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Operational Obstetrics & Gynecology The Health Care of Women in Military Settings

Operational Obstetrics & Gynecology The Health Care of Women in Military Settings. Captain Mike Hughey, MC, USNR. Operational Medicine is not Identical to Civilian Medicine. Isolated Settings. Minimal Support Limited Consultation Long MEDEVAC times. Limited Resources.

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Operational Obstetrics & Gynecology The Health Care of Women in Military Settings

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  1. Operational Obstetrics & GynecologyThe Health Care of Women in Military Settings Captain Mike Hughey, MC, USNR

  2. Operational Medicine is not Identical to Civilian Medicine

  3. Isolated Settings • Minimal Support • Limited Consultation • Long MEDEVAC times

  4. Limited Resources • What did you bring with you? • Resupply? Maybe • Whatever you use up today you won’t have tomorrow. • IV antibiotics often mean transfer.

  5. Operational Commitments • Medical care is not the first priority. • It may not be the second priority either.

  6. Then sometimes, medical care is the mission • Medical personnel, supplies and equipment for combat are different than those used for humanitarian missions. • Before deployment, learn as much as you can about everything.

  7. Field Expedient GYN Exam Table • Litter • Litter Stands • IV Poles • Small Battle Dressings

  8. Field Expedient Vaginal Speculum • GI mess kit spoons (2) bent at 45° angle, or • Two spoons joined by rubber band

  9. Ectopic Pregnancy ManagementNaval Hospital Pensacola FL • Transvaginal ultrasound • Quantitative  HCG • Serial hgb • Laparoscopy • Methotrexate • Blood bank

  10. Ectopic Pregnancy Management

  11. Ectopic Pregnancy ManagementOperational Setting • Laparotomy (sometimes) Non-surgical management • IV fluids • Mast suit • Donor-to-victim blood transfusion

  12. Field Expedient Vaginitis Rx • If it itches, it’s yeast. (Monistat) • If it smells bad, it’s BV. (Flagyl) Mucopurulent, chlamydia Dry, curdy, yeast Bubbly, frothy, trichomonas

  13. Urinary Tract Infections • Treat UTI’s based on symptoms. • Cultures and dipsticks in many operational settings are, at best a waste of time, and may be misleading and dangerous.

  14. Unknown Lesions of the Vulva • Each of these requires some unavailable test to confirm the diagnosis. • What is the test for each of them?

  15. Bartholin Duct Cyst and Abscess • Drain it or leave it alone?

  16. Draining a Bartholin Cyst

  17. Operational Obstetrics & Gynecology

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