Trauma Scenario #2 with Dirty Pic ;)

[apssbc]

Excellent answer. I think the surgery is doable if you have the skills or reference material to attempt it. However this brings up another major question post SHTF?

Do you know what you, your family, or group members want if severely injured?
Also do you keep the body to learn to do surgery?

Me personally would want the surgery if someone was capable. I would want to perform the surgery on someone if given the chance. I've seen abd surgeries they can be trickey but I watched surgeons pack the intestines back in like they were stuffing a piniata.

[izzyscout21]

Great observations, Gunfixr

[Gunfixr]

Thanks guys. Really, I look at it kind of like anything else. Fix the leaks, repair the broken things, etc. Yes, the techniques are different, and the cleanliness thing is important, but a lot of it seems more straightforward than I think most non-medical people realize.

Me and my wife have already discussed this sort of thing, although not really as a post-shtf plan. We are both settled on quality of life over quantity of life. We need to evaluate it in a post-shtf setting as well.
Keep the body for practice? That's going to depend. I don't think I could keep one of my kids or my wife's body to practice on.
I'd hate to even leave them on the field, but understand me getting killed to bury a body isn't a proper trade. After all, who we are has "left the building" so to speak, nothing but physical remains are left.

[infamous1]

so would you open the abdomen up more for exploratory on the possible fragments??

[Gunfixr]

Personally, with my lack of real medical knowledge, I wouldn't be opening up an abdomen just to go exploring for possibles. Since I'd be about as likely to create almost as much damage as I could fix, I'd need a pretty solid reason to go inside.

Others with more expertise in this area may do otherwise.

[Twitchy]

Excellent answer. I think the surgery is doable if you have the skills or reference material to attempt it. However this brings up another major question post SHTF?

Do you know what you, your family, or group members want if severely injured?
Also do you keep the body to learn to do surgery?

Me personally would want the surgery if someone was capable. I would want to perform the surgery on someone if given the chance. I've seen abd surgeries they can be trickey but I watched surgeons pack the intestines back in like they were stuffing a piniata.

Good point on the cadaver exploration concept... Not so sure on doing it with humans, but deceased animals could be used to get basic anatomy down... The big question during any surgery is, while it may be easy to do the cutting, what do you do once you see the full extent of damage?

[ditchmedic]

I had an opportunity to go to a cadaver lab earlier this year. I passed cause it was pretty expensive. Im planning to do it next time.

Once a year my employer has pig cadavers brought in as well but ive always had to work that day

[Gunfixr]

Bummer.

Speaking of pig cadavers, apparently they are used for several things, as in many ways they replicate working with human flesh. I was getting stitches on a work injury once, watching and asking about stitching. The doc showed me the basic stitch, and then said it would be good to buy pigs feet at the store to practice on, as it was very close to stitching human flesh. He said that was how many docs practice during med school.

[Fidel MD]

Excellent thread!

Hi, Everybody! I'm new here, and so far loving it. Great topic, and great questions/answers.

As far as long term outcomes, keep in mind that as recently as the late 1800's a belly wound like that was a slow, painful death. A few things happened that changed that, and allowed medical science to figure out how to fix wounds like that.

Those things were the discovery of anesthesia, the understanding of the germ theory of disease, and the discovery of antibiotics.

Field treatment would be cover the protruding viscera with a damp dressing, cover that with an occlusive dressing, don't try and replace anything (it'll just have to come out later, anyway), nothing by mouth except perhaps a combat pill pack with antibiotics, maintain hydration with an IV if possible, and get to higher levels of medical care.

What higher levels would do is anesthetize the patient, administer pretty large doses of IV antibiotics and a tetanus booster, open the belly up (xiphoid to pubis), pick out all the foreign matter, tie off bleeders, check the bowel and other organs for leaks and make certain blood flow isn't compromised, flush the abdominal cavity out with sterile saline, and close up the many layers of stuff that make up the anterior abdominal wall, using different suture materials, needles, stitches and techniques for the different layers. Then bandage and wait, checking for bowel sounds and signs of infection.

- - - Updated - - -

I had an opportunity to go to a cadaver lab earlier this year. I passed cause it was pretty expensive. Im planning to do it next time.

Once a year my employer has pig cadavers brought in as well but ive always had to work that day

Pigs feet, with the skin on, work. So do bananas, and if you're really good, oranges. But sewing is easy, knowing when to suture and more importantly NOT to suture is key. Closing up a dirty, or bleeding wound is a really, really bad idea. I won't do primary closure on wounds (clean or dirty) that are more than 8 hours old: The risk of infection is too high. The patient can wait a couple of days and then have the wound closed.

[bacpacker]

Good info. Wel ome to the forum MD, glad to have you on board.