ABSTRACT
Current operational theaters have developed to where medical evacuation and surgical assets are accessible in times comparable to the United States. While this has been an essential tool in achieving the best survivability on a battlefield in our history, the by-product of this experience is a recognized shortcoming in current protocols and capabilities of Special Forces medics for prolonged care. The purpose of this article is to provide a theory of care, identify training and support requirements, and to capitalize on current successful resuscitation theories in developing a more efficient and realistic capability under the worst conditions.
Subject(s)
Cardiopulmonary Resuscitation/methods , Military Medicine/organization & administration , Military Personnel , Warfare , Wounds and Injuries , Acidosis, Respiratory/prevention & control , Blood Coagulation Disorders , Hemostasis , Humans , Hypothermia/prevention & control , Time Factors , United StatesABSTRACT
Retrobulbar hemorrhage is an uncommon, but potentially devastating complication associated with facial trauma. It can rapidly fill the orbit and cause an "orbital compartment syndrome" that subsequently cuts off perfusion to vital ocular structures, leading to permanent visual loss. Treatment must be initiated within a limited time in order to prevent these effects; however, specialty consultation is not always available in remote field environments. This article addresses the mechanism, diagnosis, and treatment ofretrobulbar hemorrhage via lateral canthotomy and cantholysis, and recommends that 18D medical sergeants be properly trained to evaluate and perform this sight-saving procedure in emergent settings where upper echelons of care are not immediately available.
Subject(s)
Blindness/surgery , Decompression, Surgical/methods , Eye Injuries/surgery , Eyelids/surgery , Retrobulbar Hemorrhage/surgery , Blindness/etiology , Emergencies , Humans , Ophthalmologic Surgical Procedures , Retrobulbar Hemorrhage/complications , Wounds, Nonpenetrating/surgeryABSTRACT
Present and future Special Forces missions will require prolonged care of the trauma patient. The Special Forces Medic and Independent Duty Corpsman must be prepared to deal with these situations in the most challenging and austere environments. The implementation of damage control resuscitation for prolonged trauma care can maximize results with minimal support while preventing death, priming the patient for surgical success, and expediting recovery. Establishing this model of care and equipping medics with the essential equipment will have a lasting effect on the survival rate of our casualties, and negate the enemy's political victories when American and allied lives are lost.
