Page 38 - JSOM Summer 2020

TABLE 3 Mission Critical Tasks and Equipment That May Require Power
Model Function or Task Equipment
Patient warming HPMK, ready heats, wool or space blankets
Blood cooling Person-portable preconditioned coolers
Blood warming Small, battery-powered in-line products
Medical electronics Battery-powered portable ventilator, monitors, and ultrasound
Ruck Electrical power Plan for person-portable, battery-operated equipment
Battery-operated head lamps (consider equipment that uses standard batteries such as C123, AA, or AAA,
Lights as opposed to nonstandard, rechargeable lithium batteries, because replacement batteries are more easily
acquired)
Communications Battery-powered radios
Personal electronics Minimal battery power only
Patient warming HPMK, ready heats, wool or space blankets
Coolers with wet ice for blood or dry ice for plasma; battery-powered man-portable blood refrigerators
Blood cooling
(e.g., HemaCool )
®
Recommend Belmont Rapid Infuser or plasma-thawing devices if power capability allows; if unable to
®
Blood warming
support Belmont, use in-line device
Truck Medical electronics Battery power with recharging cords (stress awareness of 110V versus 220V)
(monitors)
Electrical power Plan for generator size 5kW–20kW and associated fuel requirement
Lights Battery-operated head lamps; person-portable, free-standing, LED spot lights
Communications Vehicle-mounted radio
Personal electronics Minimal rechargeable
HPMK, ready heats, wool blankets, Bair hugger, consider wall space- or area-heating units with understanding
Patient warming
that these have tremendous power requirement
Multiple battery-powered, portable blood refrigerators (e.g., HemaCool ), ensure backup power source
®
Blood cooling is available should primary power source fail
Recommend Belmont Rapid Infuser or plasma-thawing devices if power capability allows; if unable to
®
Blood warming
support Belmont, use in-line device
House Medical electronics In-line power (stress awareness of 110V versus 220V)
(monitors)
Electrical power Central power versus large generator
Lights Battery-operated head lamps; person-portable, free-standing spot lights; wall-mounted lights
Communications Nonclassified IP router network, or secret IP router network or WiFi (choice)
Personal electronics Choice
Abbreviations: HPMK, hypothermia management kit; IP, Internet protocol; LED, light-emitting diode.

be challenging. In the ARSC environment, documentation is non US forms in their native language may be beneficial med-
essential not just as part of a clinical standard but second- ically and practically.
ary to the need to further define, refine, and understand the
limitations of this battlefield capability. The relatively low The JTS MASCAL/Austere Trauma Resuscitation Record and
volume of causalities these teams have managed, combined an operative note and anesthesia record for surgical patients
with the paucity of documentation received for performance are the minimum required documentation for all patients.
improvement (PI) analysis makes understanding the true ca- Minimum documentation includes mechanism of injury, in-
pability and capacity of ARSC teams a challenge. In addition, juries identified, signs and symptoms, treatments, vital signs
appropriate and reliable analysis requires accurate and com- data, neurologic status, medications, and interventions pro-
plete data, which will then allow more appropriate medical vided. Follow the Combatant Command or regional standard
planning. In some cases, documentation and transmission are naming convention for trauma pseudonyms and maintain one
challenging due to a lack of communication equipment that consistent name for each patient during transfers. This im-
enables reliable communications with higher levels of medical proves continuity of care, patient tracking, blood resupply, and
care. The ARSC environment is resource and personnel lim- outcome analysis. In the operational setting, include ethnicity,
ited, and time must be committed to complete documentation unit affiliation, and geographic location of injury, as able. Use
on all patients. Experience has shown that in the setting of the JTS Burn Resuscitation Flow Sheet for major burns and
a MASCAL (when taking time to document seems the most Prolonged Field Care Flow Sheet for prolonged care. When
challenging), proper documentation aids communication, evacuating to a higher level of care, records should be trans-
decreases redundant evaluations, avoids errors, and ensures ferred with the patient. A photograph or copy of the record
complete care. Consider language barriers with documenta- should be kept by the surgical team in the event the record is
tion. In unconventional warfare and depending on the unit lost. When documentation cannot be completed before patient
the ARSC team is supporting, using patient identifiers may evacuation, complete the documentation immediately after
not be permitted. If caring for host-nation casualties, using evacuation and send it electronically to the next level of care as

36 | JSOM Volume 20, Edition 2 / Summer 2020