TCCC Flashcards
3 stages of TCCC
Care Under Fire
Tactical Field Care
Tactical Evacuation Care
Tourniquet placement if you cannot see site if bleed
High tight and in pocket
Care Under Fire questions
Are you hurt
Can you fight
Can you move
Apply a tourniquet
First step of tactical field care
Security perimeter
Maintain tactical awareness
Big pipe search
Hemostatic adjuncts
Felix gauze Chito gauze Chat gauze Stat Itclamp
Xstat
Syringe with sponges
Good for narrow tract deep junctional wounds
Syringe with sponges
X-Stat
Best tool for deep narrow tract junctional
X-Stat
Best bleeding control of neck & head wounds
ITclamp
Needed after you apply hemostatic dressings
3 minutes of pressure
Important thing to remember if using iTclamp
Can use on head/neck but not within 1in of orbits
Unconscious casualty without airway cinpronise
Recovery position
NPA
Chin lift /jaw thrust
Uncinacious with airway compromise
Cri-key
Igel
When don’t you need c-spine
If only penetrating injury
Why is airway first in TCCC
No one cares if you have great c-spine if you don’t have a secured airway
What type of airway is IGel
Extraglotric
Progression of untreated tension pneumo
Resp distress
Obstructive shock
Traumatic cardiac arrest
Needle D both sides
If significant traumatic cardiac arrear (no pulse, resp, response to pain, other signs of life)
Intervention for traumatic cardiac arrest
Double dart
When do you move from “A”to “C”
Fail A twice
Needle D procedure
Over rib
Down to hub
Hold 5-10 sec to deconpress
Needle D site
5th ICS
2nd ICS mid claviculae
Choosing needle for needle D
10-14 gague
3.25 in
Intervention for open chest wound
Vented seal
When to burp the vented chest seal
Hypoxic
Reap distress
Low BP
(Suspect t. Pneumo)
Intervention needed if head i jury
O2 above 90% if TBI
When do you place the pelvic binder
“C”
When do you check for bleeding in TCCC
m = big pipes C = little pipes
Suspect pelvic fracture
Pelvic pain Unstable in exam Lower extremity amputation Unconscious Shock
3 criteria to meet to turn limb/junctional tourniquet to hemostatic/pressure dressings
- Not in shock
- You can continue to monitor the site
- Tourniquet isn’t being used to control an amputation
Indication of radial pulse
SBP at least 80-90
DCAP-BTLS
Deformities Contusions Abrasions Puncture/penetration Burn Tender Lacerations Swelling
Rx in C if bleeding
TXA 1gram in 100ml over 10 mon
Can repeat immediately after first
When do you need an IV
Only if can’t take PO or in shock
Needed if in shoxk
IV/IO
TXA
IVF/blood
1:1:1
Plasma, rbc, plt
Goal if giving blood
Until palpable radial pulse
Improved mental status
Sbp over 90
Used to reauscitate
Blood
Hextend
Lr
In shock but not responsive to IVF
Consider t. Pneumo the cause of refractory shock
Pain options in TCCC
Triple Option
Morphine
Option 1
Mild/mod
Can still fight
Tylenol 650 2 PO q8hr
Mobic 15mg PO once a day
Option 2
Not fighting
Fentanyl Lilly 800ug
Don’t chew
Option 3
Hemorrhagic shock/resp distress
Ketamine 50mg IM/IN q30min
Ketamine 20mg iv/IO q20min
End points of giving ketamine
Nystagmus
Ketamine iM/IN
30mg q 30min
Ketamine IV/IO
20mg q 20 minutes
Ketamine if head injury
Ketamine and fentanyl can worsen TBI but if can c/o pain, likely not serious enough to preclude use of ketamine
Morphine
IV/IO
5mg
Q10 minutes
Zofran
4-8mg ODT
2nd dose of 4mg in 15min
No more than 8mg q8hr
ABX
PO = Moxifloxacin 400mg PO IV= Ertapenem 1 gram
CPR
Never in field
If torso/polytrauma, without pulse or respirations, needle D x2 before calling it
