We’ve had several requests for more medical articles.  In order to do this justice, we have to keep in mind a few fundamental truths about medical care in austere conditions.

1.  Do no harm. – Good medicine at the wrong time is bad medicine.  Obtain good training in how and when to apply medical care.  Start with a self-aid/buddy-aid program and build your skills from there.

2.  Prevent Injury – An ounce of prevention is worth a pound of cure.  In combat this may mean that we defer medical care until after the threat has been eliminated.  The old adage of “the best medicine is fire superiority” comes to mind.  Beyond bullet wounds and explosions, avoid misery and illness by dressing appropriately for conditions, avoid dehydration, and use appropriate protective equipment (eye protection, gloves, body armor, etc).  If you train with live fire, be sure to appoint a safety officer and make sure he or she is not included in the scenario.  Good people die in training from preventable errors.  Always follow the strictest safety practices when training with any kind of weapon system.

3.  Shock is the enemy.  Preventing shock is key to survival.  Get life saving care started as soon as possible, even if you have to treat yourself (self-aid).  A previously healthy body will immediately start trying to offset the changes caused by an injury.  Early on, these processes are helpful.  In cases where severe injury or significant delays in care occur, these internal processes can spiral out of control and survival becomes less likely.  Get yourself a good tourniquet and some hemorrhage control training and be ready to act immediately.  I also recommend learning CPR and knowing how to treat choking and near-drowning.

4.  If shock doesn’t kill you, infection might.  Infection begins at the time of injury.  Any disruption in the natural barriers of the body (skin, mucous membranes) allows nasty bugs already on the skin and in the environment to set up infection.  Do everything you can to avoid adding to the burden of infection.  Survival decreases rapidly when you combine deep shock and infection.

5.  Err on the side of caution.  When circumstances permit, have a trained medical provider evaluate an injury as soon as possible.  It can save trouble down the road.

6.  Know how to access the emergency system no matter where you are.  A good sheepdog always has an exit strategy.  Take a little time to figure out your medical contingency and emergency plans.  Medical emergencies place huge demands on attention and delays can cause irreversible injury or death.  Trying to figure out your emergency plan in the middle of a crisis just plain sucks. Get comfortable with the emergency resources in your area and know how to activate them.


Juliet 2