Day 4: Sunday---ATLS Testing

Today was testing day at Doctor Trauma School (aka, ATLS). We started the day doing mock trauma scenes, then did the same thing for testing. I somehow passed, even though I think that before the Army makes me go anywhere I might have to do any of this stuff, they better have me retrain on it. Then we talking about triage situations, which is definitely something that I will have to do. The job of triage officer when deployed goes to the medical (or dental, as it is in some cases) officer with the least clinical experience, because you want all the clinical people to be inside the hospital treating the people who are being triaged.

The basic tenets of triage are to treat the maximum number people with the resources available. There are four categories of triage: red, yellow, green, and blue. Red are your first priorities, the ones who need treatment as soon as possible. Yellow patients come next—they'll be fine for 24 hours or so, but should be treated sooner rather than later. Green patients are the “walking wounded”, the ones who maybe need a cut sutured or aspirin for their headache or something like that. They definitely don't need care in the next 24 hours if there are other people who around who need care. Blue are the expectant group, the ones who are going to die no matter what you do, so there's no point in wasting resources on them. It sounds cold, but you have to treat as many people as possible, and if you spend time working on the people who are going to die, that means that there are red patients, those who need care and will probably live if they get it, who will probably die. Obviously, if there are blue patients who are still alive after the critical patients are taken care of, you would go back to them, but that generally doesn't happen.

Anyway, after that was the paper test for ATLS, for which most of the questions could be answered by choosing the answer that said something about intubation. You always take care of the airway first (ABCDE—airway, breathing, circulation, disability, environment), and intubating someone and establishing a definitive airway is usually the first thing you have to do.

MRE lunch at Ft. Sam

We were supposed to have a burn lecture in the afternoon, but that was canceled, so they bussed us back to Camp Bullis and gave us lectures on providing medical care in a combat situation (as in, bullets are flying over our heads) and how to do medical evacuations. It was interesting stuff, but it boils down to, doctors are not expendable and should not be in situations where there are bullets flying, and medical evacuations are organized by medical service corps officers. Then we had a couple of hours of freetime, during which I went on the four mile loop, and then sat around and laughed with (at?) some of the guys in my squad. They are absolutely hilarious, and could just feed off each other for hours at end. And then it was back into uniform to go to the DFAC for dinner, and then time to pack our rucksacks for the field tomorrow. We have one nurse in our squad who was ROTC in college and knew how to pack a ruck, so she helped us with ours. We also broke down our MREs (which mostly involves trading side dishes and throwing out the ones we won't eat, like the cheese spread and the strawberry dairyshakes) to make them lighter so we have less to carry in our rucks. And then we tried on all our gear to make sure everything fits—from inside out, it's person, uniform, flak vest, ammo belt, camelback, and rucksack, with a kevlar helmet on top. I felt like a turtle with everything on.

Me and 2LT Kuyt in gear

It's going to be an interesting day in the field tomorrow.