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  #1  
Old 14 December 2017, 16:18
bobmueller bobmueller is offline
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Writer Research: Oxygen in the field

A writer on an email loop I moderate posted this question:

"In my scenario, the medic arrives at the location in a helicopter having been told there are wounded. From my research, I've learned that the Army uses a modified Black Hawk for medevac purposes. It houses an integrated oxygen-generating system for onboard patient care. Would that oxygen be delivered via a mask or a cannula?

What about when the medic has gotten off the helicopter and is treating the wounded? There's no shooting going on at that point. Would he carry an oxygen cylinder? How would it be delivered to the wounded?"

She's specifically asking about "Ranger medics" here. That would more correctly be "Ranger-qualified medic," right?

I'm assuming mask vs cannula is situation-dependent, although I'd guess a mask is more likely. If a wounded person needs O2, they need all they can get, and a cannula won't get them that much, will it? Had no clue about the O2 system in medevacs though. Can anyone help here?
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Old 14 December 2017, 19:14
Devildoc Devildoc is offline
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Typically O2 will be delivered via FM. I say "typically" because research is always showing us something new; we use to give every swinging dick with angina oxygen, but there's no improvement in outcomes. Right now, if a trauma needs oxygen, they need a lot.

The medic can carry a small cylinder, a "D" or an "E" tank.

I will leave the Rangers/Army folks to talk about their titles.....
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Old 14 December 2017, 19:23
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litepath litepath is offline
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The Writer is doing research. Might be a good idea to spell out your acronyms.
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Old 14 December 2017, 20:26
Dogwelder Dogwelder is offline
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O2 use in MEDEVAC

The HH-60 has onboard oxygen and suction capabilities. The OBOGS can in theory generate about 7 liters per minute.......when it is working. It often craps the bed and it was explained to me the more particulates in the air, the more it struggles. As such.....our load out meant we always had 2-3 D cylinders of oxygen on the aircraft. If we are anticipating an extremely long transport......we may bring more.

As far as bringing oxygen cylinders out of the aircraft, the only time I was taught we were to do that was if we were picking up a patient at one treatment facility to transport to a different treatment facility. Any Point of Injury we are going to do the minimum to stabilize the patient and get them on the aircraft as quickly as possible. For most trauma what the patient needs is a surgeon, so we try to limit our time on the ground to about a max of 5 minutes. It doesn’t always work that way....but it is the goal. The sooner we get those folks to a higher echelon of care.....the better.

This is just from my limited experience. Hope this helps a bit.
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Old 15 December 2017, 00:35
bobmueller bobmueller is offline
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Good info about the onboard system - thanks. Silly question: are military O2 cylinders painted a subdued color at all, or the normal stainless and green?

She mentioned later that this was "a combat situation after the bullets have quit flying. An ex-soldier, current CIA Paramilitary Operations Officer involved has been shot."

Not sure why the Ranger medic is involved, unless it's her main character in a series or something.
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Old 15 December 2017, 01:30
Dogwelder Dogwelder is offline
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Quote:
Originally Posted by bobmueller View Post
Silly question: are military O2 cylinders painted a subdued color at all, or the normal stainless and green?
Stainless and green, all green, or white and green is what I have seen. I believe it is one of the things the military is on point with the civilian side, due to hazmat and such. God.....can you imagine if they changed the patterns on the tanks every time the Army changed uniforms?

Here is what I was able to dig up online. The thing for us is that we often trade out cylinders with receiving facilities..which are not always military in nature....hence a mix of “greens” if you will.

http://www.usamma.army.mil/assets/docs/Oxygen%20Cylinder%20Markings.pdf
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Old 15 December 2017, 11:11
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160th guys would be your best resource to answer her question for the specific scenario given.

In my experience, nobody on the ground is carrying-around an O2 cylinder. Except for maybe PJs, because they like to carry things.
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Old 15 December 2017, 11:26
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Forgot to mention:

Higher flow-rates via nasal cannula are more mainstream these days. Especially in cardiac arrest patients, but also plenty of utility in trauma.

In any scenario, we are not flooding patients with O2 anymore. Of key importance is just ensuring adequate oxygenation and ventilation - not OVER doing it.

I like the nasal cannula a lot in trauma because: (1) it allows for continued visualization/observation of the patient's airway, and if the patient is conscious, allows for better communication; and (2) plenty of people will feel claustrophobic/suffocated with a mask on their face, especially if anxiety from injury is high and/or they feel like they are struggling for air.
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Old 15 December 2017, 12:40
TerribleDan TerribleDan is offline
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It is highly unlikely that the medic would be carrying an O2 cylinder in that scenario.
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Old 15 December 2017, 12:51
johca johca is offline
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Quote:
Originally Posted by O_Pos View Post
In my experience, nobody on the ground is carrying-around an O2 cylinder. Except for maybe PJs, because they like to carry things.
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Old 15 December 2017, 13:03
TerribleDan TerribleDan is offline
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Ideally the patients have been stabilized and packaged for transport as well by the time the aircraft arrives. The medics on the ground likely would not be carrying O2, particularly on a walking infil. The evac platform may or may not have O2 on it.

There may be a number of reasons why there would be a Ranger medic on the bird but the idea is to get the patient to the FST as rapidly as possible so it isn't a tremendous factor, most deployed flight medics these days are very competent in their craft. The scenario isn't very detailed on patient condition so it is tough to say what the patient treatment would be. If the patient had low O2 sats and the platform had the capability then the medic would provide it with whatever delivery mechanism he had. Like O Pos said, patients don't get flooded with O2 anymore just because.
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Old 15 December 2017, 17:13
bobmueller bobmueller is offline
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Much appreciated, all. I've passed this on.
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