Transcript UNIT ONE & MORPHINE

M.O.L.L.E. MEDIC BAG
Purpose
•The purpose of this tutorial is to familiarize
the student with the Modular Light Weight
Load Bearing Equipment (MOLLE) Medic
Bag and its equipment.
Components
• The MOLLE Medic Bag consist of:
– Eight external pouches.
– Two detachable flaps.
– One detachable IV bandoleer.
– Approx. weight 22 lbs. full load
– Physical characteristics:
– Length – 22 in.
– Width – 16 in.
– Height – 12 in.
EIGHT EXTERNAL POUCHES
DETACHABLE FLAP
DRESSING, BURN 4X16
SATURATED WITH WATER/GEL
• Purpose- specifically intended for the use in treating white
phosphorus burns (WP).
DRESSING, CHEST WOUND
SEAL
• Purpose- treating sucking chest wounds.
LARYNGOSCOPE
Purpose- for
introducing
endotrachael tubes.
The set contains a
handle with fiber
optic light and two
blades (curved and
straight).
CHEMICAL COLD PACK, REUSABLE, DUAL ICE
• Purpose- for use on sprains and blunt
trauma injuries. The packs can be used in
the field where ice is not available.
BASIC CORPSMAN ENT KIT
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Otoscope.
Speculums.
Fiberoptic nose light.
Red light lens.
Cobalt blue light.
Flour-I strips.
Fiberoptic wands.
• Vortec Headlamp/red lens.
VORTEC HEADLAMP
• Purpose- provides
no-hands way of
lighting the area to
examine battle
injuries.
Packing/Configuration of the
M.O.L.L.E. Bag
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Type of Mission.
Duration of Mission.
Environment (Urban, Jungle, Desert, Mountain).
Casualty estimation.
CASEVAC time.
Resupply.
Level of training.
Weather (Cold, Hot)
The Field Medical Card
DD 1380
Purpose
• Furnishes the attending physician with
essential information about the diseases,
injuries and treatment provided to the casualty
during evacuation through the various echelons
of care.
• Records disposition of patient, including death.
• Utilized by all U.S. and NATO Forces.
Disposition of the DD Form 1380
• Transferred Cases
– Remains with the patient when transferred
from one MTF to another.
– It should be attached to the patient or with
established health record until the patient
reaches hospital, dies, is buried, or returns to
duty.
Carbon Copies
• In the U.S., the Senior Command Surgeon
prescribes the use of these through the SOP or
the administrative or logistics order.
• Overseas commands they are used as the
Senior Command Surgeon prescribes.
Accuracy
• The DD Form 1380 is the first and sometimes
the only record of combat casualty treatment.
• Accuracy and completion is of utmost
importance.
Required Information on the
DD Form 1380
Block #1
• Personal Identification:
– Name.
– Rank.
– SSN.
– Sex.
– Specialty Code.
– Religion.
Block #2
• Unit Information:
– Unit.
– Nationality.
– Force.
Block #3
• Injury identification:
– Mark appropriately on diagram.
Block #4
• Level of Consciousness:
– Mental status.
– AVPU.
Block #5
• Pulse:
– Record time.
– Pulse characteristics and location.
Block #6
• Tourniquet:
– Indicate with yes or no and time if applied .
Block #7
• Morphine:
– Record dose and time .
Block # 8
• IV:
– When.
– Where.
– What size IV catheter
Block #9
• Treatment/Observations/Medications/Allergies
/NBC Antidote
Block #10
• Disposition of the patient , I.e. SIQ, light duty,
MEDEVAC’d
Block #11
• Provider Signature.
The backside of the DD-1380 is used
for reassessment and follow-up.
STANDARD
ISSUE
PHARMACEUTICALS
Morphine
(MSO4)
Accountability
• During time of war, HM’s will be issued
Morphine injectors under very strict controlled
procedures.
• Possession is a medical responsibility and must
not be taken lightly.
Indications include:
• Relief of severe pain.
Contraindications
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Allergy to morphine or any other opiate.
Airway and respiratory related injuries.
Head injuries.
Loss of consciousness, Altered mental status.
Massive hemorrhage.
Evidence of severe or deepening shock.
Dosage
• Adult dosage: 10mg Q4hrs
• Autoinjector is given intramuscularly which
may be repeated, if necessary, in no less than 4
hours.
NOTE:
• In the past, morphine came in the form of a
syrette (similar to a small toothpaste tube).
• Dosage was 16mg (1/2 grain).
• NO LONGER USED !!!
AUTOINJECTOR
Syrette
Procedures
• Remove the safety cap and inject into a large
muscle, i.e thigh or buttocks. Hold in place 10
seconds.
• Massage the area in which the morphine was
injected to increase the absorption into the
circulatory system.
• After the morphine has been administered it is
important to attach the spent injector to the pocket
flap of the uniform blouse or blouse lapel. This is
to show conspicuously that morphine has been
given.
Procedures (cont’d)
• The letter “M” and the Time that the morphine
was administered must also be written on the
patient’s forehead.
• Lastly, it is important to document the
administration of morphine on the DD-1380 in
Block 7.
Morphine Poisoning
• Constricted pupils.
• Slowed respirations less than 12.
• Progressive fall in blood pressure.
Treatment:
• Oxygen.
• Pain stimulants.
• Administer Narcan.
Narcan:
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Drug of choice.
Located in the BAS .
Adult dosage is 0.4 mg, I.V.
repeated every 2 -3 minutes.
Can be given SQ
M.O.L.L.E. Medic Bag
Standard Issue Drugs
Diphenhydramine Hyrdochloride
(Benadryl)
• Is a antihistamine drug with anti-cholinergic
(drying) and sedative effects.
• In oral form it is effective in the treatment in
the following indications:
»Skin allergies.
»Anaphylactic reactions.
»Food allergies.
»Motion sickness.
Contraindications
• Hypersensitivity to diphenhydramine
hydrochloride and other antihistamines of
similar chemical structure.
Dosage and Administration
• A single oral dose of 50mg is quickly absorbed
with maximum activity occurring in
approximately one hour.
Epinephrine Injection, USP 1:1000
(Ana-Guard)
• The most valuable drug for the emergency
treatment of severe allergic reactions is
epinephrine
Principle Indications
• Allergic reactions. Anaphylactic shock.
• Severe reactions due to allergy injections.
• Exposure to pollens, dust, molds, foods, drugs or
unknown substances.
• Severe, life threatening asthma.
• Other symptoms:
– bronchoconstriction,
– wheezing,
– sneezing,
– erythemia and pruritis
Contraindications
• Cardiogenic, traumatic, or hemorrhagic shock.
• Cardiac dilation.
• Cerebral arteriosclerosis.
• Organic brain damage.
Dosage and Administration
• Epinephrine Injection USP 1:1000
– 1 ml syringe, designed to deliver 2 doses of
0.3 ml each
• ( 0.3 ml - 0.5 ml recommended dose )
• Intended for SQ or IM.
Dosage and Administration
• Epinephrine Injection USP 1:1000 also comes
in a Auto-Injector, which delivers a 0.3 ml
dose.
• Also called an EpiPen.
• You may see both types of Epinephrine in the
Supply system.
Atropine
• Is the drug of choice for treating nerve agent
poisonings. Atropine will dry secretions
(including those in the airway), reduce
bronchoconstriction, and decreases
gastrointestinal motility.
Indications
• Exposure to a nerve agent
Contraindications
• None for emergencies
Characteristics and Components
of the Individual First Aid Kit
(IFAK)
Old
– 1-Eye Patch Dressing
– 1-Battle Dressing with Tie Ends
– 1-Bottle of Iodine Water
Purification Tablets
– 1-Bottle of Wound Disinfectant
– 1-Lip Balm
2-Cravat’s
– 10-Adhesive Bandages
New
– 1-Packet of Adsorbent Hemostatic
Agent (QuikClot)
– 1-Package of Burn Gel (Water-Jel)
– 1-Bottle of Iodine Water
Purification Tablets
– 1-Bottle of Wound Disinfectant
– 1-Tourniquet
– 2-Pressure Dressings
– 2-Bulky Gauze Rolls
– 10-Adhesive Bandages
Components and Characteristics
• 1-Packet Adsorbent
Hemostatic Agent
– Granular mineral powder
– Sterile
– Stops high volume venous
and arterial bleeding
through rapid absorption of
liquid
– Clot remains in the wound
until removed by medical
personnel
– Food and Drug
Administration (FDA)
approved
Quikclot Precautions
• Adsorption is physical, not chemical in nature
• (Adsorption-physical adhesion/ Absorptionchemical reaction)
• In presence of normal blood, this absorption
causes only a slight body temperature increase to
approximately 109-114 degrees F
• In presence of very non-viscous/adhesive liquids
like WATER, MORE EXTREME HEAT CAN BE
GENERATED by this adsorption. This reaction
lasts approximately 4 to 5 seconds and then
ENDS!
Quikclot Precautions (cont.)
• Once granules have adsorbed all of the liquid
possible, they go INERT.
• Prior to application, REMOVE water and
excess blood from wound area.
• Caregivers hands should not be wet.
• Exothermia (production of heat) is controlled
by adjusting the balance between volume of
water and volume of product.
Quikclot Precautions (cont.)
• Exothermic reaction and adsorption can be
instantly arrested by flooding the granules with
water.
• If blood is extremely diluted, the exothermic
reaction can be more extreme!
• Quikclot may be applied in small amounts,
rather than dumping all at once if blood is
extremely diluted.
Components and Characteristics
(Cont)
• 1-Bottle of Wound
Disinfectant
– Betadine solution
– Cleansing of
Minor Wounds
Components and Characteristics
(Cont)
• 1-Tourniquet
– One Handed Use
– Use on arterial and
venous blood
– For Moderate to
Severe Bleeding
only
– For use on
Extremities only
Components and Characteristics
(Cont)
• 2-Pressure Dressings
– Vacuum Packed
– 8” x 10” Absorbent
Pad
– 4” Wide elastic wrap
with Velcro strip on
both ends
– Coated Steel tension
hook for individual
application
Components and Characteristics
(Cont)
• 2-Bulky Gauze Rolls
– Gauze roll
– Absorbent
Material
Components and Characteristics
(Cont)
• 1-Package 4”x16” Sterile
Burn Dressing (Water-Jel)
– Extinguishes white
phosphorous burns
– Cools burn area
– Reduces chance for
hypothermia
– Prevents burn from further
progression
– Protects against infection
and eases pain
– FDA approved
– Do not use for other than
intended use
Components and Characteristics
(Cont)
• 1-Bottle of Iodine Water
Purification Tablets
– To purify non potable
water for consumption
– After handling the
tablets, wash hands
thoroughly. If eyes
come in contact with
the tablets or residue, it
could cause temporary
blindness