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“That Others May Live” - CIOMR

PARARESCUE MEDICATION AND PROCEDURE HANDBOOK. Second Edition 28 February, 2001. that Others May live . 1. EDITOR. Robert C. Allen, DO, FACEP. Lt Col, USAF MC. CONTRIBUTORS. James P. Bagian, MD. Col, USAFR MC. Lewis Neace, DO. Col, USAFR MC. John M. McAtee, PA-C. Lt Col, USAF BSC. Gus Varnivas, MD. Maj, USAF MC. Gary C. Perez, PA-C. Capt, USAF BSC. Michael L. Fleming, NREMT-P. TSgt, USAF. THIS BOOK IS DEDICATED TO ALL PARARESCUEMEN, PAST AND PRESENT, WHO USE THEIR SKILL, TRAINING, COURAGE AND INGENUITY SO that Others MAY live . 2. INTRODUCTION. This handbook is designed to provide concise information regarding management of patients in austere environments. It is a quick reference' and is not meant to provide detailed discussions of physiological events. You are expected to provide the standard of care for your EMT certification, including the unique skills native to Pararescue. NOTE: No handbook can anticipate every tactical and/or medical situation that might occur in a rescue.

3 INTRODUCTION This handbook is designed to provide concise information regarding management of patients in austere environments. It is a ‘quick reference’ and is not meant to provide detailed discussions of

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Transcription of “That Others May Live” - CIOMR

1 PARARESCUE MEDICATION AND PROCEDURE HANDBOOK. Second Edition 28 February, 2001. that Others May live . 1. EDITOR. Robert C. Allen, DO, FACEP. Lt Col, USAF MC. CONTRIBUTORS. James P. Bagian, MD. Col, USAFR MC. Lewis Neace, DO. Col, USAFR MC. John M. McAtee, PA-C. Lt Col, USAF BSC. Gus Varnivas, MD. Maj, USAF MC. Gary C. Perez, PA-C. Capt, USAF BSC. Michael L. Fleming, NREMT-P. TSgt, USAF. THIS BOOK IS DEDICATED TO ALL PARARESCUEMEN, PAST AND PRESENT, WHO USE THEIR SKILL, TRAINING, COURAGE AND INGENUITY SO that Others MAY live . 2. INTRODUCTION. This handbook is designed to provide concise information regarding management of patients in austere environments. It is a quick reference' and is not meant to provide detailed discussions of physiological events. You are expected to provide the standard of care for your EMT certification, including the unique skills native to Pararescue. NOTE: No handbook can anticipate every tactical and/or medical situation that might occur in a rescue.

2 When faced with adverse situations, a PJ and his team will have to improvise, adapt, and overcome. Always keep in mind the mission, your safety, and your patient's safety. References used in the preparation of this handbook include, but were not limited to: Brady Paramedic Emergency Care, Bledsoe, et al., Prentice Hall th Emergency Medicine: A Comprehensive Study Guide, 4 Ed., Tintanelli, et al. McGraw-Hill Lippencott Nursing Manual, J. B. Lippencott Co. Physicians' Desk Reference, Medical Economics Data Production Co. Physicians GenRx, Mosby, 1998. Advanced Cardiac Life Support, American Heart Association, 2000 edition Wilderness Medicine: Management of Wilderness and Environmental Emergencies, 3rd Ed., PA Auerbach, Mosby 1995. Emergency Medicine Concepts and Clinical Practice, 4th Ed., Rosen, et al., Mosby 1998. Medical Management of Chemical Casualties Handbook, US Army Medical Research Institute of Chemical Defense, Sept 1995.

3 Medical Management of Biological Casualties Handbook, US Army Medical Research Institute of Infections Diseases, August 1996. 3. TABLE OF CONTENTS. MEDICAL COMMAND AND CONTROL ---------------------------------------- ---------------------------------------- ---------8. PRINCIPLES OF COMBAT CASUALTY CARE ---------------------------------------- ---------------------------------------- -9. Resuscitation: Initiation and Guidelines------------------------------ -------------------------------------- 10. Refusal of Medical Care ---------------------------------------- ---------------------------------------- -------- 11. TRAUMA---------------------------------- ---------------------------------------- ---------------------------------------- -------- 12. Primary Survey---------------------------------- ---------------------------------------- ------------------------------ 12. Secondary Survey ---------------------------------------- ---------------------------------------- ------------------- 12.

4 Glasgow Coma Scale ---------------------------------------- ---------------------------------------- --------------- 13. SHOCK ---------------------------------------- ---------------------------------------- ---------------------------------------- ------ 14. Hypovolemic ---------------------------------------- ---------------------------------------- --------------------------- 14. Cardiogenic ---------------------------------------- ---------------------------------------- ---------------------------- 14. Anaphylactic ---------------------------------------- ---------------------------------------- --------------------------- 15. Septic ---------------------------------------- ---------------------------------------- ------------------------------------ 15. Neurogenic------------------------------ ---------------------------------------- --------------------------------------- 16. SPINAL INJURIES-------------------------------- ---------------------------------------- ---------------------------------------- -- 17.

5 Solu-Medrol Protocol (Blunt Spinal Chord Trauma) ---------------------------------------- ---------------- 17. Clinical Clearing of the Cervical Spine ---------------------------------------- --------------------------------- 18. Dermatome Chart ---------------------------------------- ---------------------------------------- --------------------- 19. HEAD INJURIES-------------------------------- ---------------------------------------- ---------------------------------------- ---- 20. Increased Intracranial Pressure (ICP) ---------------------------------------- ---------------------------------- 21. FACIAL/EYE TRAUMA ---------------------------------------- ---------------------------------------- ----------------------------- 22. Snellen Visual Acuity Chart----------------------------------- ---------------------------------------- ------------- 24. CHEST TRAUMA---------------------------------- ---------------------------------------- ---------------------------------------- - 25.

6 ABDOMINAL TRAUMA ---------------------------------------- ---------------------------------------- ---------------------------- 27. EXTREMITY TRAUMA ---------------------------------------- ---------------------------------------- ----------------------------- 29. Open Fractures ---------------------------------------- ---------------------------------------- ----------------------- 29. Shoulder Dislocations ---------------------------------------- ---------------------------------------- --------------- 30. Thumb/Finger Dislocations ---------------------------------------- ---------------------------------------- -------- 31. Knee Dislocations ---------------------------------------- ---------------------------------------- -------------------- 33. Ankle Fracture-Dislocations ---------------------------------------- ---------------------------------------- ------- 33. COMPARTMENT SYNDROME ---------------------------------------- ---------------------------------------- -------------------- 33.

7 CRUSH INJURIES ---------------------------------------- ---------------------------------------- ---------------------------------- 34. BURNS ---------------------------------------- ---------------------------------------- ---------------------------------------- ------ 35. Burn Nomogram ---------------------------------------- ---------------------------------------- ---------------------- 39. MEDICAL PROCEDURES ---------------------------------------- ---------------------------------------- ------------------ 40. AIRWAY ---------------------------------------- ---------------------------------------- ---------------------------------------- ---- 40. Jaw Thrust ---------------------------------------- ---------------------------------------- ----------------------------- 40. Chin Lift ---------------------------------------- ---------------------------------------- --------------------------------- 40. Naso-Pharyngeal Airway---------------------------------- ---------------------------------------- ----------------- 40.

8 Oral-Pharyngeal Airway ---------------------------------------- ---------------------------------------- ------------ 40. Endotracheal Intubation ---------------------------------------- ---------------------------------------- ------------ 41. Nasotracheal Intubation ---------------------------------------- ---------------------------------------- ------------ 41. Lighted Stylet Intubation------------------------------ ---------------------------------------- ---------------------- 42. Tactile Intubation ---------------------------------------- ---------------------------------------- --------------------- 42. Cricothyroidotomy----------------------- ---------------------------------------- ------------------------------------- 43. 4. BREATHING ---------------------------------------- ---------------------------------------- --------------------------------------- 44. Oxygen Therapy--------------------------------- ---------------------------------------- ----------------------------- 44.

9 Needle Thoracentesis--------------------------- ---------------------------------------- ---------------------------- 44. Thoracostomy (Chest Tube) ---------------------------------------- ---------------------------------------- ------ 45. CIRCULATION ---------------------------------------- ---------------------------------------- ------------------------------------- 46. Intravenous Insertion ---------------------------------------- ---------------------------------------- ---------------- 46. Saline Lock Insertion ---------------------------------------- ---------------------------------------- ---------------- 47. Intraosseous Infusion ---------------------------------------- ---------------------------------------- --------------- 48. DIAGNOSTICS AND PATIENT CARE ---------------------------------------- ---------------------------------------- ------------ 48. Naso-Gastric Tube Insertion ---------------------------------------- ---------------------------------------- ------ 48.

10 Urethral Catheterization ---------------------------------------- ---------------------------------------- ------------ 49. Suprapubic Needle Cystotomy ---------------------------------------- ---------------------------------------- --- 50. Wound Irrigation ---------------------------------------- ---------------------------------------- ---------------------- 50. Debridement ---------------------------------------- ---------------------------------------- --------------------------- 51. Delayed Primary Closure ---------------------------------------- ---------------------------------------- ---------- 51. Escharotomy----------------------------- ---------------------------------------- -------------------------------------- 51. Fasciotomy ---------------------------------------- ---------------------------------------- ---------------------------- 53. Amputations ---------------------------------------- ---------------------------------------- --------------------------- 53.


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