Page 140 - Journal of Special Operations Medicine - Summer 2014

Medical Provider TLO 7.1.2: Demonstrate proficiency in ELOs:
basic and advanced treatment of hypoperfusion • Explain the indications for oral resuscitation
• Explain the contraindications to oral resuscitation
ELOs: • Explain the appropriate volume and composition of oral
• Follow tactically appropriate resuscitation guidelines
• Perform continual assessment of adequacy of interven- resuscitation fluid
tion—monitor vital signs and mental status Medical Provider TLO 7.3.2: Demonstrate familiarity in
providing IV/IO fluid resuscitation in the tactical setting com-
Competency 7.2: Vascular access mensurate with scope of practice
Operator TLO 7.2.1: Describe the potential need for IV
access ELOs:
• Describe the different resuscitative fluid options avail-
ELOs:
• Recognize specific clinical situations where IV access is able in the tactical setting including crystalloid, colloid,
and blood products
needed including, inadequate profusion, severe pain, po-
tential for rapid decompensation. • Describe the timing of fluid resuscitation in relation to
the operational situation and the patient’s condition
Operator TLO 7.2.2: Describe the potential need for IO • Determine an appropriate endpoint of resuscitation based
access on injury and patient type (e.g., controlled hemorrhage, un-
controlled hemorrhage, head injury, or pediatric patients)
ELOs: • Describe the risks of fluid resuscitation (e.g., exacerba-
• Describe the equipment that would be used for IO
placement tion of hypothermia, pulmonary edema)
Medical Provider TLO 7.2.1: Describe the indications for DOMAIN 8: Medication Administration
and tactical considerations of obtaining IV access
Competency 8.1: Administration of oxygen.
ELOs: Operator TLO 8.1.1: Describe when it is appropriate to
• Recognize specific clinical situations where IV access is provide oxygen therapy in a given tactical situation.
needed including, inadequate profusion, severe pain, po- ELOs:
tential for rapid decompensation.
• Describe when oxygen is medically indicated and appro-
Medical Provider TLO 7.2.2: Demonstrate familiarity with priate in a tactical environment
obtaining IV access commensurate with scope of practice • Demonstrate the administration of oxygen
ELOs: Medical Provider TLO 8.1.1: Describe when it is appropriate
• Describe the differences in obtaining IV access in the tac- to provide oxygen therapy in a given tactical situation.
tical environment ELOs:
• Perform or assist with obtaining IV access in the tactical • Describe the process for conducting a mission analysis to
environment
determine if it is safe and necessary to bring oxygen into
Medical Provider TLO 7.2.3: Describe the indications for the tactical setting.
attempting IO access • Describe when oxygen is medically indicated and appro-
priate in a tactical environment
ELOs:
• List specific indications where it is appropriate to place Competency 8.2: Administration of analgesia
an IO including need for vascular access when unable to Operator TLO 8.2.1: Describe use of an analgesic for a
rapidly obtain adequate IV access given tactical situation.
Medical Provider TLO 7.2.4: Demonstrate familiarity in ELOs:
obtaining IO access commensurate with scope of practice • Describe the implications of administration of analgesia
in a tactical setting. (i.e. operational status under analge-
ELOs: sia, ease of evacuation of patient, etc.)
• Describe the differences in obtaining IO access in the tac-
tical environment Medical Provider TLO 8.2.1: Select an appropriate analge-
• Perform or assist with obtaining IO access in the tactical sic for a given patient and tactical setting.
environment
ELOs:
Competency 7.3: Fluid resuscitation • Describe how to conduct a mission analysis to determine
Operator TLO 7.3.1: Describe the use of oral resuscitation types and amount of analgesia appropriate for a given
for volume depletion during times of delayed definitive care. mission. (i.e. location of mission – urban vs. rural, dura-
tion of mission, number of personnel involved, need to
ELOs: distribute medication to operators pre-mission, etc.)
• Explain the indications for oral resuscitation • Describe the implications of administration of analgesia
• Explain the contraindications to oral resuscitation to a patient in a tactical setting. (i.e. operational status
• Explain the appropriate volume and composition of oral of patient under analgesia, ease of evacuation of patient,
resuscitation fluid
hemodynamic status, etc.)
Medical Provider TLO 7.3.1: Describe the use of oral resus-
citation for volume depletion during times of delayed definitive Competency 8.3: Appropriate and safe use of over the coun-
ter (OTC) medications in the tactical setting
care.
(continues)

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