Intro To Battlefield Medicine

Question 1

What percentage of combat deaths occur in prehospital setting and what percentage are non-survivable?

Answer 1

87.3% prehospital, 75.7% non-survivable.

Question 2

What percentage of survivable deaths where due to hemorrhage?

Answer 2

90.9%

Question 3

What is the three categories of hemorrhage?

Answer 3

Extremity 13.5%, junctional 19.2%, truncal 67.3%

Question 4

What are the three preventable causes of death?

Answer 4

Hemorrhage 90%, tension pneumothorax 2%, airway obstruction 8%.

Question 5

What are the wound location percentages?

Answer 5

Extremities 60%, head and neck 25%, torso 9%.

Question 6

What are the types of wounds in combat?

Answer 6

Explosion 73.7%, GSW 22.1%, other 4.2%.

Question 7

What percentage of deaths are instantaneous, acute, and after reaching MTF?

Answer 7

35.2% instantaneous, 52.1% acute, 12.7% after MTF.

Question 8

What percentage of spinal injuries require immobilization and what are the common indications?

Answer 8

1.4% require immobilization and indications can be MVA’s, falls greater than 15 feet, and IED blasts involving MRAPS.

Question 9

What is the most significant obstacle to providing care? V

Answer 9

Enemy fire

Question 10

Who decides if and when the casualty is evacuated?

Answer 10

The tactical leader

Question 11

What are some painkiller options for mild to moderate pain?

Answer 11

Tylenol (acetaminophen) 2 500gm tabs every 8 hours, Meloxicam (mobic) 15mg daily.

Question 12

What are some painkiller options for a casualty in moderate to severe pain not in shock or respiratory distress?

Answer 12

OTFC 800ug, IV morphine 5mg repeated as necessary every 10 minutes, Dsuvia 30mcg (newer and not common).

Question 13

What painkiller should be used for a casualty in moderate to severe pain and in shock or respitory distress?

Answer 13

Ketamine either 50mg IM/intranasal, or 30mg slow IV, repeat 30 min for IM or IN and 20 for IV. Stop if development of nystagmus (back and forth eye movements).

Question 14

What should be used for nausea or vomiting?

Answer 14

Zofran (indansetron) 4-8mg every 8 hours IV/IM/IO.

Question 15

What are some antibiotics that can be used?

Answer 15

Moxifloxacin 400mg PO once a day, ertapenem 1gm IV/IO once a day.

Question 16

Where is a WALK located and what is inside it?

Answer 16

Warrior aid and litter kit, a vehicle, contains a folding talon litter and first aid supplies for hemorrhage control and shock.

Question 17

What are antibiotics not indicated for?

Answer 17

Burns, unless there is also penetrating trauma.

Question 18

What are the goals of TCCC?

Answer 18

Complete the mission, prevent additional casualties, treat the casualty.

Question 19

What is the first phase of TCCC?

Answer 19

Care under fire, at the scene of the injury, care is limited to hasty tourniquet.

Question 20

What is the second phase of TCCC?

Answer 20

Tactical field care, when medic and casualty are no longer under fire.

Question 21

What is the third phase of TCCC?

Answer 21

Tactical evacuation care, care rendered once casualty is picked up by another vehicle, such as treatment received by flight medics during transportation.

Question 22

What does MARCH stand for?

Answer 22

Massive hemorrhage, airway, respiration, circulation, hypothermia.

Question 23

What are role one capabilities?

Answer 23

Self/buddy aid, CLS, medical personal (combat medic, physician or PA).

Question 24

What are role one organizations?

Answer 24

Battalion aid station, medical platoon.

Question 25

What are role two medical capabilities?

Answer 25

Advanced trauma management, TCCC, provide packed red blood cells, limited x-rays, clinical laboratory, dental support.

Question 26

What are role two organizations?

Answer 26

Medical company, forward surgical teams.

Question 27

What are role three medical capabilities?

Answer 27

Resuscitation, wound surgery, damage control surgery, postoperative treatment.

Question 28

Role three organizations.

Answer 28

Hospital center

Question 29

What is the difference between role three and four medical centers?

Answer 29

Role 3 is more immediate and field-based, while Role 4 involves care beyond the operational theater, often in more established medical facilities.