Digital Supplement, Special Topics

September 2008 Supplement, War on Trauma

This supplement presents proven concepts, techniques and products from military trauma care that have immediate application to civilian EMS. This supplement is sponsored by North American Rescue, Inc.

Forward Thinking REQUIRED

You check your rig and prepare for another shift full of chest pain and dyspnea calls. But what you don’t know is that terrorists have walked unabated into a middle school near your station, forced 1,800 students and teachers into the auditorium and killed several hostages who resisted their takeover.Minutes later, you get dispatched to assist police at the scene. On arrival, you see five dead children being thrown out school windows and at least 48 others with gunshot wounds laying on or running across the school property.

Terror in America’s Schools

Americais a nation at war. That’s a reality, not political rhetoric. And some of the battles in that war are going to be fought on American soil—in our communities, among our homes and loved ones. Our enemy has promised us that some of those battles will be fought in our schools as our children are captured, tortured and even killed.

The Origins of EMS in Military Medicine

“It is appropriate that experience during unavoidable ‘epidemics of trauma’ be exploited in improving our national capability to provide better surgical and medical care for our citizens.”
Spurgeon Neel,
Colonel, Medical Corps, U.S. Army1

From the Battlefield to Our Streets

In 1996, a revolutionary concept occurred in military medicine. Until then, battlefield prehospital trauma care followed the same guidelines developed for the urban U.S. civilian environment. But following the October 3, 1993, Battle of Mogadishu1, the U.S. Special Operations Command sponsored a study to review how casualty care was conducted. The panel’s consensus: Conventional civilian medicine was not appropriate for optimizing casualty care within the tactical environment.

Tourniquet First!

Few issues in the long and colorful history of medicine have generated as much controversy and confusion as the use of tourniquets to arrest severe extremity hemorrhage. As with many strongly held, traditional beliefs, the tradition is strong, but the evidence weak.

The Stress Paradox

A trauma surgeon was recently involved in a case where stress affected his ability to perform a tracheotomy. The case involved a tactical team officer, who was brought to the ED with a gunshot wound that required an emergency tracheotomy. The surgeon knew the officer well, knew the members of his tactical team and had actually trained with the team on many occasions as their emergency team doctor. Therefore, a special bond existed between them.

FDNY EMT Involved in Controversial Case Killed in Off-Duty Shooting

NEW YORK – An EMT worker who was involved in a controversial incident in which a pregnant woman died last year was shot and killed Sunday, New York police said.

Authorities said they had no immediate link between the EMT’s shooting and the widely publicized case last year but that would be an aspect of their investigation.

“That part of the case will be investigated by NYPD. We will be in touch with Manhattan detectives who will be investigating the murder (of the EMT),” Brooklyn District Attorney spokesman Jerry Schmetterer.