An Cosantóir

| 21 www.military.ie THE DEFENCE FORCES MAGAZINE www.military.ie THE DEFENCE FORCES MAGAZINE nasopharyngeal tube would be used when the oropharyngeal device cannot be used. This could be due to oral airway obstruction, lack of facial structures or trismus (lock jaw). It is inserted through the nose and allows for an efficient airflow as a backup method. The most effective and widely used emergency airway management device for the cardiac arrests is the I-gel tube. It has a whole array of benefits but from the MFR point of view, it provides for easier insertion, minimal risk of tissue damage or compression and stability. It can be also used together with mechanical breathing support devices and oxygen straight after insertion. All of these airway management devices are a part of the MFR training and together with complex CPR A training, they arm the students with the most effective aid tools. Another crucial part of the training is the primary and secondary patient surveys. These are unified across the emergency services staff and allow for a full analysis of the patient, injury, and the location, where the injury happened. In the tactical environment it is adding a layer of army-typical situations, such as Care Under Fire. Patient's survey not only enables the MFR to gather critical information about any underlying health conditions and medical history, but it also enables the practitioner, to prepare a patient's handover report to a medical professional who is taking the patient over. Further modules take the students through soft tissue and musculoskeletal injuries, which then lead straight to various techniques of lifting and moving patients. This also covers both peacetime and combat situations. These can vary in carrying techniques for a soldier who twisted his ankle in training to an evacuation of casualty with a suspected spinal injury under enemy fire. Part of the training is also covering pharmacology, paediatric care and childbirth, however special focus is laid on bleeding and shock care, which is rather natural given the nature of military operations. Combat medicine is changing daily and what was a norm yesterday, might be a thing of the past today. The instructors are making sure that Students are also being taught how to use various types of compression bandages such as "Israeli" types. As the MFRs can come across various types of wounds, they are also being trained how to use haemostatic gauze and how to pack a wound with it. This would be the best course of action with a gunshot wound or where a bleeding cannot be stopped using tourniquet. A final wound, very common in battle injury is a sucking chest wound. This type of trauma can very quickly become lethal as injured lung will quickly collapse and a MFR is not trained nor equipped to perform a chest needle decompression to treat the condition of pneumothorax, which happens when air enters the chest via wound and fills it with air instead of the lung. MFRs are trained in the use of "chest seal", which allows the air, blood, and fluid to leave the chest but will not allow any air back in. The final component of the training, which incorporates most of the previous lessons is the battlefield injury management. With casualties in combat action, one thing remains the same – winning the firefight. Medical personnel trying to attend to a wounded soldier becomes a great opportunity for enemy fire, therefore all MFRs are trained on how to work as an integral part of section/platoon and how and when to approach a casualty. Another important part of the process is proper patient survey, as there might be multiple injuries that can be hard to spot. After three multiple choice papers, MFRs are tested in a practical environment, where their colleagues are equipped with various simulated wounds or are simply out in the field unconscious, and it is down to an individual MFR to manage not only the injury but also the surrounding ground and all resources available, including fellow soldiers. Upon completion of the course, MFRs can return to their home units and take on their role during exercises, ranges, and training. The Military First Responder course is designed to fit into all army applications. It issues soldiers with complex skills and knowledge, which enable them to provide pre-hospital emergency care. They are fully prepared to attend to wounded soldiers under fire and evacuate them for the attention of medical staff. While the Defence Forces have a full Medical Corps in place, it is usually a MFR who will treat an injured troop first and then pass the patient to military EMT/Paramedic for further care. All the skills learned during the course are fully transferable onto civilian life as well, which is an added value to the course. The course is attended by all ranks, from Private through NCOs up to Officers and truly enables all to add a set of great skills to their portfolio. Students train on Automated External Defibrillator with the use of resuscitator bag Casualty scenarios test the students skills Students treating a leg injury

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