战术战地救护教员指南 3E 伤员后送准备和要点 INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS

![](/media/202412//1733388774.7914236.jpeg)I**NSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

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1.

**TacticalCombat** **Casualty** **Care** **for** **Medical** **Personne**

**August** **2018**

![](/media/202412//1733388774.8177698.jpeg)(Based on TCCC-MP Guidelines 180801)

Tactical Field Care 2c

**Hypothermia** **Prevention**

**Tactical** **Combat** **Casualty** **Care** **for** **Medical** **Personnel**

**August** **2018**

**(Based** **on** **TCCC-MP** **Guidelines** **180801)**

**TacticalField** **Care** **3e**

**Preparing** **for** **Casualty** **Evacuation** **and** **Key** **Points**

In this presentation we will discuss preparation for CASEVAC and review some of the key points in TFC.

2.

![](/media/202412//1733388774.8450985.png)**Disclaimer**

“The opinlons or assertions containel herein are he prhae weHs the ahor andare o be constrwed s

icial or as rylecring the viehs ofthe Deparims可th Armj Air Forcs,Ma ar the Depare可Defensa"

There are no co/ict可inierei dickorurs

**Disclaimer**

**“The** **opinions** **orassertions** **containedherein** **are** **the** **private** **views** **of** **the** **authors** **and** **are** **not** **tobe** **construed** **as** **official** **o**r **as** **reflectingthe** **views** **of** **the** **Departments** **ofthe** **Army,Air** **Force,Navy** **or** **the** **Department** **ofDefense.** **”**

**There** **are** **no** **conflict** **ofinterest** **disclosures**

Read the disclaimer.

3.

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**LEARNING** **OBJECTIVES**

Terminal Learning Objective

Perform preparation of casualties for evacuation in Tactical Field Care.

Enabling Learning Objectives

Identify the importance and considerations of preparing casualties for evacuation in tactical field care

Identify critical actions and checks to prepare casualties for evacuation.

Read the text.

Terminal Learning Objective

Perform preparation of casualties for evacuation in Tactical Field Care

Enabling Learning Objectives

Identify the importance and considerationsof

preparing casualties for evacuation in tactical

Oeld care

**Identify** **critical** **actions** **and** **checks** **to** **prepare**

casualties for evacuation

![](/media/202412//1733388774.9261017.jpeg)I**NSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 18080**1

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4.

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**LEARNING** **OBJECTIVES**

Enabling Learning Objectives

·Identify factors in litterselection and evacuation equipment in

Tactical Field Care

·Identify considerations for the evacuation of

ambulatory/walking wounded casualties in Tactical Field Care ·Identify considerations and fundamental procedures for staging casualties for evacuation at any location or platform

Read the text.

Enabling Learning Objectives

·Identify factors in litter selection and

evacuation equipment in Tactical Field Care

·Identify considerations for the evacuation of ambulatory/walking wounded casualties in

Tactical Field Care.

·Identify considerations and fundamental

procedures forstaging casualties for

evacuation atany location or platform.

5.

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**LEARNING** **OBJECTIVES**

Enabling Learning Objectives

·Identify the importance of pre-mission evacuation equipment preparation and rehearsals.

·Describe the preparation ofa casualty for evacuation in Tactical Field Care.

Read the text.

Enabling Learning Objectives

**Identify** **the** **importance** **ofpre-mission**

evacuation equipment preparation and

**rehearsals**

Describe the preparation of a casualty for

**evacuation** **in** **Tactical** **Field** **Care**

6.

![](/media/202412//1733388774.9748342.jpeg)

**Tactical** **Field** **Care** **Guidelines**

19.Prepare for Evacuation

a.Complete and secure the TCCC Card (DD 1380)to the casualty.

b.Secure all loose ends of bandages and wraps.

c.Secure hypothermia prevention wraps/blankets/straps

d.Secure litter straps as required.Consider additional padding for long evacuations.

These are things you should do to get the casualty readyto board the evacuation platform.

Read the guidelines.

**19.Prepare** **for** **Evacuation**

**a.Complete** **and** **secure** **theTCCC** **Card** **(DD** **1380)**

**to** **the** **casualty.**

**b.Secure** **all** **loose** **ends** **of** **bandages** **and** **wraps**

c.Secure hypothermia prevention

wraps/blankets/straps

d.Secure litter straps as required.Consider additional padding for long evacuations.

![](/media/202412//1733388774.9885666.jpeg)IN **STRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 18080**1

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**Tactical** **Field** **Care** **Guidelines**

**19.Prepare** **for** **Evacuation(cont)**

e.Provide instructions to ambulatory patients as needed

f.Stage casualties for evacuation in accordance with unit standard operating procedures

g.Maintain security at the evacuation point in accordance with unit standard operating procedures.

Read the guidelines.

**19.Prepare** **for** **Evacuation** **(cont)**

**e.Provide** **instructions** **to** **ambulatory** **patients** **as**

needed.

f**.Stagecasualties** **for** **evacuation** **in** **accordance** **with** **unitstandard** **operating** **procedures.**

g.**Maintain** **security** **at** **the** **evacuation** **poin** **i**n **accordance** **with** **unit** **standard** **operating**

**procedures**

8.

![](/media/202412//1733388775.0265508.jpeg) **Tactical** **Field** **Care** **Guidelines**

19.Preparefor Evacuation(cont)

e.Provide instructions to ambulatory patients

as needed

f.Stagecasualties for evacuation in

accordance with unit standardoperating procedures

g.Maintain secuity at the evacuation point in accordance with unit standardoperating

procedures.

**Secure** **Loose** **Ends**

·Secure all loose ends ofbandages,wraps and hypothermia prevention materials.

Consider padding for long evacuations.

Secure all loose ends of bandages,medical equipment and

hypothermia prevention materials.You need to prevent

dressings and other medical items from being blown around by rotor wash or becoming entangled with other equipment. Loose materials can catchon everything from tree limbs to body armor of litter bearers to parts of aircraft or vehicles. Any snag like this can cause delays in evacuation or even further injury to patients or providers.

Blankets and foil-based hypothermia materials are especially susceptible to being caught in the wind.

9.

![](/media/202412//1733388775.0402918.jpeg) **Packagethe** **Casualty**

·Secure the casualty's weapons/equipment as required

![](/media/202412//1733388775.053945.jpeg)

**Package** **the** **Casualty**

Secure the casualty's weapons/equipment as required

Secure the casualty's weapon and equipment in accordance with unit SOP or missionrequirements.

Clear and render safe anyweapons evacuated with the casualty.

Do not evacuate explosives with the casualty ifpossible.

Keep in mind that receiving medical personnel may not be familiar with the equipment or have a way to secure it.

![](/media/202412//1733388775.0706935.jpeg)**INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

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10.

![](/media/202412//1733388775.1117096.jpeg) **Prep** **for** **Evacuation**

·Evacuation equipment should be prepped by

unit personnelwhile treatment continues

![](/media/202412//1733388775.1243968.jpeg)

**Prep** **for** **Evacuation**

Evacuation equipment should be prepped by unit personnel while treatment continues.

Coordinate activities to save time.

Other unit members can prepare litters and evacuation equipment while you provide treatment.

Do not delay getting casualties onto litters.

You can better prevent hypothermia by getting casualties off of the ground.

If tactical situation developments demand a rapid movement of casualties,it is easier to move them ifthey're already on litters.

11.

![](/media/202412//1733388775.143133.jpeg)

**Prep** **for** **Evacuation**

Casualty movement in TFC may be better accomplished using litters.

Remember that we used carries and drags in Care Under Fire

We did it that way to get the casualtyto cover as quickly as possible.

Now we have time to use litters.

Litters are usually better for moving a casualty a long distance.

Casualties do NOT have to be placed supine on a litter.The

litter exists only to facilitate casualty movement.The casualty can be placed in the best position that facilitates their care and comfort.The casualty must,however,be secured to litter prior

to movement.

![](/media/202412//1733388775.1720073.jpeg)Casualty movement in TFC may be better

accomplished using litters

12.

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**Litter** **Selection**

·Selection is based on the mission and the unit type.

·Rigid litters work better than pole-less or improvised.

Consider terrain and obstacles in the operating area.

The unit should plan for ahead of time for how it will move casualties in the operating environment.Unit members should be trained on the chosen equipment.

Selection is based on the mission and the unit type *Rigid litters work better than pole-less or improvised

![](/media/202412//1733388775.1984012.jpeg)·Consider terrain and obstacles in the operating area

![](/media/202412//1733388775.2348905.jpeg)INSTRUCTOR GUIDE FOR **TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

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**13.**

![](/media/202412//1733388775.2864819.jpeg)**Be** **Prepared** **for** **the**

**Operating** **Environment**

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**Be** **Prepared** **for** **the** **Operating** **Environment**

**A** **pole-less** **litter** **is** **great** **as** **a** **contingency** **item** **in** **a** **rucksack,** **but** **will** **not** **be** **as** **efficient** **as** **a** **poled** **litter** **in** **carrying** **a** **casualty.**

**A** **Skedco** **is** **a** **great** **tool** **for** **moving** **over** **land** **on** **snow,but** **can** **literally** **become** **a** **runaway** **sled** **ifcontrol** **is** **lost.**

14.

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**Evacuation** **Equipment**

·All unit members should know how to open and set up litters and rehearse their use during pre-mission training.

·All unit members should know who will carry litters and/or where litters are located on vehicles.

Read the text.

All unitmembers should know how to open andset up litters and rehearse theiruse duringpre-mission

traing

·All unit members shouldknow who will carry litters

![](/media/202412//1733388775.3774736.jpeg)and/orwhere hitters are located on vchicles.

15.

![](/media/202412//1733388775.3869596.jpeg) **Package** **theCasualty**

Secure litter straps

![](/media/202412//1733388775.4009218.jpeg)-Knowyour litter!Does ithaveattached strapsor does it need supplementary strapping?

**Package** **the** **Casualty**

·Secure litter straps.

-Know your litter!Does it have attached straps,ordoes it need supplementary strapping?

Read the text.

![](/media/202412//1733388775.4211287.jpeg)![](/media/202412//1733388775.4652503.jpeg)**INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

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**16.**

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**Package** **theCasualty**

**Package** **the** **Casualty**

**Hypothermia** **prevention** **equipment** **should** **be** **tucked** **and**

**secured** **beneath** **the** **casualty** **and** **litter** **straps.Loose** **edges** **can** **be** **caught** **up** **in** **wind** **or** **rotor** **washor** **snagged** **on** **objects** **in** **the** **helicopter** **as** **the** **casualty** **is** **loaded** **aboard.**

17.

![](/media/202412//1733388775.5039978.jpeg)

Provide putients

**Walking** **Wounded**

instructions orassistance to ambulatory

as needed

**Walking** **Wounded**

·Provide instructions or assistance to ambulatory patients as needed.

·Depending on the nature oftheir injuries,they may be able to assist with carrying litters or providing security.

·Best to guide disoriented or visually impaired casualties hand- to-shoulder to the evacuation platform.

·Instruct them on repeatedlychecking their own wounds and dressings to ensure that bleeding remains controlled

Read the text

Depending onthe natureof their injuries,theymay be able to assist with carrying litters or providing security ·Bestto guidedisorientedor visually impaired

casualties hand-to-shoulder to the evacuation platform Instruct them on repeatedly

![](/media/202412//1733388775.5170815.jpeg)checking their own woundsand

dressings to ensure thatbleeding

remains trolled.

18.

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**Stage** **Casualties** **for** **Evac**

**Stage** **Casualtiesfor** **Evac**

·Be prepared for the arrival of the evacuation platform ● Stage the casualties in the loading sequence ofthe evacuation platform.

Many units use tagging or color-coded chemlights to identify casualty evacuation categories.

·Be prepared for the arrival of the evacuation platform.

·Stage the casualties in the loadingsequence of the evacuation platform

![](/media/202412//1733388775.547444.jpeg)

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**INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

19.

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**Instructions** **from**

**PlatformCrew**

**Instructions** **from** **Platform** **Crew**

Take direction from the crew of the evacuation platform on approaching the platform,loading casualties,and tumover with receiving medics.

Read the text.

Take direction from the crew of the evacuation

platform on approaching the platform,loading

casualties,andturnoverwith receiving medics.

![](/media/202412//1733388775.6125655.jpeg)

20.

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Maintain security at theevacuation point in accordance with unit SOP.

**SECURITY**

![](/media/202412//1733388775.6323564.jpeg)

**SECURITY**

Maintain security at the evacuation point in accordance with unit SOP.

Read the text.

21.

![](/media/202412//1733388775.642677.jpeg) **Litter** **Carry** **Video**

![](/media/202412//1733388775.652486.jpeg)·Secure the casualty

on thelitter

·Bring hisweapons

·Maintain security

pr Bogine

**Litter** **Carry** **Video**

·Secure the casualty on the litter

·Bring his weapons.

·Maintain security

Click on the photo to play the video.

Remember -Don't let the casualty fall off the litter!

![](/media/202412//1733388775.664254.jpeg)

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**INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

**22.**

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**Questions?**

23.

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**Further** **Elements**

**of** **Tactical** **Field** **Care**

**Further** **Elements** **ofTactical** **Field** **Care**

·Reassess regularly.

·Minimize removal ofuniform and protective gear,but get the job done

Replace body armor after care,or at least keep it with the

casualty.He or she may need it again if there is additional contact.

A few final points...

·Reassess regularly.

·Minimize removal of uniform and protective gear,but get the job done.

·Replace body armor aftercare,or at least

keep it with the casualty.He or she may need it again if there is additional contact.

24.

![](/media/202412//1733388775.708146.jpeg)

**Summary** **of** **Key** **Points**

**in** **Tactical** **Field** **Care**

·Stillin a hazardous environment

Limited medicalresources

Hemorrhage control

Airway managemen

Breathing-treatsuspected tenslonpneumothorax Transition from tourniquetto another form of hemorrhage control when appropriate

Use TXA for casualties in or atrisk o shock

For hemorrhagie shock,resuscitate with blood products

per the TCCC Guidelines when they are available

·Hypotensiveresuscitation with Hextend for hemorrhagie

shockwhen blood products are notavailable

**Summary** **of** **Key** **Points** **in** **Tactical** **Field** **Care**

·Still in a hazardous environment

·Limited medical resources

·Hemorrhage control

·Airway management

·Breathing-treat suspected tension pneumothorax

·Transition from tourniquet to another form ofhemorrhage control when appropriate

·Use TXA for casualties in orat risk of shock

·For hemorrhagic shock,resuscitate with blood products per the TCCC Guidelines when they are available

·Hypotensive resuscitation with Hextend for hemorrhagic shock when blood products are not available

TFC takes place in a hazardous environment.

The enemy may be close,and medical care may be far away.

There is more time here than in Care Under Fire,but still,you should do only those aspects of care that are really important.

Remember that your unit may have to move quickly at short notice

![](/media/202412//1733388775.727872.jpeg)

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IN **STRUCTOR GUIDE FOR TACTICAL FIELD CARE 3E PREAPRING FOR CASUALTY EVACUTION AND KEY POINTS 180801**

25.

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**Summaryof** **Key** **Points** **in** **Tactical** **Field** **Care**

**Summary** **of** **Key** **Points** **in** **Tactical** **Field** **Care**

**·Hypothermia** **prevention**

**·Shield** **and** **antibiotics** **for** **penetrating** **eye** **injuries** **·Pain** **control** **using** **the** **TCCC** **Triple-Option** **Analgesia** **strategy**

**·Antibiotics** **for** **all** **open** **wounds**

**·Treat** **burns**

**·Reassure** **casualties**

**·No** **CPR** **in** **this** **phase** **of** **care**

**·Bilateral** **NDC** **for** **casualties** **with** **torso** **trauma** **who** **lose** **vital** **signs**

**·Documentation** **of** **care** **on** **the** **TCCC** **Casualty** **Card**

Review these elements of TFC.

**Hypothermia** **prevention**

**Pa**![](/media/202412//1733388775.7593062.png)**rategya** **rol** **using** **ctipOpt**![](/media/202412//1733388775.7689257.png)![](/media/202412//1733388775.778609.png)**esla**

**An** **biotics** **for** **all** **openwounds**

**Treat** **burns**

**Reassure** **casualties**

**iaceaiNDCToresalis** **wt** **tarso** **raumawho**

**·Documentationof** **are** **on** **the** **TcCC** **Casualy** **Card**

26.

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**Questions?**

![](/media/202412//1733388775.7989774.jpeg)

**Questions?**

**Wear** **your** **body** **armor!**