Page 70 - ATP-P 11th Ed

Table 17 PCC Role-based Guidelines for Nursing Care and Wound Management
PCC Role-based Guidelines for Nursing Care and Wound Management
SECTION 1 T T T T *All Personnel - Complete Basic TCCC Management Plan for Nursing/Wound
C
C
C C Management then:
C
C
C C • Many “nursing” interventions are actually basic soldier skills that need to be performed on
C
those casualties who cannot perform them on themselves.
- C - C - C - • Therefore, many traditional non-medical tasks are listed at the Tier 1 level since they can
A C C C essentially be performed by anyone, but the activity can be overseen by medical personnel.
S L M P
M S C P Intervention Frequency Paradigm
Lip care Every hour • Minimum: Commercial lip balm
• Better: Moisturizing lotion
• Best: Petroleum jelly
Oral/Nasal Care 24 hours • Minimum: Rotate site around mouth/nares, as
feasible.
• Better: Rotate site and suction.
• Best: Rotate and suction with commercial device.
Oral/Dental Care Every 12 • Minimum: Brush with gauze, water, and gloved
hours finger
• Better: Brush with toothbrush with toothpaste.
• Best: Use toothbrush with Chlorhexidine rinse.
Cough/Deep Every hour • Minimum: Encourage deep breathing/forced
Breathing cough x 10.
• Better: Sit up. Encourage deep breathing/forced
cough x 10.
• Best: Sit up, turn, and encourage deep breathing with
incentive spirometer/forced cough x 10.
Repositioning/ Every 2 • Minimum: Turn to opposite side, pad with clothing
Check Padding hours or textiles.
• Better: Turn to opposite side, pad with pillows or
blankets.
• Best: Turn to opposite side, pad with pillows to all
bony prominences and between legs.
Splint Care Every 2 • Minimum: Use improvised splints (i.e., wood fence,
hours plank).
• Better: Use commercial splinting device (e.g., SAM
splint).
• Best: Use ortho-fiberglass splint with fluffing and
elastic wrap.
• **Re-check all pulses after splint placement.
Hypothermia Continuous • Minimum: Wrap patient in dry clothes or blankets.
Prevention • Better: Wrap patient in commercially available
hypothermia prevention kit, using air-activated
heating element.
• Best: As above, add use of warmed, forced air and
infusion of warmed fluids using commercially
available devices.
(continues)

60 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 61