TCCC Flashcards
How to apply hemostatic dressings?
-With at least 3min of direct pressure -If one doesn’t work, try another
IT Clamp?
-Head and neck wounds easily approximated -Pack wound first -No extra external pressure needed -Continuously re-evaluate airway for hematoma *DONOT apply on or near eye (1cm within orbit)
Airway for unconscious pt without airway obstruction?
-Recovery position -Chin lift/jaw thrust OR -NPA OR -Extraglottic airway
What is combat gauze?
Gauze impregnated with kaolin *No shellfish, animal prots, low allergy potential *Has radiopaque strip down middle
What is Kaolin?
Inorganic mineral Speeds up clotting by activating factor XII
What are the CoTCCC recommended limb tourniquets?
-CAT Gen 6, Gen 7 -RMT-T (mil model) -SOFTT-W (new 1.5” nylon strap) -TMT -TX2, TX3
First two things you do when transition to tactical field care?
1) Establish a perimeter 2) Triage *any pt w/ AMS needs their weapons and comms taken away immediately
Where to place tourniquet in tactical field care?
-Directly to the skin - 2 to 3’’ above bleeding site
Use of hemostatic dressings?
-For compressible hemorrhage you can’t tourniquet -dressing of choice = COMBAT GAUZE -alternatives = celox/chito/stat/it clamp
Most recent update to TCCC?
01 Aug 2019
What specific type of airway will you place in case of cricothyroidotomy?
Flanged and cuffed airway cannula <10mm outer diameter 6-7mm internal diameter 5-8cm of intra-tracheal length
What are the preferred options for Cric’s?
Preferred option: Cric-Key technique Next: Bougie aided open surgical Last: Standard open surgical technique
What is the preferred extraglottic airway?
I-gel *simpler b/c no need for cuff inflation/monitoring
What is the recovery position?
What type of needle for needle D?
10 gauge, 3.25 inch
Last thing you do before giving up resuscitation?
Bilateral needle decompression
Where to placed the needle D?
5th ICS in the AAL
OR
2nd ICS in the MCL
**DO NOT insert medial to nipple line
How to place needle D?
Perpendicular to chest wall
Just over top of lower rib
Hub it, hold in place for 5-10sec
If initial needle D fails to improve the signs/symptoms, what next?
What should be initiated immediately during assessment of breathing?
pulse oximetry
When to put on a pelvic binder?
Severe blunt force or blast injury PLUS
pelvic pain
OR
lower limb amputation or near so
OR
Unconsciousness OR shock OR PE suggestive
What should you do every time you address Circulation during a triage?
Reassess prior tourniquet application
First thing you do for suspected tension pneumothorax?
If pt has a chest seal, burp it or remove it
Should you attempt to convert tourniquets to hemostatic/pressure dressings?
Yes, as soon as posible, but only if certain circumstances met
What three criteria must be met before tourniquets can be converted?
1) Casualty is not in shock
2) Its possible to monitor the wound for bleeding
3) Tourniquet is not being used to control blding from an amputation
How long can you go before converting a tourniquet?
Withing 2hrs (never 6hr or later)
What is of utmost importance when utilizing tourniquets?
Documenting their time of application and conversion on the TCCC card
Does every casualty get an IV?
NO
Only those with hemorrhagic shock OR at risk for it OR need IV fluids OR can’t take oral meds
Who gets TXA?
Patients needing blood products (pts in shock)
How much/how to give TXA?
1gm TXA in 100mL of NS or LR
push over 10min
Never after 3hrs
When to give second dose of TXA?
After initial fluid resuscitation has been completed.
What are measures of adequate resuscitation?
Papable radial pulse
Improved mental status
SBP 80-90
When should you begin hypothermia prevention on a trauma patient?
When you initiate blood products (if not obvious before that)
What to do for penetrating eye trauma?
Perform rapid field test of visual acuity and document
