Equipment of a combat medic

This article discusses the standard equipment of a combat medic.

Combat Medics must put themselves in greater harm than many other roles on the battlefield. In the type of asymmetric warfare which typifies modern conflicts, the enemy often has no respect for the laws of war and may in fact actively target medics (in addition to officers and radio operators), for the significant value they have in keeping the unit combat-effective. Thus, in most modern forces, medics are armed and do not wear large identifying red cross insignia.^[1] A rifle or carbine is standard, often augmented with a sidearm because the medic may have to pass his rifle off to his patient or fellow war fighter in order to treat the wounded.

Arms and insignia

There is actually no requirement to wear identifying insignia or to be unarmed. Geneva Conventions require that Medics use weapons to defend themselves or their patients. To understand this, one must know that litter-bearers fall under the same protection, but are not required to be marked or unarmed. Chaplains can also carry weapons to defend themselves. In Chapter II of the Geneva Convention of 1929 Article 8 states: A sanitary formation (medical) or establishment shall not be deprived of the protection of Article 6 by the fact:

1. that the personnel of the formation or establishment is armed and uses their arms in self-defense or defense of wounded and sick personnel
2. that in the absence of armed hospital attendants the formation is guarded by an armed detachment or by sentinels
3. that hand firearms or ammunition taken from the wounded and sick and not yet turned over to the proper authorities are found in the formation or establishment;
4. that there is found in the formation or establishment personnel or materiel of the veterinary service which does not integrally belong to it

The Combat Medic is commonly referred to as "Doc." Within a combat unit, they function as a member of an infantry platoon up until the point that one of their comrades is wounded. Therefore, the Medic carries basically what a Rifleman or any other soldier carries. His/ Her Basic Equipment is usually:

• An M4 rifle and/or an M9 pistol.
• A MOLLE Vest with a full "combat load," being (most often) 210 rounds for the M-4/M-16 rifle.
• An IBA or Interceptor Body Armor, now being phased out in favor for the newer IOTV;
• The Army Combat Uniform;
• An ACH, or Advanced Combat Helmet.

Medical Equipment

A combat medic will typically carry a backpack styled bag known as a "Unit One Pack". Aid bags are available from many different manufacturers, in many different styles. Depending on the unit and their standard operating procedures, the medic may have to follow a strict packing list, or may have the liberty of choosing their kit depending on the mission at hand. A typical aid bag will include:

Fluid Resuscitation

• IV fluids and tubing. The amount will depend on the length of mission. Normal Saline/Sodium Chloride, Hetastarch/Hextend, and Lactated Ringers(LR) are usually carried.
• 18, 16, and 14 gauge IV catheters.
• FAST 1 intraosseous infusion kit. The FAST 1 is a quick way to administer fluids when peripheral and external jugular venous access is unavailable due to massive blood loss, burns, or loss of limbs.

Hemorrhage (blood loss) Control

• CAT, SOFT-T or improvised tourniquets. Tourniquets are used for the care under fire phase of tactical combat casualty care, to stop massive life-threatening hemorrhage.
• Emergency Trauma Bandages, a newer version of the first aid pressure dressing.
• Kerlix gauze, for stopping hemorrhage, or creating a bulky dressing.
• Hemostatic agents, such as Celox, Hemcon bandages, and others. Some hemostatic agents are controversial due to their thermodynamic nature, which causes collateral damage if the user is not properly trained. These have been mostly phased out with newer versions which do not cause burns.

Airway Management

• 14 gauge catheter, at least 3.25 inches long, for needle chest decompression.
• Asherman chest seal, Bolin chest seal or Hyfin chest seal, as an occlusive dressing for sucking chest wounds.
• Nasopharyngeal Airway (NPA)w/surgilube or "nasal trumpet." This flexible tube secures a nasal airway when the casualty does not have, or may lose their ability to keep their own airway open. Contraindicated by signs of skull fracture.
• Oropharyngeal Airway, a hard "J" shaped plastic device that secures an oral airway, and can also be used to keep the teeth open for a more permanent airway device.
• King LTD, a simple tube airway with an inflatable cuff to create a sealed airway.
• Combitube, like a King LTD, but designed to be able to function almost no matter how the tube is placed due to the dual lumen tube design.
• Surgical Cricothyrotomy kit. Many different styles and kits exist, the choice is up to the individual medic's supply or preference. The most simple is a scalpel to open an airway, and to use an NPA to keep the airway patent.

Assorted Equipment

• Nitrile gloves
• Alcohol or Providine/Iodine swabs
• Cravats (muslin bandages)
• Assorted gauze bandages
• Band-Aids
• Assorted sizes of tape
• Coban, a stretchy, self clinging wrap/gauze
• Ace Bandages
• Assorted hypodermic needles and syringes
• Combat Casualty Card
• SAM Splint—a flexible, reusable splint with a metal core covered in closed cell foam.
• Water Jel burn dressing
• Small sharps shuttle
• Trauma Shears
• Safety pins

Battlefield Medicine

• Morphine
• Antibiotics
• Narcan, a narcotics antagonist, to counter morphine's respiratory-depressing effects.
• Phenergan, an anti-nausea treatment, which also increases the pain-reducing effects of morphine.
• Epi-pen, epinephrine in an auto injecting "pen" to counter anaphylactic (severe allergic) reactions.

A combat medic is generally expected to care for the needs of the soldiers in his group, including their everyday ailments. A medic will usually carry a small amount of what are referred to as "snivel" or "sick call meds." These are common over-the-counter medications that do not require a prescription.

• acetaminophen (Tylenol), anti-pyretic and pain reducer.
• Naproxen and ibuprofen, different NSAIDs which reduce pain and inflammation.
• Diphenhydramine (Benadryl), an antihistamine with a sedative side effect.
• Pseudoephedrine, a nasal decongestant.
• Guaifenesin, an expectorant.
• Loperamide (Imodium AD) an anti-diarrheal agent.
• Pepto Bismol tablets, to settle upset stomachs, treat diarrhea, and heartburn.
• Colace (docusate sodium), a medium strength stool softener.

A Combat Medic may also carry other supplies as the mission dictates. A stethoscope, blood pressure cuff, pulse oximeter, otoscope, ophthalmoscope, and thermometer may help the medic treat his/her soldiers or civilians on the battlefield (COBs) while on an extended mission, as space dictates.

References

1. Middleton, Thomas (2010). Saber's Edge: A Combat Medic in Ramadi, Iraq. UPNE. p. 7.