Imagine you find yourself trapped into a fight or flight situation: you have a patient lying in front of you on a stretcher and he is bleeding, heavily. You have tried everything textbooks and classrooms have taught you. You are a professional and you have done it right and yet, the red stuff is hitting the floor.
This is when the most important skill for survival, both yours and the patient's, comes into play: adaptability, the quality of being able to adjust to new conditions.
This is a patient myself and my team managed in a real-world situation, without a medical facility in the 2+ hours radius and without the chance to fly him out. The only transport available was the back of an empty ambulance, without anybody to keep the vital pressure on his neck shrapnel wound. It was then that our own adaptability came into play and made us tackle the unconventional solution you see in the picture: a Foley catheter. Foleys are normally used to allow urine to flow outside the bladder, however, we inserted one into the wound cavity to tamponade the bleeder. The bleeding was successfully controlled and the patient survived after a rough, bumpy journey through some long desert roads.
When the situation gets real you don't elevate yourself to it, but you fall to your level of training. Adaptability, like any other skill, needs to be specifically addressed in training and within your scope of practice. This is especially true if you are a pre-hospital provider, an EMT, a remote medic or simply a bystander in a disastrous accident. For your survival and your patients'. If you are interested in knowing more about this case and many other more do not forget to register for the Special Operations Medicine Scientific Assembly, where you will hear me as a speaker for multiple lectures.
Full credit to Ty, Josh, Pete, Rico and the rest of the team. Another case solved for M**** Medics!
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