Tactical Combat Casualty Care - NOAA Office Of Marine And .

2y ago
33 Views
2 Downloads
1.51 MB
27 Pages
Last View : Today
Last Download : 2m ago
Upload by : Jayda Dunning
Transcription

General Chest injuries may result from: Gunshot wounds (GSW) Shrapnel Explosions Motor vehicle crashes (MVC) Falls Crush injuries Stab wounds Pulmonary Over Inflation Injury2

Organs of the Thorax TracheaBronchiLungs Mediastinum 3

Organs of the Abdomen4

Assess Respirations Respiratory rate and effort: Tachypnea Bradypnea Labored Retractions Progressive respiratory distress5

Assess the Chest Wall Lung sounds – Percussion. Absent or decreasedUnilateralBilateral HyperresonancePneumothoraxTension pneumothorax Hyporesonance (hemothorax)6

Assess the Chest Wall Compare both sides ofthe chest at the sametime when assessing forasymmetry.7

Chest Physiology Chest normally has negative pressure. Penetrating wound creates a positive pressure in chestcavity. Air will enter the easiest route. If a hole in the chest issmaller than 2/3 the size of the trachea, air will enterthrough the trachea preferentially and not through thehole in the chest.8

Tension Pneumothorax Air builds in pleural space with no where for the air toescape Results in collapse of lung on affected side that resultsin pressure on mediastium,the other lung, and greatvessels

Tension PneumothoraxEach time we inhale,the lung collapses further. Thereis no place for the air toescape.

Tension PneumothoraxEach time we inhale,the lung collapses further. Thereis no place for the air toescape.

Tension PneumothoraxThe trachea ispushed tothe good sideHeart is beingcompressed

Tension PneumothoraxAir pushes over heartand collapses lungAiroutsidelung fromwoundHeart compressed not ableto pump well13

Signs and Symptoms of TensionPneumothorax Anxiety, agitation, and apprehension Diminished or absent breath sounds Cyanosis Rapid shallow breathing (tachypnea) Distended neck veins

Signs and Symptoms of TensionPneumothorax Clinical presentation: Diminished or absent breath sounds Hyperresonance to percussion on affected side Hypotension, cold clammy skin Casualty begins to deteriorate rapidly Decreased lung compliance (intubated) Tracheal deviation (late)15

Tension Pneumothorax If after sealing the open pneumothorax, thecasualty develops progressive difficulty breathing,consider this a tension pneumothorax and performa needle chest decompression. If no capability of NCD exists and the casualtycontinues to have progressive respiratory distress,remove the occlusive dressing and stick a glovedfinger into the open wound and attempt to “burp”the wound.16

Needle Decompression Locate 2-3 Intercostal space midclavicular line Cleanse area using aseptic technique Insert catheter ( 14g or larger) at least 3” in lengthover the top of the 3rd rib( nerve, artery, vein liealong bottom of rib) Remove Stylette and listen for rush of air Place Flutter valve over catheter Reassess for Improvement

Needle Chest Decompression Procedure: Identify the second ICS on the anterior chest wall, MCL:18

Needle Chest Decompression Prep the area with anantimicrobial agent. Insert a 14 ga. Catheter at90 angle over the top of3rd rib, into the 2nd ICSthe MCL. Needle should be longto enter the chest(3 inches).atheatenoughcavity (2½ –19

Performing a Needle ChestDecompressionFirmly insert the needle into the skin at a 90degree angle relative to the curvature of the skin.

Needle Chest Decompression If a tension pneumothorax is present,a “hiss of air” may be heard escapingfrom the chest cavity. Remove the needle, leave the catheter in place.21

Flutter Valve Asherman Chest Sealmakes good FlutterValve .

Flutter ValveMay also use a finger from a latex glove.

Tension Pneumothorax Management: Ensure an open airway Decompress the affected side Indications:– Penetrating chest wound with progressiverespiratory distress24

Needle Chest Decompression Tape the catheter hub to the chest wall. The casualty's condition should rapidly improve. Evacuate ASAP.25

Needle Chest Decompression Complications: Insertion of the needle over the top of the rib preventslaceration of the intercostal vessels or nerve which cancause hemorrhage or nerve damage.26

Questions?

casualty develops progressive difficulty breathing, consider this a tension pneumothorax and perform a needle chest decompression. If no capability of NCD exists and the casualty continues to have progressive respiratory distress, . Tactical Combat Casualty Care Author:

Related Documents:

Tactical Combat Casualty Care Tactical Evacuation Care The term “Tactical Evacuation” includes both Casualty Evacuation (CASEVAC) and Medical Evacuation (MEDEVAC) as defined in Joint Publication 4-02. Many medical protocols here and a few non-medical. (One of them

Tactical Combat Casualty Care Section I: Introduction Tactical combat casualty care (TCCC) is the pre-hospital care rendered to a casualty in a tactical, combat environment. The principles of TCCC are

Tactical Combat Casualty Care Introduction For US military men and women wounded on the battlefield, the most critical phase of care is the period from the time of injury until the time that they arrive at a medical treatment facility (MTF) capable of providing surgical care. If a casualty survives long enough to reach the care of a combat .

Tactical Combat Casualty Care (TCCC) based casualty cards, TCCC after action reports, and unit-based prehospital trauma registries need to be implemented globally and linked to the DoD Trauma Registry in a seamless manner that will optimize prehospital trauma care delivery.

casualty card. 6 (3) Tactical Evacuation Care (a) Casualty picked up by an aircraft, vehicle or boat. Additional personnel and equipment may be pre-staged for continued casualty care. 1 Encompasses both Casual

TACTICAL COMBAT CASUALTY CARE (TCCC / TC3) ABBREVIATED TCCC GUIDELINES 31 JAN 2017 Return Fire and take cover Direct or expect casualty to remain engaged as a combatant if appropriate Direct casualty to move to cover and apply self-aid if able.

Tactical Field Care / Indirect Threat: What medical care would you provide across the street from the burning building? 3. Casualty Evacuation Care: The threat is largely over, the casualty is ready to be taken to the hospital. Why does it matter? 40% of Vietnam combat casualty deat

Tourism is not limited only to activities in the accommodation and hospitality sector, transportation sector and entertainment sector with visitor attractions, such as, theme parks, amusement parks, sports facilities, museums etc., but tourism and its management are closely connected to all major functions, processes and procedures that are practiced in various areas related to tourism as a .