#austermedicine

[redleader-standingby-blog]

I had no training with the FAST1. It was a new device. The med shed had given me two of them, told me they were IO (intraosseous) kits, and I had tossed them in my trauma bag, where they had stayed for the last 8 months until now. I removed the contents of the package and laid them on my patient’s anesthetized chest. I handed the package to one of the corpsman. “Here. Read these instructions to me.” I prepped the site and held the group of needles over the chest as instructed. “…apply firm even pressure”, THUNK!, “…holy shit!” The IO needle launched like a spear gun into the man’s sternum. I connected my IV line to his chest then piggy backed a couple of 500ml bags: one with ketamine to keep him under, and the other with a gram or so of Ancef because this was surgery at its dirtiest. Next, my surgical team (shown), consisting of myself (18D), an 18C SF engineer, an SF warrant officer, a 68W combat medic (in the poncho), and two Navy corpsman prepped the leg for removal. We were on the clock. With a marker, I drew a horizontal v-shaped cut line on my side of the leg. I was attempting to execute a shark bite technique where I cut the bone farther up than the tissue in order to have muscle and skin to cover the stump. I handed the marker to my assistant surgeon, my 18C, and he made his mark. “Scalpel”, I instructed a corpsman. I touched the blade to the skin. “WhoaAAAAAA!” The old man moaned. Everyone froze. He didn’t move or retract but he did yell at the top of his lungs. I had learned that nightmares, specifically sex nightmares, were a side effect of ketamine. I didn’t know if he was in pain or dreaming. I looked at my warrant, who I had trained to be my mud hut anesthesiologist. “Hand me that syringe of lidocaine.” I finished my cut and handed the knife to the 18C. He started his cut. “NO! STOP!” It was too late. #specialforcesmedics #18D #narescue #readyman #oef #austermedicine #19sfg (at Naray, Konar, Afghanistan)