Page 150 - 2022 Ranger Medic Handbook

Upper Respiratory Infection / Common Cold
DEFINITION: Inflammation of nasal passages due to a respiratory virus
S/Sx: Nasal congestion; sneezing; post-nasal drainage; sore throat; cough; hoarseness; malaise; headache; low-grade
fever; body ache; fatigue
MANAGEMENT:
1. Increase PO hydration.
2. Acetaminophen 1,000mg PO q6hr AND/OR ibuprofen 800mg PO q8hr.
3. Treat symptomatically with pseudoephedrine 60mg PO q6hr OR fexofenadine 60mg/pseudoephedrine 120mg PO bid
OR loratadine 10mg/pseudoephedrine 120mg PO qd.
4. Consider oxymetazoline 2–3 sprays each nostril bid (not to exceed 3 days). Lozenges for sore throat.
SECTION 3 DISPOSITION: Evacuation usually not required. Monitor for worsening conditions.

Urinary Tract Infection
DEFINITION: Infection of urinary tract; more common in females, tactical setting, dehydration, kidney stones.
S/Sx: Dysuria; increased urinary urgency and frequency; cloudy, malodorous, or dark urine may be present; suprapubic
discomfort; normally no CVAT/back/flank pain; normally no fever, hx of STD exposure.
MANAGEMENT:
1. If < 35 years old treat for sexually transmitted infection, ceftriaxone 500mg IV/IM × 1 AND doxycycline 100mg bid for
7 days (can replace doxycycline with azithromycin 1g PO once if compliance in question).
2. For others, cephalexin 500mg PO qid × 7–10 days OR trimethoprim-sulfamethoxazole 1 PO bid for 7–10 days in
males (bid for 5–7 days or 3–5 days respectively in females).
3. Treat per Pain Management Protocol.
4. If fever, back pain, flank pain, and/or costovertebral angle tenderness develop, suspect kidney infection and treat
per Flank Pain Protocol.
5. Encourage PO hydration.
DISPOSITION: Usually responds to therapy and evacuation not required if it does. Routine evacuation for worsening
signs and symptoms. Priority evacuation for pyelonephritis (see Flank Pain Protocol).
SPECIAL CONSIDERATIONS:
1. More common after instrumentation, in females, or in tactical settings with dehydration and/or kidney stones.
2. Symptoms may be confused with a sexually transmitted disease (STD).

136 SECTION 3 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) & SICK CALL