It is time to put this out there. What do we think about a garage or basement hospital, should someone theoretically need one? I’m not talking about field-care but, rather, the second level of care for guerillas (one step removed from the battlefield). The time may be here soon for MEDICAL when, like guns, ammo, and food you will be stuck with what you have, with NO RESUPPLY. I know there are great medical minds out there willing to give advice. I will get us started. I ask that you temper your comments with a heavy dose of realism. Please don’t suggest something that would be out of reach for most of us.

GOAL: Have a place, supplies, and people, and policies to handle skirmish injuries for your Team, day or night. How about a goal of handling a gunshot, a burn, and a motor vehicle accident? Your combat medic will get the injured person to your doorstep. What will you do next?

LOCATION: Should be inconspicuous but near your area of operation, like a suburban garage, basement, etc. Medical supplies must be at the location. Medical Team must either live there on site, be able to get there quickly, or be there on standby for the duration of any missions.

PERSONNEL: You use who you have. Here’s where there’ll be wide variation between groups, unless we organize regionally later in the fight (and why haven’t we done this yet?). Something is better than nothing. Tailor your program to your people. Do you have an RN, a PA, a dentist, an MD, a veterinarian? Anyone with any medical knowledge is going to be valuable. Like COMMS, the time will come when it will be irrelevant whether anyone has a current medical license. Do not get hung up on this detail. Who is going to be in charge? Who is going to help? Will you have a formal security element at your G-Hosp or just a shotgun leaning in the corner?

CAPABILITIES: Total transparency here: my team has IV fluids (albeit expired), IV stands, IV catheters and administration sets, and oral antibiotics. We have three large laundry baskets full of bandaging supplies, splints, gloves and cleaning supplies. We have local anesthetics, needles/syringes, NSAIDS like acetaminophen, ibuprofen, etc. We have BP cuffs and stethoscopes. We have a couple of tracheal tubes. We have maybe 10 pairs of sterile operating gloves but only 15 packets of suture material. We have basic surgical instruments, but they will be cold-sterilized. The photo below is not my Team’s, but is from a medical mission trip I was on in Central America.

What we lack is fancy electronic equipment: EKG, blood oxygen meters, blood chemistry analyzers, centrifuges, autoclaves (more about that below). We have no gas anesthesia machine.

FLOW: There should be an assessment area (think examination room at a Dr’s clinic). Similarly there must be a treatment area. Somehow this area must be cleanable from blood, body fluids, etc. Ideally it would have running water, a sink or floor drain. How about some curtains for a little privacy. Will everyone be treated as outpatients (gone by morning light) or will some stay in a bed a few days?

HAZARDOUS WASTE REMOVAL: What will you do with bloody clothes, drapes, bandages?

BODY REMOVAL: What will you do if someone on our side doesn’t make it?

Photos are mine, from a medical trip to Central America. The stethoscope in the top photo had no bell on the end of it and was non-useable. Very symbolic of that trip. There were also no gloves at that clinic. We worked there two or three weeks.

DVM is a retired Doctor of Veterinary Medicine and Professor of Human Anatomy and Physiology, devout Christian, Father and American Patriot.

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