. stabilization of fractures 2. … Read more
CPT Brendan Masini, MD A. Define compartment syndrome and describe the diagnostic limitations presented by an austere environment I. Acute Compartment Syndrome A. Occurs when pressure within myofascial compartment exceeds threshold perfusion gradient across capillary beds 1. if unchecked, leads to tissue hypoxia and cell death 2. ischemia and necrosis … Read more
CPT Daniel J. Stinner, M.D. CPT Chad A. Krueger, M.D. A. Describe the initial evaluation and management of a burn patient I. Background A. Types of burn injuries 1. thermal 2. electrical 3. chemical 4. cold 5. radiation B. Recent civilian disasters resulting in multiple burn casualties1 … Read more
CPT Daniel Stinner, M.D. B. Define early management of extremity burns I. Early Wound Management A. Introduction 1. not necessary to perform immediately, but should be done within first 24 hours 2. ensure patient receives adequate pain medicine, as wound care can be very painful B. Goal 1. … Read more
CPT David Crawford MAJ Joanna Branstetter A. Define the initial evaluation and demonstrate appropriate evaluation techniques of a patient with an extremity vascular injury I. Initial Evaluation A. Initial evaluation should always follow acute trauma lifesaving support (ATLS) B. Application of a tourniquet above the level of injury is appropriate … Read more