Page 148 - ATP-P 11th Ed

2. Triage and treat other injuries as required. As soon as tactically feasible evaluate for
mTBI.
SECTION 1 4. Administer MACE
3. Red Flags present
a. If red flags are present—consult with medical provider for possible urgent evacuation.
a. If MACE <25 or symptoms persist despite rest and appropriate treatment, consult
with medical provider for possible priority evacuation.
b. If MACE is normal:
i. Recommend 24-hr rest and reevaluate
5. Follow Service specific, DVBIC, Joint Trauma System (JTS) Clinical Practice Guide-
lines (CPGs)
6. Contraindications:
®
®
a. If possible, avoid the use of COX 1 NSAID medication (Motrin /ibuprofen, Aleve /
naproxen) due to effects on platelets and a potentially increased risk of bleeding. If
COX 1 NSAIDs are the only medication available and the patient has no red flags,
they MAY be used to treat the headache.
b. Avoid the use of tramadol (Ultram ) due to its effects on platelets, increased bleed-
®
ing, and altered level of consciousness.
c. Avoid the use of diphenhydramine (Benadryl ) due to possible alteration of the pa-
®
tient’s level of consciousness.
d. Avoid the use of narcotics due to alteration of the patient’s level of consciousness.
Disposition
• Urgent evacuation in the presence of Red Flags
• Priority evacuation in the presence of MACE <25 and persistent symptoms de-
spite appropriate treatment and rest
• Routine evacuation MACE persistently <25 OR MACE >25 and persistent
symptoms despite appropriate treatment

138 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 139