Page 151 - 2025 Ranger Medic Handbook

Upper Respiratory Infection / Common Cold
DEFINITION: Inflammation of nasal passages due to a respiratory virus
S/Sx: Nasal congestion; sneezing; post-nasal drainage; sore throat; cough; hoarseness; malaise; headache; low-grade
fever; body ache; fatigue
MANAGEMENT:
1. Increase PO hydration.
2. Acetaminophen 1,000mg PO q6hr AND/OR ibuprofen 800mg PO q8hr.
3. Treat symptomatically with pseudoephedrine 60mg PO q6hr OR fexofenadine 60mg/pseudoephedrine 120mg PO bid
OR loratadine 10mg/pseudoephedrine 120mg PO qd.
4. Consider oxymetazoline 2–3 sprays each nostril bid (not to exceed 3 days). Lozenges for sore throat.
DISPOSITION: Evacuation usually not required. Monitor for worsening conditions. SECTION 3

Urinary Tract Infection
DEFINITION: Infection of urinary tract; more common in females, tactical setting, dehydration, kidney stones.
S/Sx: Dysuria; increased urinary urgency and frequency; cloudy, malodorous, or dark urine may be present; suprapubic
discomfort; normally no CVAT/back/flank pain; normally no fever, hx of STD exposure.
MANAGEMENT:
1. For others, cephalexin 500mg PO qid × 7–10 days OR trimethoprim-sulfamethoxazole 1 PO bid for 7–10 days in
males (bid for 5–7 days or 3–5 days respectively in females).
2. Treat per Pain Management Protocol.
3. If fever, back pain, flank pain, and/or costovertebral angle tenderness develop, suspect kidney infection and treat
per Flank Pain Protocol.
4. Encourage PO hydration.
DISPOSITION: Usually responds to therapy and evacuation not required if it does. Routine evacuation for worsening
signs and symptoms. Priority evacuation for pyelonephritis (see Flank Pain Protocol).
SPECIAL CONSIDERATIONS:
1. More common after instrumentation, in females, or in tactical settings with dehydration and/or kidney stones.
2. Symptoms may be confused with a sexually transmitted disease (STD).

Sexually Transmitted Infection
DEFINITION: Bacterial, viral, fungal, or parasitic infection that is passed from one person to another through sexual
contact.
S/Sx: Bumps, sores, or warts: These can appear around the genitals, rectum, or mouth, and may be painful or itchy.
a. Discharge: discharge is a common symptom.
b. Pain: Pain or tenderness in the genital area, buttocks, or inner thighs, or pain during urination.
MANAGEMENT:
1. Send to a medical treatment facility for STI testing
2. Seek guidance from medical provider
3. Treat pain symptoms per pain protocol
GONORRHEA / CHLAMYDIA:
If < 35 years old, treat for sexually transmitted infection, ceftriaxone 500mg IV/IM × 1 AND doxycycline 100mg bid × 7
days (can replace doxycycline with azithromycin 1g PO once if compliance is in question).
SYPHILIS:
1. Penicillin G 2.4 million units IM single injection
2. Penicillin allergy: doxycycline 100mg PO BID × 7–10 days
HSV-2:
1. Acyclovir 400mg PO TID × 7–10 days or valacyclovir 1g PO BID × 7–10 days

2025 RANGER MEDIC HANDBOOK 137