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 manage-
ment. 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.
Common Breast Conditions
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 condi-
tions 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 anti-
microbial. 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 exami-
nations 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,
The following terms are defined as used in this
ABSCESSa localized collection of pus in a
cavity formed by distintegrating tissues in or about
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
BUCCALpertaining to or directed toward
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
CERVIXthe neck of the tooth
CROWNthe portion of a tooth covered by
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