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

* 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

• 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