Combat Casualty material Flashcards
(29 cards)
What factors affect coagulation?
Top 3
- Hypothermia - Treat for shock
- Lactic Acidosis (Poor perfusion) - Treat for shock
- Hemodilution - Give fluids judiciously
- — - Increased BP - (Breaks clots) - Give fluids judiciously
- Rx - meds interfering with clotting process
Two most important things to do in the field to prevent coagulation problems?
- Treat for shock
2. Give fluids judiciously
When should fluids be given?
Lost of radial pulse or AMS
What sites on the body are noncompressible and what is the best way to treat?
Torso (Chest/Abd) and TXA
How should TXA be given in the field?
2 grams TXA with 100ml Saline followed by 500 ml Hextend.
What is the pharma-physiology of TXA?
Prevents fibrin degradation aka prevents clots from breaking down
Criteria to place a D-TQ?
W/in 2hrs to surgery per tactical situation
Wound exposed and assessed
H-TQ on <6hrs or on amputation
Or in profound shock
TC3 card is also known as?
DD Form 1380
Is a TQ ever removed in the field?
NO - only loosened
TXA administration indications?
Significant bleeds
Penetrating torso trauma
Severe ABD trauma (+/-)
Profound hemorrhagic shock
At what point should TXA not be given?
3H post injury
In addition to a TQ what should be placed for an above/below the knee amputation AKA/BKA?
Pelvic Binder
What is does the MIST report stand for?
MOI
Injuries/Interventions
S/S
Treatments provided
What is Lactated Ringer used for generally?
Burns or Dehydration
What is the target blood pressure in fluid resuscitation and how can it be checked in the field
Target BP = 80-90 Systolic and if a pulse is located at 1. Radial indicates >80 2. Femoral indicates >70 3. Carotid indicates > 60
What is the minimum blood pressure to maintain perfusion?
80 systolic
Preferred fluid resuscitation guideline list?
Whole blood type O 1:1:1 - RBCs/Plasma/Platelets 1:1 - RBCs/Plasma RBCs alone, Thawed FFP alone, Reconstituted plasma Hextend LR or Plasma-Lyte A
After initiating a saline lock or IO access what is the next thing to do?
Flush with Saline
Criteria to switch to the IO intervention?
If in combat
- AMS and NO radial pulse
- Will req fluids
- Missed at least two IVs
How much blood can be lost before blood pressure drops?
1500-2000mL (1.5-2L)
Two ways to open airway w/out adjuncts (Least invasive?
Head Tilt/Chin Lift
Jaw Thrust
At what point can you let go of C-Spine stabilization?
After fully secured on spine board with blocks
What happens if a patient gags while inserting an airway adjunct?
Back out the adjunct
NPA is contraindicated if?
Clear fluid running from nose or ears
Maxilla-facial trauma
