Page 177 - Journal of Special Operations Medicine - Summer 2015

– For every 10kg ABOVE 80kg, increase initial rate abdominal bleeding. Application and extended use must
by 100mL/h. be carefully monitored. The PASG is contraindicated for
– If hemorrhagic shock is also present, resuscitation casualties with thoracic or brain injuries.
for hemorrhagic shock takes precedence over re- 18. CPR in TACEVAC care
suscitation for burn shock. Administer IV/IO fluids a. Casualties with torso trauma or polytrauma who have
per the TCCC Guidelines in Section 7. no pulse or respirations during TACEVAC should have
e. Analgesia in accordance with TCCC Guidelines in Sec- bilateral needle decompression performed to ensure
tion 13 may be administered to treat burn pain. they do not have a tension pneumothorax. The proce-
f. Prehospital antibiotic therapy is not indicated solely dure is the same as described in section 2a above.
for burns, but antibiotics should be given per TCCC b. CPR may be attempted during this phase of care if the
guidelines in Section 15 if indicated to prevent infec- casualty does not have obviously fatal wounds and
tion in penetrating wounds. will be arriving at a facility with a surgical capability
g. All TCCC interventions can be performed on or within a short period of time. CPR should not be done
through burned skin in a burn casualty. at the expense of compromising the mission or deny-
h. Burn patients are particularly susceptible to hypother- ing lifesaving care to other casualties.
mia. Extra emphasis should be placed on barrier heat 19. Documentation of care
loss prevention methods and IV fluid warming in this Document clinical assessments, treatments rendered, and
phase. changes in the casualty’s status on a TCCC Casualty Card
17. The Pneumatic Antishock Garment (PASG) may be useful (DD Form 1380). Forward this information with the ca-
for stabilizing pelvic fractures and controlling pelvic and sualty to the next level of care.

Tactical Combat Casualty Care Guidelines 167