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COMBAT MEDIC FIELDCRAFT EXAM WITH SOLUTIONS
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Tactical indications for C-spine precautions - Solution Motor vehicle crashes, falls greater than 15 feet, IED blast involving and MRAP vehicle Three types of blast injuries - Solution primary, secondary, tertiary Single biggest obstacle to the Combat Medic's ability to provide care - Solution Enemy fire Who makes the decision to extract casualties - Solution The tactical leader Technical name for a Combat Casualty Care card - Solution DD Form 1380 What is a WALK kit? - Solution Warrior Aid and Litter Kit Medications given for casualty with mild to moderate pain and is still able to fight: Option 1 - Solution 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 - Solution 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 - Solution 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 - Solution Morphine 5 mg IV/IO Always used when administering morphine - Solution Narcan 0.4 mg IV/IM
Medication given for soldiers with nausea or vomiting - Solution Zofran (Ondansetron) 4-8 mg IV/IM/IO What should be done prior to administering opioids or ketamine? - Solution Document mental status What can Ketamine and OTFC potentially due to severe TBI? - Solution Worsen the injury What are antibiotics recommended for? - Solution All penetrating wounds Antibiotic given to patient if ABLE to take PO - Solution Moxifloxacin ( mg once daily) Antibiotic given to patient if UNABLE to take PO - Solution Ertapenum (1 g IV/IM once daily) What is the most important contraindication to antibiotics? - Solution Burn casualties The three Tactical Combat Casualty Care phases of care - Solution Care under fire, tactical field care, tactical evacuation care The three goals of Tactical Combat Casualty Care - Solution Complete the mission, prevent additional casualties, treat the casualties Role 1 - Solution The first medical care a soldier receives Role 2 - Solution Operations operated by the area support squad, medical treatment platoon, or medical companies Role 3 - Solution Casualty treated at MTF Role 4 - Solution Medical care found in CONUS-based hospitals Urgent classification evacuation time - Solution 1 hour Urgent-Surgical classification evacuation time - Solution 1 hour Priority classification evacuation time - Solution 4 hours
MaxPro MRAP ambulance casualty load capacity - Solution 2 litter or 3 ambulatory HAGA MRAP ambulance casualty load capacity - Solution 3 litter or 6 ambulatory What way are casualties loaded into vehicles? - Solution head first In what way are the most seriously wounded loaded? - Solution Loaded last UH-60 maximum casualty loading capacity - Solution 6 litter and 1 ambulatory or 7 ambulatory How should casualties be oriented when in a helicopter? - Solution Head will be forward in the cabin When do you reassess Ketamine IM or IN? - Solution Every 30 minutes When do you reassess Ketamine IV or IO? - Solution Every 20 minutes When do you reassess morphine dosages? - Solution Every 10 minutes Antibiotics given for patients if able to PO? - Solution Moxifloxacin 400 mg one a day Antibiotics given for patients if unable to PO? - Solution Ertapenem 1g IV once daily Leading cause of preventable death on the battlefield - Solution Hemorrhage Components of blood - Solution plasma, red blood cells, white blood cells, platelets Body temperature at which casualty is considered hypothermic - Solution 95 degrees or less Body temperature at which blood factors start to become ineffective - Solution 93 degrees or less
When the body suffers from shock and lactic acid builds up as a result - Solution acidosis When too much intravenous crystalloid fluid such as saline or lactated ringers has been given - Solution hemodillution How long aspirin can inhibited clotting - Solution 5-10 days How does acidosis affect clotting? - Solution Decreases the pH of the blood At what point should the Combat Medic prevent or treat the casualty for hypothermia? - Solution As soon as the casualty is identified An adult can bleed up to __________ into each side of the chest - Solution 1500 ml An adult can hemorrhage up to _________ of blood and IV fluid into the abdomen even though there is only _______ in circulation - Solution 10 L, 6 L An adult can bleed _________ of blood into one thigh - Solution 1 L How does transexamic acid work? - Solution Prevents the body from breaking down clots Time frame for administration of transexamic acid - Solution Within the first three hours of injury Dosage and administration of transexamic acid - Solution 1 g IV/IO during 6a and after giving hextend Indications of an NPA - Solution unconscious casualty with spontaneous respiration and NO respiratory distress, no airway obstruction, altered casualty with intact gag reflex Tube size used for a cricothyroidotomy - Solution At least 6 mm definitive treatment for a pneumothorax - Solution chest tube
Solution of choice for dehydration if not able to swallow - Solution Lactated Ringer's The ONLY solution to be used in conjunction with a blood transfusion - Solution Saline solution Minimum blood pressure to perfuse all organs - Solution 80 mmHg systolic Blood pressure high enough to dislodge any blood clots - Solution 93 mmHg systolic Gauge catheter used for IVs - Solution 18 gauge Condition that involves inflammation of the wall of the vein - Solution Phlebitits How often is it recommended to change the tubing of an IV? - Solution Every 48 hours How often is it recommended to change the solutions and dressings of an IV? - Solution Every 24 hours How often is it recommended to change the site of an IV? - Solution Every 72 hours Key sign for indicating circulatory overload - Solution Shortness of breath Math equation for IVs - Solution (volume to be infused X Drops/ml of infusion set) / Total infusion time in minutes