Page 179 - ATP-P 11th Ed

Changes in 2007:
➤ The changes in the combat pill pack moxifloxacin (Avelox ) and meloxicam
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(Mobic ), as recommended by the Committee on Tactical Combat Casualty Care
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(CoTCCC), have been changed in the TMEP Protocols.
➤ The fentanyl oral dosage of 800mcg, as recommended by the CoTCCC has been
incorporated into the Pain Protocol.
➤ The change in the IV antibiotics has also been changed to reflect medication
availability.
➤ When possible, alternate antibiotics or anti-emetics have been listed.
Changes in 2008: SECTION 2
➤ The Cellulitis and Cutaneous Abscess Protocols were combined.
➤ An Altitude Illness Protocol was created, combining AMS, HACE, and HAPE.
➤ The Chest Pain was expanded to provide more guidance.
➤ The following new protocols were added: Determination of Death and Envenomation.
➤ The following medication changes were made: the use of azithromycin (Zithro-
max ) was decreased; cefalexin (Keflex ), quinine, doxycycline, and corticosporin
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otic were removed.
➤ The following medications were added: amoxicillin/clavulanic acid (Augmentin ),
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rabeprazole (Aciphex ), trimethoprim and sulfamethoxazole (Septra ) DS, salme-
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terol (Serevent ), rifampin (Rifadin ), ketolorac (Toradol ), and diphenhydramine
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(Benadryl ) quick dissolve strips.
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➤ The Meningitis Disposition typo error from 2007 was corrected.
➤ Modifications were made to most of the TMEPS with respect to further refinement
in recommendations.
➤ The “Clinical Pearls” section was added.
Changes in 2009:
➤ Crush Protocol added
➤ Blast Protocol added
➤ MACE charts added
➤ Traumatic Brain Injury – Mild (mTBI) Protocol added
➤ Bronchitis/Pneumonia: Disposition changed
➤ Flank Pain: antibiotics modified (order of preference)
➤ Joint Infection: antibiotics modified (order of preference)
➤ Spontaneous Pneumothorax: indications for tube thoracostomy added
➤ Urinary Tract Infections: antibiotics modified
➤ Drugs added: calcium chloride, calcium gluconate, sodium bicarbonate, mannitol
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(Osmitrol )
168 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 169