Page 71 - ATP-P 11th Ed

Table 17 Cont.
PCC Role-based Guidelines for Nursing Care and Wound Management
T T T T Intervention Frequency Paradigm
C C C C Head Injury Continuous Elevate head of bed 30 degrees and then: SECTION 1
C C C C • Minimum: Lay patient against ruck sack/
C C C C backpack
- - - - • Better: Pillows or blankets
A C C C • Best: NATO litter back rest
S L M P
M S C P Non-medical Every hour • Minimum: Distract the patient and perform
Interventions guided imagery.
• Better: Splint wounds, pad boney
prominences, provide ice packs to injured/
swollen areas (or alternate with warm packs).
• Best: As above, combine both elements.
Psycho-social Needs Continuous • Minimum: Speak in calm tone, addressing
casualty concerns, to reduce fear and anxiety.
• Better: Support with caring touch, listening to
fears/concerns; explain all procedures.
• Best: Institute rest/sleep cycle system to
minimize delirium.
Nutrition Every 4–6 • Minimum: If patient is alert, encourage oral
hours food/water intake.
• Better: As above, use MRE protein powder
mixed with water.
• Best: As above, use commercially available
tube feeding products or protein shakes.
Hygiene Every 24 • Minimum: Rinse face, armpits, and groin
hours with warm water, soap, and gauze roll.
• Better: As above, use baby wipes or wash
cloth.
• Best: As above, use chlorhexidine-
impregnated cleansing wipes.
Bowel Management As required • Minimum: Cleanse soiled skin as described
for bath; reapply new dressings/hypothermia
management as appropriate.
• Better: As above, add a cloth/linen/ plastic
barrier to protect wounds/hypothermia
management kit from future soiling.
• Best: As above, add barrier cream to skin for
protection against breakdown.
• Perform all recommended interventions from guidelines for above Tier level.
• Additional interventions include:
(continues)

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