Triage
- For triage, most current methodology is Revised Trauma Score (RTS).
- Takes into account Glasgow Coma Score (GCS, level of conciousness), Systolic Blood Pressure, and Respiratory rate
- Continuous reassessment is required
- RTS score of 12 is labeled DELAYED (walking wounded), 11 is URGENT (intervention is required but the patient can wait a short time), and 10-3 is IMMEDIATE (immediate intervention is necessary).
- The last possible label is MORGUE, which is given to seriously injured people with an RTS score of 3 or lower.
Standard Practice for Combat Medics
* Return fire as directed or required
* The casualty(s) should also continue to return fire if able.
* Try to keep yourself from getting shot
* Try to keep the casualty from sustaining any additional wounds
* Airway management is generally best deferred until the Tactical Field Care phase
* Stop any life-threatening hemorrhage with a tourniquet
* Reassure the casualty
Key Differences between Civilian and Military EMT in Standard of Care
- Use a tourniquet
- Don't manage airway until no longer under fire
- If a victim of a blast or penetrating injury is found without a pulse, respirations, or other signs of life, DO NOT attempt CPR
- Don't perform spine mobilization (unless fall greater than 15 ft)
- Move casualty to safer location to begin Tactical Field Care
- Consider loosening tourniquet during TFC to control any additional hemorrhage
Breakdown of Care Regimes
Each regime has different protocols.
- Care under Fire
- Tactical Field Care
- Combat Casualty Evacuation Care
Applicable Technologies
Mortality Causes
- Penetrating head trauma--31%
- Uncorrectable torso trauma--25%
- Potentially correctable torso trauma--10%
- Exsanguination (blood loss) from extremity wounds--9%
- Mutilating blast trauma--7%
- Tension pneumothorax (collapsed lung under pressure)--5%
- Airway problems--1%
-- SamsonPhan - 17 Nov 2008