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AHS TEMS protocols Flashcards

1
Q

S/S of mild to moderate dehydration? (7)

A 
Thirst
Cramping
Dry mouth
Decreased urine output
Headache
Dry skin
Dizziness
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2
Q

S/S of severe dehydration? ( 8)

A 
Cramping
Decreased or no urine output
Presyncope/syncope
Rapid HR
Rapid RR
Sunken eyes
Lethargy
Confusion, irritability
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3
Q

Dehydration Abnormal Vital Signs? (6)

A 
Resting HR > 120
RR > 20
BP > 180 Systolic
BP > 120 Diastolic
Temp > 38 or < 36
SpO2 < 94%
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4
Q

Mild to Moderate Dehydration treatment? (2)

A

1 portion electrolyte to 500ml water
or
Water PO PRN

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5
Q

Severe Dehydration treatment? (3)

A

Remove TAC member from active role
Remove from environmental factors
IV 20ml/kg NS to 1L

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6
Q

TAC member with abnormal vital signs after rehydration? (3)

A

Remove TAC member from active role
Remove from environmental factors
IV 20ml/kg NS to 1L

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7
Q

Dehydration symptoms resolved with rehydration? (2)

A

Rest 20 min

Return to active tactical role

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8
Q

Dehydration S/S with chest pain or HR > 150? (2)

A

Continue MARCHE

Tactical evacuation

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9
Q

Hemorrhage control - Direct threat care? (3)

A

Identify obvious major extremity hemorrhages
Apply tourniquets
Tactical rescue to cover

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10
Q

Hemorrhage control - Indirect threat care first step?

A

Wet check

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11
Q

Wet check order? (6)

A 
Groin
Thighs
Legs
Neck
Axilla
Arms
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12
Q

Hemorrhage control - Complete or partial amputation?

A

Apply tourniquet

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13
Q

Pt has S/S of massive extremity hemorrhage?

A

Apply tourniquet

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14
Q

Pt has S/S of massive hemorrhage not from an extremity? (4)

A

Consider junctional tourniquet
Consider wound packing
Indirect pressure control
Consider removing gauze and repacking

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15
Q

Consider wound packing for what kind of injury?

A

Wound is open and has skeletal backing

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16
Q

Signs of Massive hemorrhage? (4)

A

Spurting or pooling blood
Clothing or ground rapidly soaking with blood
Mangled limb with bleeding
Injuries associated with major bleeding but no bleeding occurring

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17
Q

MARCHE mneumonic

A 
Massive hemorrhage
Airway
Respirations
Circulation
Hypothermia
Eyes/everything else
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18
Q

Symptoms of suspension trauma? (8)

A 
Pre-syncope
Palpitations
Nausea/vomiting
Dizziness
Weakness
Paresthesia
Sweating
Confusion
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19
Q

Onset time for suspension trauma?

A

5-20 minutes of being motionless

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20
Q

Pt conscious but immobile or c/o symptoms of suspension trauma? (2)

A

Encourage pt to lift legs parallel to ground
Or
Bicycle legs to keep active

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21
Q

Pt unconscious and suspended?

A

Raise pt legs into sitting position with rope loop

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22
Q

Steps for suspension trauma rescue? (3)

A

Work with TAC to facility rescue
Do not position pt vertically if possible
Rappel to pt position to assess

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23
Q

Treatments while high angle rescue of suspension trauma pt being conducted? (2)

A

Initiate IV access

If prolonged hang time 1000ml bolus

24
Q

Suspension trauma - Once rescue completed treatment? (2)

A

IV access

If prolonged hang time or symptomatic 1000 ml NS

25
Suspension trauma symptomatic patient post fluid bolus treatment? (2)
Sodium Bicarb - 1 mEq/kg SIVP q 1 PRN | Sodium Bicarb infusion 75 mEq in 500 ml D5W at 150 ml/hr
26
Suspension trauma Sodium Bicarb infusion set-up?
75 mEq in 500 ml at 150 ml/hr = 25 gtts/min = 1 gtts every 2 seconds
27
Suspension trauma dysrhythmia treatment? (3)
Calcium gluconate 3 g IV/IO Sodium Bicarb 1 mEq/kg SIVP q 1 time Salbutamol 5 mg Neb PRN or MDI 10 puffs q 5 min PRN
28
Suspension trauma cardiac arrest treatment?
Treat as hyperkalemic | Utilize TEMS/IRP crush protocol
29
Transport considerations for suspension trauma? (2)
If suspended longer than 2 hours consider facility with dialysis capabilities >10 min motionless suspension must be transported
30
Analgesia for alert pt without significant injury?
Acetaminophen 975 mg PO q 4-6 hrs
31
Analgesia for altered LOC or weak radial pulse without vascular access? (2)
Ketamine 50 mg IN - 0.5ml per nare | Ketamine 50 mg IM
32
Analgesia with vascular access and no S/S of shock?
Fentanyl 0.5 mcg/kg SIVP single max of 100 mcg q 5 to max of 250 mcg
33
Analgesia with vascular access and S/S of shock? (2)
Treat with adult shock protocol | Ketamine 0.2 mg/kg SIVP/IO
34
Thoracic trauma management initial actions? (5)
Remove pt from hazards or active tactical role Follow MARCHE Assessment and vitals Apply O2 Move to position of comfort or position injury side up
35
Suspected isolated thoracic injury, stable with minimal SOB? (2)
Follow MARCHE | Tactical evacuation
36
Suspected open pneumothorax? (3)
Apply vented chest seal Monitor for development of tension If vent occludes or tension occurs, burp chest seal
37
Suspected hemothorax?
1g TXA in 250ml NS over 10 min = 250 gtts/min = 4 gtts/s
38
Thoracic trauma with respiratory or hemodynamic compromise?
Suspect tension pneumothorax
39
Suspected tension pneumothorax? (2)
Needle decompression | Digitally manipulate tissues to align and allow decompression
40
Cardiac arrest secondary to hemothorax? (2)
Needle decompression | Digitally manipulate tissues to align and allow decompression
41
Open Pneumothorax signs? (3)
Wound visibly bubbling Wound has air sucking into chest cavity Shortness of breath
42
Thoracic trauma signs of respiratory or hemodynamic compromise? (3)
Weak or absent radial pulse Decreasing LOC SpO2 < 85%
43
How long is direct pressure required for wound packing? (2)
5 min for hemostatic gauze | 10 min for gauze only
44
After direct pressure on wound packing if blood continues to flow? (2)
Remove gauze from wound | Repack wound
45
If unsuccessfully controlled bleeding after 2 attempts at wound packing?
Apply tourniquet
46
TECC mnemonic
Tactical Emergency Casualty Care
47
TCCC mnemonic
Tactical Combat Casualty Care
48
STOP mnemonic
Situational awareness update Triage all other casualties Ongoing documentation Pass up pertinent information
49
MARCHE - M actions?
Massive Hemorrhage - control life threatening hemorrhage
50
MARCHE - A actions?
Airway - Establish and maintain a patent airway
51
MARCHE - R actions? (4)
Respiration - decompress seal chest wounds support ventilation STOP mnemonic
52
MARCHE - C actions? (2)
Circulation - IV/IO | Fluids
53
MARCHE - H actions? (2)
Hypothermia/head injury - treat/prevent hypothermia | TBI protocol
54
MARCHE - E actions?
Everything else/Eye injury - visual acuity test - cover eye with rigid shield
55
Immediate action for casualties with altered level of consciousness?
Disarm them of weapons and communication devices

TEMS (6 decks)

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