Combat Livesaver - Now What?

[gvi]

Hi, all! First time poster, long-time lurker. Some of you may know me from Frugal's. Nurse Ratchet talked me into registering here.

First of all, thanks for all the information I've been able to glean thusfar. This is a valuable resource, and RR is to be commended for providing it.

I'm most interested in the skill that I need to acquire. For the record, the acme of my medical training was the Army's Combat Lifesaver Course. I can perform basic fluid therapy, basic first aid and then some (focus on trauma rather than illness, w/exception of heat and cold injuries), taking vitals, they also taught us how to use an OP airway (j-tube) and various other things.

Regarding self-study, the greatest degree of skill I've been able to acquire is performing primary and secondary examinations (no prostates, though-don't want to go there!:eek: ), and I could ligate a bleeder if I had to.

So what should I focus my time on? I haven't the time and/or money to take an EMT course, but I'd like to be able to build on my skill set, within reason and safety.

Thanks in advance,

gvi

[Reasonable Rascal]

gvi, first off, what are you aiming at addressing? I could offer a number of suggestions but first we need to establish your goals insofar as a medical care provider.

Do you wish to be able to address basic infectious disease, fracture management, wound closure/care, or what? Since we are talking about self-study we need to be specific as I know of no overall self-study courses addressing everything (speaking broadly).

RR

[gvi]

See, that's the trouble. I don't really know where to begin. There are so many areas that I know I need to look at, but I can only realistically study one at a time.

Every task you mentioned is important; no doubt about it. To it I'd also add things like occupational therapy (if TSHTF it would be wise to help rebuild someone I'd patched up), basic lab work (blood typing ala "Lucifer's Hammer" if that even works, basic urinalysis), basic nursing (care of the sick/injured), enough pediatrics to be able to administer basic care to my 4-year old (I don't know much, but I do know that they're not "little adults," and I don't want to hurt her through ignorance).

I would say that wound closure/care, while important, is somewhat low on my list. Reason being that it's the thing that worries me most about doing right. Wounds closed incorrectly or inappropriately make things worse, not better. I'd prefer to have a better grounding in anatomy and physiology before I tackle that hurdle. It will happen, but first things first.

One of my problems is that I'm too ignorant of the vast sphere of medicine, especially as regards priorities, to know where to start. I know where I'd like to end up; If the SHTF, and my daughter or one of my neighbors/friends/team members gets injured or falls ill, I want to be able to help him or her, while not harming either. I know my limitations. If I'd wanted to be a doctor, I'd have gone to med school. I don't want to be a doctor, but I do want to know more than I know now; and while I'm willing to study anything someone tells me is important, my funds and time are limited.

I suppose, ultimately, I ought to re-phrase my question. Based on your greater command of the topic than mine, and also based on your assessment of my skills (such as I've been able to describe them), what should I focus on next? Besides keeping current on my already acquired skills?

Basically, if you were me, what would you do? I didn't expect that there would be some all-inclusive self-study course or collection of study materials. But in what order of topics, taken one at a time, would you proceed if you were me?

Perhaps I ought to study anatomy first. I figure you need to know that if you want to go beyond basic first aid.

Thanks,

gvi

[RESQDOC]

Read this: http://medtech.syrene.net/forum2/showthread.php?s=&threadid=225&highlight=Getting+and+started

Then read all the posts here.

Have inter-library loan get you copies of “Anatomy Made Ridiculously Simple” “Physiology Made Ridiculously Simple” and “Pharmacology Made Ridiculously Simple” Read them about a million times each.

Focus on ABCDE interventions, learn all you can about advanced airway management, bleeding control, shock management, and injuries to the respiratory, cardiovascular, and neurologic system. The Paramedic textbooks by either McSwain or Bledsoe are excellent. Read ‘em about a million times.

Next, learn all you can about orthopedics – these are very common injuries. Try “Pocketbook of Orthopedics & Fractures” excellent guide.

Learn about specific diseases or problems you and your family already have to deal with. In particular, deal with any medication supply issues you have.

Get hands on practice. If you don’t have time for EMT how about a 60 hour First Responder?

[jagdkampf]

If you can find a way to volunteer your time with a first responder team or get into an Emergency Dept., nothing beats hands on experience as well. Maybe get into an EMT class, they rotate people through the ED's all the time.
Jag

[themadmedic]

Originally posted by Reasonable Rascal

Do you wish to be able to address basic infectious disease, fracture management, wound closure/care, or what? Since we are talking about self-study we need to be specific as I know of no overall self-study courses addressing everything (speaking broadly).

RR

:kool: Unless you are still in the military....



Actually...you already answered the question on where to start....anatomy! Once you get a handle on A&P and know how things SHOULD work...you can better identify and address things that aren't working as they should...

[Flygirl]

gvi,
First, kudos for your drive to learn and realization of your limitations. Both are very admirable, and you have received a lot of good advice from the others here, so I'll limit mine to one comment you made in a post. With regards to wound care/closure, for the most part you really don't need any extensive knowledge of anatomy/physiology. I've taught a few Central American bush guides how, and more importantly when to close wounds, and they've taught me methods they have used in the past that can be very effective. The concepts are all pretty basic, its really a matter of tools and developing your skills. It also depends on your situation, and access to services. If you are in a pinch in an area with out rapid access to services, a few basic principles and the ability to improvise go a long way.
If you truly want to learn about this, a great book is Wounds and Lacerations: Emergency Care and Closure by Alexander T. Trott. Covers all the topics you need including assessment, anatomy, cleaning, materials, etc, with good illustrations.
Good luck!

[themadmedic]

A good point is made above...it is often the when, not the how of wound closure that causes problems...

Sometimes "doing nothing" and letting the wound heal by secondary intent is the best thing---and the hardest thing to do...:kool:

[gvi]

Resqdoc,

I've got inter-library sending me "Anatomy..." and "Physiology..." as you recommended. On a whim I had them look for "Neurosurgery in 3 Easy Lessons" and "Proctology for Fun and Profit," but no luck.

Thanks again for all the recommendations. I've copied this thread and I'll be using it as my beginner's bibliography.

I'd like to take a course, and probably will in the future. First things first.

gvi

[tangent]

gvi - a friendly note on research... ILL librarians are your friends. They just saved you a bit over $40 on the two books you ordered. It's best to stay on their good side and do as mutch of your own footwork in locating a book as possible. ISBN's, authors names, publisher, etc. all help. The ones in universities are quick and through. The ones in public libraries can take months to get a book in and often can't find even common books.

There are two things that piss ILL librarians off to no end, they are:

1) ILL'ing a book that is in the local library system and not being told this and given a call number, or worse! a book on the shelves at the requesting library.

2) Requests for books that do not exist.

that said, my sugestions for you would be as a first step to get a good, short guide to medical vocabulary and learn it. You want one that breaks the words into prefixes, suffixes and roots. Ya gotta speak the lingo if you want to communicate with the natives.

second, get a cheap, thin, paperback medical dictionary - bantum makes a good one. You want one that's small enough to carry arround and throw in a daypack. Get in the habit of reaching for it whenever you come across a word you don't recognize.

third, find a medical library that you can access and get a card. Learn your way arround it and how to track medical citations in journals. don't forget to check out the databases available at specialty and regular university libraries. one especially usefull tool is Science Citation Index - you can find out every (OK, most) journal artical that referenced an artical you found usefull. Some of these will be usefull and you can search for every artical that references those. Then start searching by authors name, etc. It's possible to pull together a bibliography in a day or two. Actually get the papers - some will be great, others will be garbage.

good luck!,

-t