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    Skill Instr Mod 5 Junio

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    Sae Tum
    The document provides instructions for performing a tactical trauma assessment and treating casualties in a combat environment. It outlines the steps to take under fire, establish tactical field care, and assess casualties using the MARCH PAWS sequence to treat massive hemorrhage, secure airways, check respiration and circulation, prevent hypothermia, assess for head injuries, manage pain, administer antibiotics, treat wounds, and splint fractures. It also describes communicating with casualties, leadership, and evacuation teams as well as documenting treatments and preparing casualties for evacuation.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Skill Instr Mod 5 Junio

    Uploaded by

    Sae Tum
    71 views5 pages
    The document provides instructions for performing a tactical trauma assessment and treating casualties in a combat environment. It outlines the steps to take under fire, establish tactical field care, and assess casualties using the MARCH PAWS sequence to treat massive hemorrhage, secure airways, check respiration and circulation, prevent hypothermia, assess for head injuries, manage pain, administer antibiotics, treat wounds, and splint fractures. It also describes communicating with casualties, leadership, and evacuation teams as well as documenting treatments and preparing casualties for evacuation.

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    SKILL INSTR MOD 5 JUNIO

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    The document provides instructions for performing a tactical trauma assessment and treating casualties in a combat environment. It outlines the steps to take under fire, establish tactical field care, and assess casualties using the MARCH PAWS sequence to treat massive hemorrhage, secure airways, check respiration and circulation, prevent hypothermia, assess for head injuries, manage pain, administer antibiotics, treat wounds, and splint fractures. It also describes communicating with casualties, leadership, and evacuation teams as well as documenting treatments and preparing casualties for evacuation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    71 views5 pages

    Skill Instr Mod 5 Junio

    Uploaded by

    Sae Tum
    The document provides instructions for performing a tactical trauma assessment and treating casualties in a combat environment. It outlines the steps to take under fire, establish tactical field care, and assess casualties using the MARCH PAWS sequence to treat massive hemorrhage, secure airways, check respiration and circulation, prevent hypothermia, assess for head injuries, manage pain, administer antibiotics, treat wounds, and splint fractures. It also describes communicating with casualties, leadership, and evacuation teams as well as documenting treatments and preparing casualties for evacuation.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    MODULE 05:

    TACTICAL
    TRAUMA
    ASSESSMENT
    SKILL INSTRUCTIONS
    30 JUN 2020

    COMBAT LIFESAVER (CLS) TACTICAL COMBAT CASUALTY CARE

    SKILL INSTRUCTIONS

    TACTICAL TRAUMA ASSESSMENT INSTRUCTION


    TASK: Perform a tactical trauma assessment
    CONDITION: Given a combat scenario in which casualty and responder are in combat gear and the
    casualty has sustained one or more injuries, and the casualty’s Joint First Aid Kit (JFAK)
    and a Combat Lifesaver (CLS) kit are available
    STANDARD: Perform a tactical trauma assessment following all steps and meeting performance
    measures without causing further injury to the casualty in accordance with Service
    and/or unit standard operating procedures
    EQUIPMENT: JFAK or other individual first aid kit, a CLS kit, and any other equipment required per
    Service guidelines

    Perform Care Under Fire (CUF).


    (a) Return fire and take cover.
    (b) Direct or expect the casualty to remain engaged as a combatant, if appropriate.
    (c) Direct the casualty to move to cover and apply self-aid, if able.
    NOTE: If the casualty is not responsive or cannot move, assess the tactical situation for the best
    options to move the casualty or secure the site.
    NOTE: If the casualty is unable to move on their own, perform a casualty drag/carry to move the
    casualty to cover.
    (d) Extract casualties from burning vehicles or buildings and move to places of relative safety. Do what
    is necessary to stop the burning process.
    (e) Apply a tourniquet to control life-threatening external bleeding.
    NOTE: Apply the tourniquet over the uniform proximal (above) the bleeding site(s). If the site of the
    life-threatening bleeding is not readily apparent, place the tourniquet “high and tight” (as proximal as
    possible) on the injured limb.
    NOTE: Always use the casualty’s personal JFAK and supplies.
    Perform Tactical Field Care (TFC).
    (a) Establish a security perimeter and maintain tactical situational awareness.
    (b) Triage casualties as required.
    (c) For casualties with an altered mental state, take away weapons and communications equipment
    immediately.
    Assess and treat the casualty using the MARCH PAWS sequence:
    - Massive hemorrhage - Pain
    - Airway - Antibiotics
    - Respiration - Wounds
    - Circulation - Splint
    - Hypothermia/Head
    Assess and treat Massive hemorrhage.
    (a) Assess for unrecognized hemorrhage and control all sources of bleeding.
    NOTE: If not already done (in CUF), use a limb tourniquet recommended by the Committee on
    Tactical Combat Casualty Care (CoTCCC) to control life-threatening external hemorrhage that is
    anatomically amenable (where the tourniquet can be applied) to tourniquet use or for any traumatic
    amputation. Apply directly to the skin 2–3 inches above the bleeding site.
    NOTE: If bleeding is not controlled with the first tourniquet, apply a second tourniquet side-by-side
    with the first (above, if feasible).
    (b) For compressible (external) hemorrhage where a limb tourniquet cannot be applied, apply
    improvised junctional hemorrhage control techniques using a CoTCCC-recommended hemostatic
    dressing.

    TCCC CLS SKILL INSTRUCTIONS #TCCC-CLS-09-01 30 JUN 20


    1

    COMBAT LIFESAVER (CLS) TACTICAL COMBAT CASUALTY CARE

    SKILL INSTRUCTIONS
    Assess and secure the Airway.
    (a) Allow a conscious casualty to assume any position of comfort that best facilitates breathing and
    protects the airway, including sitting up.
    (b) If the casualty’s airway is obstructed, use a head-tilt/chin-lift or jaw-thrust maneuver to open the
    airway.
    (c) Insert an NPA in an unconscious casualty or a semiconscious casualty.
    (d) Place an unconscious casualty in the recovery position.
    Assess Respiration.
    (a) Look for chest wounds.
    (b) Apply a chest seal in the presence of an open chest wound.
    (c) Assess for tension pneumothorax.
    (d) Burp the chest seal.
    (e) Perform needle decompression in the presence of tension pneumothorax.
    (f) Reassess to confirm needle decompression was successful.
    Assess Circulation.
    (a) Reassess prior tourniquet application and/or wound packings with pressure bandages after each
    movement of the casualty.
    (b) Assess for pelvic fracture (signs and symptoms, and treatment considerations) and inform medical
    personnel.
    (c) Assess for hemorrhagic shock (altered mental status in the absence of brain injury and/or weak or
    absent radial pulse).
    Prevent and treat Hypothermia (active/passive).
    (a) Minimize casualty exposure to the environment.
    (b) Employ active warming measures, if available.
    (c) Use passive warming measures if active warming device is unavailable.
    Assess for Head injury.
    (a) Check for signs and symptoms of a head injury, and report your observations to medical personnel.
    NOTE: Share any information about how you found the casualty, any signs you observed or casualty-
    reported symptoms (e.g., conscious or unconscious, headache, vomiting, ears ringing, double vision,
    dizziness).
    (b) Assess and document mental status using AVPU (Alert, Responds to Voice, Responds to Pain,
    Unresponsive).
    If a penetrating eye injury is noted or suspected, cover the eye with a rigid eye shield, and administer an
    oral antibiotic from the Combat Wound Medication Pack (CWMP).
    NOTE: Do not apply pressure directly to the eye.
    Control Pain: Administer the CWMP if the casualty is conscious and can swallow.
    (a) Administer the CWMP for pain
    (b) If pain is severe, refer to medical personnel.
    Administer Antibiotic(s): Administer the CWMP if the casualty is conscious and can swallow.
    (a) Administer the CWMP for all open wounds.
    NOTE: Casualties with penetrating injuries should receive antibiotics.
    (b) If the casualty cannot swallow (because of shock or unconsciousness), refer to a medic.
    Treat additional Wounds.
    (a) Inspect and dress known wounds.
    (b) Check for additional wounds (e.g., scalp lacerations) and dress, as necessary.
    (c) Assess and treat burns by applying dry, sterile dressings to burns and preventing hypothermia.
    NOTE: Burn patients are particularly susceptible to hypothermia. Place extra emphasis on barrier
    heat loss prevention methods.
    Splint any fractures found on the casualty.
    NOTE: Splinting fractures can bring significant pain relief and minimize bleeding.

    TCCC CLS SKILL INSTRUCTIONS #TCCC-CLS-09-01 30 JUN 20


    2

    COMBAT LIFESAVER (CLS) TACTICAL COMBAT CASUALTY CARE

    SKILL INSTRUCTIONS
    NOTE: Do not disrupt impaled objects.
    Communicate: Transmit the 9-Line MEDEVAC information in the proper sequence.
    (a) Communicate with the casualty, if possible. Encourage, reassure, and explain care.
    (b) Communicate with tactical leadership as soon as possible and throughout casualty treatment as
    needed. Provide leadership with casualty status and evacuation requirements to assist with
    coordinating evacuation assets.
    (c) Communicate with the evacuation system (the Patient Evacuation Coordination Cell) to
    arrange for Technical Evaluation Care (TACEVAC). Communicate with medical providers on the
    evacuation asset (if possible)
    and relay mechanism of injury, injuries sustained, signs/symptoms, and treatments rendered.
    Provide additional information as appropriate.

    Document: Record all findings and treatments on a DD Form 1380 TCCC Casualty Card and attach it to
    the casualty.
    Prepare for evacuation.
    (a) Complete the DD Form 1380 TCCC Casualty Card and secure it to the casualty.
    (b) Secure all loose bandages, equipment, blankets, etc.
    (c) Secure litter straps as required; consider additional padding for long evacuations.
    (d) Provide instructions to ambulatory patients as needed.
    (e) Stage casualties for evacuation and identify litter team(s).
    (f) Maintain security/safety at the evacuation point.

    TCCC CLS SKILL INSTRUCTIONS #TCCC-CLS-09-01 30 JUN 20


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