MEDS
Which CoTCCC-recommended analgesia medications can be given by the intranasal route?
The medications that are potentially delivered intranasally include: ketamine and naloxone.
True or False: The Snellen Eye Chart is used for performing a rapid field visual acuity test?
False. Rapid visual acuity testing is NOT a formal vision screening with a Snellen Eye Chart. It is a rapid assessment and includes testing the casualty’s ability to read print, count fingers, identify hand motion, or differentiate light from dark.
After applying pressure to stop bleeding, if necessary, what is the next step in treating a minor wound?
Next, irrigate and clean wounds with either sterile water, if it is available, or even clean water if your supplies are limited or you have no access to sterile water.
What kind of dressing should be placed on burned areas?
A dry sterile dressing.
True or False: When applying a splint, ensure the joints above and below the fracture are immobilized in the splint whenever possible.
True. Always incorporate the joint proximal and the joint distal to the site of the fracture in your splint.
What anatomical sites can be used to safely administer an intramuscular injection?
The three potential sites are the deltoid, the thigh, and the buttock.
When should a pressure dressing be used in treating traumatic eye injuries?
A pressure dressing or patch should NEVER be used to treat a traumatic eye injury.
How do you care for an amputated body part?
Wrap the amputated body part loosely with moistened gauze. If possible, place it in a plastic bag; if not, wrap it with cravats to cover all of the gauze. Then place the bag, or the cravat-covered body part, in a container with ice, if available.
What should you do first when you encounter a casualty with an electrical burn?
Secure the power, if possible; otherwise, remove the casualty from the electrical source using a nonconductive object, such as a wooden stick.
What should you assess before and after splinting?
Pulses, skin color, and sensorimotor function distal to the site of the fracture should be assessed. Once you have applied a splint, be sure to reassess the pulses motor and sensory (PMS) function distal to the fracture, and compare that to the baseline PMS assessment you performed prior to splint application.
When should you use ertapenem instead of moxifloxacin as an antibiotic therapy?
If the casualty is in shock or unconscious, or cannot swallow oral medications, they should be given one gram of ertapenem.
What kind of dressing should be used on penetrating eye trauma with an impaled object?
A rigid eye shield should be used to cover and protect the injured eye. Alternatively, an improvised eye shield (Styrofoam or other cup, etc.) taped over the eye can be used if there is a protruding foreign body in the eye that would extend beyond the rigid eye shield. Tactical protective eyewear can be used to protect the injured eye. A pressure dressing or patch should NOT be used.
If an impaled object is on an extremity, what do you need to do in addition to stabilizing the object?
If the impalement is on an extremity, treat it like a fracture and stabilize the joint above and below the location of the object with splints.
What should you do first when you encounter a casualty with a thermal burn?
Stop the source of the burn.
What should be removed from the patient's affected limb and why?
Jewelry, watch, clothing, and/or boots as the situation dictates due to a concern for swelling.
True or False: Only the injured eye should be covered with a rigid eye shield?
True. Rigid eye shields should be placed over both eyes ONLY when you are sure or at least strongly suspect that both eyes have been injured. When only one eye has been injured, do not place an eye shield over the unaffected eye to prevent eye movement. Movement has not been shown to worsen the outcome for the injured eye. Blindness, resulting from placing eye shields over both eyes unnecessarily, is psychologically stressful and makes an otherwise ambulatory casualty a litter casualty.
What is the first step of care in Wounds of our MARCH PAWS assessment?
Reassess prior life-threatening wounds to ensure bleeding is still controlled.
What size burn requires a fluid resuscitation?
For burns > 20% TBSA, initiate fluid resuscitation as soon as IV/IO access is established.
What is indicated in any casualty who suffers severe blunt force or blast injury with symptoms of a pelvic fracture?
A pelvic compression device such a pelvic binder.
What are the advantages of using an oral antibiotic over a parenteral antibiotic?
The logistical issues associated with carrying, reconstituting, and then injecting or infusing parenteral medications makes use of oral antibiotics the preferred route, when oral administration is possible.
Using ______ in the field will generally prevent an eye injury from occurring.
Eyepro.
Name three of the four complications of open abdominal wounds.
What would be the fluid infusion rate for a 90 kg person with a 40% burn according to the USAISR Rule of Ten?
500ml/hr. The initial IV/IO fluid rate is the %TBSA x 10 ml/hr for adults weighing 40-80 kg. For every 10 kg above 80 kg, increase the initial rate by 100 ml/hr. 40% x 10 ml/hr = 400ml/hr 400ml/hr + 100ml/hr = 500ml/hr
What are the three objectives of fracture management and splinting?
The primary objectives of fracture management and splinting are to prevent further injury to local tissues or organs, to protect the nerves and vessels that run parallel to bones, and to make the casualty more comfortable by relieving some pain.