sexually transmitted diseases and are criminal offenses. The medical management of sexual offenses must be a joint medicolegal function. The Medical Department representative (MDR) should ensure that the victims commanding officer is notified. It is the responsibility of the command to contact NIS and the responsibility of the Medical Department to provide medical management. BUMEDINST 6320.57 series, Family Advocacy Program, provides guidelines on managing sexual offenses. The victim of a sexual assault should be referred immediately to the nearest NRMC or other fixed medical treatment facility when circumstances permit. When the circumstances of the command do not permit such (e.g., when at sea), the MDR must treat any resultant injuries and safeguard and obtain evidence, as directed by NIS and instructed in the NIS Sexual Assault Investigative Kit. Reassurance and calm, efficient, sympathetic handling of the victim is essential. In all cases, refer the victim to a medical treatment facility as soon as possible for further treatment.
Usually afflictions of the breasts that will be brought to your attention may be referred to a physician for routine evaluation and treatment. The most commonly encountered breast conditions are contusions. These are best treated by using a breast binder for immobilization and support. Hot or cold compresses may help to alleviate the severity of pain. Breast infections and abscesses are rare in nonlactating women, but they do occur. Treat these conditions with antimicrobial. Refer patients with breast abscesses, drainage, lesions, lumps, or persistent pain and related symptoms for definitive treatment.
Although discussed earlier in this chapter, it would be appropriate to again stress that the cultivation of a professional, mature, sincere, and compassionate attitude by the hospital corpsman is essential. Medical ethics is stressed at all times and is indeed mandatory when treating patients, regardless of the sex.
Ensuring that the entire crew is in good dental health before deployment will prevent most dental-related problems. Predeployment examinations are therefore very important.
In the absence of a dental officer aboard ship, you, the MDR, must perform basic emergency dental first aid to alleviate pain, arrest hemorrhage, and prevent further or complicating injury to dental structures that are associated with the most common oral conditions and injuries.
Only attempt to administer emergency basic dental care. You should refer all routine cases to a dental treatment facility, and refer all cases treated by nondental personnel for follow-up at the earliest opportunity.
Some knowledge of dental terminology is important to interpret emergency treatment plans prepared by dentists and to prepare consultation sheets for referral to a dental treatment facility. Make sure you use standard dental abbreviations when recording entries in a patients dental record. These abbreviations are in MANMED, chapter 6, article 115. Terminology The following terms are defined as used in this section.
ABSCESSa localized collection of pus in a cavity formed by distintegrating tissues in or about the tooth
ALVEOLAR BONEa thin layer of bone making up the bony processes of the maxilla and mandible, and surrounding and containing the teeth. It is pierced by many small openings through which blood vessels, lymphatic, and nerve fibers pass.
APICAL FORAMENan aperature at or near the apex of the root of a tooth, through which blood vessels and nerves supplying the pulp pass
BUCCALpertaining to or directed toward the cheek
BUCCAL VESTIBULEthe area between the cheeks and the teeth and gingivae
CEMENTUMthe bonelike connective tissue covering the root of a tooth and assisting in tooth support
CERVIXthe neck of the tooth
CROWNthe portion of a tooth covered by enamel
DENTINthe chief hard tissue of the tooth; it surrounds the tooth pulp and is covered by enamel on the crown and by cementum on the root