Page 42 - JSOM Summer 2020

APPENDIX A:
AUSTERE RESUSCITATIVE AND SURGICAL CARE EQUIPMENT CONSIDERATIONS

The following equipment lists are not complete packing lists. J Spec Oper Med. 2017;17(3):40–45. https://www.jsomonline
Teams should pack according to mission requirements, with .org/JournalArticles/20173.php#Article708
expected numbers and types of patients significantly influenc-
ing quantities of medications and supplies. Disclosure
This clinical practice guidelines (CPG), the US Air Force, US
For specific surgical instrument recommendations, please refer Army, US Navy, and US Department of Defense do not en-
to: Hale DF, Sexton JC, Benavides LC, et al. Surgical instru- dorse or promote any specific products.
ment sets for Special Operations expeditionary surgical teams.

Ruck model: Plan for 1–2 surgical patients with 80% of combat Ruck model: Plan for 1–2 surgical patients with 80% of combat
trauma injury patterns trauma injury patterns (cont.)
• Litter • Head lamps
• Tourniquets • Cricothyroidotomy kit
• Dressings, splints (e.g., Combat Gauze ,
®
ACE, medical tape, Coban , Kerlix ) • GIA staplers with reloads
™
™
TCCC equipment • Needle decompression catheters • Topical hemostatic agents
• Airway equipment (e.g., oropharyngeal • Surgical sponges (an ample supply
airways, nasopharyngeal airways, definitive of sponges cannot be overstated or
airways, AMBU bag) Other surgical overemphasized)
• Muzzle and large ETTs for MWD use equipment
• Personal protective equipment • Vascular shunts
• IV start kits, IO devices, extension tubing, • REBOA catheter and introducer kit
blood tubing • Chest tubes, chest seals, and Heimlich valves
Nursing • Syringes/flushes
equipment • IV fluids • Skin staplers
• Assorted catheters/tubes/drains • Temporary abdominal closure device
• Walking blood bank supplies (e.g., citrate (e.g., Ioban)
bags, Eldon cards) • Portable, battery-powered EtCO monitor
2
• Airway instrumentation • Video laryngoscope (GlideScope )
®
• Ventilation equipment
Airway and • Portable, battery-powered pulse oximeter
anesthesia • Regional anesthetic block needles • Portable, battery-powered vital signs
equipment • Dial-a-flow (infusion set)
• Centurion pressure transducer monitor
• Nonelastic bougie • Blood-cooling container (e.g., golden
Electronics
• Tranexamic acid hour box)
• IV calcium • Hand-held Doppler device
• Anesthetics
• IV and PO analgesics • Hand-held ultrasound device
• IV and PO antibiotics • Portable ventilator
Medications
• ACLS medications • In-line IVF/blood-warming device
• Antiepileptics
• IV fluids (including hypertonic saline for • Clippers for MWD use
traumatic brain injury) • Internal and external communication
• Assorted “sick call” medications equipment (e.g., hand-held encrypted
Surgical • Major instrument set radios, Peltors)
instruments • Chest set with rib spreader and Lebsche • Eye protection, ear protection
knife • Night-vision equipment
• Limited vascular set: a few fine instruments • Headlamp capable of red/green/blue light
and vascular clamps Operational • Navigation tool(s)
• Orthopedic bone saw (Gigli wires are equipment (e.g., lenzatic compass, GPS)
intended to be single use, are fragile, and
difficult to resterilize) • Survival equipment (e.g., blood chit, escape
and evasion kit)
Suture material • Absorbable suture, given high likelihood of
contaminated wounds • Tactical protective equipment (body armor),
IFAK
• Heavy PDS for fascia • Personal weapons and ammunition
• Fine Prolene for vascular repair Abbreviations: ACLS, advanced cardiac life support; EtCO , end-tidal
2
• Fine PDS for urologic and airway repairs carbon dioxide; ETT, endotracheal tube; GPS, global positioning sys-
• Absorbable free ties for ligation of small tem; IFAK, individual first aid kit; IO, intraosseous; IV, intravenous;
vessels MWD, Military working dog; PO, per os (by mouth); TCCC, Tactical
• Heavy silk to secure tubes/drains Combat Casualty Care.
• Umbilical tape
• Heavy chromic for hepatic repairs
• Bone wax for amputations
• Vessel loops, large and small
• Pledgets

40 | JSOM Volume 20, Edition 2 / Summer 2020