Trauma Assessment per Da form

Question 1

Three phases of Combat Casualty Assessment

Answer 1

1. Care Under Fire (CUF)
2. Tactical Field Care Phase (TFC)
3. Tactical Evacuation Care (TAC-EVAC)

Question 2

What occurs during CUF?

Answer 2

Fire Superiority
Can Pt assist himself or the squad
Secure site - concealment/cover/perimeter
Treat major life-threatening extremity injuries. (HASTY)

Question 3

What is another name for TFC?

Answer 3

Primary and Secondary Assessment

Question 4

What is another name for Secondary assessment?

Answer 4

Detailed Physical Exam

Question 5

Primary events during TFC? (9)

Answer 5

BSI
Responsiveness
Blood sweep
ABC's
Vascular Access PRN
Jx wound care
Request Evac - 9 line
Reassess Interventions
Drug Allergy/Pain Mgmt/Abx

Question 6

What occurs if the Pt is unresponsive/AMS?

Answer 6

Assess Carotid and Respirations

Question 7

What areas are assessed during blood sweep?

Answer 7

Neck
Axillary
Inguinal
Extremities

Question 8

During blood sweep, what also occurs in addition to identifying additional bleeds?

Answer 8

Assess previous TQs
Apply Delibrate TQ’s to new wounds
Apply Hemostatic Agents PRN

Question 9

How long is pressure held on hemostatic agents?

Answer 9

At least 3-5m PRN

Question 10

Where are the only sites hemostatic agents are applied?

Answer 10

Neck
Axillary
Inguinal Wounds

Question 11

Are hemostatic/pressure dressing agents applied to the Torso?

Answer 11

No

Question 12

What are two questions regarding airway and what should occur during Airway assessment?

Answer 12

Is there an Airway? Will it stay open?
-
Head Tilt and look, listen, and feel
Insert adjunct as needed or perform surgical cric
Position Pt to continue airway patency

Question 13

What is the first thing that MUST happen during breathing assessment?

Answer 13

Expose Torso and assess

Question 14

What is the primary injury to identify while assessing the torso and breathing?

Answer 14

Penetrating chest trauma

Question 15

What must occur after identifying a penetrating chest trauma?

Answer 15

Apply occlusive dressing

Question 16

What must also be considered with a penetrating chest wound?

Answer 16

Needle Decompression PRN per respiratory effort

Exit Wound

Question 17

How is breathing assessed?

Answer 17

Look - Equal rise and fall of the chest

Question 18

What is palpated during breathing assessment and for what?

Answer 18

DCAP-BTLS and TIC

Question 19

What sites are checked for DCAP-BTLS and TIC during breathing assessment?

Answer 19

Shoulder Girdle
Sternum
Rib Cage
Axilla

Question 20

What is the indications of NCD?

Answer 20

Chest Trauma AND progressive respiratory effort

Question 21

Sites where NCD is inserted?

Answer 21

MCL 2-3rd intercostal space

AAL 4-5th intercostal space

Question 22

What is the size of a NCD needle?

Answer 22

14 gauge, 3.25 inch needle

Question 23

How long is NCD held before removing needle?

Answer 23

5-10 seconds - woosh of air

Question 24

What is the best position for breathing?

Answer 24

Position of comfort

Question 25

What needs to occur during circulation (C)?

Answer 25

``` Pulse check - Radial Y/N > Carotid Pack/Pressure dress significant non-pulsatile bleeds Assess H-TQ for conversion to D-TQ Vascular access and need for fluids Wrap any Jx wounds Evacuation - 9 line Reassess Interventions Drug allergies and Pain Mgmt/Meds ```

Question 26

Where is D-TQ applied?

Answer 26

2-3 inches above wound w/out binding joint

Question 27

D-TQ performance steps?

Answer 27

Apply D-TQ Loosen H-TQ and check distal pulse If Distal pulse present tighten D-TQ further If Distal Pulse still present apply new D-TQ just above

Question 28

Criteria for vascular access?

Answer 28

Significant trauma

Question 29

Criteria for Saline Lock?

Answer 29

Radial Pulses present and normal mental status

Question 30

Criteria for Fluid Resuscitation?

Answer 30

Absent radial pulses and AMS

Question 31

What is 1st line fluid for combat fluid resuscitation?

Answer 31

500mL Hextend

Question 32

What are the criteria for establishing IO?

Answer 32

Two unsuccessful IV attempts

Question 33

Minimum lines to initiate 9-line?

Answer 33

3,4,5 3 - Number of pts by precedence 4 - Special Equipment required 5 - Number of patients

Question 34

Detailed Physical exam of Head includes

Answer 34

DCAP BTLS PERRL Inspect Ears, Eyes, Nose, Mouth

Question 35

Detailed Physical exam of Neck includes

Answer 35

DCAP BTLS - TIC | Inspect Trachea/Jugular Veins

Question 36

Detailed Physical exam of Chest includes

Answer 36

DCAP BTLS - TIC Inspect Shoulder Girdle, Sternum, Ribs, Axilla PRN Auscultate

Question 37

Detailed Physical exam of ABD/Pelvis includes

Answer 37

DCAP BTLS and Pelvic for TIC | Inspect perineum

Question 38

Detailed Physical exam of Lower Extremities includes

Answer 38

DCAP BTLS - TIC Assess Motor, Sensory, Circulatory Fx Splint PRN Convert Hemorrhage control PRN

Question 39

Detailed Physical exam of Upper Extremities includes

Answer 39

DCAP BTLS - TIC Assess Motor, Sensory, Circulatory Fx Splint PRN Convert Hemorrhage control PRN

Question 40

Detailed Physical exam of Posterior includes

Answer 40

DCAP BTLS - TIC

Question 41

What does DCAP stand for?

Answer 41

Deformities Contusions Abrasion Penetrations

Question 42

What does BTLS stand for?

Answer 42

Burn Tenderness Lacerations Swelling

Question 43

What does TIC stand for?

Answer 43

Tenderness Instability Crepitus

Question 44

What must occur during TAC-EVAC?

Answer 44

``` Protect against hypothermia Prep extraction device SAMPLE Baseline vitals Document ABX PRN ```

Question 45

Timeframe for ABX consideration?

Answer 45

Over 3-hour evac delay for penetrating trauma