TCCC

Question 1

3 stages of TCCC

Answer 1

Care Under Fire
Tactical Field Care
Tactical Evacuation Care

Question 2

Tourniquet placement if you cannot see site if bleed

Answer 2

High tight and in pocket

Question 3

Care Under Fire questions

Answer 3

Are you hurt
Can you fight
Can you move
Apply a tourniquet

Question 4

First step of tactical field care

Answer 4

Security perimeter
Maintain tactical awareness
Big pipe search

Question 5

Hemostatic adjuncts

Answer 5

Felix gauze
Chito gauze
Chat gauze
Stat
Itclamp

Question 6

Xstat

Answer 6

Syringe with sponges

Good for narrow tract deep junctional wounds

Question 7

Syringe with sponges

Answer 7

X-Stat

Question 8

Best tool for deep narrow tract junctional

Answer 8

X-Stat

Question 9

Best bleeding control of neck & head wounds

Answer 9

ITclamp

Question 10

Needed after you apply hemostatic dressings

Answer 10

3 minutes of pressure

Question 11

Important thing to remember if using iTclamp

Answer 11

Can use on head/neck but not within 1in of orbits

Question 12

Unconscious casualty without airway cinpronise

Answer 12

Recovery position
NPA
Chin lift /jaw thrust

Question 13

Uncinacious with airway compromise

Answer 13

Cri-key

Igel

Question 14

When don’t you need c-spine

Answer 14

If only penetrating injury

Question 15

Why is airway first in TCCC

Answer 15

No one cares if you have great c-spine if you don’t have a secured airway

Question 16

What type of airway is IGel

Answer 16

Extraglotric

Question 17

Progression of untreated tension pneumo

Answer 17

Resp distress
Obstructive shock
Traumatic cardiac arrest

Question 18

Needle D both sides

Answer 18

If significant traumatic cardiac arrear (no pulse, resp, response to pain, other signs of life)

Question 19

Intervention for traumatic cardiac arrest

Answer 19

Double dart

Question 20

When do you move from “A”to “C”

Answer 20

Fail A twice

Question 21

Needle D procedure

Answer 21

Over rib
Down to hub
Hold 5-10 sec to deconpress

Question 22

Needle D site

Answer 22

5th ICS

2nd ICS mid claviculae

Question 23

Choosing needle for needle D

Answer 23

10-14 gague

3.25 in

Question 24

Intervention for open chest wound

Answer 24

Vented seal

Question 25

When to burp the vented chest seal

Answer 25

Hypoxic Reap distress Low BP (Suspect t. Pneumo)

Question 26

Intervention needed if head i jury

Answer 26

O2 above 90% if TBI

Question 27

When do you place the pelvic binder

Answer 27

"C"

Question 28

When do you check for bleeding in TCCC

Answer 28

``` m = big pipes C = little pipes ```

Question 29

Suspect pelvic fracture

Answer 29

``` Pelvic pain Unstable in exam Lower extremity amputation Unconscious Shock ```

Question 30

3 criteria to meet to turn limb/junctional tourniquet to hemostatic/pressure dressings

Answer 30

1. Not in shock 2. You can continue to monitor the site 3. Tourniquet isn't being used to control an amputation

Question 31

Indication of radial pulse

Answer 31

SBP at least 80-90

Question 32

DCAP-BTLS

Answer 32

``` Deformities Contusions Abrasions Puncture/penetration Burn Tender Lacerations Swelling ```

Question 33

Rx in C if bleeding

Answer 33

TXA 1gram in 100ml over 10 mon | Can repeat immediately after first

Question 34

When do you need an IV

Answer 34

Only if can't take PO or in shock

Question 35

Needed if in shoxk

Answer 35

IV/IO TXA IVF/blood

Question 36

1:1:1

Answer 36

Plasma, rbc, plt

Question 37

Goal if giving blood

Answer 37

Until palpable radial pulse Improved mental status Sbp over 90

Question 38

Used to reauscitate

Answer 38

Blood Hextend Lr

Question 39

In shock but not responsive to IVF

Answer 39

Consider t. Pneumo the cause of refractory shock

Question 40

Pain options in TCCC

Answer 40

Triple Option | Morphine

Question 41

Option 1

Answer 41

Mild/mod Can still fight Tylenol 650 2 PO q8hr Mobic 15mg PO once a day

Question 42

Option 2

Answer 42

Not fighting Fentanyl Lilly 800ug Don't chew

Question 43

Option 3

Answer 43

Hemorrhagic shock/resp distress Ketamine 50mg IM/IN q30min Ketamine 20mg iv/IO q20min

Question 44

End points of giving ketamine

Answer 44

Nystagmus

Question 45

Ketamine iM/IN

Answer 45

30mg q 30min

Question 46

Ketamine IV/IO

Answer 46

20mg q 20 minutes

Question 47

Ketamine if head injury

Answer 47

Ketamine and fentanyl can worsen TBI but if can c/o pain, likely not serious enough to preclude use of ketamine

Question 48

Morphine

Answer 48

IV/IO 5mg Q10 minutes

Question 49

Zofran

Answer 49

4-8mg ODT 2nd dose of 4mg in 15min No more than 8mg q8hr

Question 50

ABX

Answer 50

``` PO = Moxifloxacin 400mg PO IV= Ertapenem 1 gram ```

Question 51

CPR

Answer 51

Never in field | If torso/polytrauma, without pulse or respirations, needle D x2 before calling it