|
NOTES |
|
TIME: |
|
Return
fire, and take cover
|
|
|
Direct or expect casualty to remain engaged as a combatant, if
appropriate |
|
|
Direct casualty to move to cover and apply self-aid, if able |
|
|
Try to keep the casualty from sustaining additional wounds |
|
|
Stop LIFE-THREATENING hemorrhage if tactically feasible
-
Direct casualty to control
hemorrhage by self-aid, if able
-
Use a tourniquet for life
threatening external
hemorrhage
-
For hemorrhage not
controlled with a tourniquet, apply HemCon or QuikClot dressing with
pressure |
|
|
C-SPINE CONSIDERATION–
(PRN) *Dependent upon MOI |
|
|
TIME
(5 Minutes max time limit): |
|
|
TACTICAL FIELD CARE |
|
|
NOTES
|
|
Casualties with an altered mental status should be
disarmed immediately |
|
|
Airway
Assessment (for UNCONSCIOUS PATIENT) |
|
Assess
Airway |
|
|
Casualty with airway obstruction or
impending airway obstruction
-
Chin lift or jaw thrust maneuver
-
Consider Nasopharyngeal airway
- If previous measures unsuccessful perform a
cricothyroidotomy
REASSESS AIRWAY ADJUNCT |
|
|
Breathing
NOTES
|
|
NOTE RESPIRATORY
EFFORT |
|
|
INSPECT/ AUSCULTATE
PALPATE Anterior Chest |
|
|
TREAT LIFE THREATS |
|
|
LOG ROLL (Log roll
IF chest or abdominal wounds are noted) |
|
|
TREAT/ REASSESS |
|
|
Bleeding
NOTES |
|
PULSE CHECK
|
|
|
BLOOD SWEEP
* Assess for
unrecognized hemorrhage, and control all sources of bleeding. |
|
|
ASSESS PULSES
* Assess radial pulse for
quality. |
|
|
Bleeding (con’t) |
NOTES |
|
TOURNIQUET CONVERSION
* Assess for
possibility of tourniquet conversion to a pressure dressing or a HemCon
dressing as appropriate |
|
|
IV/IO ACCESS
(FLUID CONSIDERATION)
* Determine
fluid resuscitation needs
* If
NOT in shock: No IV fluids
necessary, PO fluids if conscious
* If in
shock: Hextend 500 mL IV, Repeat in 30 minutes if still in shock,
No more than 1000 mL of Hextend |
|
|
PREVENTION OF
HYPOTHERMIA |
|
|
MONITOR VITAL SIGNS
|
|
|
HEAD (DCAP-BTLS)
Notes
|
|
SKULL |
|
|
EYES |
|
|
EARS |
|
|
NOSE |
|
|
MOUTH |
|
|
TREAT/ REASSESS |
|
|
NECK (DCAP-BTLS)
Notes |
|
ASSESS NECK
|
|
|
TREAT/ REASSESS |
|
|
CHEST (DCAP-BTLS)
Notes |
|
INSPECT/ AUSCULTATE/
PALPATE |
|
|
TREAT / REASSESS |
|
|
ABDOMEN (DCAP-BTLS)
Notes
|
|
INSPECT/ PALPATE |
|
|
TREAT / REASSESS |
|
|
PELVIS (DCAP-BTLS)
Notes
|
|
INSPECT/ PALPATE |
|
|
TREAT / REASSES |
|
|
LOWER
EXTREMITIES (DCAP-BTLS)
Notes |
|
INSPECT/ PALPATE |
|
|
TREAT/ REASSESS |
|
|
UPPER EXTREMITIES (DCAP-BTLS)
Notes |
|
INSPECT/ PALPATE |
|
|
TREAT/ REASSESS |
|
|
POSTERIOR (DCAP-BTLS)
Notes |
|
LOG ROLL (If
NOT previously done during assessment) |
|
|
INSPECT/ PALPATE |
|
|
TREAT/ REASSESS |
|
|
PAIN
MANAGEMENT
|
NOTES |
|
* Able
to fight: Mobic, 15 mg PO qd and Tylenol, 650 mg
bilayer caplet, 2 PO q8h
*
Unable to fight:
(Must have Naloxone available)
* No IV/
IO access: Oral Transmucosal fentanyl citrate, 800 ug, transbuccally
* IV/ IO
access: Morphine Sulfate 5 mg, IV, reassess in 10 minutes, repeat every 10
minutes PRN to control pain, monitor for respiratory depression
*
Promethazine, 25 mg, IV/IO/IM PRN for Nausea |
|
|
IMMOBILIZATION
|
NOTES |
|
SPLINTING AND
SECURING PATIENT FOR TRANSPORT |
|
|
ANTIBIOTICS
|
NOTES |
|
* If able to
tolerate PO: Moxifloxacin, 400 mg, PO qd
* If NOT able
to tolerate PO: Cefotetan, 2g IV/IO (slow push) or IM q12h OR
Ertapenem, 1g, IV/IO/IM q 24h |
|
| |
|
|
