Page 86 - 2021 Advanced Ranger First Responder Handbook

Canine TCCC Management
Canine trauma management follows the same TCCC/MARCH principles as for humans. This section covers specific de-
viations and/or requirements from human protocols, which may improve survivability of MPC trauma patients. Handlers
are trained in these principles and will usually be the first to initiate aid.
Safety: Injured MPCs may bite from fear and/or pain, even with decreased consciousness, posing a risk to anyone
nearby. Wounded MPCs MUST be muzzled when performing assessment and procedures unless presenting with respi-
ratory distress. Sedation/pain meds are authorized for MPCs not amenable to physical exam or treatment.
CANINE CASUALTIES WILL NEVER SUPERCEDE WOUNDED RANGERS IN PRIORITY

TCCC
Care Under Fire: Handler Wounded: Remove the injured MPC to cover if tactically feasible. Every handler should have
members of their platoon identified and comfortable working with the MPC. This person will help maintain control of the
injured MPC while another medic or ARFR provides care.
Tactical Field Care: MPC moves to CCP with other casualties. Medic triages other casualties before attending to MPC’s
wounds. Handlers and/or other ARFR/RFR will provide initial care until medics can divert their attention. Remove equip-
ment and tactical vests to fully assess the chest area. Provide sedation/pain meds (dosages on MPC Card) as needed
in conscious patients to complete exams and treatments. Communicate MPC casualty status and evacuation require-
ments through normal C2 channels.
Tactical Evacuation: MEDEVAC per usual manner according to precedence (Urgent, Priority, Routine). However, MPCs
will not precede other casualties of the same category. Handlers or trained representatives must remain with the MPC
throughout transport. Always reassess the patient and all interventions after movement. Always complete a K9 Casualty
Card and maintain with the patient throughout transport. Complete a casualty AAR in the normal manner and include
the RVET on all communications. MPC casualty information is maintained in the Pre-Hospital Trauma Registry the same
as Rangers.
M ARCH
2
Muzzle/Massive Hemorrhage: Control extremity bleeding with combat gauze and pressure bandages. CAT tourniquets
are large, and effectiveness can be tricky. If used, place above the stifle or elbow for injuries distal. SOF-T tourniquets
are 100% useless on dogs. Pack GSWs to the neck, hip and shoulder with combat gauze using hemostats or curved
8" forceps.
Airway: First check the airway to ensure it is clear using a finger sweep. Then determine the dog’s breathing pattern, rate
and if it is having difficulty to determine if interventions are necessary.
a. NPAs are not functional in MPCs.
b. Emma/EtCO 2 Monitor. (Ref Range is 35–45mm Hg). Opioids can depress the CNS leading to a higher CO 2 reading.
Pain will cause an animal to hyperventilate and decrease the CO 2 reading.
Respirations:
a. Remove the vest. Check both sides of the chest and neck.
b. In the conscious patient with an actively sucking wound – use a large vented occlusive dressing. Try to cover as
much surface area as possible with the occlusive dressing. Wrap the chest circumferentially with an elastic bandage
if adherence is a problem. Be careful not to restrict breathing. Be prepared to treat a pneumothorax or hemothorax.
c. Dogs with pneumothorax and/or hemothorax often have increased resistance when bagging.
d. Needle decompression: Place between 6th to 8th intercostal spaces cranial to the rib using a standard 14G catheter.
Place in highest portion of chest when laterally recumbent to remove air and lower third (near sternum) to remove
fluid. Repeat needle decompressions often indicates need for finger thoracostomy.
Circulation: Make sure there is not major bleeding and control, as necessary. Penetrating wounds to the neck that you
believe communicate with the thorax (or severs major vasculature of the neck), obvious penetrating wounds to the chest,
abdomen or hip are all considered significant mechanisms of injury. Treat for hemorrhagic shock if two or more clinical
signs below are seen:
a. Pulse > 160bpm.
b. Loss of consciousness.
MISC d. HR > Systolic Blood Pressure.
c. Weak femoral pulse.
Hypothermia: PLACE HPMK

76 SECTION 7 MISCELLANEOUS PROTOCOLS