Page 10 - 2026 SMOG

TACTICAL EVACUATION
Ground “Pick–Up” Phase
• Attempt to gain info prior to landing • Brief and guide litter teams to the aircraft
• Ensure 360-degree scene security • Load and secure patients
• Collect medical information and patient • Goal on ground time <5min prior to
documentation wheels up
• Triage casualties • If military working dogs (MWD) are present
• Treat all preventable causes of death (injured or uninjured), subdue/muzzle
IAW TCCC MWDs first, then treat all human casualties
• Package and secure patients for transport before treating injured MWDs
“In-Flight” Phase
• Triage casualties as required: reassess patients and interventions
• Hemorrhage control
˚ Check/add tourniquet, pack/dress wound, apply pressure dressing, apply hemostatic
dressing.
˚ Initiate blood (DCR)
• Airway/vent management
˚ Reposition airway, nasopharyngeal airway, RSI (intubation/BIAD), cricothyroidotomy
Target SpO 90–96%
˚
• Chest trauma 2
˚ Vented occlusive dressing, needle thoracostomy, finger thoracostomy, chest tube
• Hypothermia management
• Head injury/altered mental status
˚ Monitor and treat for signs and symptoms of ICP (elevate head, 3% hypertonic saline,
target EtCO )
2
˚ Monitor BGL
• Pain management
• Consider antibiotic therapy
• Document care
Notes, Cautions, Warnings
• Damage control resuscitation (DCR) order of precedence:
˚ Control hemorrhage if able
˚ Administer blood products
˚ Consider TXA 2g, over 10min, <3hr from injury
˚ Calcium administration during or after 1st unit and after every 4th unit of blood
(Calcium may be given before TXA)
˚ Consider pressors (as a last resort)
• Replace any limb tourniquets placed over the uniform with one applied directly to the skin,
2–3 inches above the wound.
• Maximize blood/fluid therapy prior to considering pressor administration
• At any time, if the patient becomes pulseless and apneic, go to the TRAUMATIC ARREST
PROTOCOL
• If the tactical situation allows, load deceased patients on a separate transport
• Consider full RSI prior to advanced airway management to prevent aspiration

2 • GENERAL