View Full Version : Simulating wounds

04-23-2008, 12:24 PM
Nope, this is not Hollywood's Exploding Heads 101. Rather I am reprinting an e-mail where I was asked how I simulated the casualty treatment at the late Glendale Malvern Hill. I shared it with him, but I thought it would be polite (and fun) to share with the rest of you, if only to get an idea of how one of us practices in the field.

How do you do simulated bullet extraction etc in the field?

I have them roll up the sleeve/cuff or open the coat. I probe with a blunt instrument - my director at the moment, though I think I will develop an improvised Nealton probe. The vast majority have read Kevin O'Beirne's article "Kicking and Screaming like Dervishes in our Ranks", which discusses wounds and how to react to them. The reenactors take my gentle proddings as their cue to react. I tend to narrate what I'm doing to them as well - "Well, from what I can see, it looks like the ball just missed your artery . . " It's a habit I picked up from my mentor; when we worked together he'd report the wound's damage, and I'd be scribbling notes. I should learn more formal anatomy in order to make my diagnoses sound more professional.

I then poke them in the "affected area" some more with the bullet extractors or whatever instrument I think I'd need for this "procedure". Usually they tend to look away, a natural reaction anyhow, which allows me to fish a demo expended ball from my box and have it on hand to "show."

I retrieve a suturing needle, but I don't thread it for real. I then fake suture near their flesh, as they once again take their cues from my dialogue - "I'm sorry this hurts corporal, but I'm gonna suture loosely so it will drain properly. . ." From a distance it looks like I am suturing for real. Typically I simulate an uninterrupted suture. Given more time and some advance makeup work I could probably do interrupted sutures or figure eight sutures - something that escapes most surgeons. I use one of the arterial clamps to simulate tying off the suture. I then roll a bandage around the "wounded area" and tuck it into place.

I don't use fake blood - I don't want to damage their clothing, and it can be awkward squirting blood as I inspect the wound. Also, it seems goofy and - disrespectful?

Most of the wounds came to me via fate cards issued to the reenactors. I have no idea what they are, so I go with the initial patient's remarks or behavior. I simulate expended rounds, near misses, spalling and "miracle wounds" where the ball penetrated but missed vital stuff. Remember, I do a field dressing station - just slap a bandage on them and wait for the ambulances to arrive. The capital surgery will be done at an actual field hospital.