TECC SCAB-E Acronym

C - Circulation:

Assess for and treat life-threatening extremity bleeding. Direct pressure on the proximal brachial or femoral artery should be immediately applied by kneeling on the artery with body weight. This allows both hands to be free to perform other interventions. Tourniquets are to be placed immediately on extremity wounds for which bleeding cannot be adequately controlled with pressure dressings. This includes, but is not limited to, total or near-total amputations, large vessel arterial bleeding, or massive venous bleeding. Mechanical pressure dressings may be applied for anatomically amenable extremity wounds. Deep wounds should be packed with gauze to transmit pressure deep into the wound to site of bleeding.

A - Airway:

Any patient with an occluded airway or altered mental status will have a nasopharyngeal (Nay-Zo-Fe-ren-JiaL) airway placed. Place victim in any position that best protects the airway, including a seated position.

E - Evaluate and Evacuate:

Assess effectiveness of applied interventions and initiate evacuation. Check tourniquets and pressure dressings for effective hemorrhage control. Assess for unrecognized hemorrhage. Reassess for respiratory distress and proactively treat if present. Roll patient and examine posterior for injury. Place conscious patients in position of comfort and unconscious patients in recovery position while awaiting evacuation. If adequate supplies remain and there are untreated patients in the building, RTF should continue into the building toward those patients, remaining in the warm zone. If no supplies remain or all patients are treated, initiate evacuation to a CCP according to triage categories, using appropriate patient movement technique. Evacuate to CCPs and, as feasible, communicate with the CCPs or Triage Officer. o Within the same triage category, public safety personnel should receive priority assessment and evacuation since they may not fully comprehend the extent of their injuries. The members of the RTF, including LE members, remain together during egress

B - Breathing:

Assess for any open or sucking chest wounds, and place an occlusive chest seal to any trunk wound (anterior or posterior) between the level of the umbilicus and the level of the shoulders. Assess for and treat tension pneumothoraces.( (n 'mō-thôr'āks')..WHEN A LUNG IS PUNCTURED

S - Situational Awareness:

Be aware of surroundings, potential threats such as IEDs, and always maintain open routes for rapid egress. Be constantly mindful of the possibility of multiple attackers or the potential for an attacker to circle around and turn your warm zone into a hot zone. Ambulatory patients should be directed to evacuate according to guidance from command. Non-ambulatory patients should be medically stabilized and either evacuated or placed in proper position while awaiting evacuation. Understand the difference between cover (obstructions likely to stop fired rounds) and concealment (hiding behind objects that may reduce the likelihood of being fired upon, but that would not necessarily stop rounds from penetrating), and consider appropriate tactical positioning in case the team should come under fire. Consider the possibility of a chemical threat, improvised explosive devices (IEDs), or decoys at the scene including non-primary sites (e.g., the perpetrator's home).