December 20th, 2009

Random - Flowered Books

(no subject)

I've got a question for all of the corpsmen and combat medics out there. =)

Here's the scenario:

I've got an Independent Duty Corpsman deployed with a platoon of Recon Marines in Afghanistan, time unspecified. The guy is a licensed PA.

He has a patient present with brief unconsciousness, followed by a lucid interval of a few hours, then rapid deterioration eventually leading to death. The impact is the result of an IED explosion, so the patient is also presenting with a myriad of other wounds, most of them non-lethal. Whether or not the Corpsman knows his patient loss conciousness briefly can be toyed with, to fit the scenario.

As an IDC and a PA, is he immediately going to think epidural hematoma? Especially if he nor the patient are aware the patient lost consciousness, and the patient is not reporting any symptoms of head trauma. The lucid interval is about 8-10 hours, after which the Doc knows immediately what's happening, because healthy people don't typically present with brain damage for no reason at all.

Without any available imaging, and not really any time to do a thorough neuro workup (several men were wounded in the encounter), is this something that the corpsman could reasonably miss? I know that PAs are no slouches by any definition, corpsmen either, but I'm just not sure as to what kind of training they're going to be getting, and I know this is something that seasoned ER docs and nurses can miss.

Thanks in advance, anyone who can help out. =D