Page 37 - ATP-P 11th Ed

Key Considerations in MASCAL
1. Usually, simpler is better.
2. Focus on those that will preserve scarce resources, such as blood.
3. Triage is a continuous process and should be repeated as often as is clinically and op- SECTION 1
erationally practical.
4. Avoid high resource and low yield interventions.
5. Emergency airway interventions should prioritize REVERSIBLE pathology in salvage-
able patients.
6. Decisions will depend on available resources and skillsets (i.e., penetrating traumatic
brain injury [TBI] triaged differently if no neurosurgery is available in a timely manner
or at all in theater).
7. Conserve, ration, and redistribute additional scarce resources (i.e., blood, drug).

Massive Hemorrhage
Background
Early recognition and intervention for life-threatening hemorrhage are essential for sur-
vival. The immediate priorities are to control life-threatening hemorrhage and maintain
vital organ perfusion with rapid blood transfusion. 4
Pre-deployment, Mission Planning, and Training Considerations
1. Conduct unit level blood donor testing (for blood typing, transfusion transmitted dis-
eases and Low Titer blood type O titers) and develop operational roster.
2. Define Cold Chain Stored Whole Blood (CSWB) distribution quantities in area of
responsibility.
3. Manage and equip prehospital blood storage program if unit policies and procedures
allow for prehospital blood storage.

26 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 27