Page 90 - 2022 Ranger Medic Handbook

TICS/TIMS
Toxic Inhalation/Eye Exposure Box
This kit is meant to be carried as an adjunct in aid bag as mission dictates the threat to personnel. The surplus
of drugs is meant to provide continuous care and re-dosing as symptoms persist. Be mindful that nebulizers do
not work if they are not kept upright. Collapsible and bendable airway tubes may be needed to provide nebulizer
treatment to a casualty that is prone. If you use the Omron Nebulizer, read the directions for use and maintenance
SECTION 2 ■ 1ea Pelican 1150 Case ■ Eye treatment not in case, carried in Aid Bag:
before you pack it in your aid bag.
1ea Toxic Inhalation SOP Quick Ref Card
1ea 1,000mL bag of NS or
1ea Omron Micro Air Nebulizer w/batteries
1ea Extension Tubing Lactated Ringer’s
2ea Morgan Lens
1pkg (5 vials) 5mL 4% Lidocaine HCl 1ea Morgan Lens Admin Set
40mg/mL
1ea 8.4% Sodium Bicarbonate 50mEq/mL – Dilute ■ Carried on Vehicle
1:1 with Normal Saline for use 2ea D Cylinders of O 2
15ea bullets 2.5mg Albuterol in 3mL 5ea NRB Masks
4ea vials Dexamethasone IV 20mg/5mL 5ea Nebulizer Masks
5ea 3mL NS Pre-Filled Syringes
3ea 18g Hard Needles ■ Supplemental items:
2ea Neomycin or Gentamicin Ophthalmic Oint. 1ea Peak Flow Meter
2ea Tetracaine Ophthalmic 1ea Capno Check
Toxic Industrial Chemicals/Materials
Inhalation Injury Treatment SOP
Administration via Nebulizer (in order)
1. 1 Albuterol bullet, 2.5mg in 3mL, by nebulizer
2. 1mL 4% lidocaine w/1mL normal saline or 2mL
2% lidocaine w/o NS by nebulizer (for cough/pain
suppression)
3. Administration via IV/IO:
• Dexamethasone: 8mg q6hr (Preferred) Or
• 125mg Solumedrol IV/IM q6hr
If no resolution of symptoms (efficacy is unproven by
research) attempt
• 1mL 8.4% Sodium Bicarbonate w/1mL normal
saline by nebulizer. Do not use undiluted 8.4%
Sodium Bicarbonate
– for acidic inhalation
– do not mix with other drugs
TIC/TIMS
Eye Injury Treatment SOP
1. Tetracaine eye drops for pain
2. 20 min NaCl flush with Morgan Lens
3. Neomycin eye drops prevent eyelids sticking shut
4. Allow eyes to drain. Avoid tight bandaging.

76 SECTION 2 PRIMARY TRAUMA PROTOCOLS