Military Acute Care & Cause of Injury

Question 1

Describe Scene Management approach

Answer 1

This is an all inclusive approach to the management of military casualties that aims to take into consideration the identification and elimination of all matters relating to any incident

Question 2

Describe the Casualty Management Approach

Answer 2

• S-A-F-E
• Quick history/look
• Cat haem - Massive bleeds
• Airway - HTCL
• Breathing - LLF
• Circulation - Pulse
• Disability - AVPU
• Environment and exposure - Cold, wet, hot

Question 3

Define SAFE

Answer 3

Send for help, Assess for further danger, Find and free the casualty rom the danger if there is a risk to life or remove the danger from the casualty, Evaluate the casualties (triage, TRaPS - Tactical Rapid & Primary Survey)

Question 4

Define CSCATT

Answer 4

Command and control, Safety, Comms, Assessment, Triage, Treatment, Transport

Question 5

Define ATMIST

Answer 5

Age, Time of injury/time on scene, MOI, Injuries sustained, signs and symptoms (AVPU, resp rate, pulse, pupils), Treatment so far

Question 6

Describe a 9 liner

Answer 6

A 9liner provides the information needed to request CASEVAC. A MIST report is given at handover between each successive level of care.

Question 7

Describe METHANE

Answer 7

My c/s, Exact location, Type of incident, Hazards, Access, Number & severity of casualties, Emergency services present or required

Question 8

Describe the types of injuries seen in vehicle collisions

Answer 8

• C-spine
• Head injuries
• Broken, fractured or sprained bones
• Cat haems and internal bleeds

Question 9

Describe the timing of trauma death

Answer 9

• Instantaneous - 0-10mins
• Early - 2hrs
• Late days - later

Question 10

Describe the effects of burns

Answer 10

Can be caused by high temp combustion or secondary ignition of fuel. Weapons designed to inflict burn injury. Can be complicated by inhalation which can take several hours to develop.

Question 11

Describe the effects of crush injury

Answer 11

Damage to muscles cells releasing myoglobin into circulation. Myoglobin blocks renal tubes causing renal failure. Casualty mate require fluid rises prior to release of crush and may require amputation on scene.

Question 12

Describe the effects of climatic injury

Answer 12

Hyperthermia -extreme heat (core body goes above 37c)

Hypothermia - extreme cold (core body goes below 35c)

Question 13

Describe medical emergencies

Answer 13

• Causes more casualties than trauma - Virus (pandemic/ epidemic)
• Severe medical illness
• Infections
• Bites and stings (anaphylaxis)

Question 14

What are the stages of impact in an RTC?

Answer 14

1. The vehicle collides with another object or vehicle
2. The unrestrained occupant collides with eh inside of the vehicle
3. The occupants internal organs collide with each other or the wall. The cavity that contains them

Question 15

Describe a frontal or head on impact

Answer 15

An unrestrained occupant will follow one of two paths. Down and under or up and over

Question 16

Describe whiplash

Answer 16

A low headrest can act as a pivot point causing whiplash when a vehicle is hit from the rear. A head on collision can result in the occupants head hitting the windscreen. If the windscreen is damaged then assume a C spine injury.

Question 17

Describe the pathophysiology of missile injury

Answer 17

A missile is any object propelled forward by and external force. Primary missiles originates from the source of the energy such as bullets. Secondary missiles are particles picked up by the blast wave or the passage of the primary missile.

Question 18

Describe blast injuries

Answer 18

Primary - Shockwave

Secondary - Bone fragments and projectiles

Tertiary - blast wind displaces body

Quaternary - Flash burns, physiological sequelae