Page 49 - 2022 Spring JSOM

■ Better: Ear Pro and Eye Pro and blankets in all bony areas, Ear Prolonged Casualty Care Patient Packaging Flowchart
Protection and Eye Protection – foamies or actual hearing protec-
tion inserts, goggles
■ Best: Above with gastric tube (NG/OG) or chest tube for decom-
pression, if indicated. Depending on altitude/platform, consider
bleeding air of out bags of fluid.
Secure Interventions and Equipment
■ Good: Tape (securely tape all interventions to include IVs, IOs,
Airway interventions, Gastric Tubes and TQs). Oxygen tanks
should be placed between the patients legs and the monitor should
be secured on the oxygen cylinder to prevent injury to the patient.
Pumps should be secured to the litter
■ Better: Additional litter straps to secure equipment and extend the
litter with back support as indicated for vented patients to prevent
VAP.
■ Best: Above and use the SMEED to keep the monitor and other
transport equipment off patient
*if possible, identify with tape the location of interventions or access
points on top of hypothermia management to allow transport teams
quick identification of location.
Prepare Dressings
Air Evacuation and other MEDEVAC assets do not routinely change
dressings during transport; therefore, ensure all dressings are changed,
labeled, and secured before patient pick up LEAD AUTHORS
■ Good: Secure and reinforce dressings with tape, date, and time all MSG Michael Remley, NRP, SO-ATP, USA
dressings. Paul Loos, 18D, USA
■ Better: Change dressings within 24 hr of departure, secure as COL Jamie Riesberg, MC, USA
above. Dan S. Mosely III, MD
■ Best: Change and reinforce dressings within 4 hr of departure. En- AUTHORS
sure additional Class VIII is available for any unforeseen issues in MSG Michael Remley, NRP, SO-ATP, USA
flight.
MSG (Ret) Harold Montgomery, SO-ATP, USA
Secure the Patient CAPT Brendon Drew, DO, USN
■ Good: Litter with minimum of 2 litter straps Sean Keenan, MD
■ Better: Litter with padding (example: AE pad or Sleep Mat) with CPT John Maitha, PA-C, USA*
minimum of 3 litter straps HMC Wayne Papalski, FP-C, USN
■ Best: Litter with padding and flight approved litter headrest with SMSgt Brit Adams, USAF, NRP, FP-C*
minimum of 3 litter straps (additional litter straps can be used to SCPO Tyler Scarborough, ATP, USN*
secure patient or equipment) LCDR Nic Rohrhoff, MC, USN
CAPT Michael S. Tripp, MC, USN
Moving a Critical Care Patient Shelia C Savell, PhD, RN
■ Good: Two person little carry to CASEVAC/MEDEVAC platform CDR Brendan Byrne, MC, USN
■ Better: Three person little carry on a rickshaw to CASEVAC/ Andrew Fisher, MD*
MEDEVAC platform John Fruendt, MD
■ Best: Four person little carry on a rickshaw to CASEVAC/ Col John Wightman, USAF, MC CPT
MEDEVAC platform
Steven Benavides, USA
Walter Engle, PA-C
Prolonged Casualty Care Patient Packaging Flowchart
MAJ Laura Tilley, MC, USA*
Equipment Possible Complications Edward Otten, MD, FACMT
• Litter with at least three litter straps • Inadequate medications CDR Shane Jensen, MC, USA
• Three channel IV pump (airworthy) • Injuries not addressed before COL Matthew Martin, MC, USA SFC
• Cardiac monitor and cables transport Justin C. Rapp, 18D, USA*
• Suction Device • Inexperienced provider on flight
• Equipment issues LT Dana Flieger, RN, USN*
LTC Christopher VanFosson, PhD, RN, USA
Pearls: MAJ Sabas Salgado, MC, USA
■ Document all times – TCCC Card or DA4700. CPT Jeffrey Maler, RN, USA
■ Assist Ensure the patient is stable before initiating a critical patient CMSgt (Ret) Tom Rich, NRP, USAF
transfer. Don Adams, MD
■ POI/unstable patients ensure the appropriate transport team MSG Kaleb Twilligear, NRP, SO-ATP, USA*
(MEDEVAC W/ECCN or Advanced provider) Don L. Parsons, PA
■ Interfacility transfers should meet the following minimum: COL Sandra Wanek, MC, USA*
o Hemorrhage control CDR Levi Kitchen, MC, USN
o Resuscitation adequate (SBP 70–80mmHg, MAP >60, or UOP CAPT Matthew D. Tadlock, MC, USN
>0.5mL/kg/hr) Maj Erica Simon, USAF, MC
o Initial post-op recovery as indicated COL Cord Cunningham, MC, USA COL
o Stabilization of fractures Jennifer Gurney, MC, USA
Col Stacy A. Shackelford, USAF, MC
*Denotes a sub-working group chair.

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