Field Craft 1 Study (FC1)
how do you calculate IV flow rates?
(volume to be infused) X (gtts/ml of infusion set) / (total time of infusion in MINUTES)
commonly, what size needle is used with an IV?
18g/1.25inch
Intercellular fluids makes up what % of total fluid in your body?
45%
How much of what solution do you use to flush after placing a catheter?
5ml of sterile saline IV solution
the human body is what % of water/fluid?
60%
What is the minimum length for the tubing that you use when doing a Cric?
6mm
what is Septic Shock?
A systemic infection that damages the blood vessel walls causing peripheral vasodilation and leakage of fluid from the capillaries into the interstitial space
What type of medication should you give for all penetrating combat wounds?
Antibiotics
what is Anaphylactic shock?
Body's hypersensitive reaction to an antigen that results in vasodilation and bronchospasm
during what step of march would you access for shock?
Circulation (C)
Does the diaphragm contract or relax during inhalation?
Contract
What are the 3 ways to provide IV solution to a casualty?
Direct line, Intraosseous, and Conversion of saline lock to direct line
What are some signs and symptoms of Circulatory Overload?
Elevated blood pressure, Distended neck veins (JVD), Rapid breathing, shortness of breath, tachycardia, rhonchi/rales, and pedal edema
What are the three options we have for blood products?
Fresh Whole Blood (FWB), Stored Whole Blood (SWB), and Low Titer O Whole Blood (LTOWB)
What is Crystalloid?
IV solutions that contain electrolytes in concentrations resembling those of plasma. Unlike colloids, these solutions leave the blood and enter cells
What are the four types of infections or issues you run into when dealing with IV's?
Infiltration, Phlebitis, Air Embolism, and Circulatory Overload
What is a tertiary blast?
Injury caused by a fall or someone getting thrown in a solid object (impact)
What is the purpose of the target patch?
It is used to direct the application of the introducer.
What fluids are you going to give a burn patient?
Lactated Ringers
What does the acronym MARCH stand for?
Massive Hemorrhage, Airway, Respiration, Circulation, and Hypothermia
is FDP ready to administer immediately after the diluent bag is empty?
No, you must ensure that all FDP particles are dissolved before administering to the causality.
If we don't have Blood Products, what can we use?
Packed Red Blood Cells (RBCs), Fresh Frozen Plasma (FFP), Freeze dried plasma (FDP), Platelets, Cryoprecipitate (Cryo)
What is a secondary blast injury?
Punctures from shrapnel (holes in a juicebox)
What does SNAP stand for?
Septic Shock, Neurogenic Shock, Anaphylactic Shock, Psychogenic Shock
what is Psychogenic Shock?
Stimulation of vagus nerve causes vasodilation and hypotension (usually caused by medications or drugs)
what are signs and symptoms of Infiltration from an IV?
Swelling, Cold skin, slow or stopped flow rate, patient complains or pain, burning, or irritation
What are some signs and symptoms of Phlebitis?
Swelling, redness, warmth along the vein, or patient complains of pain
What is Neurogenic shock?
The sympathetic control of the smooth muscle within the vessels is lost
Who decides if casualties will be evacuated?
The tactical leader
What are the three main parts of the lower airway?
Trachea (windpipe), Bronchi/Bronchioles, and the Lungs
If Y tubing is NOT available, how do you administer blood?
Use regular infusion tubing for the normal saline and the available blood recipient tubing for the blood pack
Under what conditions would you consider spinal precautions possibly necessary?
a MVC, falls greater that 15 ft, and with an IED blast involving a MRAP (vehicle)
What are some signs and symptoms of an Air embolism?
abrupt drop in blood pressure, weak/rapid pulse, cyanosis, chest pain
If a causality is dehydrated and not able to swallow, what should you do?
administer a 500ml bolus of Lactated Ringers by IV.
When completing an IV in the prehospital setting, how is the intervention documented?
amount and type of fluid should be written within the causalities DD 1380.
What is a Circulatory Overload?
an increased vascular volume resulting from excessive IV fluid being infused too rapidly into a vein
Where is the ideal space to place an IV?
antecubital space
What are the three phases of care? (TC3)
care under fire, tactical field care, and tactical evacuation care
What is the difference between compressible and non-compressible hemorrhage?
compressible can be stooped w/ direct pressure while noncompressible cannot.
What is the final step for placing a saline lock?
cover both the hub and saline lock with a transparent dressing
What is hemodilution?
dilute of blood due to things other than blood being in the veins (fluid from IV's)
What is the single biggest obstacle you will face when providing battlefield care?
enemy fire
How is blood pressure assessed in combat?
estimation of the systolic blood pressure by radial pulses
IV bags should be replaced how often?
every 24 hours
Iv tubing should be replaced how often?
every 48 hours
a catheter should be replaced how often?
every 72 hours
What is a hallmark sign of impending death and decompensated shock?
falling blood pressure
What type of sticky net is created to trap platelets and red blood cells during blood clotting?
fibrin net
What is the leading cause of preventable death on the battlefield?
hemorrhage
the leading cause of preventable battlefield death is?
hemorrhage
What is the most common cause of shock is trauma casualties?
hemorrhagic shock
What five factors can affect blood clotting?
hypothermia, acidosis, medication, blood pressure, and hemodilution
what should you do to a patient who has an air embolism?
immediately place the causality on his left side with feet elevated
What is phlebitis?
inflammation of the wall of a vein
What is a primary blast injury?
injury caused directly from the first wave of a blast that affects hollow organs
What is the issue with normal saline?
it is very acidic (LOW PH)
When does decompensated shock usually start?
it occurs when at least 1500 ml or more of blood is lost
What does Osmotic pressure do involving Hextend?
it pulls additional water from the interstitial and intracellular spaces in the vessels
Why do you think spinal immobilization is limited on the battlefield?
it takes too much time and exposes us in combat
What is the function of the nasal cavity?
it warms, humidifies, and filters to remove impurities of inhaled atmospheric air
What will happen to a Casuality's reparation rate when his CO2 blood level increases?
it will increase
How is Fresh Whole Blood (FWB) collected?
its collected from a walking blood bank (a battle buddy)
You have made a (1) unsuccessful IV attempt on the right arm. Where would your second attempt be made?
left arm, if uninjured
What is the definition of Acidosis?
more CO2 and less oxygen in the blood
Where is a warrior aid and litter kit (WALK) located and what could you find in it?
one WALK is carried on each ground vehicle, includes a folding talon litter, and first aid supplies
What are the benefits to using IV piggybank?
prevents from having to obtain a new IV access site to administer an infusion medication and it prevents infections of complications
What causes cardiogenic shock?
pump failure in the heart
What are the four types of distributive shock?
septic, neurogenic, anaphylactic, psychogenic
On the battlefield, where is the first place you should consider when accessing medical supplies?
the casualties IFAK pouch
What's the orientation of the bags when reconstituting Freeze Dried Plasma?
the diluent bag will be held higher than the FDP bag
Where on the body are the majority of combat wounds suffered?
the extremities
What are the two main parts of the upper airway?
the nasal and oral cavity
What is an air embolism?
the obstruction of a blood vessel by air carried via the bloodstream
What are the four ABO types?
type A, type B, type AB, and type O