Page 138 - Journal of Special Operations Medicine - Summer 2014

• Describe how selection of extraction method is effected Medical Provider TLO 4.3.1: Demonstrate TQ application
by egress route
• Describe which extraction methods will require modifi- ELOs:
• Identify and reassess casualties who require hemorrhage
cation of medical care
control
• Describe how selection of extraction method is affected • Perform self-application of an commercial tourniquet in
by the casualty’s specific injuries
both a light and dark environment, on each extremity,
with one hand
DOMAIN 4: Hemostasis
• Perform application of a commercial tourniquet on a ca-
Competency 4.1: Conventional hemorrhage control includ- sualty in both a light and a dark environment
ing: tourniquet, direct pressure, wound packing, wound dress- • Perform application of an effective improvised tourniquet
ing and pressure dressing • Assess tourniquet for adequacy of application
Operator TLO 4.1.1: Perform effective hemorrhage con- • Identify or discuss options to address tourniquet failure
trol techniques for self-aid, buddy-aid, and to assist a medical • Assess casualty for tourniquet removal
provider
Competency 4.4: Application/administration of hemostatic
ELOs: agents
• Demonstrate basic hemorrhage control techniques (in- Operator TLO 4.4.1: Understand indications and adminis-
cluding tourniquets) tration of available hemostatic agents
• Explain the limitations of basic hemorrhage control in
the tactical environment (including when these tech- ELOs:
niques should be bypassed) • Describe the indications for the use of hemostatic agents
• Recognize failure of basic hemorrhage control techniques • Demonstrate the proper application/administration of
hemostatic agents
Medical Provider TLO 4.1.1: Perform hemorrhage control • Re-evaluate the effectiveness of hemostatic agent hemor-
at your level of training, and evaluate adequacy of hemorrhage rhage control initiated previously
control performed by operators
Medical Provider TLO 4.4.1: Understand indications, use
ELOs: and available hemostatic agents
• Demonstrate basic hemorrhage control techniques (in-
cluding tourniquets) • Describe the indications for hemostatic agents
• Explain the limitations of basic hemorrhage control in • Perform the proper application/administration of hemo-
the tactical environment (including when these tech- static agents
niques should be bypassed) • Reevaluate the effectiveness of hemostatic agent hemor-
• Recognize failure of basic hemorrhage control techniques rhage control initiated previously
Competency 4.2: Identification of life threatening hemorrhage DOMAIN 5: Airway
Operator TLO 4.2.1: Understand the characteristics of life-
threatening hemorrhage Competency 5.1: Management of the airway including: ca-
sualty positioning (rescue position, chin-lift, jaw-thrust), basic
ELOs: airway clearance techniques, airway adjuncts (nasopharyngeal
• Recognize wound types/mechanisms associated with airway (NPA), supraglottic airway (SGA) device, surgical air-
high-risk for life-threatening hemorrhage, both internal way (cricothyroidotomy), and endotracheal (ET) intubation
and external Operator TLO 5.1.1: Identify airway compromise during
initial survey
Medical Provider TLO 4.2.1: Identify and reassess casual-
ties who require hemorrhage control ELOs:
• Demonstrate the ability to determine a patient’s level of
ELOs: consciousness
• Recognize wound types/mechanisms associated with
high-risk for life-threatening hemorrhage, both internal • Demonstrate the ability to utilize the look, listen and feel
technique to determine an unresponsive patient’s airway
and external
status
• Demonstrate ongoing reassessment of efficacy of previ- • Demonstrate the ability to examine the upper airway for
ously employed hemorrhage control techniques
trauma or obstructions, and clear as appropriate
Competency 4.3: Application of a tourniquet (TQ), commer-
cial and improvised Medical Provider TLO 5.1.1: Identify airway compromise
Operator TLO 4.3.1: Demonstrate proficiency and un- during initial survey
derstanding of the use of tourniquets, both commercial and ELOs:
improvised • Demonstrate ability to assess the airway during initial survey
ELOs: Operator TLO 5.1.2: Establish a patent airway
• Perform self-application of an effective tourniquet in
both a light and a dark environment, on each extremity, ELOs:
with one hand • Demonstrate appropriate airway management given
• Perform application of a commercial tourniquet on a ca- patient and tactical conditions (e.g., Allow a conscious
sualty in both a light and a dark environment patient to assume a position of comfort; if the patient is
• Perform application of an effective improvised tourniquet
• Identify or discuss options to address tourniquet failure (continues)

128 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014