Main Topics for Discussion

• First hand experience as a GMO

• Resources available to you

• Orthopedic Emergencies

• Basic ortho injuries from neck to toe

• When (and how) to refer

• What your orthopedic consultant can (and can’t offer)

• Recommended texts

• Casting and splinting

My Experience

• I served as a Diving Medical Officer for 2 years

• Dive site injuries at waterfront versus remote sites

• Useful tools to have at your disposal

  • Digital Camera, Jump Drive, Internet access

  • Casting/splinting materials

  • Local anesthetics (without epinephrine)

  • A comprehensive phone list

Physical/Occupational Therapy

• These departments can be a huge help

• OT works with the UE from the elbow down. They make custom splints, provide therapy protocols, utilize modalities

• PT works with the shoulder, back, and lower extremities. Consider them for back school, ankle proprioception, post-injury pre-op rehab, etc.

• If you do not have these on your ship or nearby, protocols are often available on-line, in texts, or from a civilian provider in town.

The Role of the Operational Navy Corpsman

• The operational corpsman is a very active and hands-on part of the healthcare team.

• They often know more than you do about common problems.

• Make sure you get them OJT in nearby castrooms, pt depts, etc.

• Ingrown toenail removal, blister care, splinting, crutch sizing - these are just a few of the things they can help you with.

• If you have the good fortune to have an experienced IDC, you’re living the good life

Orthopedic Emergencies

Aka "Fire up the helicopters…"

Cauda Equina Syndrome

• Bilateral buttock/le pain

• Urinary retention

• Bowel incontinence

• Saddle anesthesia

• Decrease in LE strength/sensation

• This can be rapidly progressive. Loss of bowel, bladder, or erectile function may be irreversible!