Is this the standard for a FST (Military)

jeckrn, BSN, RN · Oct 7, 2017

Yes, this is where an FST (Forward Surgical Team)could preform surgery. You have to remember the role of an FST. They only get patients who would not make it back to a CSH (Combat Support Hospital) alive. This is "meatball" surgery at its best. FST's only have 20 members assigned to it and often are splint into 2 teams. Their equipment must fit into 2-4 vehicles. You have to remember this is "field" surgery not surgery in a fixed facility. A CSH has better facilities but is still a field unit. The roles of both of these units is to save a service members life and get them back to a fixed facility. There are even some ghost teams which operate with SF groups which is even more primate.

Why did the video piss you off?

ggoodman · Oct 9, 2017

There is no central command presence, It is apparent they have not worked together, the tech has to be told how to use the drapes. It seems there is discussion about sututre/ silk ties. The Docs are not doing there part (IE mask your self, gown and glove yourself, assess patient develop mental plan). Nurses job should be Airway secure, prep drape patient, start. Tech should open laps, sharps, instruments, drapes while airways is secured, patient is prepped. We practice this for trauma cases. This weekend we had unrestrained MVC with rollover and extended extrication patient. From in the room to start we are a ~15 min for a propper sterile set up and less than 5 for quick and dirty fix it or they die type stuff. We operate on OR tables and have done cases on stretcher as there was not time for transfer.

I came from a large militaristic metro fire department and expected the same structure and cooperation from the military. especially for what is seems to be a dedicated team who sole function is rapid deployment with rapid initiation of life saving surgical procedure.

I realize this is all armchair quarterbacking, and rather than ***** about the system I should work to change it. Which I have started, I have contacted the local Reserve office and have begun the process or joining with the intent to join and FST, or at least get involved in the training process.

jeckrn, BSN, RN · Oct 9, 2017

By watching the first few minutes you can see that this is a training with students at a school house. By the hair and shirts they are SF medics learning how to do crachs. Yes, the tech should have know how to drape, if it was a ST at all. As far as counts, there are not done in this environment very often. As far as a "command presence" the civilian is watching how the team acts together. I just skimmed it before so my guess this is not even a FST but training for SF medics learning how to do surgery when they are by themselves and can not get the patient back to an FST or CSH. It is a good guess that there is not a nurse in the video and the surgeon is not a surgeon but a senior student.

FST's will cross train medics to function as ST's and ICU or ER nurses to work as circulatorys in the field.

ggoodman · Oct 9, 2017

Thanks for the responce, I see my ignorance of the situation has led me to make assumptions that may not be. I get the omission of counts when we are doing true life saving procedures where minutes make the difference the counts go out the window and we shoot an x ray at the end.

RobtheORNurse · Oct 20, 2017

This is obviously a training scenario but, yeah, combat medicine is different from anything else. Worry about sterility? Not possible in most instances. When you are trying to find an abdominal bleed in a combat area with things blowing up and shrapnel flying by, you do the best you can and hope the antibiotics do their job. You don't always have a doctor or PA around to operate. This looks like a training session for new doctors in the army. They have to learn how to work in difficult situations. I have operated in the back of trucks, on helicopters, in tents and just about anywhere you can imagine. It is dirty and chaotic but lives are saved because of it. I remember using a combat knife to make an incision to relieve a tension pneumothorax and put in a makeshift chest tube. It gets crazy but I would not trade the experience for anything.

williams84 · Oct 22, 2017

As dumb as it sounds, they are removing OR nurses from FSTs. They are replacing them with another trauma physician. They believe that the OR NCOs can accomplish most of the "circulating" duties and the other nurses in the unit can take care of the documentation part. If you do join up in the reserves, chances are you'll be assigned to a CSH and you'll rarely deploy in the combat role. If you go active, you'll work in military hospitals.

-Recently discharged OR nurse from an FST