Page 182 - ATP-P 11th Ed

DON’T FORGET . . . CLINICAL PEARLS

➤ When IV route is recommended, but not obtainable, consider IO, IM, PO, or PR
unless contraindicated.
➤ Currently available SL medication formulations include: Phenylephrine (Sudafed
PE ) orally disintegrating strips, and Ondansetron (Zofran ) orally disintegrating
®
®
tablet.
DO NOT give Epinephrine IV unless given under the ACLS protocols or the
SECTION 2 ➤ All IV medications may be given slow IV push with the exception of antibiotics,
Neurogenic/Spinal Shock Protocol.
which should be in a drip, unless otherwise specified.
➤ Remember to document dose and time of all medications so the receiving facility
may be informed.
➤ Do not use local anesthetic with epinephrine on the ears, nose, digits, or penis.
➤ When oxygen is called for in the Protocols, the authors realize that it is recom-
mended, but may not be available.
➤ Due to the high level of physical fitness of SOF personnel, there may be a pro-
longed period of mental lucidity and apparent stable vital signs despite a severe
injury. Treat the injury, not the Operator!
➤ Medical Documentation (SOAP note): In order to ensure proper care and medi-
cal information transfer during patient treatment a standardize format for medical
documentation is required. The standard format is the SOAP note (Subjective, Ob-
jective, Assessment, and Plan).

Subjective: In the patient’s own words, describe the chief complaint. At a
minimum you need to include the OPQRST (Onset, Palliative or Provocative,
Quality, Radiation, Severity, and Timeline of symptoms). AMPLE (Allergies,
Medication, Past medical and surgical history, Last meal, and Events leading up
to this condition) history is also included in this section.
Objective: vital signs and physical examination findings. At a minimum you
need to document pertinent positives and negatives, and measurements of inju-
ries or lesions. Be as detailed as possible.
Assessment: a brief summary of your medical decision making to include what
you think it is and what it is not. Include your differential diagnosis list in this
section.
Plan: your course of treatment to include any medications, additional studies,
consultation, rehabilitation, evacuation category and disposition of the patient.

172 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 173