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Blood red fake fingernails
17 April

Capillary Refill Time: Theoretical but not sound

  • Posted by Mike Shertz
  • Categories (C) Circulation, MARCH
  • Comments 0 comment

BLUF: “Normal” values vary by age, gender, temperature (both environmental and casualty’s), and lighting conditions. Different providers will see different durations of refill time. With all these adjustments and limitations of how normal is defined, as well as no standard …

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Amyl Nitrite Inhalents
11 April

Is amyl nitrite a useful prehospital intervention in cyanide poisoning?

  • Posted by Mike Shertz
  • Categories More, Tactical CBRN
  • Comments 0 comment

Amyl nitrite is a highly flammable, volatile, liquid medication that is proposed as a prehospital inhalation treatment of cyanide casualties while awaiting parenteral (IV / IO) access.  BLUF: In a high-risk tactical environment with both cyanide poisoned and traumatically wounded …

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White Phosphorous exploding Over Raqqa, 2017
21 March

A Plan for Treatment of White Phosphorous Casualties

  • Posted by Mike Shertz
  • Categories More, Tactical CBRN
  • Comments 0 comment

With the Russian invasion of Ukraine, there have been discussions about the management of casualties injured by white phosphorous munitions. A social media post by @nardoctor sharing the DOD clinical practice guidelines was one of the first to address this …

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A still photo from a video demonstrating proper placment to insert an IO into a femur
15 March

Diversifying your options: Distal femur IO access

  • Posted by Mike Shertz
  • Categories (C) Circulation
  • Comments 0 comment

Typically, intra-osseous access is performed either in the proximal humerus or proximal tibia in the civilian setting and sternally in the military. A recent study of 2016 US prehospital IO placements in adult out-of-hospital cardiac arrests included 888 IOs in …

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An evisceration on a 14-year-old who impaled himself on his bicycle handlebars
06 March

Distracting but not life-threatening: Managing abdominal eviscerations

  • Posted by Mike Shertz
  • Categories More
  • Comments 0 comment

Photo from a 14-year-old boy who sustained a penetrating injury to his abdominal wall after impacting the handlebars of his bike. Note the bowel perforation at approximately 7 o’clock on the bowel. This should not be reduced, as it will …

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image
31 January

Best Parenteral Access in a CBRN Environment?

  • Posted by Mike Shertz
  • Categories Tactical CBRN
  • Comments 0 comment

When providing medical treatment to CBRN casualties, to save lives, initial treatment will need to be conducted before formal decontamination can be completed. These procedures, performed in a “dirty casualty collection point,” will require the medical provider themselves to still …

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