COMPREHENSIVE GUIDE TO FIELD MEDICINE

[Ivoreyy 2303]

COMPREHENSIVE GUIDE TO FIELD MEDICINE

IMPERIAL STATE ARMY MEDICAL CORPS

PREFACE:

The COMPREHENSIVE GUIDE TO FIELD MEDICINE’s primary purpose aims to standardize medical protocol as part of the Imperial State Army Medical Corps. Focusing upon trauma injuries, as most commonly seen within the active field, this guide shall serve to detail the accepted methods of wound identification and treatment.

 

---

 

Summary of Common Herbology and Treatments:

Each ISA Medical Corps Officer should familiarise themselves with the following common herbs and treatments, to be carried at all times whilst on active service.

 

TIPPEN’S ROOT:

The most commonly used medicinal herb in practice is TIPPEN’S ROOT. It serves as a means for stemming external and internal bleeding due to trauma. Tippen’s should be applied generously in salve form, and left on the wound for as long as is required for the bleeding to cease. 

 

FROSTVINE:

As the primary cooling agent, FROSTVINE is another essential medicinal herb. When applied correctly in salve form, it shall act as a fast means to numb an area and reduce swelling. Frostvine is preferable to blissfoil in this sense, as it does not possess the same toxic properties. However, if applied too liberally, Frostvine can freeze tissue and cause permanent damage.

 

SERPENT’S STALK:

When treating first or second degree burns, SERPENT’S STALK shall be the most important element used. Applied as a salve, it will aid in providing a cooling effect to burns, and promotion of healing said burns. It should be noted that Serpent’s Stalk is not guaranteed to be of benefit to third degree burns, it should be applied nonetheless.

 

THYME OIL:

Whilst treating open wounds, the application of THYME OIL is essential in the prevention of further infection. Observed as a golden liquid, it should be applied just beneath bandages.

 

MANDRAGORA:

As one of the most open-ended medicinal herbs in terms of benefits, MANDRAGORA aids in the promotion of healing in almost any wound. Mandragora should be applied post-suturing and/or the ceasement of bleeding, and can be re-applied continually during recovery. It will also help to ensure that scarring fades.

 

OSTRO-CLOT:

As a newly developed medicinal alchemic remedy, OSTRO-CLOT serves similarly to Tippen’s root in stemming bleeding. Ostro-clot works quickly, however it can cause extensive pain. It is to be used for severe bleeding only. Ostro-clot should be used while the skin is being held in a linear fashion, as to ensure that the proper lining of skin and flesh is cauterised and shut. Ostro-clot is an alternative to suturing.

 

COWSLIP WINE:

Acting as an anesthesia, COWSLIP WINE is a strong liquid in which can put a patient to sleep for a period of time. It is typically used for surgeries and/or cases in which extreme medical attention is required, and the patient’s conscious state may adversely affect the outcome. It is ingested orally.

 

BLISSFOIL:

Whilst holding strong medicinal properties, BLISSFOIL is a particular herb in which should be regarded with caution. Though it works effectively in numbing pain and feeling in certain areas, it can cause permanent loss of feeling if applied too generously or improperly. Due to this, the use of frostvine is recommended instead. The only times in which blissfoil should be applied is to areas intending to be amputated.

 

---

 

Identifying Trauma Wounds:

When approaching an injury, first and foremost one must identify the type of injury in order to promote the best treatment and recovery. Whilst on service within the ISA, there are a number of typical traumatic injuries in which can be identified.

 

ABRASIONS:

Abrasions refer to areas of the skin in which have been exposed to a rubbing or scraping action, to which has broken the upper layer of the skin. Abrasions are typically not life-threatening.

 

LACERATIONS:

Lacerations refers to wounds that are characterised by the tearing of the skin. This type of wound can be a tear that is jagged, torn or irregular. A bone fracture that breaks the skin can be classified as a laceration. Lacerations are typically non-life threatening, however should one occur upon the chest area, or be noted to be extremely deep, it can progress to a life-threatening situation.

 

CRUSH WOUNDS:

Crush wounds are injuries which occur when a body part is subjected to a significant degree of force or pressure. Crush wounds will often shatter bones, or otherwise cause significant bruising and/or swelling. Crush wounds can lead to amputation, and if severe are considered life-threatening.

 

PUNCTURE WOUNDS:

Puncture wounds are a small, yet deep wound in which is typically caused by sharp objects - such as an animal’s teeth, a nail, or a pin.  They are extremely prone to infection, however will usually not present as extreme bleeding unless very severe. Puncture wounds in the chest/head area can in some cases be considered life-threatening.

 

PENETRATION WOUNDS:

Penetration wounds can be characterised similarly to puncture wounds, however are to a much greater degree of severity. Notably, they will have an EXIT wound, whereas Puncture wounds will not. They can range from more shallow injuries upon the extremities, to much deeper injuries and internal bleeding. Penetration wounds are typically caused by knives, daggers, or swords. Penetration wounds are almost always life-threatening, especially if occurring in the head or chest.

 

BONE FRACTURES:

A bone fracture refers to the complete or partial fracturing of a bone. Typically, this injury is caused by blunt trauma from falls and/or extreme force. Bone fractures can be identified by the deformity of extremities, as well as extreme pain and swelling.

 

BURNS:

Burns refer to the exposure of the body to extreme heat or harmful chemicals. Burns are characterised by external damage to the skin, and will be categorised into one of three ‘degrees’. 

 

FIRST DEGREE BURNS

First degree burns, as the most minor classification, refer to burns in which are considered to be superficial and non life-threatening. The burn site will present as red, painful, dry, and with no blisters.

SECOND DEGREE BURNS

Second degree burns are considered to be more severe than first degree, and will run much deeper under the skin. The burn site will look red, blistered, and may be swollen and painful. Second degree burns can be life-threatening.

THIRD DEGREE BURNS

Third degree burns are considered to be the most severe. They will present as blackened and charred skin, and the patient may feel no pain and/or feeling in the area. Third degree burns are almost always life-threatening.

 

---

 

Off-Field Treatment Protocols:

Treatment protocols when not on an active, high intensity field should stem around the central goal to preserve life, and promote the best recovery possible. The following treatment protocols do NOT refer to on-field first aid, however refer to the correct treatment off-field.

 

ABRASIONS: 

Abrasions will typically not require much medical attention. Should there be reason for concern, these steps should be followed:

1. Apply Tippen’s Root to stem any bleeding. Remove Tippen’s after bleeding has ceased.

2. Disinfect the abrasion with a certified disinfectant, or otherwise with a strong alcohol. Remove any debris.

   1. OPTIONAL: Apply Mandragora to promote quicker healing

3. Bandage wound with sufficient pressure applied.

 

LACERATIONS: 

Lacerations, especially if deep or bleeding extensively, should be treated quickly and effectively using these steps.

1. Apply Tippen’s Root to stem any bleeding. Remove Tippen’s after bleeding has ceased.

2. Disinfect the laceration with a certified disinfectant, or otherwise with a strong alcohol. Remove any debris.

   1. If observed to be very severe, apply Ostro-Clot. It should be carefully applied only to the thin line in which the skin has been torn. If applying Ostro-clot, suturing will not be necessary

3. Should the laceration be severe enough, use a thin needle and threat from a suture kit to stitch the wound closed.

   1. OPTIONAL: Apply Mandragora to promote quicker healing

4. Bandage wound with sufficient pressure applied.

 

CRUSH WOUNDS:

Crush wounds can be more difficult to treat. An important step is to first and foremost identify the severity of the force in which was applied to the wounded area, and what injuries have occurred due to that force. From there, the following steps should be taken.

1. Apply Tippen’s Root (If necessary) to stem any bleeding. Remove Tippen’s after bleeding has ceased.

2. Apply Frostvine to areas of swelling in order to reduce it. If possible, elevate the area to above the chest height.

3. Should an extreme crush wound be observed upon an extremity (arms, legs etc.), amputation may be required.

   1. IF AMPUTATING: Apply Blissfoil generously to the area until there is no feeling. Ensure that you wear gloves and do not come into direct contact with the blissfoil. Patients may be required to be sedated using Cowslip Wine.

   2. Remove limb utilising a surgical saw. As soon as bleeding is observed, stem with Tippen’s.

   3. Once limb is removed, apply additional Tippen’s alongside Thyme Oil.

   4. Bandage with sufficient pressure applied

4. Alternatively, crush wounds will always require some form of surgery to heal effectively. Sedate the patient with Cowslip Wine, and follow surgical protocol.

   1. Should a bone fracture be observed, shift the bone into its traditional placement and bandage tightly to disallow for much movement.

 

PUNCTURE WOUNDS:

Puncture wounds require a simple procedure to treat, however should be approached with caution - severe puncture wounds can be life-threatening.

1. Use a numbing agent to numb the area. If severe, small amounts of Blissfoil can be used. Alternatively, use Frostvine.

2. If possible (Or necessary), remove the object in which has punctured the skin.

3. Apply Tippen’s Root to stem any bleeding. Remove Tippen’s after bleeding has ceased.

4. Disinfect the wound with a certified disinfectant, or otherwise with a strong alcohol.

   1. OPTIONAL: Apply Mandragora to promote quicker healing

5. Bandage wound with sufficient pressure applied.

 

PENETRATION WOUNDS:

Penetration wounds, if observed to be severe in nature, should be treated swiftly using the following steps.

1. If possible (Or necessary), remove the object in which has penetrated the skin.

2. Apply Tippen’s Root to stem any bleeding. Remove Tippen’s after bleeding has ceased.

   1. If observed to be very severe, apply Ostro-Clot. It should be carefully applied only to the small area in which the penetration wound has occurred.

3. Disinfect the wound with a certified disinfectant, or otherwise with a strong alcohol.

4. Should the wound be severe enough, use a thin needle and threat from a suture kit to stitch the wound closed.

5. OPTIONAL: Apply Mandragora to promote quicker healing

6. Bandage with sufficient pressure applied.

 

BONE FRACTURES:

Bone fractures, as typically less severe injuries, should be treated in the following way.

1. Observe the nature of the fracture. Numb the affected area using Frostvine.

2. Gently manipulate the bone back into its traditional placing. Should the bone have broken the skin, apply tippens and follow the general laceration protocol.

3. Bandage the wound in order to prevent substantial movement. A wheelchair or splint may be required.

   1. SHOULD THE FRACTURE BE MORE SEVERE, surgery may be required. Follow all standard surgical protocols, then proceed to manipulate the bone back into placement. 

 

BURNS:

Burns should be dealt with swiftly, in order to increase the chances of a full recovery. It should be noted that there will be cases (particularly those of third degree burns) in which extend beyond the medical capabilities of the medicinal remedies available. Consider amputation in the cases of third degree burns on a patient’s extremities.

1. Apply Frostvine to reduce pain and/or swelling

2. Apply Serpent’s Stalk to the exposed burns area. Remove any debris.

3. Bandage the area with sufficient pressure applied.

 

SURGICAL PROTOCOL:

Described here, this surgical protocol should be followed each time surgery is performed on a patient. Ensure that surgery is completed in a sterile environment.

1. Sedate the patient with Cowslip wine, until they are unconscious.

2. Apply Thyme oil to the surgical area.

3. Make a thin incision where the surgery shall be performed using a sharp utensil. 

   1. Desired surgeries may vary - bone reconstructions and/or placements will be performed this way, as will suturing to stem internal bleeding. Most importantly, keep the area and utensils sterile and free of any debris.

4. Once said surgery is complete, the area may be sealed with Ostro-Clot or suturing. If any external bleeding continues, small amounts of Tippen’s root can be applied.

5. Swelling and pain can be further maintained with Frostvine, and Mandragora may also be applied in order to promote quicker healing.

 

---

 

High Intensity (On the Field) Treatment Protocols:

Whilst on the field in high-intensity situations, the same resources are not always available to a medic. The primary goal while on field is to preserve the life of the patient until further resources and medical teams can move the patient into a treatment area. This is typically referred to as ‘First Aid’.

 

ON-THE-FIELD FIRST AID STEPS:

1. REMOVE IMMEDIATE DANGER. Ensure that there is no immediate danger to yourself or the patient.

2. ALWAYS STEM BLEEDING. Utilise Tippen’s root to stem bleeding wherever possible

3. APPLY PRESSURE. Ensure that sufficient pressure is applied to any open wounds.

   1. The use of a TOURNIQUET may be required whilst on the field. A tourniquet is a device in which will stop blood flow to an extremity by extreme pressure. You may use a specifically designed tourniquet, or a makeshift one (Such as a belt or strong bandage/fabric strip). It should be used when severe injuries are observed to an extremity, and the bleeding cannot be properly stopped with Tippen’s or applied pressure.

   2. Apply the tourniquet about two to three inches above the wound. It should be tightened until the bleeding from the wound stops.

4. SEEK MEDICAL HELP. Wherever possible, further medical help and treatment should be sought.

 

---

AS COMPILED BY ENSIGN ELIZABETH ANNE