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COMBAT MEDIC 68W FIELDCRAFT 1 EXAM
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Tactical indications for C-spine precautions Motor vehicle crashes, falls greater than 15 feet, IED blast involving and MRAP vehicle Three types of blast injuries primary, secondary, tertiary Single biggest obstacle to the Combat Medic's ability to provide care Enemy fire Who makes the decision to extract casualties The tactical leader Technical name for a Combat Casualty Care card DD Form 1380 What is a WALK kit? Warrior Aid and Litter Kit Medications given for casualty with mild to moderate pain and is still able to fight: Option 1 Acetaminophen (650 mg) and Meloxicam (Mobic) (15mg) Medications given for casualty with moderate to severe pain. Casualty is NOT in shock or respiratory distress AND casualty is NOT at significant risk of developing either condition: Option 2 Oral transmuccosal fentanyl citrate (OTFC) 800 micrograms
Medications given for moderate to severe pain. Casualty IS in hemorrhagic shock or respiratory distress OR casualty IS at significant risk for either condition: Option 3 Ketamine 50 mg IM/IN or Ketamine 20 mg slow IV or IO. End treatment with development of nystagmus (rythmic back and forth movement of the eyes) Alternative medication to ketamine Morphine 5 mg IV/IO Always used when administering morphine Narcan 0.4 mg IV/IM Medication given for soldiers with nausea or vomiting Zofran (Ondansetron) 4 - 8 mg IV/IM/IO What should be done prior to administering opioids or ketamine? Document mental status What can Ketamine and OTFC potentially due to severe TBI? Worsen the injury What are antibiotics recommended for? All penetrating wounds Antibiotic given to patient if ABLE to take PO Moxifloxacin (400 mg once daily) Antibiotic given to patient if UNABLE to take PO Ertapenum (1 g IV/IM once daily)
Priority classification evacuation time 4 hours Routine classification evacuation time 24 hours Convenience classification evacuation time Whenever convenient Lines needed to get a helicopter in the air for a Nine Line MEDEVAC request Lines 1 - 5 Maximum time for a Nine Line MEDEVAC request 25 seconds Who's callsign is to be given in line 2 of the Nine Line MEDEVAC The callsign of the individual at the pickup site Standard Battlefield documentation DD 1380 card Nonstandard Battlefield documentation Sharpie Marker on tape Documentation used by aeromedical personnel? SF 600
How does "fight or flight" reactions affect your ability to do your job and complete the mission? Fine motor skills will diminish Optimal distance to be away from the casualty to gain leverage 2 - 3 feet Name of the litter primarily used by the US Army Talon II M997 casualty load capacity 4 litters or 8 ambulatory or 2 litter and 4 ambulatory M113 APC casualty load capacity 4 litter or 10 ambulatory or a combination of the two Armored Medical Evacuation Vehicle casualty load capacity 4 Litters or 8 ambulatory casualties M1133 Stryker Medical Evacuation Vehicle casualty load capacity 4 Litters or 6 ambulatory casualties or a combination of the two MaxPro MRAP ambulance casualty load capacity 2 litter or 3 ambulatory HAGA MRAP ambulance casualty load capacity 3 litter or 6 ambulatory What way are casualties loaded into vehicles?
Ertapenem 1g IV once daily Antibiotics given for patients if unable to PO? Hemorrhage Leading cause of preventable death on the battlefield plasma, red blood cells, white blood cells, platelets Components of blood 95 degrees or less Body temperature at which casualty is considered hypothermic 93 degrees or less Body temperature at which blood factors start to become ineffective acidosis When the body suffers from shock and lactic acid builds up as a result hemodillution When too much intravenous crystalloid fluid such as saline or lactated ringers has been given
5 - 10 days How long aspirin can inhibited clotting Decreases the pH of the blood How does acidosis affect clotting? As soon as the casualty is identified At what point should the Combat Medic prevent or treat the casualty for hypothermia? 1500 ml An adult can bleed up to into each side of the chest 10 L, 6 L An adult can hemorrhage up to of blood and IV fluid into the abdomen even though there is only in circulation 1 L An adult can bleed of blood into one thigh Prevents the body from breaking down clots How does transexamic acid work?
Four types of distributive shock Lack of pale, cool, or clammy skin Signs of neurogenic shock Intrinsic causes Result of direct damage to the heart itself Extrinsic causes Result of problems outside of the heart 20 percent or more Amount of fluid loss to indicate hypovolemic shock Increased heart rate and blood pressure Signs of compensated shock falling blood pressure Signs of decompensated shock Dehydration, dehydration secondary to vomiting and diarrhea, burns greater than 20% of body surface area Non-hemorrhagic causes of hypovolemic shock
1500 - 2000 ml or 30 - 40% How much blood can be lost before the casualty's blood pressure will begin to drop? 70 percent Percentage of the total amount of water in the body fluids Hextend Current prehospital choice for combat trauma casualties suffering from hemorrhagic shock in the absence of blood components 8 hours How long the effects of hextend last Lactated Ringer's Solution of choice for burn casualties Lactated Ringer's Solution of choice for dehydration if not able to swallow Saline solution The ONLY solution to be used in conjunction with a blood transfusion
Shortness of breath Key sign for indicating circulatory overload (volume to be infused X Drops/ml of infusion set) / Total infusion time in minutes Math equation for IVs
