Module 14 - Analgesia and Antibiotic Administration: Speaker Notes

COMBAT LIFESAVER TACTICAL COMBAT CASUALTY CARE (TCCC)
SPEAKER NOTES
MODULE 14 – ANALGESIA AND ANTIBIOTIC ADMINISTRATION
SLIDE 1 – TITLE SLIDE
SLIDE 2 – TCCC ROLES

Tactical Combat Casualty Care is broken up into four
roles of care. The most basic is taught to All Service
Members (ASM), which is designed to instruct in the
absolute basics of hemorrhage control and to recognize
more serious injuries.
You are in the Combat Lifesaver (CLS) role.
This teaches you more advanced care to treat the
most common causes of death on the battlefield, and to
recognize, prevent, and communicate with medical personnel the life-threatening complications of
these injuries.
The Combat Medic/Corpsman (CMC) role includes much more advanced and invasive care requiring
significantly more medical knowledge and skills.
Finally, the last role, Combat Paramedic/Provider (CPP) is for Combat paramedics and advanced
providers, to provide the most sophisticated care to keep our wounded warriors alive and get them to
definitive care.
Your role as a CLS is to treat the most common causes of death on the battlefield, which are massive
hemorrhage and airway/respiratory problems. Also, you are given the skills to prevent complications and
treat other associated but not immediately life-threatening injuries.
SLIDE 3 – TLO/ELO
The Combat Wound Medication Pack (CWMP) module
has five cognitive learning objectives and one
performance learning objective. The cognitive
learning objectives are to identify the indications,
contraindications, and administration methods of
acetaminophen, analgesics, and antibiotics in Tactical
Field Care (TFC), the indications and considerations of
the analgesia approaches, and the evidence and
considerations for early antibiotic administration. The
TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

SPEAKER NOTES
performance learning objective is to demonstrate the administration of a combat wound medication pack
to a trauma casualty.
The critical aspects are to recognize when analgesia or antibiotic administration is indicated, whether the
casualty can take the CWMP, when to administer the CWMP, and then to demonstrate how the CWMP
is administered to a trauma casualty.
SLIDE 4 – THREE PHASES OF TCCC

Remember, you are now in the TFC phase of care,
so the focus has shifted from immediate life-
threatening hemorrhage control while still under
enemy fire in the Care Under Fire (CUF) phase, to
the reassessment of all previous interventions,
followed by the prevention and treatment of other
injuries and complications, including the use of the
combat wound medication pack, if indicated.
SLIDE 5 – MARCH PAWS

Combat Wound Medication Pack is both the “P”
(pain) and the “A” (antibiotics) in the MARCH PAWS
sequence.
SLIDE 6 – COMBAT WOUND

MEDICATION PACK
The CWMP is a prepackaged pill pack containing

CoTCCC-recommend medications for use in combat
casualty care. The CWMP can be found in the JFAK.

SPEAKER NOTES
SLIDE 7 – CONSIDERATIONS FOR
PAIN MANAGEMENT FROM
COMBAT WOUND MEDICATION
PACK (CWMP)
The CWMP contains the following components:
1. Two 650mg caplets of acetaminophen (total
1,300mg) in extended-release form
2. One 400mg tablet of moxifloxacin
3. One 15mg tablet of meloxicam
Each of the three medications in these dosages is contained in a blister pack.
Note: The popular nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and
aspirin interfere with platelet function and blood clotting and can significantly increase the risk of
bleeding in combat casualties.
1. Tylenol and meloxicam do not alter platelet function and are safe and effective for use in
combat casualties.
2. Meloxicam does not alter platelet function and is the preferred NSAID for personnel who may
see combat in the next 7–10 days.
SLIDE 8 – ANALGESIA
ADMINISTRATION VIDEO
Play video
SLIDE 9 – ANTIBIOTICS OVERVIEW

VIDEO
Play video

SPEAKER NOTES
SLIDE 10 – COMBAT WOUND MEDICATION PACK
Play video
The CWMP is found in the casualty’s Individual
First Aid Kit (IFAK) or Joint First Aid Kit (JFAK). It
contains the medications for pain and antibiotics
that can be taken by mouth.
Take the CWMP as soon as possible after life-
threatening conditions have been addressed.
Document all medications administered and time
given on the DD Form 1380.
Pain is common with battlefield injuries. Some injuries and levels of pain can be treated safely by using
pain medications (also known as analgesics) in the CWMP. These include fractures, burns, and eye
injuries.
For pain relief on the battlefield of mild to moderate pain that will not keep the casualty out of the fight,
ensure they take their CWMP. The casualty should take all three medications in the CWMP. This can
give significant pain relief and will not alter the casualty’s mental status. This is a good option when the
casualty’s pain and wounds are not severe enough to keep them out of the fight.
NOTE: If the casualty has wounds or pain severe enough to render them unable to fight, then
medical personnel have other options for more effective pain relief. Giving these meds will
generally require that the casualty be disarmed because the meds can alter the casualty’s mental
status.
SLIDE 11 – WHEN TO GIVE CWMP

GIVE the CWMP when the casualty:
• Is conscious and able to swallow?

• Has mild to moderate pain?
• Is still able to fight if needed?
• Has any penetrating wounds or break of
the skin?
DON’T GIVE if the casualty:

• Is unable to swallow or take oral meds, such as when the casualty is unconscious or has severe
facial trauma or burns
• Has known allergies to the medications
If the casualty is unconscious, refer them to medical personnel as soon as possible.
Note: If the casualty has a break in the skin in a traumatic injury, they should take the CWMP.
Otherwise, consult with medical personnel before giving it.

SPEAKER NOTES
SLIDE 12 – SKILL STATION
At this time we will break into skill stations to
practice the following skills:
• Combat Wound Medication Pack
SLIDE 13 – CWMP IN SUMMARY

Battlefield wounds are often dirty and susceptible to
infection. Early administration of antibiotics from the
CWMP may reduce the chance of later infections.
Wound infections can kill the casualty or delay their
recovery.
The CWMP should be given ASAP for wounds
after life-threatening issues have been
addressed.
Remember: The CWMP should be given for any penetrating wounds.
SLIDE 14 – CHECK ON LEARNING

Ask questions of the learners referring to key
concepts from the module.
Now for a check on learning.
1. True or False – The CWMP contains pain
medication and antibiotics.
- True
2. How should the CWMP be taken?
- The entire CWMP should be taken orally.
3. Who should take the CWMP?
- Casualties who have a break in the skin and/or are in pain
SLIDE 15 – QUESTIONS

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COMBAT LIFESAVER TACTICAL COMBAT CASUALTY CARE (TCCC)

MODULE 14 – ANALGESIA AND ANTIBIOTIC ADMINISTRATION

SLIDE 1 – TITLE SLIDE

SLIDE 2 – TCCC ROLES

TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

SLIDE 4 – THREE PHASES OF TCCC

SLIDE 5 – MARCH PAWS

SLIDE 6 – COMBAT WOUND

The CWMP is a prepackaged pill pack containing

TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

SLIDE 9 – ANTIBIOTICS OVERVIEW

TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

SLIDE 11 – WHEN TO GIVE CWMP

• Is conscious and able to swallow?

DON’T GIVE if the casualty:

TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

• Combat Wound Medication Pack

SLIDE 13 – CWMP IN SUMMARY

SLIDE 14 – CHECK ON LEARNING

TCCC CLS SPEAKER NOTES #TCCC-CLS-14-01 25 JAN 20

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