TCCC (part 3) TEST
Three Objectives of Tactical Combat Casualty Care (TCCC) - answer - Treat the casualty
- Prevent additional casualties
- Complete the mission
Tactical Combat Casualty Care (TCCC) Guidelines 1996 - answer - Tourniquets
- Aggressive needle thoracostomy
- Nasopharyngeal airways
- Surgical airways for maxillofacial trauma
- Tactically appropriate fluid resuscitation
- Battlefield antibiotics
- Improved battlefield analgesia
- Combine good tactics and good medicine
- Scenario-based training
- Combat medic input to guidelines
The threat - answer During the gunfight, attention is focused primarily on eliminating what?
3 Phases of Care in TCCC - answer - Care Under Fire
- Tactical Field Care
- Tactical Evacuation Care
Care Under Fire - answer Is the care rendered by the first responder or combatant at
the scene of the injury while they are still under effective hostile fire.
- Available medical equipment is limited to that carried by the individual or by the medical provider in his or her aid bag
Tactical Field Care - answer Is the care render by the first responder or combatant once he and the casualty are no longer under effective hostile fire.
- It also applies to situations in which an injury has occurred, but there has been no hostile fire.
Tactical Evacuation Care - answer Is the care rendered once the casualty has been picked up by an aircraft, ground vehicle or boat.
P-MARCH-P - answer - Is a combat medicine algorithm
- It is used to effectively treat battlefield casualties to prevent missing vital medical interventions
- It can be tailored to any environment and casualty
- It is considered the "Framework for ALL TCCC interventions" Massive Hemorrhage (step 1 in care under fire) - answer - Is the only step done on the "X" (point of injury)
- Stop Massive bleeding
- Tourniquets
- Perform blood sweeps after PT has been moved off the "X" (Big pipes, little pipes down to the joints).
Airway Management - answer - Check level of consciousness (LOC)
- Check carotid (Dead check)
- If patient is unresponsive, look, listen, feel (LLF)
- Check for lacerations, obstructions broken bones, blood, and swelling (LOBBS)
- Clear obstructions. NEVER BLIND SWEEP
- Open airway with head tilt chin lift or jaw thrust
- If still not breathing, readjust a second time and LLF. - Breathing? = nasopharyngeal airway
- IF STILL not breathing, consider cricothyrotomy
Types of Carries for Care Under Fire - answer - One-person drag with/without line
- Two-person drag with/without line
- SEAL Team Three Carry: One/Two person
- Hawes Carry
Early control of severe hemorrhage is CRITICAL - answer What is the number one medical priority in Care Under Fire?
- There is pulsatile or steady bleeding from the wound
- Blood is pooling on the ground
- The overlying clothes are soaked with blood
- Bandages or makeshift bandages used to cover the wound are ineffective and steadily
becoming soaked with blood.
- There is a traumatic amputation of a limb
- There was prior bleeding, and the patient is now in shock (unconscious, confused, pale) - answer When is Bleeding Life Threatening?
Casualties with such an injury can bleed in as little as 3 minutes - answer How long does it take to bleed to death from a complete femoral artery and vein disruption?
The MARCH algorithm - answer Is a guide to the sequence of treatment priorities in caring for combat casualties
Massive hemorrhage - answer Control life-threatening bleeding
Airway - answer Establish and maintain a patent airway
Respiration - answer Decompress suspected tension pneumothorax, seal open chest wounds, and support ventilation/oxygenation as required. Circulation - answer Establish IV/IO access and administer fluids as required to treat shock.
Head injury/Hypothermia - answer Prevent/treat hypotension and hypoxia to prevent worsening.
Disarm them immediately - answer What is the first thing you should do when you have a casualty who has an altered mental status?
Unconscious casualty without airway obstruction - answer - Chin lift or jaw thrust maneuver
- Nasopharyngeal airway
- Place casualty in recovery position
Casualty with airway obstruction or impending airway obstruction - answer - Chin lift or jaw thrust maneuver
- Nasopharyngeal airway
- Allow casualty to assume any position that best protects the airway, to include sitting up
- Place unconscious casualty in recovery position.
Bougie-aided open surgical technique - answer Using a flanged and cuffed airway cannula of less than 10 mm outer diameter, 6-7 mm internal diameter, and 5-8 cm of intratracheal length.
Maxillofacial trauma - answer Casualties with severe facial injuries can often protect their own airway by sitting up and leaning forward.
Surgical Airway (Cricothyroidotomy) - answer - Thyroid cartilage
- Cricoid Cartilage
- Cricothyroid Membran
Surface Landmarks for Cricothyrotomy - answer - Top of thyroid cartilage
- Bottom of thyroid cartilage
- Thyroid prominence- Adam's apple
- Cricothyroid Membrane
- Cricoid Cartilage
Beneath Surface Landmarks for Cricothrotomy - answer - Hyoid Bone
- Thyroid prominence (Adam's apple) usually visible only in males
- Thyroid Cartilage
- Cricothyroid membrane
- Cricoid Cartilage
- Thyroid Gland
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