1632: Medicine and Disease after the Ring of Fire by Eric Flint

Author:Eric Flint [Flint, Eric]
Language: eng
Format: epub
Tags: Science Fiction, Alternate History, Germany, Canada, 1632, Grantville, Eric Flint, alt history, 30 years war, Ring of Fire
Publisher: Ring of Fire Press
Published: 2013-06-23T14:00:00+00:00

The C4 program includes ATLS for physicians (and physician extenders like Nurse Practitioners (NPs) and Physicians’ Assistants (PAs) and TNCC for nurses. Please note that while NPs generally have collaborative but independent practices with physicians, they are still considered as physician extenders by the American College of Surgeons as far as the ATLS certification is concerned. [iii]

Any family medicine physician who wants to work in the ED or even to practice in a rural area will most likely have taken ATLS [iv] . Similarly, the TNCC course is recommended for any nurse wanting to work in an ED or a trauma ICU. Any physician, dentist or nurse with more than three years of (US) active duty military experience [v] will probably have taken the C4 course during that time. These courses, of themselves, do not qualify a physician or nurse to perform major surgeries, but instead gives them a good basis for starting treatment, and the knowledge to provide immediate life-saving care involving critical airway and chest injuries. I expect that Drs. Adams and Shipley will have taken ATLS in the years just before the Ring of Fire (RoF), Drs. Sims and McDonnell may have taken ATLS in the late 1970s or early 1980s, and that at least Mary Pat Flanagan may have been exposed to TNCC before the RoF. I have not found any evidence in canon that this was the case, but based on my experience in the ED during the 1990s, I believe it is likely.

Major surgeries associated with trauma care range from the short procedures best described as “damage control,” to hours-long reconstructive procedures. Aseptic (without infection) conditions are the norm in surgery and later care OTL. Frequently, further surgeries and treatments work together to help the patient heal fully or to address areas that could not be safely dealt with until the patient was more stable. These may range from an assortment of powerful antibiotics to high-technology instruments that monitor a patient's condition. Life support can include everything from a ventilating machine that can breathe for a seriously injured patient to a specialized bed that helps prevent bedsores. Skin, bone, muscle and even digits can be re-implanted, transplanted, or grafted to repair or replace missing parts. Powerful anesthetic and analgesic drugs are available to allow the most seriously injured patients rest while intravenous or tube feedings prevent dehydration and malnutrition, provide routes to administer medications and allow healing to continue. This is the general pattern for trauma care in the US and Canada, and, with a few modifications, true in the rest of the developed world.

What can be done immediately after the Ring of Fire?

The complex and comprehensive care taken for granted in the developed world is not available in most of the world in OTL. This state of affairs will most likely be true in the NTL at least through the late 1640s or even the mid 1650s, due to the need to develop both the physical plants and the medical infrastructure out of the ruins left by the “Fifteen Years War.

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