Tactical Field Care

Question 1

Step 1

Answer 1

Establish security perimeter. Maintain situational awareness.

Question 2

Step 2

Answer 2

Triage casualties as required. Remove weapons and communications if altered LOC.

Question 3

Mnemonic MARCH definition

Answer 3

Massive hemorrhage 
Airway
Respiration
Circulation
Hypothermia prevention

Question 4

Massive Hemorrhage - 2 steps

Answer 4

Assess for unrecognized hemorrhage (wet check)

External hemorrhage control

Question 5

Tourniquet application process

Answer 5

2-3 inches proximal injury

If bleeding remains uncontrolled apply second tourniquet

Question 6

Hemostatic application

Answer 6

Apply with wound packing and 3 minutes of direct pressure

Question 7

iTClamp application

Answer 7

Wound packed with hemostatics
Wound edges together
Do not apply near the eye or eyelid

Question 8

Airway Management - Unconscious casualty without airway obstruction intervention (4)

Answer 8

Recovery position
Chin lift or jaw thrust
NPA
Extraglottic airway

Question 9

Airway management - Airway obstruction or impending airway obstruction interventions (7)

Answer 9

Allow to assume position of comfort
Chin lift or Jaw thrust
Suction if indicated
NPA
Extraglottic airway
Recovery position
Cricothyroidotomy

Question 10

Airway Management - Cervical spine management for penetrating trauma?

Answer 10

No c-spine precautions indicated

Question 11

Airway Management - monitoring equipment?

Answer 11

Oxygen saturation

Question 12

Airway Management - Frequent reassessment is required why?

Answer 12

Casualty’s airway status can change over time

Question 13

Respiration - 4 steps to management

Answer 13

Assess and treat tension pneumothorax
Open or sucking chest wounds managed
Initiate pulse oximetry
Moderate to severe TBI given O2 to maintain >90%

Question 14

Respiration - S/S of tension pneumo: Chest injury and? (6)

Answer 14

SOB
Tachypnea
Absent or decreased unilateral breath sounds
SpO2 < 90%
Shock
Cardiac arrest without oxygen obviously fatal wounds

Question 15

Respiration - Initial treatment of suspected tension pneumothorax (5)

Answer 15

Burp or remove chest seal
Establish SpO2
Position casualty supine unless conscious
Decompress on injured side
Bilateral decompression if in arrest

Question 16

Respiration - NDC successful if: (4)

Answer 16

Respiratory distress improves
Obvious hissing sound
SpO2 improves
Arrest has return of vital signs

Question 17

Respiration - NDC unsuccessful. Next interventions? (2)

Answer 17

Perform second NDC

Consider decompressing the opposite side

Question 18

Circulation - 5 considerations

Answer 18

Bleeding control
IV access
TXA
Fluid resuscitation
Refractory shock

Question 19

Circulation - Bleeding control - 4 steps

Answer 19

Consider pelvic binding
Reassess prior tourniquet application
Consider converting tourniquet
Expose and mark tourniquets

Question 20

Circulation - Pelvic binding indications (5)

Answer 20

Significant injury and:
Pelvic pain
Lower limb amputation or near amputation
Exam findings suggestive of pelvic fracture
Unconsciousness
Shock

Question 21

Hypothermia - Prevention

Answer 21

Minimize casualties exposure to ground, wind and air
Replace wet clothing with dry
Place heating blanket
Enclose casualty in impermeable enclosure bag
Prepare for evacuation

Question 22

Penetrating eye injury Tx?

Answer 22

Rapid field visual acuity test

Cover eye with rigid shield

Question 23

Circulation - TXA administration

Answer 23

2g SIVP or IO

Question 24

Circulation - Suspected Head Injury goal BP

Answer 24

90mmhg systolic

Question 25

Hypothermia exposure prevention (5)

Answer 25

``` Minimize exposure Replace wet clothing Apply ready head blanket Use any equipment available to insulate Warm IV fluids are preferred ```

Question 26

Penetrating eye injury treatment (2)

Answer 26

Perform rapid visual acuity test | Cover with rigid eye shield

Question 27

Analgesia options for mild to moderate pain?

Answer 27

Tylenol | Meloxicam

Question 28

Analgesia options for moderate to severe pain without shock?

Answer 28

Oral Transmucosal Fentanyl

Question 29

Analgesia options for moderate to severe pain with shock?

Answer 29

Ketamine 50 mg IN/IM q 30 | Ketamine 20 mg IV q 20