Jaycee Woods

When editing “Harvest of Blood” as Chapter 1 in Boudica and The Butcher, I relied on Copilot for factual information about treatment of Boudica’s head injury.

Prompt: Question about a combat medic treating a head wound: victim unconscious, bleeding scalp laceration, contusion, no exposed brain matter. Does the medic give the patient a morphine jab in addition to the IV bag?

Copilot: In a scenario where a combat medic is treating an unconscious patient with a bleeding scalp laceration and contusion, but no exposed brain matter, the primary focus is on stabilizing the patient and preventing further injury. Here are the general steps a combat medic might follow:

Assess and Secure Airway: Ensure the patient’s airway is clear and they are breathing. If necessary, use airway adjuncts like a nasopharyngeal airway.

Control Bleeding: Apply direct pressure to the scalp laceration to control bleeding. Use a sterile dressing or bandage.

Spinal Precautions: Treat the patient as if they have a spinal injury, especially since they are unconscious. Immobilize the spine if possible.

IV Access: Establish an IV line to administer fluids and medications as needed.

Monitor Vital Signs: Continuously monitor the patient’s vital signs, including heart rate, blood pressure, and oxygen saturation.

Regarding the use of morphine:

Morphine is typically used for pain management. However, in an unconscious patient, pain assessment is challenging.

Caution is advised when administering morphine to patients with head injuries, as it can potentially mask neurological symptoms and depress respiration.

In this case, the medic might prioritize other treatments and monitor the patient closely before considering morphine. The decision would depend on the medic’s assessment and the specific protocols they follow.

Prompt: How would the medic address the potential spinal injury if they didn’t have a back board, but had to improvise a litter from branches and clothing from corpses?

Copilot: In a situation where a combat medic needs to address a potential spinal injury without a backboard, improvisation is key. Here’s how they might proceed using branches and clothing:

Select Sturdy Branches: Find two strong, straight branches that are long enough to support the patient’s body from head to toe.

Prepare the Clothing: Use clothing from corpses to create a makeshift stretcher. This involves tying or weaving the clothing tightly between the branches to form a supportive surface.

Secure the Patient: Carefully log-roll the patient onto the improvised litter, ensuring minimal movement to avoid further spinal injury.

Immobilize the Spine: Use additional pieces of clothing or any available material to secure the patient to the litter, especially around the head, neck, and torso, to prevent movement.

This method ensures the patient is transported with as much spinal stability as possible under the circumstances.

Prompt: So that would include tying the patient to the litter to immobilize the neck, torso, and legs, correct? Anything else?

Copilot: Yes, that’s correct. Tying the patient to the litter to immobilize the neck, torso, and legs is crucial. Here are a few additional steps to ensure maximum stability and safety:

Neck Immobilization: Use a rolled-up piece of clothing or a makeshift collar to support the neck. Secure it gently but firmly to prevent any movement.

Torso and Pelvis: Tie the patient across the chest, abdomen, and pelvis. Ensure the ties are snug but not so tight that they restrict breathing or circulation.

Legs and Feet: Secure the legs individually to prevent them from moving independently. Tie around the thighs, knees, and ankles.

Additional Tips:

Padding: Place padding (clothing or other soft materials) between the patient and the branches to prevent discomfort and further injury.

Head Support: Ensure the head is well-supported and immobilized. You can use additional clothing to create a headrest that keeps the head in line with the spine.

These steps help maintain spinal alignment and minimize the risk of further injury during transport.

Prompt: If a large strong man were to attempt to pick up an unconscious woman to protect her spine as he put her on the litter. How would he be extra precautious?

Copilot: To protect the woman’s spine while lifting her onto the litter, the man should follow these steps with extra caution:

Stabilize the Head and Neck: Ensure the head and neck are stabilized. If possible, have another person support the head and neck to maintain alignment with the spine.

Log Roll Technique: Use the log roll technique to turn the woman onto her side. This involves rolling her body as a single unit to avoid twisting the spine. Ideally, this should be done with the help of at least one other person.

Positioning for Lift

Kneel Beside the Woman: The man should kneel beside her, positioning himself at her midsection.

Support the Shoulders and Hips: Place one arm under her shoulders and the other under her hips. If another person is available, they can support the legs.

Lift with Care

Lift Smoothly: Lift her smoothly and steadily, keeping her body as straight as possible.

Avoid Twisting: Ensure there is no twisting or bending of her spine during the lift.

Place on Litter

Lower Gently: Lower her gently onto the litter, maintaining spinal alignment.

Secure Immediately: Once on the litter, secure her head, neck, torso, and legs as previously described to prevent any movement. By following these steps, the man can minimize the risk of further spinal injury while moving the unconscious woman.