68W Phase 3 Mod 1

Under the laws of war, certain persons are protected as "noncombatants". Who falls into this category?

-Civilians -Wounded and Sick in the Field and at Sea -Prisoners of War -Medical Personnel

What are some of the signs and symptoms associated with Malaria?

-Fever alternating with chills -Headache -Muscle aches -Sweats -Abdominal pain with diarrhea

If you must report a known or suspected violation of the Geneva Convention by someone in your chain of command, what are some of your reporting options?

-Local office of the Inspector General -Office of the Provost Marshal -Judge Advocate -A chaplain who can help you report through official channels -Chain of Command

What are examples of conditions that would put a person into the Immediate Triage Category?

-Massive external bleeding -Airway Obstruction -Tension pneumothorax -Open pneumothorax with respiratory distress -Hypovolemic shock -Any burns of the face, neck, hands, feet or perineum and genitalia -Unstable abdominal wounds with shock -Open fractures of long bones

What are examples of conditions that would put a person into the Minimal Triage Category?

-Minor lacerations and abrasions -Contusion -Sprains and strains -Minor combat stress problems -1st or 2nd degree burns under 20% of the body -Upper extremity fractures without neurovascular compromise -Behavioral disorders or other obvious psychiatric disturbances -Suspicion of blast injury -Symptomatic but unquantified radiation exposure

What are examples of conditions that would put a person into the Delayed Triage category?

-Open chest wound without respiratory distress -Abdominal wounds without shock -Eye and CNS injuries -Soft tissue wounds requiring debridement -Other fractures open or closed -2nd and 3rd degree burns covering 20% or more

The Geneva Conventions authorizes the use of these 4 distinctive emblems on a white background:

-Red Cross -Red Crescent -Red Crystal -The Red Star of David

What are the Five S's for processing detainees?

-Search -Segregate -Silence -Safeguard -Speed

What are examples of conditions that would put a person into the Expectant Triage Category?

-Unresponsive casualties with penetrating head wounds and signs of impending death -Burns, mostly 3rd, covering more than 85% of the body -High Cervical spine injuries -Mutilating explosive wounds involving multiple anatomical sites and organs -Profound shock with multiple injuries -Agonal respirations -Convulsions and vomiting withing 24 hours post-radiation exposure -Transcranial gunshot wound -Open pelvic injury with uncontrolled bleeding

After experiencing a bite from a brown recluse spider, how soon would you expect to see symptoms?

1-4 hours

After experiencing a bite from a black widow spider, how soon would you expect to see symptoms and how long do they last?

10-60 minutes 24-36 hours

Research has shown that adverse childhood events increase the risk of attempting suicide by how much?

2 - 5 times

How long does it take for soldiers to become acclimated to a new environment, and when should they be considered non-acclimated?

2 weeks During periods of sudden temperature change

Usually it takes _____ hours after warming of frostbite to determine extend of injury

24-48

After experiencing a bite from a brown recluse spider, how long would you expect to see the pustule grow?

3-4 days

Malaria is a tremendous problem in tropical, developing countries; causing ________ million cases each year.

300-500

Approximately how long does it take for symptoms to appear for malaria?

7-30 days after the infective bite

Suicides ______ triggered by relationship problems ______ occurred while soldiers were pending UCMJ action ______ triggered by financial problems ______ triggered by drug/alcohol problems

75% 50% 42% 34%

Nearly ____ percent of those who attempt or commit suicide give some warning of their intentions.

80

When are expectant casualties treated?

A re-triage and treatment of these casualties should be performed after all other casualties have been treated

Transmission: The disease causing agent undergoes some change in the body of the arthropod. The pathogen may multiply or simply develop into an infectious form.

Active

Altitude Injuries: The most common altitude disorder. In an un-acclimatized person about 6,500 ft may present with headache and one of the following; anorexia, nausea, vomiting, lethargy, dizziness or lightheadedness

Acute Mountain Sickness

Definition: Animals, including ticks, spiders, mites and other insects as well as crustaceans such as shrimp, lobster and crabs

Arthropods

Disease: -Symptoms include itching, and small welts appearing over the bite area. Bites may continue to itch up to 2-3 weeks. -Spread by mites in areas of tall grass, associated with low wet spots such as ponds and forest underbrush

Chiggers

Definition: A condition caused by repeated prolonged exposure of bare skin in damp nonfreezing temperatures. It is often precipitated by acute repeated exposure to cold, more common in damp environments

Chilblains

Signs and Symptoms: Redness or cyanosis of affected areas, blue and red patches commonly on the lower extremities, face, hands, and feet. Hot, tender, itching skin, subcutaneous nodules may be present. May have ulcerated or bleeding lesions with chronic repeated episodes

Chilblains

Definition: Interned during an international armed conflict for security reasons, for protection, or because they have committed an offense against the detaining power

Civilian Internee

What are the 5 mechanisms of heat loss?

Conduction Convection Evaporation Radiation Respiration

Active Transmission: The vector is smashed onto the skin of the host. When the host wipes off the dead bug, the pathogen is rubbed into the skin.

Crushing Vector

Triage Categories: Casualties who have less risk of losing life or limb by non-immediate treatment. Casualties can tolerate delay prior to intervention without unduly compromising the likelihood of a successful outcome. When medical resources are overwhelmed, soldiers in this category can be held until the previous category have been cared for.

Delayed

Definition: Any person captured or otherwise detained by an armed force. All will be treated in accordance with the principles applicable to enemy prisoners of war unless and until a more precise legal status is determined.

Detainee

Definition: One who, while engaged in combat under orders of his or her government, is captures by the armed forces of the enemy

Enemy Prisoner of War

Definition: The injection of poisonous materials by bites or stings of arthropods or snakes

Envenomations

Triage Categories: Casualties so critically injured that only complicated and prolonged treatment offers any hope of improving life expectancy. Casualties in this category have wounds that are so extensive that, even if they were the sole casualty and had the benefit of optimal medical resources application, their survival would be very unlikely.

Expectant

Active Transmission: The vector defecates into a wound on the host. As the wound itches, scratching and rubbing by the host causes the pathogen to enter the host's body.

Fecal Contamination

Definition: Condition involving the freezing injury of tissue caused from exposure to cold, usually below 32 degrees depending on the wind chill factor, duration of exposure, and adequacy of position

Frostbite

Signs and Symptoms: -Loss of sensation or numb feeling -Sudden whitening of skin in affected area -Redness of skin in light-skinned soldiers -Blisters with clear fluid -Swelling or tender areas -Loss of previous feeling of pain in affected area -Pale, yellowish, waxy-looking skin -Affected area feels solid or wooden

Frostbite

Types of Acclimatization: Limits the daily altitude gain to allow partial acclimatization. The altitude at which soldiers sleep is the critical element. Having soldiers spend two nights at 9,000 ft and limit the sleeping altitude to no more than 1,000 ft per day above the previous night's sleep altitude will reduce altitude illnesses.

Graded Ascent

Heat Injury: A systemic reaction to prolonged heat exposure and is due to excessive fluid loss and electrolyte depletion

Heat Exhaustion

Heat Injury: Caused by failure of the temperature-regulating system in the brain. Usually involves excessive exposure to strenuous physical activity under hot conditions.

Heat Stroke

Heat Injury: A muscle cramp or spasm of the voluntary muscles caused by depletion in the body of water and salt

Heat cramps

Altitude Injuries: A potentially fatal condition with acute brain swelling due to rapid ascent in altitude. The cause is unclear. Altitude causes chemical changes in small vessels in the brain which causes them to leak fluid and cause swelling.

High Altitude Cerebral Edema

Altitude Injuries: Caused by rapid ascent to high altitude. Can be rapidly fatal and is the most common cause of death due to an altitude illness. After ascent to 10,000-12,000 ft without proper acclimatization, the casualty's alveolar membranes become leaky and fluid starts filling the alveoli decreasing alveolar surface area to conduct gas exchange.

High Altitude Pulmonary Edema

When dealing with an individual experiencing a cold injury, if you notice a conscious individual with an altered mental status what can you assume and what would you do?

Hypoglycemia Provide warm, high-caloric or glucose fluids orally

Definition: A condition defined as a systemic cold injury. Generally occurs from prolonged exposure to low temperatures often above freezing, especially room immersion in cold water.

Hypothermia

Signs and Symptoms: -Conscious to altered mental status to unconscious. -Shivering, poor muscle coordination to rigid muscles -weak pulse to absent pulse -pale, cold skin to ice cold skin

Hypothermia

Triage Categories: Casualties whose condition demands immediate resusicitative treatment to save life. Casualties in this category present with severe. life-threatening wounds. Generally, the procedures used to correct these conditions are short in duration and economical in terms of medical resources. Casualties within this group have a high likelihood of survival.

Immediate

Definition: Injuries that result from prolonged exposure of the feet to cool or cold water or mud. Inactive feet in damp or wet socks and boots, or tightly laced boots that impair circulation are even more susceptible to injury.

Immersion Syndrome

Signs and Symptoms: Early Stages- area is cold, pale, numb, tingling, with pulses that are diminished or absent Advanced Phases - Area is pale, may be blisters, swelling, redness, and ulcerations

Immersion Syndrome

Active Transmission: A vector injects the pathogen into the host with its saliva while it feeds on the host.

Inoculation

Has the official role in protecting victims of war, does not have the power to enforce these rules.

International Community of the Red Cross

Definition: The body of rule which, in wartime, protects people who are not or are no longer participating in the hostilities its central purpose is to limit and prevent human suffering in times of armed conflict

International Humanitarian Law

Arthropod: -Easily transmitted from person to person under direct contact. -There are three types of this arthropod and they often infest those who do not practice good personal hygiene

Lice

Disease: Characterized by distinctive skin lesion, systemic symptoms and neurologic, orthopedic and cardiac involvement that occur in combinations over a period of months to years. -Will see the development of a red, slowly expanding "bulls-eye" -Spread by ticks

Lyme Disease

A ______ situation occurs if a soldier medic has more than one seriously injured soldier to be cared for at one time

MASCAL

Hypothermia: Core body temperature 93<x<97

Mild

Triage Categories: Can be managed by self-aid or buddy-aid. This category is comprised of casualties with wounds that are so superficial, they require no more than cleansing, minimal debridement under local anesthesia, administration of tatanus toxoid, and first-aid dressing. They must be rapidly directed away from the triage area to uncongested areas where first-aid and non-specialty medical personnel are available.

Minimal

Arthropod: -Tiny, barely visible to the naked eye -Generally found in areas of tall grass or underbrush in close proximity to mammal resting places and watering hoels

Mites

Hypothermia: Core body temperature 86<x<93

Moderate

What treatment can be performed in the triage areas?

No significant treatment, except HABC and NCD

Definition: A person in the custody of U.S. Armed Forces that have not yet been classified as an EPW, CI, or RP

Other Detainee

A psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood

PTSD

Transmission: The arthropod carries the pathogen from one host to another. The pathogen does nothing during the transfer except except go along for the ride

Passive

Fleas are common and efficient vectors for what three diseases?

Plague, Typhus, and Tularemia

The transportation and disposition of the dead is a function of what group?

Quartermaster

Active Transmission: The vector vomits the pathogen into the host while it feeds on the host

Regurgitation

Definition: Enemy personnel who are medical, chaplains or are in voluntary air societies are eligible to be considered retained personnel

Retained Person

Arthropod: Small, bloodsucking gnats that look like small mosquitoes. Attack on the wrists, ankles or any exposed parts of the body.

Sandfly

Disease: -Acute, self-limiting viral disease transmitted through the bite of a sandfly.

Sandfly Fever

What are two diseases that can be spread by the sandfly?

Sandfly Fever and Leishmaniasis

Disease: -Highly contagious infestation of humans caused by the itch mite. Can occur in all populations but most common in developing countries. -Found in skin folds, such as finger and toe webs, axilla or genitals

Scabies

Hypothermia: Core body temperature x<86

Severe

Definition: Burns to the eye from UV radiation. The damage is to the cornea and similar to a welding flash burn to the eye. More likely to occur in hazy, cloudy weather than in sunny weather

Snow Blindness

Signs and Symptoms: Scratchy, watery, red feeling in eyes

Snow Blindness

Types of Acclimatization: Require soldiers to ascend to a moderate altitude and remain there for 3 days or more to acclimatize before ascending higher. When possible, soldiers should make several stops for staging during the ascent to allow a greater degree of acclimatization

Staged Ascent

What is the best way to treat an individual suffering from an altitude injury?

Stop the ascent and provide oxygen

Definition A series of treaties that establish the humanitarian protections that we apply during armed conflict. These protocols specifically protect people who do not take part in the fighting and those who can no longer fight

The Geneva Conventions

Where should active rewarming be confined to when dealing with a cold injury?

The trunk

Arthropod: -The most efficient arthropod when it comes to disease transmission. This is because the female will pass the pathogen to the egg. -Generally found in areas of tall grass or underbrush in close proximity to mammal resting places

Ticks

The medical sorting of casualties according to the type and seriousness of injury, likelihood of survival and the establishment of priorities of treatment and evacuation.

Triage

Definition: A carrier. This term is used to describe an arthropod that transports a disease causing organism, or pathogen, from one host to another

Vector

Definition: Toxin produced by some animals, such as scorpions, spiders and snakes

Venom

Triage establishes the order of treatment based on life signs of the casualty, not _________.

Whether treatment is given