Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Wilderness and Rescue Medicine 244

Chapter 34 Review: Appropriate Medical Technology

• You are looking for equipment that is simple and light with few moving parts. • There is no point in carrying anything that you don’t know how to use, and no reason to carry any- thing that can be improvised from something else. • A simple pocket or intraoral mask connected to a helpful rescuer provides heated and humidified ventilations. • Pain medication that can be administered by mouth, transmucosal route, or intramuscular injection is easier to manage than anything that requires an intravenous (IV) line. • A well-padded litter or vacuummattress effectively splints everything from the neck through the tibia. • It may work best for each member of the team to have his or her own supply of frequently used items. The more critical but less frequently used supplies can be kept elsewhere. • Any prescription medications should be accompanied by documentation from the prescribing prac- titioner, especially if you will be crossing international borders. • For each medication, you should know the actions, indications, contraindications, side effects, dos- age, and route. • In many cases where dehydration is the primary mechanism, rehydration in the field can make a carry-out evacuation unnecessary. Oral fluid replacement can be very effective if the patient can swallow safely and is not vomiting. • Aggressive fluid replacement for shock from uncontrolled bleeding can be dangerous when surgical care is not immediately available. • The most basic risk in the use of any device is that it will take up space, weight, and money that could be better used for something more likely to reduce risk and improve outcome. • A good question to ask when deploying diagnostic instrumentation is: what am I going to do with the information it gives me, and what difference will it make in my treatment?