Field Craft 1
What are the brevity codes for line 8 of the nine-line MEDEVAC request?
A) US Military B) US Civilian C) Non US mil D) Non US civ E) EPW (p40)
What are the codes for precedence on the nine-line MEDEVAC request?
A) Urgent B) Urgent Surgical C) Priority D) Routine E) Convenience (p38)
Applying tourniquets side by side makes the band __________.
wider
What are the dosages of Ketamine?
50mg IM/IN or 20mg IV/IO (p13)
Describe a simple rescue.
A rescue from an open field, vehicle, or structure
Pneumothorax [p117]
An accumulation of air within the pleural space between the visceral and parietal pleura
Sucking Chest Wound (open pneumothorax) [p121]
An open chest wound, at least 2/3 size of the trachea, that will present with a "sucking" sound
You encounter a casualty that has a blood soaked pant leg and an airway compromised from heavy bleeding. What do you do?
Apply a tourniquet on the injured extremity [p74]
What provides advanced ballistic, fragmentation, and impact protection for the head?
Army Combat Helmet [p16]
What protects the neck, torso, and arms against fire?
Army Combat Shirt [p16]
How do you manage acidosis?
Assess and manage H-A-B-C
What is the most significant obstacle to the Combat Medic's ability to provide care? A.) The effectiveness of the Soldier Medics' muscle memory. B.) Enemy Fire. C.) The possibility of other casualties. D.) Medical Equipment Limitations
B.) Enemy fire (p9)
What are contraindications for NPA?
Basilar skull fracture Facial trauma Exposed brain matter CSF draining from nose or mouth [p107]
What side can you load a UH 60 from?
Both sides
How do the signs and symptoms of neurogenic shock differ from other types of shock? [p133]
Bradycardia instead of tachycardia
The use of non medical vehicles, boats, or aircraft to evacuate wounded from the battlefield
CASEVAC (p38)
Role 4
CONUS based hospitals and other safe havens (p24)
What are the three phases of TCCC?
Care Under Fire Tactical Field Care Tactical Evacuation Care [p72]
What is Care Under Fire?
Care Under Fire is care rendered by the Combat Medic at the scene of the injury while he and the casualty are still under effective hostile fire. [p72]
What are the phases of TCCC?
Care under fire Tactical Field Care Tactical Evacuation Care (p18-19}
You have a casualty with a axillary wound. You are in the tactical field care phase of your assessment. After reassessing the packing of the wound, your next step is what?
Check radial pulses. [p77]
How does hypothermia affect clotting?
Chemical reactions of the clotting mechanisms are affected by the decrease in temperature and blood clotting will not occur
You have a casualty who has been receiving an IV infusion. You notice the patient has JVD and shortness of breath. Vital signs reveal tachycardia and hypertension. What do you suspect?
Circulatory overload [p156]
What are the four major aspects of MEDEVAC?
Collect the wounded Sorting (Triage) providing transportation Care en route [p22]
Contains high molecular weight (larger size) molecules such as protein or starches [p140]
Colloids
With intervention with _______________, and rapid evacuation to a surgical facility, combat fatalities can be reduced by 24%.
Combat Medic Tasks (p6)
What can happen if a tourniquet is tightened until the bleeding is stopped, but there is still a distal pulse?
Compartment Syndrome
You have converted your hasty to deliberate tourniquet. The bleeding is controlled, but you still have a distal pulse. What can occur if this is left untreated?
Compartment syndrome
What are the goals of TCCC? Which is the most important?
Complete the mission Prevent additional casualties Treat the casualty Complete the mission is the most important (p18)
Your patient is inside of a vehicle that was struck by an IED, and bleeding heavily from a leg wound. She has applied a tourniquet, but it is not effective. However, you need to remove the patient from the vehicle immediately because it is on fire. Is this a simple or complex rescue?
Complex rescue
Precedence assigned to casualties for whom evacuation is a matter of medical convenience rather than necessity is:
Convenience (p35)
After two failed IV attempts on a dehydrated casualty, what do you do?
Evacuate the casualty to an MTF. [p148]
What type of wound has historically been the most common type (MOI) of wound suffered in combat?
Explosions (p7)
Historically, 60% of wounds are suffered in the __________, because of the lack of body armor protection.
Extremities (p6)
Do you normally carry a casualty feet or head first?
Feet first
What composes the battle roster number?
First letter of the casualty's first name, the first letter of their last name, and the last four of their SSN (p29)
What is the normal evacuation configuration for a UH60A?
Four litter casualties and one ambulatory casualty
What type of tourniquets are placed during CUF?
Hasty tourniquets
Life threatening extremity hemorrhage discovered in the CUF phase should be treated with?
Hasty tourniquets [p94]
If my casualty has an tibia fracture, and I am taking him downhill, should I carry him head or feet first?
Head first
The majority of potentially survivable combat fatalities are due to what?
Hemorrhage (p4)
What is the pre-hospital fluid of choice for combat casualties? [p141]
Hextend
If the casualty is able, transport the casualty in the position of comfort, which is normally sitting up If the casualty is unable, transport casualty with the injured side down [p129]
How is the casualty transported after a NCD or chest seal is placed?
What is the opening statement for a nine-line MEDEVAC request?
I have a MEDEVAC request! (p41)
What is corrective action for an air embolism?
Immediately place the casualty on left side with feet elevated to allow the pulmonary artery to absorb small air bubbles. [p155]
What does ITD stand for?
Impedance Threshold Device
1) Torso trauma (penetrating or blunt) 2) Development of progressive respiratory distress [p127]
In a combat environment, the two things needed to be present for you to assume that the casualty is suffering from a tension pneumothorax are:
When can the Combat medic use the Res-Q guard? [p146]
In casualties that have spontaneous breathing, absent radial pulses, significant MOI, AMS, and the Combat Medic does not have the time or equipment to gain IV access
What are tactical considerations?
In certain circumstances, the mission will take precedence over medical care (p10)
Where is the surgical opening made in the cricothyroidotomy?
In the cricothyroid membrane, which is located between a cricoid and thyroid cartilage [p109]
During infusion, you see fluid leaking around the infusion site, and the site is cool, hard to the touch, and swollen. What do you suspect is happening?
Infiltration [p153]
What is infiltration?
Infiltration is the accumulation of fluid in the tissue surrounding an IV infusion site. [p153]
What is phlebitis?
Inflammation of the wall of the vein [p154]
What are two causes of cardigenic shock? [p140]
Intrinsic and extrinsic
No. The NCD is a temporary lifesaving intervention for a tension pneumothorax until the casualty arrives at the MTF. [p128]
Is a NCD definitive treatment?
My name is John Smith and my SSN is 125790545. What is my battle roster number?
JS0545
What are the brevity codes for line five of the nine-line MEDEVAC request?
L) litter A) ambulatory (p38)
On what line of the nine-line will you transmit the patient's blood type if known?
Line six in peacetime (p39)
On what line of the nine-line would you transmit the patient's injuries?
Line six in peacetime (p39)
What two lines of the nine-line MEDEVAC request have wartime and peacetime differences?
Lines 6 & 9 (p40)
What lines of the nine line must be transmitted to allow the evacuation unit to begin the MEDEVAC operation?
Lines one through five (p42)
What is line one of the nine-line MEDEVAC request?
Location of pick up site (p37)
What is the difference between MEDEVAC and CASEVAC?
MEDEVAC is performed by dedicated medical vehicles and aircraft with medical personnel, CASEVAC is performed by nonmedical vehicles or aircraft (p19)
Can you apply a Sam Junctional Tourniquet during care under fire, if you initially observe a high level amputation?
No. The SJT is applied during Tactical Field Care.
Is BSI applied during Care Under Fire?
No. The time invested in gloving must be spent performing essential casualty care and moving the casualty out of the line of fire. [p73]
In tactical field care, your patient has lost radial pulses and is showing abdominal distension. You suspect Internal bleeding .All you have on hand for bleeding control is two CATs. How would you describe this bleed, compressible or non-compressible hemorrhage?
Non compressible hemorrhage
What is the only solution to be used in conjunction with a blood transfusion? [140]
Normal Saline
In care under fire, a patient is suffering from facial burns and an axillary wound that you observe bright red spurting blood. What will you use to control this bleed?
Nothing. Junctional wounds are not treated until tactical field care.
What is line three of the nine-line MEDEVAC request?
Number of casualties by precedence (p37)
What is line five of the nine-line MEDEVAC request?
Number of casualties by type (p38)
If the casualty is not in shock or respiratory distress, and in moderate to severe pain, what analgesic do you use?
OTFC or Morphine (p13)
Describe cardiogenic shock. [p133]
Occurs when the heart's pumping mechanism no longer functions correctly which results in inadequate perfusion. "PUMP FAILURE"
Where is a WALK carried?
On ground vehicles [p12]
What is OTFC and what is the route and dose?
Oral Transmucosal Fentanyl Citrate transbuccall (in between cheek and gum) 800 micrograms (p13)
What is Role 2?
Organizations operated by the area support squad or medical treatment platoon of medical companies. The Role 2 MTF provides a greater capability to resuscitate trauma patients than at a Role 1. (p24)
You are caring for a casualty with bilateral lower extremity amputations. Hasty tourniquets have been applied. You have moved the casualty behind cover, assessed consciousness, and carotid pulse. What is the next step?
Perform blood sweep [p75]
Describe the clotting cascade.
Platelets become activated, and red blood cells stick to the fibrin net forming a clot.
the "X"
Point of injury or wounding
At what point should the combat medic prevent or treat the casualty for hypothermia?
Prevention of hypothermia should begin as soon as the casualty is identified, regardless of the ambient temperature.
What precedence is assigned to casualties who be evacuated within four hours?
Priority (p35)
What precedence is assigned to casualties who have a condition that may deteriorate to an urgent precedence if not evacuated?
Priority (p35)
What personnel resources will be available to you on the battlefield?
Soldiers trained in WTBD CLS trained Soldiers other medically trained Soldiers [p11]
What are the three components of body fluids? [p144]
Solvent Solute Solution-
What are complications of the King LT?
Sore throat Dysphasia (difficulty swallowing) hematoma [p108]
What is line four of of the nine-line MEDEVAC request?
Special equipment (p38)
Neurogenic shock is caused by: [p133]
Spinal cord injury
24% of combat fatalities are _____ by early intervention with Combat Medic tasks, and rapid evacuation to a surgical facility.
Survivable (p6)
What is the first priority in Care Under Fire?
Take cover, return fire, and avoid becoming a casualty. [p73]
While on an unmounted patrol, your squad encounters an IED. Most of your squad is OK, however, one of your Soldiers was blown into a wall resulting in an open fracture to the femur. What kind of blast injury is this?
Tertiary Blast Injury
I am in an an armored unit. I have to execute a vertical extraction for a dismounted soldier who has fallen off of a cliff. What type of litter should I use to perform the extraction?
The SKED litter
What is Role 1?
The first medical care a Soldier receives, from first aid to the Battalion Aid Station. (p23)
How does blood pressure affect clotting?
The higher the blood pressure inside of a vessel, the faster it will bleed. Clotting requires time to form a fibrin clot.
Parietal Pleura [p115]
The membrane attached to the surface of the chest wall
Visceral Pleura [p115]
The membrane attached to the surface of the lung
The decision to use CASEVAC rather than MEDEVAC is made by who?
The tactical commander (p20)
Who directs the use of vehicles for CASEVAC?
The tactical commander (p20)
Who is responsible for delivering the casualty to the helicopter landing site?
The tactical leader
Who makes the determination to request medical evacuation?
The tactical leader or senior military person present (p34)
What is over classification?
The tendency to classify a wound more severe than it is (p34)
What is distributive shock? [p132]
The vascular container enlarges without a proportional increase in the fluid volume
What are indications for NPA?
Unconscious casualty with spontaneous respiration and no respiratory distress Altered mental status with intact gag reflex [p107]
What are indications of the King LT?
Unconscious casualty without a gag reflex [p107]
What is the proper loading sequence for a four litter ambulance?
Upper right, lower right, upper left, lower left
What precedence is assigned to a casualty who needs to be evacuated within one hour?
Urgent (p35)
What precedence is assigned to casualties who need evacuation in order to save life limb or eyesight?
Urgent (p35)
Casualties with non compressible hemorrhage are what evacuation category?
Urgent Surgical
What precedence is assigned to casualties who need surgical intervention within one hour?
Urgent Surgical (p35)
What are the five precedence of patients?
Urgent, Urgent Surgical, Priority, Routine, Convenience (p35)
How can the Combat Medic improvise suctioning?
Using a large syringe and tubing [p106]
Retractions [p118]
Utilizing accessory muscles to assist breathing
Pleural fluid [p115]
What is the lubricating fluid between the visceral and parietal pleura
Lidocaine
What medication do you use to perform a cric on a conscious casualty?
An artery, nerve, and vein (neurovascular bundle) [p129]
What runs below each rib that can cause unnecessary complications if damaged while performing a NCD?
14 gauge needle & catheter, 3.25 inches in length. [p128]
What size needle & catheter is used for a NCD?
When does the MEDEVAC process begin?
When the medical personnel receive injured or ill Soldiers (p34)
2nd intercostal space, mid clavicular line, anterior chest, on the same side as the injury, directly over the third rib [p128]
Where is the needle & catheter placed for a NCD?
Vented chest seals have been shown to be effective at preventing tension pneumothorax
Which kind of chest seal is more effective, vented or non-vented?
You have started fluid resuscitation with Hextend, when do you stop administering Hextend? [p143]
With the return of palpable radial pulse, improved mental status, or a systolic blood pressure of 80-90mmHg
Can a cricothyroidotomy be performed on a conscious casualty?
Yes, with the use of anesthesia [p109]
Can you use abbreviations on the DD 1380?
Yes. All abbreviations approved for use in DOD health records or DOD trauma registries may be used (p28)
You have called a MEDEVAC two casualties who are urgent, one who is routine. As the aircraft approaches, your team leader asks what side of the UH60A Blackhawk can he take the patients to. What side do you tell him?
You can load the UH60 from both sides.
A casualty has suffered an amputation to his finger. You have controlled bleeding. You decide to give the casualty OTFC. After a few minutes, the casualty says he feels woozy and nauseous. What can you give for nausea?
Zofran (Ondasteron), 4-8 mg IV/IM/IO [p13]
What do you need to determine there is significant extremity hemorrhage?
a sleeve or pant leg soaked in blood [p74]
What are signs and symptoms of an air embolism?
a) Abrupt drop in blood pressure b) Weak rapid pulse c) Cyanosis d) Chest pain
What two analgesics are used for mild to moderate pain?
acetaminophen and meloxicam (p13)
When blood pressure is increased by IV fluids tourniquets may require __________.
additional tightening
For all casualties given opioids or Ketamine, monitor _____, _____, and _____ closely.
airway, breathing, circulation (p12)
If a casualty is not nauseated, dehydrated, and able to swallow, you should: [p144]
allow the casualty to drink fluids by mouth
Blast overpressure is more effective in __________.
an enclosed space, such as a vehicle or building (p9)
In the Tactical Field Care phase, the goal is to:
assess for and treat preventable causes of death and disability (p20)
At what temperature should a casualty be considered hypothermic?
below 95 degrees Fahrenheit
What is non-compressible hemorrhage?
bleeding that cannot be compressed with direct pressure, wound packing, and/or pressure dressings
If you have applied a tourniquet and evacuation is delayed greater than two hours, you should:
change to another method of hemorrhage control to reduce tissue damage
Remove the body armor if ___________.
chest injuries are found or MOI indicates chest injuries [p76]
What is the tactical priority of care under fire?
gaining fire superiority [p73]
Open the airway using the ___________.
head-tilt/chin lift maneuver [p75]
The initial blood sweep is performed at the __________ areas.
neck, axillary, inguinal, and extremity [p74]
How do you apply a hasty tourniquet?
over the clothing, high on the injured extremity [p74]
Most Soldiers who die in combat do so within minutes due to what ?
penetrating trauma and hemorrhage (p21)
What can you use to reduce the friction of body surface contact points?
poncho, tarp, blanket, drag litter, or SKED
If unable to start a direct line IV with two attempts, initiate a ______.
sternal IO line to provide fluids [p142]
If unable to initiate a peripheral IV after two unsuccessful IV attempts, initiate a _______ to provide fluids. [p143]
sternal intraosseus (IO) line to provide fluids
What is the maximum ambulatory patient capacity of the M113?
10 ambulatory patients
How much time should the Combat Medic limit their suctioning to?
15 seconds [p106]
A typical casualty can bleed up to __________ into each side of the chest.
1500ml
What size needle catheter is recommended for a combat casualty?
18 gauge 1.25 inch [p149]
What is the dose of TXA
1gm in 100cc of IV solution (NS or LR)
Hypovolemic shock occurs when you lose more than ______ of your body's blood supply. [p135]
20%
I require analgesics for moderate to severe pain. You have established Direct-Line IV access. What medication/dose should you use?
20mg Ketamine (p11)
How much time do you have to transmit your nine line MEDEVAC request?
25 seconds (p41)
What is the maximum litter patient capacity of the Haga MRAP ambulance?
3 litters
Once the medic completes his primary assessment, he can provide which lines of the nine line MEDEVAC request?
3, 4, & 5 (p34)
How many levels of medical care are there?
4 (p23)
What is the maximum litter capacity of the M997 ambulance?
4 litters
What is the maximum patient capacity of the M113?
4 litters or 10 ambulatory
I have bilateral arm amputations. You have controlled my life threatening injuries, and I am not in shock. I am awake and speaking. What antibiotic do you give me?
400mg Moxifloxacin (p13)
Which antibiotic is available from the combat pill pack?
400mg Moxifloxacin (Avelox) (p14)
For casualties suffering from any cause of shock other than hypovolemia, administer: [p144]
500ml bolus of Lactated Ringers by IV
If the tourniquet has been in place for longer than _________ hours, loosening the tourniquet can cause the release of micro-emboli resulting in PE or stroke.
6
What is the maximum ambulatory patient capacity of the Haga MRAP ambulance?
6 ambulatory patients
At what temperature are clotting factors affected?
93 degrees Fahrenheit
Sucking chest wound [p121]
A patient present is suffering from a gunshot wound to the chest. When you expose the wound, you see a quarter-sized hole and hear a sucking sound from the wound. What should you suspect?
Tension pneumothorax [p121]
A patient presents with progressive respiratory distress after a traumatic thoracic injury, what should you suspect?
What type of injury is caused by the blast wave of an explosion?
A primary blast injury (p8)
Who decides if casualties will be evacuated? A.) The Tactical Leader. B.) The Tactical Commander. C.) The Senior Medic. D.) The Senior Military Person.
A.) The Tactical Leader. B.) The Tactical Commander. D.) The Senior Military Person. (p10)
What is a tertiary blast injury? A.) When a casualty is blown into a solid object such as a wall or vehicle and suffers blunt force trauma. B.) The body hitting another object. C.) The organs of the body hitting the other organs.. D.) Debris or shrapnel from an explosion.
A.) When a casualty is blown into a solid object such as a wall or vehicle and suffers blunt force trauma. (p9)
Torso trauma Development of progressive respiratory distress [p127]
What are the indications for a NCD?
Load and unload the aircraft according to ___________.
the aircraft crew-member's instructions. (p36)
If you detect a carotid pulse, then your estimated systolic blood pressure is [p142]
60mmHg
Blood clotting requires a normal pH. What is the normal pH?
7.35-7.45
If you detect a femoral pulse, then your estimated systolic blood pressure is [p142]
70mmHg
What is the maximum ambulatory capacity of the M997?
8 ambulatory patients
What systolic blood pressure must be maintained for perfusion of vital organs? [p136]
80 mmHg
If you detect a radial pulse, then your estimated systolic blood pressure is [p142]
80mmHg
What systolic blood pressure do you need to perfuse vital organs? [p141]
80mmHg
fourth, thoracic [p116]
A penetrating wound at the ___________ intercostal space or lower should be considered an abdominal injury as well as a ___________ injury.
Open Pneumothorax [p117]
A projectile enters chest creating a hole, allowing air to enter the pleural space
Describe a complex rescue.
A rescue involving vertical movement, vehicle extrication, and/or collapsed buildings
Flail Chest [p117]
A segment of the rib cage (2 or more consecutive ribs) breaks and becomes detached from the rest of the chest wall
Closed Pneumothorax [p117]
A tear in visceral pleura allows air to enter the pleural space
Tracheal Bronchial Tree Injury [p117]
A tear or break in the trachea or bronchial tubes
A casualty has multiple gunshot wounds and is developing a tension pneumothorax on the left side. You only have one 14G NCD catheter left. After treating the obvious life threatening injuries, what should you do that should be done for all casualties with open wounds?
Administer antibiotics to all casualties with penetrating trauma.
Tension Pneumothorax [p117]
Air pressure builds and shifts the mediastinum, which compresses the heart and the uninjured lung
Where does gas exchange occur in the lungs?
Alveoli [p104]
Where is the preferred area for selecting veins for vascular access?
Antecubital space [p148]
______________ is/are recommended for ALL penetrating combat wounds
Antibiotics (p13)
What are the two IV/IM antibiotics that we use, and their doses?
Cefotetan 2g slow IV push, or IM every 12 hrs Ertapenem 1g IV/IM one time per day (p13)
Secondary blast injury is caused by ________. A.) A casualty blown into a solid object such as a wall or vehicle and suffers blunt force trauma. B.) The body hitting another object. C.) The organs of the body hitting the other organs. D.) Debris or shrapnel from an explosion.
D.) debris or shrapnel from an explosion (p9)
The majority of combat related wounds are due to ______. A.) Blasts B.) Burns C.) Projectiles D.) Penetrating Trauma
D.) penetrating trauma (p7)
What is the form number for the medical AAR used in theater?
DA Form 4700 04.1 (p27)
What is the form number for the TC3 Card?
DD Form 1380 (p27)
What type of tourniquets are placed during TFC?
Deliberate tourniquets
Made from an air tight, nonporous material, large enough to extend 2 inches past the edges of the wound
Describe an occlusive dressing
1) Diaphragm and intercostal muscles relax 2) Chest wall exerts pressure against the lungs, creating positive (greater) pressure inside the thoracic cavity 3) Air moves from area of more pressure (inside lungs) to less pressure (outside lungs) [p116]
Describe the physiology of exhalation
The patient has an altered mental status and an absent radial pulse. You will gain vascular access with a ____. [p142]
Direct IV line
What phrase do you use to initiate a MEDEVAC?
I have a MEDEVAC request, over. [p42]
What analgesic do we use for moderate to severe pain when the casualty is in hemorrhagic shock or respiratory distress, or in danger of developing either condition?
Ketamine (p13)
The fluid of choice for casualties suffering from non-hemorrhagic shock is: [p144]
Lactated Ringers
What is the solution of choice for burn casualties? [p139]
Lactated Ringers
Simple rescue
Members of your unit are injured by a land mine while moving through an open field. Of two casualties, one is oviously deceased, and one is concious with a lower leg amputation. You apply a hasty Tourniquet, and must move the casualty to the woodline for cover. Is this a complex or simple rescue?
What is line seven of the nine-line MEDEVAC request?
Method of marking the site (p39)
You are treating a casualty. You have established IV access. You are out of OTFC. What analgesic can you use?
Morphine is an alternative to OTFC if IV access has been obtained. [p13]
What are the indications for suctioning?
Mucous, vomitus, or blood in the casualty's airway [p106]
What is line two of the nine-line MEDEVAC request?
Radio frequency, call sign, and suffix. (p37)
Tachypnea [p118]
Rapid respiratory rate
What is the maximum patient capacity of a UH60A?
Six litter casualties and one ambulatory, or seven ambulatory casualties.
Bradypnea [p118]
Slow respiratory rate
What litter is the primary litter used to evacuate a casualty from confined spaces, rough and difficult terrain, and helicopter hoist missions.
The SKED litter
What is anaphylactic shock? [p133]
The body's hypersensitive reaction to an antigen that causes severe bronchospasm and vasodilation
What is the first tactical choice for life threatening hemorrhage of an extremity?
Tourniquet
How do all tourniquets work?
Tourniquets compress the tissue around the vessel, which then compresses the vessel.
The _____________ carry can be used in transporting both conscious and unconscious casualties.
Two man supporting
What two analgesics are in the casualty's combat pill pack?
Tylenol and Mobic (p13)
In peacetime, a patient has suffered massive bleeding from a gunshot wound. After stopping the bleeding, I call for MEDEVAC. What information do I want to give on line 6 of the request?
Type of injury and blood type (p39)
Insert an NPA if the casualty is __________.
Unconscious [p75]
What do you do with the DD Form 1380 when it is complete?
Visibly attach it to the casualty (p28)
While on a convoy, you encounter casualties. You have treated some, but there are still more. Your Aid Bag is depleted. What is carried on each vehicle that has a robust amount of medical supplies suitable for hemorrhage control and treatment for shock?
WALK Kit [p12]
What is line nine of the nine-line MEDEVAC request?
WARTIME: NBC contamination PEACETIME: Terrain (p40)
What is line six of the nine-line MEDEVAC request?
WARTIME: Security of pickup site PEACETIME: Number and type of wound injury or illness and blood type (p39)
What are signs and symptoms of IV site infection?
a) Erythema b) chills, fever, malaise, tachycardia c) purulent drainage from the site [p157]
What do you look for when inspecting IV bags prior to infusion?
a) Expiration date b) Punctures, rips, or tears c) Examine ports for holes or leaks d) Hold the bag to light to check for foreign particles, color, and consistency [p149]
Intraosseus infusion is not recommended for _______ casualties.
dehydration [p148]
In Tactical Field Care, after donning BSI, you should ________ ____________. If the casualty is ____________, check for ____________.
determine responsiveness; unresponsive; carotid pulse [p74]
Life threatening hemorrhage on the neck, axillary, and inguinal areas should be treated with what?
direct pressure, hemostatic agents, and/or a SJT
What is the most common complication of the NPA?
epistaxis (nosebleed) [p107]
What is the medical priority during care under fire?
extremity hemorrhage control [p73]
Get the wounded ____________ before you start working on them.
into a covered position, an armored vehicle, or a secured building [p74]
Crystalliods have a ________ PH. They are ________. [p139]
low, acidic
What are the three most commonly used devices for hoist or vertical casualty extraction operations?
the Stokes basket the Jungle Penetrator (JP) the SKED litter
The primary blast injury is caused by ______.
the blast overpressure (or wave) from an explosive (p8)
The Tactical Evacuation Care phase begins when
the casualty has been picked up by an aircraft, vehicle, or boat (p20)
Combat Medics should use ________________ before the contents of their aid bag
the casualty's IFAK (p12)
During care under fire, medical equipment is limited to:
the tourniquet in the casualty's IFAK (p20)
TXA must be given within how long of the injury?
three hours
In care under fire, you have directed your casualty to take cover. Once behind cover, if the casualty has not already done so, direct him _________.
to apply self aid. [p73]
The _____________ carry is a useful two-man carry for transporting the casualty over a long distance ( over 300 meters).
two man fore-and-aft
What are the brevity codes for line seven of the nine-line MEDEVAC request?
A) Panels B) Pyrotechnic C) Smoke D) None E) Other (p39)
What are the brevity codes for line four of the nine-line MEDEVAC request?
A) None B) Hoist C) Extraction equipment D) Ventilator (p38)
I have four patients who need to be evacuated within one hour, one patient who needs to be evacuated within 24 hours, and two patients that need to be evacuated within four hours. What do I transmit on line 3 of the nine-line MEDEVAC request?
A4 - BREAK - C2 - BREAK - D1 (p38)
Who supervises the loading of an air ambulance?
Aeromedical evacuation personnel
_____________ are recommended for all open combat wounds.
Antibiotics [p81]
What should you do if there is still a distal pulse after applying a deliberate tourniquet?
Attempt to tighten it more, if the pulse is still present, then apply a new tourniquet side by side above the tourniquet.
What is line eight of the nine-line MEDEVAC request?
Casualty's nationality and status (p40)
Traumatic Asphyxia [p117]
Caused by an intense compression of the thoracic cavity, causing veinous back flow
What is the difference between cover and concealment?
Concealment obscures visibility and cover is a physical barrier
1) The diaphragm and intercostal muscles contract, creating negative pressure in the thoracic cavity 2) Air moves from area of less pressure (outside lungs) to less pressure (inside lungs) [p115]
Describe the physiology of inhalation
During Tactical Field Care, if you have significant injuries, altered mental status, and absent radial pulse, what should you do?
Direct line I.V. access, administer 1st dose of TXA, then 500ml Hextend [p78]
Casualties may need to be _____ after giving OTFC, Ketamine, or Morphine.
Disarmed (p12)
You have initiated a direct line to administer Hextend. You later find that radial pulses have returned. What do you do? [p143]
Disconnect IV tubing leaving the catheter in place and secure a saline lock over the catheter hub.
Which causes pneumothorax, penetrating or blunt trauma?
Either one can cause pneumothorax
What factors influence care on the battlefield?
Enemy fire Medical equipment limitations Widely variable evacuation time Tactical considerations (p9-10)
All sides are taped down
How many sides of an improvised occlusive dressing are taped down?
Why are patients loaded into ambulances head first?
Less likely to experience motion sickness Less noise from doors Less danger of further injury in the event of a rear collision
Under what circumstance would you consider immobilizing the casualty's spine?
Motor Vehicle Accident IED blast involving an MRAP Fall from greater than 15 feet [p8]
What are the brevity codes for line 6 of the nine-line MEDEVAC request?
N) None P) Possible enemy troops in area E) enemy troops in area (approach with caution) X) Enemy troops in area (armed escort required) (p40)
What are the brevity codes for line nine (wartime) of the nine-line MEDEVAC request?
N) Nuclear B) Biological C) Chemical (p40)
Do crystalloids have the ability to carry oxygen?
No.
How often should you reassess the casualty's pain to see if the casualty needs more Morphine?
Reassess every 10 minutes [p13]
What are the complications of the surgical cric?
Right stem bronchus intubation Esophageal laceration [p111]
I work in a Battalion aid station. We have three beds and an ambulance. What role of the AHS do I fall under?
Role 1 (p22)
I am a first responder. What role of the AHS do I fall under?
Role 1 (p22)
My facility has limited x-ray, operational dental support, and clinical laboratory. What role of the AHS do I fall under?
Role 2 (p23)
What is the lowest level of medical care to provide packed red blood cells, limited x-ray, clinical laboratory, and operational dental support?
Role 2 (p24)
What level of care contains the Forward Surgical Team?
Role 2 (p24)
I work in a the Hospital at Bagram Airfield, Afghanistan. We have a surgery suite, emergency room, and postoperative treatment measures. What role in the AHS do I fall under?
Role 3 (p23)
What level of medical care is the Combat Support Hospital?
Role 3 (p24)
What role of medical care represent the most definitive medical care available within the AHS?
Role 4 (p24)
What precedence is assigned to casualties who have a condition that requires evacuation, but is not expected to deteriorate significantly?
Routine (p35)
What precedence is assigned to casualties who have a condition that should be evacuated within 24 hours?
Routine (p35)
The patient has an altered mental status and a present radial pulse. You will gain vascular access with a ____. [p142]
Saline lock
What type of tourniquet is used for high level extremity amputation?
Sam Junctional Tourniquet
What are the types of Distributive shock? [p139]
Septic Neurogenic Anaphylactic Psychogenic (Use the acronym SNAP) [p139]
1) Lubricates the visceral and parietal pleura 2) Surface tension created by the pleural fluid leads to unification of the chest wall and lung surface 3) The chest wall transmits pressure through the pleural surfaces and fluid to the lungs [p115]
What are the functions of the pleural fluid?
Floating ribs [p114]
What are the two lowest pairs of ribs that are only attached to the vertebrae, and not the sternum
A needle/catheter is placed into the compromised pleural space of the lung, alleviating the pressure placed on the lungs and mediastinum [p127]
What is a Needle Chest Decompression (NCD)?
Raise the edge of the occlusive dressing in the hopes that some of the trapped air will escape
What is burping the wound?
Perform another NCD directly along side of the first Flush the first NCD with 1mL saline Burp the wound [p127]
What is the appropriate action for a casualty who develops progressive respiratory distress, after the wound has been dressed and NCD performed?