大规模伤亡（Mascal）创伤小组复苏记录（英文）MASS CASUALTY (MASCAL)IAUSTERE TRAUMA TEAM RESUSCITATION RECORD

**MASS** **CASUALTY** **(MASCAL)IAUSTERE** **TRAUMA** **TEAM** **RESUSCITATION** **RECOR**D

Submit by Emai

**ARRIVAL**

Date of Arrival:

Time of Arrival:

Date of Injury:

Time of Injury:

**EVAC** **FROM**

1st Responder

Forward Resuscitative Care

Theater Hospita

Location:

**INJURY** **CAUSE**

Building Collapse

Bullet/GSW

Fall

MVC

Burn Fire/Flame/Hot Obj IED NFS/VBIED/PBIED

Knife/Other Sharp Obj

Mortar/Rocket/Artillery

Mine

Sports

Other

**TRIAGE** **CATEGORY**

C Immediate

Delayed

Q

Minimal

C Expectan

**PATIENT** **CATEGORY**

**INJURY** **TYPE**

Blunt

Burn

**PATIENT** **MEDICAL** **INFORMATION**

**ALLERGIES:** NKDN

**PMH:**UNK/:

○ ○

USA

USAF

USMC

USN

USCG

Civilian -Local Contractor

NATO-Coalition

〇 Non-NATO -Coalition ( Local Partner Forces

EPW/Detainee

Other

Penetratinc

**PSH:** UNK/:

**MODE** **OF** **ARRIVAL**

Walked/Carried

CCATT

Other (specify):

CASEVAC:Air/ground

MEDEVAC:Air/ground

Ship EVAC

Air EVAC

History of Present Illness /Notes

**INTFRVENTIONS** **PRIOR** **TO** **ARRIVAI**

**VITALS** **SIGNS**

Temp:

**BP:**

HR: RR:

SpO2

**WARMING**

Blanket

Body Bag

HPMK

Space Blanke

Other (specify):

N/A

**TOURNIQUET**

Extremity

RUE

LUE

Type:C=CAT/S=SOFT

ne Of

**HEMORRHAGE**

**CONTROL**

**MEASURES**

Combat Gauze

Celox

Chitogauze

Direct Pressure

Field Dressing

Other (specify):

**BLOOD** **PRODUCTS**

Whole Blood:#

**GIVEN**

U

RBCs #

FFP/LP:

PIts: #

None/Unknown

Other (specify):

U

**GCS**

Eyes

Verbal

Motor:

**Total**

/4

/5

/6

/15

E

Junctiona

Location(s)

Time On

Time Off

Yes-Reaction C No-Reaction

**PREHOSPITAL** **AIRWAY/BREATHING**

OPA/NPA

Intubated: ETT LMA

Trach:Size

BVM w/o intubation

Chest seal

Cric: Size

**INTERVENTIONS**

King LT Other

**PREHOSPITAL** **MEDICATIONS** **GIVEN**

Total Dose Route

Fentanyt

Morphine

Ketamine

Propofol

Versed

Rocuronium

Succinylcholine

Antibiotic (specify)

TXA(grams IV):

Other (specify):

Other (specify)

Tetanus Given: Yes No

TIG Given: Yes No

**LINE** **ACCESS**

Vs:Type/

Loc(s)

Size

1O Infusion;Loc(s)

1. 2

Needle Decompression: ( RightLoc:

Left Loc:

Central Line: LOC

Type Trip Lumen Cordis

Uther

Chest Tube:

Vent Settinf

Mode:

FiOz

Other(specify):

Right

Left

RR

Size Output (mL)

TV: Peep

Uther:

**OTHER** **INTERVENTIONS:**

Eye Shield: 0S UD

C-Spine Immobilized

o C-SoineCeared PTA? O Yes Splints Placed:location)

1. 2.

OU

O No

Comments

Pelvic Binder

Foley Catheter

CPR Prior to Arrival:Start Time:

End Time:

Patient Last Name: First Name: MI:

Rank Patient ID/SSN DOB

Age: Gender: M F MOS/AFSC/NEC:

Unit: Facilty/Loc Team Type (ie.SRT,GHOST):

RN /Medic Name

Proyider Name

Signature

Date

DD Form#,20 Jan 2020

Page 1 of 2

**MASS** **CASUALTY**

**(MASCAL)IAUSTERE**

**PRIMARY**

**TRAUMA**

**SURVEY**

**TEAM** **RESUSCITATION** **RECORD**

**INITIAL**

Time

Temp:

CT

BP:

HR:

SpO2

Pain:

**VITALS** **SIGNS**

**AIRWAY:**

Stridor Obstructed Patent Drooling OPA/NPA BVM

Intubated

c Type:

]Other (specify):

**BREATHING**

Unlabored Absent

]Labored (describe):

**Breath** **Sounds:**

Clear: 〇L B

Trachea

Midline

Deviated

Chest Symmetry

Equal

Left >

Right>

Flail: R OL

CIRCULATION

Skin

Warm Cool Hot

C Pink C Pale Cyanotic

Dry Moist Diaphoretic

Heart Sounds

Clear Muffled

**Capillary** **Refill**

Equal

<2 Sec(nml) >2 Sec (delayed)

NEURO

GCS:

Eyes:

Verbal:

Motor:

Total

/4

/5

16

/15

O

RR

/10

A

Oc

CR

Rales CR

Wheeze: CR

Diminished: ORCL Absent CRQL

CL

CB CB

B OB

Extremities

Neuro Intact

Deficit:

**SECONDARY** **SURVEY**

**HEENT:**

**Pupils/Vision**

Unable to access

TMs:

Rupture

R B

Blood

R B

**C-SPINE**

C-Collar Placed Time placed:

Cleared

NormalExam,Reliable Pt

]NormalCT,NormalExam Not Cleared

**FAST** Neg Indeterminate

Pos,describe

eFAST Neg Indeterminate

Pos,describe

**INJURY** **DESCRIPTION**

**(AB)rasion**

(**AMP)utatio**n

**(AV)ulsion**

(**BL)eeding**

(B)urn %TBSA

(**C)repitus**

(**D)eformity**

(DG)Degloving

(E)cchymosis

(EV)isceration

(FX)Fracture

(F)oreign Body

(GSW)Gun Shot Wound (H)ematoma

(LAC)eration

(PW)Puncture Wound (SS)Seatbelt Sign (SW)Stab Wound

(P)ain

(PP)Peppering

![](/media/202412//1733383621.0185413.png)**R** L 1 R

ANTERIOR POSTERIOR

Pulses Present

S=Strong

W=Wea

D=Dopple

A=Absent

R L

![](/media/202412//1733383621.0284982.jpeg)

Reactive: R

NR: R L sire mm Eye Shield:R

B

mm

**VITAL** **SIGNS**

Time

BP

HR RR

SpO2 Pain GCS Temg

**1AB** **RESULTS:**Time

attach iStat labs if prefer

![](/media/202412//1733383621.0481641.png)

**MEDS** **GIVEN**

Time

Medication Dose

Route

IV/IO ACCESS: Time

IV/IO

Size

LOC

g

![](/media/202412//1733383621.0616355.jpeg)

ABG/VBG(circle/select)

BLOOD

Type

PRODU

#Units

CTS/FLUIDS

Total

PTA+now

Type #Units

Total

PTA+now

pH

pCO²

pO2

Rlood Type

Other

BE

HCO3

Ca

**PROCEDURES:**

02 |x

Time

Lpm NC NRBBVM

Size: cm @teeth

BBS Post Intubation Vent Mode

PEEP Fi02:

R 〇L

Air Blood mL

Air Blood

Loc(s): Time off:

Oral Nasal

WB:

RBCs

Fluids:Type

Type

!Plasma

Plts

Volume

EI Intubation

EICO2 Change RB TV:

Cric

Needle D

Chest Tube

lourniquet

Gastric Tube

Thoracotomy

A-Line

Urinary Cath

REBOA

**RADIOLOGY**

Xrays

C-Spine

CXR

KUB

Pelvis

Extremity

Upperright Upper left

〇Lower right 〇 Lower left

CI

Pan

Head

C-Spine

Chest

Abd/Pelvis Other

Radiology Results

**DISPOSITION**

Date Time

Admit OR ICU ICW

RTD Fu )trs Profile

DEATH: Time:

Mechanism of Death

Loc(s) Size

Clamshell

Amt

Diagnoses/Plan

**EVACUATION:**

Prioirity. Urgent

Priority

Routine

Evacuated to

Mode:

Ambulatory

Litter

Other:

HN/Coal Fac::

Type

AE MEDEVAC

CCATT CASEVAC

Ambulance

Patient Last Name:

Unit

First Name:

Facility/Loc:

MI ID/SSN

Team Type (i.e.SRT,GHOST):

RN/Medic Name

Provider Name:

Signature

Date

DD Form#,20 Jan 2020

Page 2 of 2

大规模伤亡（Mascal）创伤小组复苏记录 （英文）MASS CASUALTY (MASCAL)IAUSTERE TRAUMA TEAM RESUSCITATION RECORD

大规模伤亡（Mascal）创伤小组复苏记录（英文）MASS CASUALTY (MASCAL)IAUSTERE TRAUMA TEAM RESUSCITATION RECORD