Basics
What anatomical sites are assesses when preforming the Ottawa ankle Rules (OAR)? What else is assessed?
What is considered a positive OAR? What does a Positive indicate?
- Lateral malleolus, medial malleolus, Navicular bone, Base of the 5th metatarsal.
- can PT bear weight for 4 steps (immediately after injury and during eval)
-Pos: Bone tenderness at 1/ more sites, inability to bear weight.
-Indicates need for foot/ ankle x-ray
What catagory of drugs includes the following:
- Naproxen, Ketorlac, Celebrex, Meloxicam
NSAIDs
What are the four catagories of triage?
Immediate
Delayed
Minimal
Expectant
What are RED Flags for "Painful/frequent urination"?
What other symptoms qualify a PT as CAT I?
-*Flank pain, Severe ABD pain, Gross Hematuria, passing blood clots*
- fever, HX diabetes, Nausea/ vomiting, vaginal symptoms, vulvar ulcer, pain with intercourse,
What does MARCH- PAWS stand for
Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia/ Head injury
Pain, Antibiotics, wounds, Splints/burns
What is Centor Criteria? What does is assess?
Used to estimate the likelihood of Group A Streptococcal pharyngitis.
- tonsillar exudates/ swelling, tender anterior cervical lymph nodes, fever (>100.4), absent cough
indicates need for testing, treatment.
What is the "5 rights"? Name them.
Right: patient, medication, dose, route, time.
- Stable close fractures, burns without airway involvment, controlled bleeding.
Delayed
What are RED FLAGS for "Ear pain/ drainage/ trauma" that categorizes a PT as CAT I?
What other symptoms indicate a PT as CAT I
-Stiff neck, fever, posterior ear pain, mastoid erythema.
- persists > 7days, decrease hearing, foreign body, visual trauma to ear, vertigo
Indications of herniation and treatment Per TCCC?
-Asymmetric, Fixed/dilated pupils, posturing
- 250ml of 3% or 5% Hypertonic saline or 30ml of 23.4%. IV/IO over at least 10 mins followed by saline flush. Repeat in 20 mins if no response (max 2 doses). Monitor IV/IO site, discontinue if signs of extravasations.
Describe the difference between and allergic reaction and Anaphylaxis . Give examples of both.
Allergic reaction is a mild to moderate immune reaction (ex. hives, runny noses, swelling, rash)
Anaphylaxis is a sever systematic allergic reaction that can affect airway, breathing, circulation and is potentially life threatening (ex. throat/tongue swelling, SOB, LOC, shock, Hypotension, severe ABD pain, diarrhea, vomiting)
What is an antihistamine? Name 2 common 1st & 2nd generation medications.
Medication that blocks histamine receptors responsible for allergic responses.
1st Gen: short acting high sedation (diphenhydramine, promethazine)
2nd Gen: once- daily, minimal sedation (cetirizine, Loratadine, Fexofenadine)
What is a M.I.S.T report?
MOI, Injury sustained, S&S, Treatment
What are RED FLAGS in a PT complaining of constipation that catagorizes them as CAT I? What other report symptoms that catagorizes as PT as CAT I?
- * Diarrhea at night, anemia, vomiting*
- Weight change, Fatigue, temp sensitivity, depression, rectal bleeding
What is the rule of nines. Describe it in detail.
Used to estimate the TBSA of burns.
head and neck: 9%
each arm: 9%
Front of torso 18%
Back of torso 18%
Each leg 18%
genitals 1%
What is the Deadly Diamond?
Hypothermia
Acidosis
Coagulopathy
Hypocalcemia
Describe the proper usage and dosing of Loperamide.
Following 72hrs ongoing diarrhea:
4mg initial dose, 2mg per loose stool (16mg max/day)
Indications to cease use: stool become softly formed, blood in stool.
Wht triage catagory does a open long bone fracture fall in?
Immediate
What Red flags and symptoms reported by a PT are catagorized as CAT I?
*abnormal PMS, Deformity, High energy trauma
-No MOI, red/warm, immediate swelling after trauma
Per TCCC guidelines 2026: What is the apropriate managemet of pain for an urgent combat casualty (medication/ routes/ dose/ endpoint of analgesia)
Ketamine;
100mg IM, 50mg IN, 25mg or (0.2 mg/kg) IV/ IO 1 min slow push. Repeat every 30 mins. cease use with reduction of pain or nystagmus.
Esketamine 14 or 28mg IN x 1 dose.
Describe orthostatic vitals and the purpose of them?
Take BP sitting, retake BP after laying down for 5 minutes, retake BP after standing for 1 min and 3 mins.
significate drop: systolic BP decr >20mmhg or Diastolic BP decr > 10mmhg
accesses potential for significant dehydration/ blood loss, orthostatic hypotension, low circulating blood volume.
Per current TCCC Guidelines, what is the order for resuscitation fluids of choice for casualties in hemorragic shock, from most to least preferred?
- Cold stored low titter O whole blood
-Prescreened low titer O fresh whole blood
-Plasma, RBCs, platelets in a 1:1:1 ratio
-Plasma, RBCs in a 1:1 ratio
- Plasma OR RBCs alone
What are the 9 lines in a MEDEVAC request
Location of pickup site, Freq/ callsign/ suffix, No. PTs by precedence, special equipment, No. PTs by type, security of site/ MIST, method of marking, Nationality, NBC/ terrain description.
What RED FLAGS or symptoms in a PT reporting cold symptoms are catagorized as CAT I?
- ABN vital signs, SOB, stiff neck, AMS, coughing blood clots
Per TCCC Guidelines 2026: What are ALL the current antibiotics used for a combat causalty (name/ dose/route)?
PO: Cefadroxil 1gm x once/day. Cephalexin 500 mg x 6hrs.
IV/IO/IM: Ceftriaxone 2gm x once/day.