Page 291 - PJ MED OPS Handbook 8th Ed

Patient
Transfer
Age State AT MIST during patient transfer 1
Time 1
Mechanism of 1
Injury
Injuries 1
Signs & 1
Symptoms
Treatment 1
Performed
Extended
Care
Hydration PO/ IV/ IO/ NG tube If not applicable to scenario, 1
verbalize appropriate actions
Hypothermia Insulates from ground, keep warm and dry If not applicable to scenario, 1
verbalize appropriate actions
Hygiene Pressure sores/roll & pad pt., keep pt. clean & dry If not applicable to scenario, 1
verbalize appropriate actions
If not applicable to scenario,
Infection Check temps, change dressings q12–24h, antibiotics verbalize appropriate actions 1
Tubes & Lines Tubes & lines are “neat and tidy” & function & drain properly If not applicable to scenario, 1
verbalize appropriate actions
Medications 6 rights: pt., med, dose, time, route, documentation If not applicable to scenario, 1
verbalize appropriate actions
Monitoring Unstable q2–4h, VS including AVPU/temp/O2 sat, q6–12h If not applicable to scenario, 1
verbalize appropriate actions
Analgesia Document with pain scale. Add Versed to ketamine or fentanyl If not applicable to scenario, 1
verbalize appropriate actions
PRN to potentiate, sedate or manage anxiety.
If not applicable to scenario,
Nutrition Discusses oral/NG routes verbalize appropriate actions 1
80% of applicable points to Pass Section 1 (Min 48) Total 60
Section 2. Knowledge Validation of Protocols / Medications
Task Condition Standard Points Points
Comprehension: 2pts=full, 1pt=partial, 0pt=marginal Available Awarded
Combat Shock Demonstrate knowledge Dx:
of the diagnosis and 1. MOI and blood loss
treatment of the combat
shock protocol based on 2. Declining LOC in the absence of head trauma
the Task Standard and the 3. Weak or absent radial pulse
PJ Med Handbook 2
Rx:
1. 2 lines (IV/IO),
2. TXA 2g flush (otherwise after 1st unit blood)
3. Whole blood or blood products
4. 1g Calcium after 1st unit, then every 4 units
TBI Demonstrate knowledge Mild
of the diagnosis and Dx:
treatment of the protocol 1. “bell rung”, “saw stars”, “stunned”, loss of consciousness <30
based on the Task minutes, memory loss around event
Standard and the PJ Med
Handbook Rx:
1. Perform neuro exam, GCS and MACE
2. Rest for 72 hours, neurology evaluation prior to return

Moderate
Dx:
1. GCS≤12, or P or U an AVPU
2. LOC/mental status changes>30 minutes 2

Rx:
1. Prevent hypoxemia (secure airway PRN)
2. Prevent hypotension (IV/IO)
3. TXA 2g slow IV push if patient cannot follow commands
4. Elevate the head 30 degrees if no shock
5. Document GCS

Severe (impending or ongoing Herniation)
Dx:
Appendix 3: Pararescue Medical Skills Certification n 289