Page 153 - Journal of Special Operations Medicine - Fall 2017

kind of surgeries performed. Not only does it provide anes-
thesia quickly and effectively, it helps control hemorrhage to a
point that it is possible to work without clinic suction.

Planning
Extracting infected, impacted wisdom teeth in the middle of
a Christian militia checkpoint in the vicinity of Mosul is not
an easy task, especially when there are firefights and vehicle-
borne improvised exploding devices going off in the back-
ground. Things had to be well planned; fortunately, a supply
of antibiotics and nonsteroidal anti-inflammatory drugs were
also in the kit. For some cases, patients started antibiotic ther-
apy 3 days before intervention. In other cases, revisits were
difficult, and without revisits, the medical effectiveness was
compromised by the danger of the treatments performed.
Sometimes, it had to be at patient discretion if he was willing
to take the chance. Some patients were in such agonizing pain
f. Dental anesthetic syringe with aspiration, type A or type that they took the risk, but for the HASF medical team, this
CW created tension in resolving the conflict between bringing ef-
g. Head lamp fective medical care to these people and the psychological war-
2. Surgery tools fare aspect of a MEDCAP mission. If the treatment worked,
a. Tooth extraction forceps No. 150 (universal maxillary everything was accomplished, but if the patient was left with
forceps) a dry socket or even osteomyelitis, the role of the American
b. Tooth extraction forceps No. 151 (universal mandibular organization might be put in question and compromise the
forceps) goal that was intended.
c. Tooth extraction forceps No. 17 (mandibular “cow
horn” forceps)
d. Tooth extraction forceps No. 53R and No. 53L (maxil-
lary “cow horn” forceps)
e. Periostal elevator Woodson No. 1 and Molt No. 9 (from
Hu-Friedy), designed for reflecting and retracting the
mucoperiosteum after incisions of the gingival tissue
f. Straight elevator small No. 301
g. Straight elevator large No. 34
h. 3mm curved luxating elevator; these have thin, sharp
blades that are used to cut periodontal ligaments, loosen
the tooth from the periodontal ligament, and ease
extraction
i. No. 4 and No. 5 Schmeckebier apexo elevator (from
Hu-Friedy), used to loosen the tooth´s broken root from
the bone and ease extraction.
j. Scalpel blade handle
k. Rongeurs (No. 15 and mini Friedmand from Hu-Friedy)
used for trimming and recontouring alveolar bone and
gross tissue removal
l. Surgical curettes (Miller No. 10 and No. 12 from
Hu-Friedy)
m. Standard needle holder
n. Adson tissue pliers, used to grasp and stabilize soft
tissue.
o. Curved scissors
3. Dentistry
a. Spoon excavator
b. Dental spatula
c. Burnisher
d. Plugger
e. Dental mixing pad MEDCAP is a very powerful policy tool, if conducted prop-
f. Plastic 10mL syringe for irrigation erly. In 1960, the United States started these programs during
the Vietnam Conflict, initially for the Vietnamese military and
One of the most important items in the kit was local anesthe- later for Vietnamese civilians. The primary objective was to
sia. The cylindrical glass ampules are perfect for oral work, win the “hearts and minds” of the people. Today, it can be
and Ubistesin 1:100 000 (articaine hydrochloride 40 mg plus much more than that—government and nongovernment orga-
™
epinephrine 10 μg) is one of most effective solutions for the nizations can help build and develop medical infrastructures
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