Page 134 - JSOM Fall 2021

Green Zone
The Green Zone is located away from the danger. Green
Team members are all physicians or medical specialists highly
trained for special invasive maneuvers, advanced respiratory
airway management, advanced circulatory support, and accu-
rate diagnosis and prognosis.
The Green Team works with the transport team, composed of
the vans and motorbikes that carry advanced medical equip-
ment and drugs, including the following. whose duty was to protect the driver with a shield while taking
the casualty to the motorbike and holding him during trans-
port. On the other hand, the van transport team included one
• Equipment: CAT, hemostatic dressings, bandages, a
cricothyroidotomy set, oropharyngeal and nasopharyn- driver, one medical expert, and two support members, possi-
geal cannulas, chest decompression needles, a tactical bly including someone with professional rescue experience or
stretcher, triage cards, foil hypothermia blankets, a la- a fireman or physician.
ryngoscope, endotracheal tubes, laryngeal masks, su- FIGURE 13 Transport teams.
tures, intraosseous lines, cervical spine protection, IV
lines, bag valve masks (e.g., Ambu bags), CPR (cardio-
pulmonary resuscitation) masks, an EKG monitor, an
SpO (blood oxygen saturation) monitor, a blood pres-
2
sure monitor, and a glucose monitor.
• Drugs: medical oxygen, salbutamol, adrenaline, atro-
pine, morphine, midazolam, phenytoin, diazepam, ibu-
pro fen, ertapenem, betadine, alcohol, metoclopramide/
ondansetron, Ringer’s solution, glucose solution, field
whole-blood transfusion sets, amiodarone, aluminum-
magnesium hydroxide solution for CS gas injuries. Signal Language
The Green Team has the objective of performing an extended The use of gas masks and the environmental noise reduced
physical examination and determining all injuries that will the possibility of verbal communication (Figure 14). Because
be treated in the field before transport to a medical center or of this, we adapted standardized hand signals for close range
which patients require immediate transport to a medical cen- engagement in the field (Figure 15).
ter. The system we used was the MARCH-P (Table 4).
FIGURE 14 Use of gas masks.
After application of the MARCH-P protocol, a patient was
categorized for transport to the best center for his treatment
or was discharged after not more than 1 hour of observation
in the Green Zone.
The MEDEVAC PMSCS for the Green Zone has eight lines
(e.g., Team identification in code, Team location) to be com-
pleted to ensure proper communication (Figure 9).

Transport Team
The transport team is divided into motorbike teams and van
teams (Figure 13). The motorbike team during our experi-
ence had special training, with the firemen rescue operators in
all-terrain motorbikes for rescue and transportation. Each mo-
torbike had two operators, the driver and the support member,

132 | JSOM Volume 21, Edition 3 / Fall 2021