Page 293 - PJ MED OPS Handbook 8th Ed

Abdominal Demonstrate knowledge Rx:
Evisceration of the diagnosis and 1. Stop bleeding
treatment of the protocol 2. Clean the bowel
based on the Task 3. Gently put back in if able, otherwise moist dressing over bowels, 2
Standard and the PJ Med occlusive over that
Handbook 4. Close abdomen if bowel re-placed
5. Ertapenem
Flail Chest Demonstrate knowledge Rx:
of the diagnosis and 1. Analgesics
treatment of the protocol 2. Monitor for desaturation or respiratory distress 2
based on the Task 3. PPV: assisted ventilations or RSI and bag/vent
Standard and the PJ Med
Handbook
Extremity Demonstrate knowledge Rx:
Trauma of the diagnosis and 1. Splint/immobilize
treatment of the protocol 2. If pelvis is stable, use traction device for isolated mid-femur
based on the Task fractures
Standard and the PJ Med 3. Document PMS 2
Handbook 4. Reduce fractures and dislocations when possible
5. R/O compartment syndrome: pain out of proportion to
appearance and pain with passive motion
6. Consider fasciotomy for leg compartment syndrome and >6
hours to definitive care
Endotracheal Demonstrate knowledge Rx:
Intubation of the diagnosis and 1. Unresponsive head trauma patient (GCS<8)
Indications treatment of the Task 2. Unable to maintain airway 2
Standard and the PJ Med 3. Persistent desaturation despite supplemental O2 and airway
Handbook maneuvers
4. Respiratory rate <8 and >24 (or 10 & 30).
Non- Demonstrate knowledge 1. Cardiogenic
hemorrhagic of the diagnosis and Dx: Chest pain, diaphoresis, abnl EKG
Shock treatment of the Task Rx: FONA, 500mL LR
Standard and the PJ Med
Handbook 2. Anaphylactic
Dx: allergic stimulus, red skin, facial swelling, respiratory distress,
hypotension
Rx: Epi, Benadryl Decadron, Pepcid 2

3. Neurogenic
Dx: Spine trauma, back pain, deformity of spine,
weakness/paralysis/decreased sensation of extremities
Rx: 1–2L LR, Epi if no response

4. Septic
Dx: Infection source, fever
Rx: Ertapenem, 1-2L LR, Epi if no response
High Altitude Demonstrate knowledge Dx:
Pulmonary of the diagnosis and 1. Shortness of breath at rest
Edema treatment of the Task 2. Rales
Standard and the PJ Med 3. Pink, frothy sputum
Handbook 2
Rx:
1. Descent
2. 02
3. Nifedipine
4. Albuterol
High Altitude Demonstrate knowledge Dx:
Cerebral Edema of the diagnosis and 1. Ataxia
treatment of the protocol 2. Confusion
based on the Task
Standard and the Rx: 2
PJ Med Handbook 1. Assisted descent
2. Decadron
Acute Mountain Demonstrate knowledge Dx:
Sickness of the diagnosis and 1. Headache, listless, loss of appetite, nausea, vomiting, etc.
treatment of the protocol
based on the Task Rx:
Standard and the PJ Med 1. Hydration 2
Handbook 2. Ibuprofen
3. Diamox 250mg BID until 2 days after resolved and still at
altitude
4. Hold any ascent until asymptomatic for 24 hours
Appendix 3: Pararescue Medical Skills Certification n 291