# Medical Equipment



## starlight_745

Thought I would start a post on something that nobody ever really discusses.  What medical equipment do you need/want to fulfill the medical mission.  I am looking for new ideas to outfit my medical section platoon.  If armymedic or any other experienced medical NCO‘s are out there let‘s get you opinion on equipment in particular at the UMS/BMS level.  If you could have anything, what would you get?


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## combat_medic

1. Something like the Kendrick Traction Device is a godsend in a jump bag (link  here). It‘s made by the same manufacturer as the KED. It‘s a small, lightweight traction splint that‘s far easier to use than the conventional traction splints, and can be carried easily in a jump bag.
2. An adjustable C-collar
3. Head lamps (a simple, LED head light makes foot parades at night far simpler)
4. Emergency solar blankets (the small, fold-up aluminium kind)
5. A small, lightweight, folding collapsible stretcher is very nice to have on exes where weight is a big consideration
6. A jumpbag that has lots of pouches, is waterproof, and has shoulder straps that don‘t tear or break at the first sign of use
7. Emergency SAS rations (the uber-powerbars - a meal worth of protein carbs and nutrition in a single bar). Great for the kids who don‘t eat and drink and thunder in.
8. Feminine hygeine products... they always seem to come in handy.
9. Waterless hand sanitizer

That‘s about the best I can think of, for now.


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## Armymedic

Medical kits, and equipment are issued as an entitlement as determined by CMED and CFMG. The items as issued are the ones you allowed to use. We really don‘t get much choice in wht high price (A+B classes) items we have such as defibilators and oxygen delivery systems. Disposible, and accountable disposable items (C + D class) equipment we have more flexibilty for personal choice, but still must follow the entitlements laid down to the UMS by CMED.
In ref to Cbt medic‘s post, the only items avail theough the medical (as opposed by the standard supply) system is the C-collar, jumpbag, and occasionally the waterless hand sterilizer.
The collapsable stretcher (and all the other items she mentioned) are used in the service but only because of local purchasing rules, and uniquely by the people who bought them.


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## Infanteer

Just a question for you medics.  I remember the CF goofball medics we had giving us first aid who where going on and on about the Asherman‘s seal.  They seemed pretty sold with it.

Went and got trained by a Brit combat medic who‘s worked on real bulletwounds and he said the Ashermans seal is junk, not suitable for the dirty and messy environment of combat medicine.  He prefers the old Field Dressing technique.

Do you guys agree?  I figured his combat experience to be pretty ****ing evidence.


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## Armymedic

The Asherman Chest seal (ACS) in theory works well, but it does not stick well to messy (read bloody)skin. It does work exteremly well over needle decompression, and moderatly well over a wound that is not actively bleeding.

So your British taught you well, its always better to know a couple of ways to deal with any given situation. And the cool kit isn‘t always the best.


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## combat_medic

Infanteer: Considering the closest I‘ve ever been to an Asherman‘s seal is a 2 minute demo once on a BTLS course, it‘s probably a good thing that I learned the other way.

Heck, through my medical supply, I have a hard time getting field dressings. If I got an asherman‘s chest seal, I‘d probably die of shock!


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## Armymedic

How about I mail one or two...


Boxes.

With our FMED closing we got all sorts of this trauma stuff that we are totally unlikely to use. Got a couple boxes of Combitubes, ACS, CO2 detectors, all sorts of ET tubes, Pentaspan volume expanders, etc. Mostly cause of the scale down of kit from camp closures (you don‘t ship back C class stuff).

I bet when you work at your Fd Amb, you‘ll get medical kit a bit easier...  

Oh, yeah, BTW, its not about the kit, it is ultimately the knowledge of how to use everything you got in whatever situation you find yourself in, that will make you a good medic. 

Right, infanteer?


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## combat_medic

If you can mail that stuff to me C/O the Seaforths, I would love it! You have my name and rank through the Mess if you‘re serious about sending it. 

And the Fd Amb are the ones being stingy and useless about giving out kit. They have a dozen O2 bottles, but the medics who are in the field aren‘t entitled to any... figure that one out for me. It‘s taken me 3 months to get alcohol swabs out of them.


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## -rb

Some of you medics might be interested in these guys, they are invloved with the US Army doing research on battlefield wound dressings, super-absorbant, fast clotting bandages etc. as well as research on chem warfare and other applications for their products.

 http://www.quickmedtech.com/technologies.shtml 

They have a few interesting downloads as well, powerpoint presentations or pdfs. 
Also seem to have a pretty qualified list of directors regarding Military Affairs.

cheers.


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## Armymedic

Heard good things about those dressings, but as of yet they are price-prohibitve for the CF.


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## starlight_745

I agree on the ACS.  I have tried using it on stab and gunshot wounds in my civilian EMS job and it is really not that useful.  I prefer something occlusive with plenty of 2" tape on the edges.  Gun/duct tape is even better.  You can never go wrong with good BLS.  I try to drive that home to the infantry types I know but all they want to do is learn how to stick IV‘s into people


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## Armymedic

IV‘s cause they are cool to do...Too bad they take lots of practice and too much time.

So what is it your actually looking for, advice on your own pers med kit you carry or your UMS/Med Coy det kit, or whatever?


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## Brad Sallows

How many O2 bottles do you figure you can carry to go along with your Flynn and your jump bag?


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## combat_medic

A single O2 bottle and flynn would be nice for a safety vehicle along with the stretchers and spine board. I wouldn‘t carry it with me, obviously, but to have so many in a Med Coy that can never go out on ex makes very little sense.


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## vr

Hi here‘s my first of what may be many 2 cent pieces:

O2 cylinders are heavy, bulky, and relatively delicate pieces of equipment.  So are the Flynns and are not designed to be used by untrained personnel.

According to the LFWA med support guidelines anytime you only have a safety vehicle on site you do not need to have a trained Med-A only a St John‘s qualified first-aider.  These personnel are not trained in the use of O2 so it is of a dubious benefit and likely hazardous to a scarce and expensive piece of kit.  Any situation where O2 would be useful an ambulance with med-As from the supporting Field Amb will be on site.

That being said in any situation involving trauma the prompt effective use of basic 1st Aid, especially the Asherman Seal/ Field dressing method is as effective as O2 in stabilizing the casualty.  Oxygen will not save someone‘s life.  keeping the pt breathing and stopping the bleeding will save their life.

As far as Field Ambs being stingy with equipment:  if you don‘t need it you don‘t get it.  The days of non-medical units having their own integral UMS‘ are,in the reg and reserve world, gone. It was found in the reserve world that neither the Med-A nor the unit was well-served by this arrangement. Any Med A in a non-medical unit is attach posted to that unit as a courtesy to the member.  As such they are not entitled to very much kit.  If any of the high-speed kit is required the supporting field amb will provide it and the personnel to use it.  

If any of you followed the discussion forum on the DND/Forces website there was rather a lively exchange on the subject of just what level of medical support was needed at the pointy end.


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## corporal-cam

> Originally posted by Usul:
> [qb] Hi here‘s my first of what may be many 2 cent pieces:
> 
> O2 cylinders are heavy, bulky, and relatively delicate pieces of equipment.  So are the Flynns and are not designed to be used by untrained personnel.
> 
> According to the LFWA med support guidelines anytime you only have a safety vehicle on site you do not need to have a trained Med-A only a St John‘s qualified first-aider.  These personnel are not trained in the use of O2 so it is of a dubious benefit and likely hazardous to a scarce and expensive piece of kit.  Any situation where O2 would be useful an ambulance with med-As from the supporting Field Amb will be on site.
> 
> That being said in any situation involving trauma the prompt effective use of basic 1st Aid, especially the Asherman Seal/ Field dressing method is as effective as O2 in stabilizing the casualty.  Oxygen will not save someone‘s life.  keeping the pt breathing and stopping the bleeding will save their life.
> 
> As far as Field Ambs being stingy with equipment:  if you don‘t need it you don‘t get it.  The days of non-medical units having their own integral UMS‘ are,in the reg and reserve world, gone. It was found in the reserve world that neither the Med-A nor the unit was well-served by this arrangement. Any Med A in a non-medical unit is attach posted to that unit as a courtesy to the member.  As such they are not entitled to very much kit.  If any of the high-speed kit is required the supporting field amb will provide it and the personnel to use it.
> 
> If any of you followed the discussion forum on the DND/Forces website there was rather a lively exchange on the subject of just what level of medical support was needed at the pointy end. [/qb]


I just thought I‘d support you‘re argument that most st. john aiders cant use 02 bottles. I am certified by st john ambulance and it‘s really really basic, infact they were handing thm out at school like cookies (probally the only reason I managed to get one) so to trust the averge st. john‘s fist aider with a 02 bottle isn‘t the best idea. (I wouldn‘t trust me)


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## combat_medic

> It was found in the reserve world that neither the Med-A nor the unit was well-served by this arrangement.


I‘m in absolute and complete disagreement with this statement. The pathetic attempts that CFMS has made at this restructure is laughable at best, and outright destructive at worst. I have nothing positive to say about the questionable decision to remove all medics from the pointy end. 

I‘ve spoken to about a half dozen UMS medics who are all in agreement with me that the restructure has been nothing but entirely negative for them. I haven‘t met one who had anything good to say about it, or who doesn‘t think it was one of the worst decisions the CF could have made.

Of course, the reserve Med Coys who now get to look special by booting their numbers think it‘s fabulous, but they‘re hardly the ones to be asking about the impact it‘s having. Why don‘t you ask the General who planned this whole thing. I‘m sure he/she also thinks it‘s a marvelous idea, but he‘s not the one facing the brunt of it. It‘s one thing to plan something out and then pat yourself on the back for the great job you‘re doing, but it‘s entirely another to go down to ground level and find out the REAL impact of your decisions.


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## starlight_745

Sorry, I‘ll just try and get this thread a little more on track with my original question here.  To answer armymedic‘s post above, how about UMS entitlement.  Is there a link to the CMED entitlement for a UMS?  I have looked but so far have come up empty.


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## Brad Sallows

If memory serves, the Mutual Support Agreement specifies that the Reg F UMSs (less the medical personnel) belong to the units.  I doubt you will find scales of issue on the public internet.

On the reserve side, over the past two decades I have watched kit go out of the med unit pharmacy, and eventually come back in due to the indifference of units toward integral medics.  It has been, frankly, a mild pain in the *** for the people managing the pharmacy (ie. medical equipment and resupply).

Entitlement is determined by what a medic is authorized to do, and that authorization is a completely separate issue from organizational reshuffling.  Check B-GL-381-001/TS-000 "Training Safety", Fig 1-5 (pg 1-91).  (There may be additional requirements imposed depending on risk assessments.)  In general, the requirement step up from first aider is all the way to a Reg QL5, or Res QL5A with _civilian qualification_.  If a non-medical reserve unit doesn‘t have at least a Reg 5 or Res 5A (civilian paramedic), I suppose its entitlement is "first aid kit".


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## Armymedic

Starlight745, do you have access to the DIN?

Usul, what is your experience? I wonder so that I can determine from where you provide your insightful comments?


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## Marauder

> Heard good things about those dressings, but as of yet they are price-prohibitve for the CF.


"Sorry Bloggs, coulda maybe saved your ***, but the check hasn‘t cleared the bank yet..."


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## starlight_745

Nope unfortunately I don‘t have easy access to the DIN right now.  I am particularly interested in the entitlements for a UMS beyond the usual pannier set.  I‘ll try my chain of command on this issue again and see if I can get any assistance.  Our medical equipment state is dismal and I‘m trying to take the initiative to improve it.


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## Armymedic

I don‘t believe there is a kit list or a "recommended" to have list anywhere in CMED. Every UMS I have been to is a little diferent, but as you know the essentials (Defibrilator, VS monitor, O2 delivery, ECG, audiogram) are usually there and brand/model is dependant on what is avail at time of delivery.


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## Arctic Acorn

Hey Kendrick: That traction device looks amazing! I volunteer as a first aider with a local SAR group, and we do a lot of backcountry work here in Yellowknife...I‘m going to look into picking up one or two of those for our jump bags. 

As for the O2 and Saint John training, I have my Advanced Medical First Responder 1 (AMFR-1) course through SJA, and I was trained on O2 (though I believe it was a separate endorsement). It does have a place, we‘ve found. We always try to have a bottle when we do first aid duties. It‘s the 2nd best thing for shock (prompt and effective first aid being the best, of course). 

Plus, it works wonders for hangovers...err, so I hear...


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## Colin Parkinson

In the Coast Guard we used a similar traction device, although you have to frequently check the traction as it changes on a rough ride, also make sure the guy is a leftie or a rightie before applying traction!!

Have you guys been issued the Combi-tube? We practiced with it and liked it, but the Medical examiner hummed and hawed on it for us. Our guys have to be compatible with the local EHS,

To avoid the cost in keeping far-flung medics on ships current, they opted for the MAST pants rather than IV's. The MAST's are not well liked by the medical profession as it restricts their options on arrival to emergency, but they where better than nothing, they were recently withdrawn and we have no replacement for now (cost-cutting)

Do you guys use AED's ? This piece of kit is really nice and gives a good record of patient care. It also helps with watching vitals, which is really hard to do in a bouncing hovercraft at night.

I have to disagree with you statements about O2. Yes the valves are delicate, although there are simple ones on the market, I just used one while treating someone on an Air Canada flight, that has a protected gauge and a simple plug in for 2 or 4 LPM's 

O2 will really make a difference to a patient, after bleeding it is the best thing a first responder can do for someone. COPD types are generally easy to spot (and not likely to be in the army!) I have seen some amazing turnarounds just by applying O2. 

The SAR techs use a O2 bottle based on chemical oxygen, similar to the Chemox masks used (or used to be used) interesting piece of kit! 

I will agree that the field dressing is truly a wonderful piece of kit and the military ones are much sought after.


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## starlight_745

Colin P.

Are you using an AED to monitor vitals, if so I‘m guessing its the pulse rate.  I would strongly caution you on this as it is not accurate and can rundown your AED battery so that when you need to defibrillate someone in Vfib/Vtach you don‘t have enough juice.  Most AEDs that have an ECG on an LED screen are not of good enough quality to do more than determine life threatening arrythmias. 
You need a paper strip to accurately look at the things like the PR interval to make a definite assessment.  If you want to monitor vitals electronically you need to get something the a Lifepak 12 that can measure Pulse Ox, ETCO2, cardiac rhythm, and bllod pressure and give you a print out.


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## Colin Parkinson

Yes we do use the AED to monitor vitals ( I am no longer in the Rescue Specialist/diver role, as I am acting in another position, I make better money but I miss it) however we normally do not have to monitor for to long. The hovercraft where I worked, normally can evacuate a patient to a higher level of care within an hour. It would be nice to have dedicated equipment to monitor patients, but due to cost and the harsh marine environment we are limited. Looking after a patient in a cramped Ridged Hulled Inflatable, pounding through a dark winter's night can be challenging to say the least! The AED has been very well received and it also allows the medical board and our Instructors to examine the effectiveness of the care we give. It often takes around 4-5 years to bring new equipment online, as we are a national program, although some of the regions have R & D initiatives which allows them to try out new stuff in the field. Thanks for the response. Here is a link to our program.

     http://www.pacific.ccg-gcc.gc.ca/sar/training/index_e.htm 

and this link has me in my â Å“other lifeâ ? now I get to do all my diving with an ROV and sipping coffee on the surface, getting fat and lazy! 

 http://www.pacific.ccg-gcc.gc.ca/photos/ccgatwork/images/ccgpeople6.jpg


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## sdimock

Colin P,

What AED units do you use?

We‘ve recently evaluated 3 brands, we went with LP12 to maintain uniformity but we (Biomed dept) preferred the zoll.

fyi

 http://www.medical.philips.com/main/products/resuscitation/products/ 

 http://www.zoll.com/EMSmseries.htm 

 http://www.medtronicphysiocontrol.com/products/index.cfm


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## combat_medic

A little mouse told me that the combi tubes would be coming into the system soon, but I‘m not holding my breath. A good friend of mine who‘s an EMT in Alberta says she loves them and that they‘re a far better system than OPA/NPS intubation. I can‘t say as I‘ve never used them.

As for an AED; I got the chance to play with one during a first aid lecture, and was endlessly impressed. It‘s god to be the most idiot-proof piece of kit in the world. If only all kit was that comprehensive! However, if I can‘t get an O2 bottle, I‘m not going to hold my breath about getting something THAT high speed. Then again, even if I had an AED, I don‘t know if I would take it into the field. I can‘t imagine too many defibrilations being needed amongst 16 year old infantrymen to make the purchase necessary. Oxygen, however, I could definitely see a lot of uses for.


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## Colin Parkinson

Sdimock

We use the Powerheart AED by Cardiac Science, model 9210RD with rescue data card.


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## starlight_745

Combitubes are in the system in the pannier sets.
Endotracheal intubation with visualization of the vocal cords is still the gold standard for definitive airway management.  A combitube is a good backup and can be used by lesser trained personnel but it is definitely not superior.  It does not secure the airway as well and endotracheal drugs cannot be administered via combitube.  It is mainly used as a rescue airway when using things like paralytics to intubate a patient.


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## Armymedic

heres two pieces of kit I have yet to use for real on a member of the military...

Combitubes, and AEDs

Thats not a good reason for us not to have them. Its good to know all the diffrent techniques,  with its indications, and counterindications.

Its always better to plan for the worst, and hope for the best.


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## Colin Parkinson

Does anyone know if the CF has Medic‘s/doctors attached to US?Brit units in Iraq? It would a good place to learn the latest in battlefield Medicine.


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## Armymedic

I know..

no. Heck, we don‘t have enough to serve us here.
But some medics (like me) do go down on exchanges and excerices with the cbt arms units, so we get some advice from those who have.


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## MedCorps

We have a RAMC Major at the school in Borden right now.  He has just come back from Iraq before getting "sent off" to Canada for a three year stint.  Lots of advice / experience if you ever get the chance to chat with him. 

Other than that... there are no CFHS pers attached to UK units in Iraq right now that I know of.


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## mudgunner49

Colin P said:
			
		

> Yes we do use the AED to monitor vitals ( I am no longer in the Rescue Specialist/diver role, as I am acting in another position, I make better money but I miss it) however we normally do not have to monitor for to long. The hovercraft where I worked, normally can evacuate a patient to a higher level of care within an hour. It would be nice to have dedicated equipment to monitor patients, but due to cost and the harsh marine environment we are limited. Looking after a patient in a cramped Ridged Hulled Inflatable, pounding through a dark winter's night can be challenging to say the least! The AED has been very well received and it also allows the medical board and our Instructors to examine the effectiveness of the care we give. It often takes around 4-5 years to bring new equipment online, as we are a national program, although some of the regions have R & D initiatives which allows them to try out new stuff in the field. Thanks for the response. Here is a link to our program.
> 
> http://www.pacific.ccg-gcc.gc.ca/sar/training/index_e.htm
> 
> and this link has me in my â Å“other lifeâ ? now I get to do all my diving with an ROV and sipping coffee on the surface, getting fat and lazy!
> 
> http://www.pacific.ccg-gcc.gc.ca/photos/ccgatwork/images/ccgpeople6.jpg



Does your medical director not have a problem with you attaching the AED to a pt who is not VSA???   The device can be fooled (especially by motion) and you may wind up shocking a pt who is not in V-Fib/V-Tach...


Blake


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## arjedrine

It has benefits to a hospital to have complete and effective medical equipments. By this they can do their best to heal a patient with the use of those equipments. They should also a smart and very brave doctors and nurses.


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## medicineman

???!!!

MM


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## Civvymedic

Ive used the Asherman chest seal on shooting's, stabbings and post chest needle. It's is not a great piece of kit in practical use. On a Mannequin...sure, but not on the street in my experience.


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## CombatDoc

arjedrine said:
			
		

> It has benefits to a hospital to have complete and effective medical equipments. By this they can do their best to heal a patient with the use of those equipments. They should also a smart and very brave doctors and nurses.


Welcome to the forum, although I'm not sure why you've resurrected a 6 year old thread that had died.   And yes, all of our doctors and nurses are very smart and very brave.


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## mariomike

Civvymedic said:
			
		

> Ive used the Asherman chest seal on shooting's, stabbings and post chest needle. It's is not a great piece of kit in practical use. On a Mannequin...sure, but not on the street in my experience.



Before ACS, all we had was three sided dressings. I've seen credit cards used.


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## PMedMoe

CombatDoc said:
			
		

> Welcome to the forum, although I'm not sure why you've resurrected a 6 year old thread that had died.   And yes, all of our doctors and nurses are very smart and very brave.



Look at the link in their signature block.  One of our wise Mods has changed it to a link to the site guidelines.  The person is a spammer.  I'll bet if you Google their user name you'll get several hits to various forums, all with this person having only one post.


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