Monday, 14 July 2014

Bulldog Loadouts: The Physician Assistant Bag

Then, Lt P and I orientating 
ourselves to our new location.

Capt P, the American PA I worked with in a NATO camp during my most recent deployment to Afghanistan went to Yale University. The Yale football team is the Yale Bulldogs. In an homage to his varsity team, all the load list for medical gear were prefaced with the 'Bulldog" identifier. This is a series of articles on specific loadouts that we packed to support distinct roles within our camp emergency plan. There will be no coverage of the emergency plan or mass casualty plan in this series as the camp is still operational. The gear and supplies used were limited to the supply chain and represent best possible practice at that current time.

Physician Assistant Medical Bag

The intention of the Physician Assistant Layout was to provide Advanced Airway Management and Advanced Trauma Life Support protocols within the confines of a NATO camp. It is NOT for missions outside the wire.This layout is setup for the higher level of interventions that the PA brings to a MASCAL or cas care within the permissive environment of an Afghan National Army garrison. Medications and kits within this layout are highly personalized to the practitioner. 

Outside of FR Bag
1. Trauma Shears on retractor attached to bag
2. Bag Label and 9-Liner

3. Lid Upper Mesh Pocket
  • 5 Sterile Kerlix Gauze
  • 2 3” ACE wraps
  • 2 6” Ace wraps
  • 5 NATO casualty tags

4. Lid Lower Mesh Pocket
  • 4 Combat Gauze™
  • 2 4” CoTCCC/CCCWG approved dressing
  • 1 6” ” CoTCCC/CCCWG approved dressing
  • 1 OALES Modular Bandage™

Elastic Organizer/Pouch Divisions
  • 3”tape
  • 1”tape
  • 3 HALO Chest Seals™
  • Sharps container
  • 10 pairs of Nitrile Gloves
  • Small bottle Hand Sanitizer
  • 6  CoTCCC/CCCWG approved Decompression Needle
  • 2 Red Glowstick
  • IR Glowstick as Buzzsaw
  • Pen or Sharpie™
  • 6 CoTCCC/CCCWG approved Tourniquet
  • 3 Triangle Bandages
  • SAM Splint™
  • Minor wounds Pack

Zipper Pouch (under Elastic Organizer/Pouch Divisions)
  • 3 1ml syringes w/needle
  • 5 3” x 8” Non-Adherent dressings
  • 20 800mg Ibuprofen tabs
  • 3 Pill Packs (800mg Ibuprofen, 1000mg Acetaminophen)

3. Airway
  • CholraPrep™
  • 3 C Cell batteries
  • 4 Surgical Lubrication pouches
  • 2 OPAs
  • 2 NPAs
  • 1 disposable scalpel
  • 3 tongue depressors

6. Lower  Mesh Pouch
  • CoTCCC/CCCWG approved Bag Valve Mask (BVM)
  • 2 KING LT airways (size 4 & 5)
  • EASYCAP CO² Detector
  • Suction device

 7. Lower Mesh Pouch

  • 1000ml N/S
  • 2 500ml Hextend
  • 3 NAR Saline Lock Kits™
  • 4 15gtts IV Administration Kits
  • FAST IO™
  • ChloraPrep™
  • 10ml syringe
  • 18 gauge needle

8. Upper Mesh Pouch
  • 10 Alcohol swabs
  • 2 20ml syringes
  • 4 10ml syringes
  • 4 3ml safety syringes w/ needle
  • 4 1ml syringes w/ needle
  • 4 18 gauge needles
  • H&H Chest Tube Kit™
  • 3 Provodine-Iodine swabsticks
  • Stethoscope
  • Pelican Med Case (stored in Pharmacy)

Within main pouch:
  • BLIZZARD Survival Blankets™
  • 4 SAM splints™
  • CoTCCC/CCCWG approved C-Collar

The choice of the Blackhawk STOMP 2 was logistical in nature. We had quite a few which allowed some uniformity in layout. There are a great many other bags we would have preferred but they were unavailable through the current supply chain. The colour selection was deliberate. We only had one ACU pattern medical bag. We only had one PA on post. It was selected for ease of rapid identification.

The concept of this layout was advanced airway interventions and advanced trauma life support at a physician assistant level in a permissive environment.

Take Care Out There

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