Page 63 - ATP-P 11th Ed

healthcare provider’s obligation to give palliative therapy to minimize the person’s suf-
fering. In these circumstances, the use of opioid analgesics and sedative medications is
therapeutic and indicated, even if these medications worsen a patient’s vital signs (i.e.,
cause respiratory depression and/or hypotension). If a patient is expectant: SECTION 1
a. Teleconsultation
b. Prepare to:
i. Give opioid until the patient’s pain is relieved. If the patient is unable to communi-
cate their pain, give opioid medication until the respiratory rate is less than 20/min.
ii. If the patient complains of feeling anxious (i.e., is worrying about the future but not
complaining of pain) or he cannot express himself but is agitated despite having a
respiratory rate less than 20/min, give a benzodiazepine until the anxiety is relieved
or the patient is sedated (i.e., is not feeling anxious or is no longer agitated).
c. Position the patient as comfortably as possible. Pad pressure points.
d. Provide anything that gives the patient comfort (e.g., water, food, cigarette).
e. Under no circumstances should paralytics be used without analgesia/sedation
*Analgesia and Sedation Management in Prolonged Field Care, 11 May 2017 CPG 15
https://jts.health.mil/assets/docs/cpgs/Analgesia_and_Sedation_Management_during_Prolonged_
Field_Care_11_May_2017_ID61.pdf
*Pain, Anxiety and Delirium, 26 April 2021 CPG 16
https://jts.health.mil/assets/docs/cpgs/Pain_Anxiety_Delirium_26_Apr_2021_ID29.pdf

Antibiotics, Sepsis, and Other Drugs
Background
Complete Basic TCCC Management Plan for Antibiotics then:
a. Antibiotics should be given immediately after injury or as soon as possible after the
management of MARCH and Pain Management and appropriately documented (medi-
cation administered, dose, route, and time).
®
b. Confirm that initial TCCC dose of moxifloxacin (Avelox ) or Ertapenem (Invanz) have

already been given for any penetrating trauma. If available, administer tetanus toxoid
IM as soon as possible.
c. Antibiotics should be given daily for seven to 10 days, depending on the type of anti-
biotic given (see below tables for antibiotics). When able/available, transition IV/IO
antibiotics to PO as soon as possible to conserve supplies and equipment.

52 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 53