FC1 Study Guide

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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


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