FC1 Study Guide
Preventative measures for phlebitis include...
-keep the infusion flowing at the prescribed rate -Select a large vein when using irritating drugs -change tubing every 48 hours -change solution and dressing every 24 hours -change IV site every 72 hours
A typical adult casualty can hemorrhage how much blood and IV fluid into the abdomen
10 liters
How many ribs does the human body have
12 pairs. 10 attached to the sternum and two connected to the sternum by cartilage
A typical adult cavity can bleed this much into each side of the chest for a total of...
1500, 3000
How is a deliberate tourniquet applied?
2-4 inches above the wound, on the skin, not over a joint
How large a wound must be to be considered a sucking chest wound
2/3 the size of the trachea
Amount of time to transmit lines 1 through 5
25 seconds
During your blood sweep is the first time you would pack a wound. Step 3A. When is the next consideration of wound packing?
6A. First consideration in circulation; for significant non-pulsatile hemorrhage
60 mmHG
A present carotid pulse indicates a systolic blood pressure of at least...
70 mmHG
A present femoral pulse indicates a systolic blood pressure of at least...
80 mmHG
A present radial pulse indicates a systolic blood pressure of at least...
93 mmHG
A systolic blood pressure above _____ is high enough to dislodge any blood clots
80 mmHG
A systolic blood pressure of ______ is sufficient to perfuse vital organs.
An air embolism
Abrupt drop in blood pressure, weak rapid pulse, cyanosis and chest pain are signs of...
Air embolism
Abrupt drop in blood pressure, weak rapid pulse, cyanosis and chest pains are signs of
Subcutaneous emphysema
Air or gas present in the subcutaneous layer of the skin
How many sides of an improvised occlusive dressing are taped down
All 4
Hasty tourniquets
All tourniquets placed during care under fire are these type
2-3 feet
Amount of distance a rescuer should have between themselves and the casualty to gain leverage
Infiltration
An accumulation of fluid in the tissue surrounding an IV needle site
Type of shock caused by the body's hypersensitive reaction to the antigen bronchospasm and vasodilation
Anaphylactic shock
What is the best method of arterial hemorrhage control for the neck, axillary and inguinal wounds?
Apply hemostatic agents
HAGA MRAP
Armored evacuation vehicle that would be appropriate to send to the site of casualties outside the operating base.
At what point does evacuation of a casualty begin?
As soon as medical personnel receive the patient
On a nine line medevac, lines 6 through 9 should be transmitted...
As soon as possible
When should the medic inform the tactical leader of the need for medical evacuation?
As soon as the medic identifies the need for evacuation
Permanent medical record
Battlefield documentation becomes part of a soldier's...
Which blocks must be completed at a minimum on the DD 1380?
Blocks 1, 3, 4, 7, 9, 11
Hematemesis
Bloody vomiting
Acid based balance is directly related to
CO2 produced and CO2 eliminated
Pneumothorax
Caused by an accumulation of air within the potential space between the visceral and parietal pleura
Secondary blast injury
Caused by debris or shrapnel from an explosion
Primary Blast Injury
Caused by the blast overpressure or wave from an explosion
Tertiary blast injury
Caused when the casualty is blown into a solid object like a wall or vehicle and suffers blunt trauma.
Subcutaneous emphysema is a sign of...
Chest injury
What is over classification?
Classifying a wound more severe than it really is
The goals of TC 3
Complete the mission, prevent additional casualties, treat the casualty
Type of rescue involving vehicle extrication or possible tactical search and rescue of collapsed buildings
Complex rescue
Hemoptysis
Coughing up blood
Which form gets attached to the casualty's clothing where it will remain until the casualty's arrival at the MTF?
DD Form 1380 Field Medical Card
Intraosseus is not indicated for
Dehydration casualties that have had two unsuccessful IV attempts
Type of tourniquet applied during Tactical Field Care
Deliberate Tourniquets
Type of shock that occurs when the vascular container enlarges without a proportional increase in the fluid volume
Distributive shock
Circulatory overload
Elevated blood pressure, distended neck veins, rapid breathing, shortness of breath, tachycardia and fluid intake is much greater than urinary output are indications of...
What is the advanced airway used in the combat environment?
Emergency cricothyroidotomy
Advanced airway skills
Endotracheal intubation and Emergency Cricothyroidotomy
M997
Evacuation vehicle that lacks armor and should be used within an operating base to move casualties between the MTF and flight line.
If you find an entrance wound, you always look for...
Exit wound
Hypothermia, acidosis, hemodilution, medications and blood pressure
Factors that disrupt the process of clotting and promote coagulopathy (difficult clotting)
When a patient is in shock, what is a sign of impending death?
Falling blood pressure
True or False? A casualty with a radial pulse receives a direct line IV
False: Saline lock. Only casualties without a radial pulse receive direct line IV
True or false: a soft abdomen indicates internal bleeding.
False; a rigid abdomen indicates internal bleeding.
Where does the medics initials the 1380?
Far right of block 11
Who supervises the loading and positioning of the casualties aboard the helicopter?
Flight Crew
Lactated Ringers
Fluid given to a dehydration casualty in a combat environment.
Lactated Ringers
Fluid of choice for civilian trauma resuscitation.
Dextrose and Water (D5W)
Fluid used as a calorie replacement or when glucose is needed for a hypoglycemic patient.
Normal Saline
Fluid used in blood transfusions and restoring loss of bodily fluids
What is the tactical priority during care under fire?
Gaining fire superiority
14 gauge 3.25 inch
Gauge and length of the needle used for an NCD
How casualties should he positioned on a Blackhawk carousel after it is rotated
Head forward in the cabin
When you first reach an unconscious casualty, how should you open the airway?
Head tilt - chin lift
This occurs when too much intravenous fluid has been given and the clotting proteins, platelets and red blood cells have been "washed out" of the vascular space
Hemodilution
The leading cause of death on the battlefield
Hemorrhage
What is HABC?
Hemorrhage, Airway, Breathing, and Circulation
How is a hasty tourniquet applied?
High and tight over the clothing
At least 2 inches beyond all edges of the wound
How far should the tape extend on the improvised occlusive dressing
What is phlebitis?
Inflammation of vein wall
Signs and symptoms of tension pneumothorax
JVD, cyanosis, progressive respiratory distress, anxiety, tracheal deviation
Reason why litter casualties are normally loaded head first into ambulances
Less likely to get motion sickness, they experience less noise from doors opening and closing and there is less danger of injury from rear end collision
Level 5
Level of care of a CONUS DoD hospital for VA hospital. Provides restorative and rehabilitative care.
Level 2
Level of care with Forward Resuscitative Care like a medical company or a forward surgical team. Is close to the point of injury and can perform stability surgery
Level 4
Level of care with definitive hospital care capabilities outside of the combat zone (CONUS or OCONUS). Provides convalescent, restorative and rehabilitative care.
Level 1
Level of care with first responder capability like a medical platoon or Battalion Aid Station. Provides immediate front line clinical care.
Level 3
Level of care with theater hospitalization capabilities like a combat support hospital. Provides in theater medical/surgical care.
What is the medical priority during care under fire?
Life threatening extremity hemorrhage control
Lines 6 and 9
Lines of a 9 line medevac that change during peace time
Upper right, lower right, upper left, lower left
Loading sequence for 4 litter casualties
The pilot-in-command (PIC)
Makes the final decision regarding how many casualties may be safely loaded aboard the helicopter
What are the contraindications for an NPA?
Maxillofacial trauma, exposed brain matter, CSF from the nose, mouth, or ears
This vein should be your first choice
Median cubital
Who signs the DD 1380?
Medical provider
Parietal pleura
Membrane attached to the surface of the chest wall
Visceral pleura
Membrane attached to the surface of the lung
Which casualty is loaded last so they will be unloaded first
Most seriously injured patient
Areas checked during blood sweep
Neck, axillary, inguinal, and extremities
Type of shock caused by spinal cord injury interrupts the sympathetic nervous pathway
Neurogenic shock
Type of hemorrhage that cannot be compressed with direct pressure. Includes the chest, abdomen, and pelvis
Non-compressible hemorrhage
"I have a medevac request."
Opening statement of a 9 line medevac
First step of circulation
Pack wounds not treatable with a tourniquet with combat gauze and hold pressure for 3 minutes and then apply a pressure bandage.
Nasal and Oral cavity
Parts of the upper airway
Deliberate tourniquets
Placed 2-3 inches above the wound on the skin and never on a joint
The cardiac box
Placement for NCD should not be medial to the nipple line to ensure the needle does not end up where...
A watery fluid with proteins, other molecules and dissolved minerals. It constitutes half the blood volume and provides a fluid environment for other blood components
Plasma
Essential airway skills
Positioning, manual maneuvers, suction and NPA
Priority 4 Convenience
Priority assigned to casualties for whom evacuation is a matter or medical convenience rather than necessity.
Priority 2 Priority
Priority assigned to casualties that are sick or wounded and require prompt medical care. Evacuation required within 4 hours in order to receive treatment not available locally or for those whose condition may deteriorate and make them an urgent priority.
Priority 3 Routine
Priority assigned to patients who require far-forward surgical intervention. Evacuation required within 1 hour in order to save life and stabilize the casualty for further evaluation.
Priority 1 Urgent
Priority assigned to the emergency cases that should be evacuated as soon as possible. Evacuation required within 1 hour in order to save limb or eyesight.
Type of shock caused by increased stimulation of the vagus nerve causes vasodilation and hypotension and leads to dramatic fall in cardiac output
Psychogenic shock
When the body has increased levels of CO2 in the body the need to eliminate the CO2 stimulates and increase in what?
Respirations
The tactical leader
Responsible for getting casualty to the evacuation site
Type of shock when infection causes damage to the walls of the blood vessels, causing vasodilation and leakage of fluid from the capillaries into the interstitial space
Septic shock
Type of rescue through open fields or structures with no obstacles to removing casualties
Simple rescue
The vagus nerve
Stimulation of this will lead to bradycardia and hypotension.
What phase of care do you provide airway management?
Tactical Field Care
What is TIC and where do you check for it?
Tenderness, instability, crepitis - bones of extremities
What is the main concern of a pneumothorax?
That it will turn into a tension pneumothorax
Endotracheal intubation
The "gold standard" for achieving maximum control of the airway in trauma victims.
Mediastinum
The cavity between the lungs that contains the heart and great vessels
Penetrating
The majority of combat related wounds are due to this type of trauma
1000 mL
The maximum amount of hextend that should be given to a casualty pre-hospital.
The superficial femoral artery (SFA)
The most commonly injured artery in combat.
The "X"
The point of wounding or injury is referred to as what?
Needle for NCD is inserted where.....
The second intercostal space on the mid clavicular line. DIRECTLY OVER THE TOP OF THE THIRD RIB.
Enemy fire
The single most significant obstacle to the medics ability to provide care.
The three most common devices used by the hoist to extract casualties
The stokes basket, the jungle penetrator, the sked litter
Who makes all the decisions, including when medevac is called, during a mission?
The tactical commander or senior military person on ground
The cricothyroid membrane is located between...
The thyroid and cricoid cartilage
Intraosseus is indicated when
There is trauma to the extremities, for small children and after two unsuccessful IV attempts on a combat casualty with altered mental status and absent radial pulses.
Red Blood Cells
These carry oxygen to the tissues and provides the bloods red color.
White blood cells
These fight infection and consume dead tissue as well as producing antibodies that help the body resist infection.
Acidosis
This occurs when the body suffers from shock and lactic acid builds up in the tissue.
What is the first tool you would use to stop massive hemorrhage in TC3?
Tourniquets
Parts of the lower airway
Trachea, bronchi and bronchioles and lungs
True or false: A simple pneumothorax can progress to a tension pneumothorax?
True
Indications for an NPA
Unconscious casualty with no respiratory distress or airway obstruction, an altered casualty with intact gag reflex.
What are the proper body mechanics for lifting patients?
Use leg muscles, keep back straight
When is a casualty considered hypothermic?
When core temp falls below 95 F
Casualties are carried on the litter feet first except...
When going uphill or upstairs
When is a casualty considered hypothermic?
When their core body temperature falls below 95 degrees
The alveoli
Where gas exchange takes place
Medic or first responder
Who signs the TC3 card DA Form 7656