How Would A Combat Medic Treat A Spinal Injury In The Field? How Might Dragging The Casualty Affect Treatment/recovery?

[fleming]

For a military fiction piece I am writing. The casualty is struck in the lower thoracic vertibrae by a 7.62mm bullet, and is dragged down a flight of stairs by a comrade, who is not aware of the spinal injury until later. I'd like to include at least semi-realistic details of the immediate medical aid he might expect to receive.

[Daiki]

the medics would throw him in a stokes and get him out of the line of fire; and worry about the spinal injury later. once clear of the hot zone; they would try to stop the bleeding, usually with a trauma dressing; start getting something in him to replace the blood, and then do sipnal immobilization and evacuate him to the field hospital as expediently as possible.keep in mind; the medics prefer a living paralyzed patient to a dead patient who might be paralyzed, anyway.   TheLightWorks 28 months ago

[Å¡lfur]

Nerve damage can come in many shapes. Sometimes, it's like part of you have just gotten "unplugged". No adjacent pain, just loss of sensor sensation, reflexes and voluntary control. Then you have the whole range of partial damage covering everything from mere muscle weakness and numb spots to bad pain together with whatever loss of function there is.A field medic would stick to the basics, particularly with an unconscious patient. If he had reason to suspect spinal injury, he might make a greater effort of immobilising the victim - if the situation allows it. But any detail would be left to the docs. Thing is, bullet wounds aren't easy to assess. There's no guarantee that the bullet has taken a straight path. You'd pretty much have to probe the wound tract to find out where it's gone. A field medic would probably settle for controlling the bleeding, slap a temporary dressing on and be done with it. A conscious and coherent patient telling the medic he couldn't feel his legs would prompt the medic to do the best immobilisation the situation allowed for - which can vary a lot. If being carried in a fireman's grip is the available route out of the line of fire, then that's what they'll do.Timeline - very dependent on injury. Nerves are "renewed", starting at the brain, at a rate of about one mm/day.(Unless it's a complete separation) you really don't know the extent of the loss until the nerves have had the chance to re-establish themselves. Then there's whatever function physio therapy can bring back after that.And if you're talking about everyday life, there are a lot of coping skills that have to be learned - so say about two years before new routines are fully developed. Time in hospital - a few months.   dabac 28 months ago

[Myron]

First order of emergency medicine isn't about the victim, but about the circumstances. If you're in a dangerous position, getting into cover may well be the most important thing. Aggravating an injury may be preferable to getting hit again, speciall as it's(at least) two people out there, the victim and the rescuer(s).And spinal injuries can come in several varieties, all from knocking a chip out of one of the bone, to a complete severing of the spinal cord. Even a bad spinal cord injury at that level shouldn't affect breathing, but certainly legs, stomach and basically any function below that point.Treatment, once out of immediate harm, would follow the traditional order of priority: breathing, bleeding, shock. The medic would probably get one or two IV lines started, or at least get the needles in. Blood vessels contract in shock, so he'd want to get that done while it's still fairly easy.Maybe a shot of morphine, or any other serious IV painkiller.As soon as the spinal injury is detected, a medic would try to stabilize the spine as well as circumstances allows, which in the field may not be that much.There are basically three options:-stay put and wait for a medevac and a stretcher-try to improvise a stretcher out of a scrounged door, tabletop or whatever, then start to move towards better care.-if they're in a risky position, carry the guy, preferably by holding on to his clothes, and take their chances.   dabac 28 months ago