MSL402 L02b Unit Level Medical Operations (NXPowerLite)

MSL 402, Lesson 02b: Unit Level Medical Operations
Unit Level Medical Operations
Revision Date: 30 November 2012
Objectives
Evaluate a Casualty Familiarize Cadets on 9 Line MEDEVAC Format
Evaluating a Casualty
Care Under Fire

Scene Assessment Return fire as directed or required Casualty should return fire if able Keep yourself from getting shot Prevent additional wounds to casualty Maintain situational awareness!
Approaching the Casualty

Asses your situation Small arms fire Fire or explosive devices Chemical/Biologic al agents Electrical hazards Structural stability

Determine best route of access to the casualty and the best route of egress Plan an evacuation route prior to exposing yourself to hostile fire How many people will it take to move the casualty Will you need a litter

Your plan should be
move to cover and/or use a tourniquet

Request covering fire
Approach the Casualty

Do not expose yourself to enemy fire in order to provide care. Talk to the casualty while moving to him Have a tourniquet ready AVPU and general impressions can be obtained once behind cover A - Alert V - responds to Verbal stimulus P - responds to Painful stimulus U Unresponsive
Revision Date: 30 November 2012 8
Tactical Field Care

Primary Survey - Airway - Breathing - Circulation - Disability - Expose/Environment
Reassess
Reassess any treatments that were done in Care Under Fire Tourniquets If you see any massive hemorrhage Tourniquets
10
Check for Responsiveness

Gently shake or tap the casualty on the shoulder and ask in a loud, but calm, voice: Are you okay? A - Alert V - responds to Verbal stimulus P - responds to Painful stimulus U Unresponsive If conscious, ask where it hurts or where his body feels different than usual.
Airway
Check for patent airway Look for rise and fall of chest and abdomen Listen for sounds of breathing Feel for breath on the side of your face
12
Breathing
Check for breathing, respiratory rate/depth
APPROXIMATE RATE: Use the method of abnormal vs. normal rate. (i.e. <10 or >28). Slow or Rapid RHYTHM: Regular vs. Irregular. DEPTH: Shallow vs. Deep
13
Breathing
If the casualty has a penetrating chest wound, is not breathing and is not making any effort to breath, do not attempt to treat the injury In a combat situation, if you find a casualty with no signs of life (no respiration and no pulse), do not continue first aid on the casualty
14
Circulation
Check for pulse presence, quality, rate, and rhythm & skin capillary refill time, color, temperature, and moisture
Assess pulses If the patient is alert - assess the radial pulse If the patient has a decreased LOC - assess both the carotid and radial pulses simultaneously
Circulation
Check for and control remaining external hemorrhage using necessary means
Look for blood soaked clothes Look for entry and exit wounds
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Circulation
Establish baseline vitals Assess pulses Normal pulse (60-100) Slow or fast pulse Assess respiration Is it to slow or to fast
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Circulation
Assessment of perfusion can be easily accomplished in three ways: Capillary refill - < 2 seconds Skin color : In light skinned patients color will be obvious, in dark skinned patients it is easiest to assess the mucous membranes of mouth or fingernail beds. Skin temperature - Warm
18
Circulation
Assess blood pressure CAROTID PULSE: BP is > 60. FEMORAL PULSE: BP is > 70. RADIAL PULSE: BP is > 80. Initiate Fluid resuscitation as needed IV Vs. IO
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Disability
Check level of consciousness Has the Patient status changed Did he respond to fluid therapy Is he getting worse Splint any fractures
20
Secondary Survey
Head to Toe evaluation Where my hands go, my eyes follow Improve on your treatments Reassess your ABCs Look, listen, and feel See, dont just look! Hear, dont just listen! Feel, dont just touch
Casualty Evacuation
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Introduction
Being able to evacuate casualties quickly and effectively will result in saving lives Your knowledge and ability to perform casualty evacuations in multiple situations and terrain will increase the likelihood of your casualty's survival
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Medical Evacuation Plan

Identify your medical evacuation requirements. Who is part of the aid and litter teams? Primary and Alternate Where are your medics? Where are the casualty collecting points located? What are your evacuation request procedures and channels?
26
Medical Evacuation Plan

Where is the nearest aid station? How will I get my casualties there? Ground or Air Identify routes, means and schedules (if any) of evacuation and responsibilities
Where are the clinics and hospitals? How far away are they? What can they do for the casualty?
Categories of Precedence
URGENT-PATIENT WHO SHOULD BE EVACUATED AS SOON AS POSSIBLE AND WITHIN TWO HOURS TO SAVE LIFE, LIMB, OR EYESIGHT.
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Categories of Precedence
PRIORITY-PATIENT WHO SHOULD BE MOVED WITHIN FOUR HOURS OR HIS/HER CONDITION WILL DETERIORATE TO SUCH A DEGREE THAT HE WILL BECOME URGENT. ROUTINE-PERSONNEL WHOSE CONDITION IS NOT EXPECTED TO WORSEN SIGNIFICANTLY AND WHO WILL REQUIRE EVACUATION IN THE NEXT 24 HOURS.
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9-Line Request
Line 1 - Location of Pick up site (6 or 8 digit grid) Line 2 Your call sign and frequency Line 3 - Number of patients (by precedence) A URGENT (1 HR. LOSS LIFE/LIMB/EYESIGHT) B URGENT SURGICAL(SURG. INTERVENTION) C PRIORITY D ROUTINE
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9-Line Request
Line 4 Special Equipment Needed A NONE B HOIST C EXTRACTION EQUIP D VENTILATOR Line 5 Number of patients by type (A) Ambulatory (L) Litter
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9-Line Request
LINE 6: SECURITY AT PICKUP SITE: E ENEMY TROOPS IN AREA N NO ENE. TROOPS P POSSIBLE ENE. TROOPS X ENE TROOPS IN AREA, ARMED ESCORT
REQUIRED
LINE 7: METHOD OF MARKING PICKUP SITE: A PANELS B PYROTECHNICS C SMOKE D NONE E OTHER IE, IR BUZZ SAW, NATO Y OR T
9-Line Request
LINE 8: PATIENT NATIONALITY/STATUS: A US MILITARY B US CIVILIAN C NON-US MILITARY D NON-US CIVILIAN
Line 9 Terrain Description Include details of terrain features in and around proposed landing site
Summary
Evacuation is a critical, life-saving skill, It can only be allied effectively is it is planned for and practiced.
34
Collect and Record Information

You are conducting a routine dismounted presence patrol with five other members of your squad. You are moving along the designated route that runs through an open field. While moving along the route, SPC Coffman sees a shiny object lying in a ditch. Without SGT Hills authorization, he leaves the road to retrieve it. Suddenly, a loud explosion is heard. SPC Coffman has just stepped on an anti-personnel mine. His left leg is completely severed just inches above his ankle, SGT Hill receives a shrapnel wound across her face. A third soldier, PFC Fuel, receives shrapnel wounds across his upper body. All casualties are conscious and in pain. Its up to you to get these casualties evacuated.
35

You begin to collect information Call sign: A6B88 Frequency is: 53.80 MHz
UTM Grid is: GF70296868

Frequencies of your medical support unit are 49.90 MHz and 23.75 MHz
36

You begin to collect information Line 1 Location of pick up site GF70296868
Line 2 Radio frequency, call sign, and suffix

53.80, A6B88 Line 3 Patient Precedence Codes Urgent 1, Priority 2 A1,C3

Line 4 Special equipment needed
Hoist (B) Line 5 Patients by type
Litter 1, Ambulance 2 (L1,A2)

Line 6 Number and type of wound or illness 1 Lower left severed foot, 1 Face shrapnel wound, 1 Upper right torso shrapnel wound All conscious, 1 B+ blood, 2 O+ blood

Line 7 Method of marking pick up site Smoke (C)
Line 8 Patient nationality and status US Military 3 (A3) Line 9 Terrain description
Open field to the east of a cliff along route red
39

Line 1 GF70296868
Line 2 53.80, A6B88 Line 3 A1, C2
Line 4 B
Line 5 L1, A2
Line 6 (Peacetime) 1 B+blood: lower left foot severed; 2 O+blood: 1 face shrapnel wound, 1 upper right torso wound. All conscious.
Line 7 C
Line 8 A3
Line 9 Open field to the east of a cliff along route red.
Questions
41

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MSL 402, Lesson 02b: Unit Level Medical Operations

Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Care Under Fire

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Approaching the Casualty

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Approaching the Casualty

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Approaching the Casualty

move to cover and/or use a tourniquet

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Approach the Casualty

MSL 402, Lesson 02b: Unit Level Medical Operations

Tactical Field Care

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Check for Responsiveness

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Medical Evacuation Plan

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Medical Evacuation Plan

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012

MSL 402, Lesson 02b: Unit Level Medical Operations

Revision Date: 30 November 2012