HMC Rod Review Flashcards
Needs lifesaving interventions within minutes up to 2 hours on arrival to avoid death or major disability.
Immediate
Which military triage category are the following?
1)Massive Hemorrhage
2)Airway obstructions or potential compromise, including potential complicationsfrom facial burns or anaphylaxis
3)Tension pneumothorax
4)Penetrating chest wound WITH respiratory distress
5)Torso, neck, or pelvis injuries WITH shock
6)Head injuries requiring emergent decompression
7)Threatened loss of limb
8)Retrobulbar hematoma (threat to loss of sight)
9)Multiple extremity amputations
Immediate
Requires medical attention but CAN wait
Delayed
Which military triage category are the following?
those who show NO signs of shock with the following injuries:
1)Soft tissue injuries without significant bleeding.
2)Fractures
3)Compartment syndrome
4)Intra-abdominal and/or thoracic wounds
5)Moderate to severe burns with less than 20% of total body surface area
6)Blunt or penetrating torso injuries without the signs of shock
7)Facial fractures without airway compromise
8)Globe injuries
Can be treated with self aid, buddy air, and corpsman aid
Minimal
Which military triage category is the following
1)Minor burns, lacerations, contusions, sprains and strains.
2)Simple, closed fractures without neurovascular compromise.
3)Combat stress reaction
Minimal
Require complicated treatments that may not improve life expectancy
Expectant
Which military triage category is the following
1)Massive head injuries with signs of impending death or in coma.
2)Cardiopulmonary failure.
3)Clearly dead casualty with no signs of life or vital signs regardless of mechanism ofinjury.
4)Second and third degree burns in excess of 85% total body surface area.
5)Open pelvic injuries with uncontrolled bleeding and class IV shock.
6)High spinal cord injuries
Expectant
Simply and quickly categorizing patients; identifying and stop life threats.Breaks patients down into more manageable groups
Primary triage
How should light combat stress be treated
Immediate return to duty or return to unit or unit’s non combat support element with duty limitations or rest
How should heavy combat stress be treated
Send to combat stress control restoration center for up to 3 days reconstitution.
Quickly choose a casualty collection point based on
(a)Proximity to patients
(b)Proximity to vehicular access.
(c)Proximity to HLZ
(d)Geography, safety “geographic triage.”
Which echelon of care?
First medical care military personnel receive. Includes immediate life saving measures, disease and non-battle injury prevention and care, combat and operational stress control (COSC), patient location and acquisition.
Role 1
Role 1 treatment provided by
(a)Self-aid and Buddy-aid
(b)Combat life saver
1)Battalion Aid Station
2)Cruisers, Destroyers, and below
Which echelon of care
Initial resuscitative care is the primary objective of care at this level. Saving life, limb, and when necessary stabilization for evacuation
Role 2
Role 2 examples
a)LHD: Largest medical capability
b)LHA
c)CVN
Medical battalion (MEDBN)
Shock trauma platoon (STP)
Forward resuscitative surgical suite (FRSS)
Which echelon of care
The highest level of care available within a combat zone. Advanced resuscitative care is the primary objective of care
Role 3
Role 3 examples
1)Fleet hospitals
2)Hospital ships (USNS Comfort/USNS Mercy)
Which echelon of care
Definitive medical care is the primary objective at this level
Role 4
Role 4 examples
(a)OCONUS Hospital Examples:
1)NH Yokosuka
2)Landstuhl Regional Medical Center
Which echelon of care
Restorative and rehabilitative care is the primary objective of care at this level.
Role 5
Role 5 examples
1)NMC SD
2)Walter Reed National Medical Center
Difference between MEDEVAC and TACEVAC
- MEDEVAC: Medical personnel
- TACEVAC: whoever is fucking there
Which MEDEVAC priority?
Casualty must be evacuated within 2 hours in order to save life, limb or eyesight
Urgent
What MEDEVAC priority is the following?
1)Cardiorespiratory distress
2)Uncontrolled hemorrhage
3)Shock not responding to IV therapy
4)Head injuries with signs of increased ICP
5)Extremities with neurovascular compromise
Urgent
What MEDEVAC priority?
Casualty must be evacuated within 4 hours or condition could worsen
Priority
What MEDEVAC category?
1)Flail chest segments without respiratory compromise
2)Open fractures
3)Spinal injuries
4)Major burns
Priority
What MEDEVAC priority?
Casualty must be evacuated within 24 hours for further care
Routine
What MEDEVAC category?
1)Minor to moderate burns
2)Simple, closed fractures
3)Minor open wounds
4)Terminal Casualties
Routine
Line 7 of 9 line
Method of marking pickup site:
(a)A - Panels
(b)B - Pyrotechnics
(c)C - Smoke
(d)D - None
(e)E – Other
What is the leading cause of preventable death on the battlefield?
Hemnorrhage
What kind of fluid resuscitation should be done for internal hemorrhaging?
Controlled hypotensive resuscitation
What is the Recommended by the CoTCCC first choice for Hemostatic Agent
Combat gauze
What is the active ingredient in Celox gauze or chito gauze
Active ingredient is chotosan, a muco adhesive, it functions independent of the coagulation cascade
How high should you apply a TQ from bleeding site?
2-3 in above bleeding site
Hemostatic dressing should be applied for how long
at least 3 minutes
Literally means “deficient in oxygen”, that is an abnormally low oxygen availability to the body or an individual tissue or organ
Hypoxia
Is a non-invasive method allowing the monitoring of the saturation of a patient’s hemoglobin.
Pulse oximeter
What kind of oxygen should be given for the following
(a)Decompression illness (the “bends”)
(b)Carbon monoxide poisoning
(c)Radiation necrosis
(d)Reconstructive surgery
(e)Some infection, wounds
Hyperbaric Oxygen.
When should NPA be given
Casualty who is unable to maintain their airway
Contraindications for combitube
(a)Patients with intact gag reflexes.
(b)Patients with known esophageal pathology.
(c)Used in patients under 5 feet with standard Combitube™, under 4 feet withCombitube™ SA (small adult).
The pleural space can accomodate how much blood?
2500-3000ml
Treatment of tension pneumothorax
Chest tube thoracotomy
Indications for chest tube
(1) Drainage of large pneumothorax (> 25%)
(2) Drainage of hemothorax
(3) After needle decompression of a tension pneumothorax
(4) Pleural effusion
(5) Empyema
(6) Simple/Closed Pneumothorax
(7) Open Pneumothorax
Contraindications for Chest tube
(1) Infection over insertion site
(2) Uncontrolled bleeding (diathesis)
(3) No contraindication if the procedure is emergent
Contraindications for Chest tube
(1) Infection over insertion site
(2) Uncontrolled bleeding (diathesis)
(3) No contraindication if the procedure is emergent
Contraindications for Chest tube
(1) Infection over insertion site
(2) Uncontrolled bleeding (diathesis)
(3) No contraindication if the procedure is emergent
Shelf life of FWB
24-48 hours
Complications of IO
(1) Important complications are tibial fracture, especially in small framed people.
(2) Compartment Syndrome
(3) Osteomyelitis
(4) Skin Necrosis
Zofran dosage
4mg PO/IV/IM q8hrs prn
EKG to evaluate electrolyte abnormalities (Hyperkalemia (causes peaked T waves))
Rhabdomyolysis
Complications of rhabdomyolysis
(1)Acute renal failure, acute kidney injury
(2)Compartment syndrome
(3)Electrolyte abnormalities
(4)Cardiac arrhythmias
(5)Death
What is degloving?
The avulsion of skin from the underlying structures is usually a result of trauma
Where is hemorrhaging from pelvic fracture come form?
venous plexus
What is the next step in identifying pelvic fracture after s/s?
Retrograde urethrogram
If a significant pelvis injury is found or a patient with a pelvic fracture remains hemodynamically unstable, the pelvis should be
“wrapped” with either a sheet or a commercial pelvic binder.
Burn center referral criteria
(a)Partial-thickness burns greater than 10% of TBSA
(b)Burns that involve the face, hands, feet, genitalia, perineum, or major joints
(c)Third-degree burns in any age group
(d)Electrical burns, including lightning injury
(e)Chemical burns
(f)Inhalation injury
(g)Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
(h)Burned children in hospitals without qualified personnel or equipment for thecare of children
(i)Burn injury in patients who will require special social, emotional, or rehabilitative intervention
Timing for TQ conversions
a)<2 hours is considered safe (attempt conversion)
b)2-6 hours is likely safe (attempt conversion)
c)>6 hours require caution (conversion not advised in PFC)
Ketamine dosages
a)Low dose pain 10-20mg IV titrate to effect repeating doses every 10minutes as needed for desired effect.
b)Mid-range – AVOID – 0.3-1mg/kg IV
c)High dose dissociative – 2.0 mg/kg IV and should also include Versed to avoid vivid dreams which can lead to lifelong dreams and PTSD.
