TCCC/TECC

Question 1

What does Skin provide?

Answer 1

Protects the body from the environment and organisms

Helps regulate body temperatures

Senses heat, cold touch, pressure

Question 2

Normal blood volume

Answer 2

5 liters

Question 3

-.5 Liters of blood

Answer 3

Mental State: Alert

Radial Pulse: Full

Heart Rate: Normal or increased

Systolic Blood Pressure: Normal

Respiratory Rate: Normal

Going to die from this? No

Question 4

-1 Liter of Blood

Answer 4

Mental State: Alert

Radial Pulse: Full

Heart Rate: 100+

Systolic Blood Pressure: Normal lying down

Respiratory Rate: May be normal

Going to die from this? No

Question 5

-1.5 Liter of Blood

Answer 5

Mental State: Alert but anxious

Radial Pulse: May be weak

Heart Rate: 100+

Systolic Blood Pressure: May be decreased

Respiratory Rate: 30

Going to die from this? Probably not

Question 6

-2.0 Liter of Blood

Answer 6

Mental State: Confused/lethargic

Radial Pulse: Weak

Heart Rate: 120+

Systolic Blood Pressure: Decreased

Respiratory Rate: .>35

Going to die from this? Maybe

Question 7

-2.5 Liter of Blood

Answer 7

Mental State: Unconscious

Radial Pulse: Absent

Heart Rate: 140+

Systolic Blood Pressure: Markedly decreased

Respiratory Rate: 35

Going to die from this? Probably

Question 8

Physicians need how many intubations

Answer 8

3

Question 9

NPA, OPA

Answer 9

Nasal Pharyngeal Airway,

Oral Pharyngeal Airway

Question 10

Complication of failing to ventilate.

Answer 10

Death or worse

Question 11

Abdomen

Right Upper Quadrant (RUQ)

Answer 11

• Gallbladder

- Liver

Question 12

Abdomen

Left Upper Quadrant (LUQ)

Answer 12

• Stomach
• Spleen
• Pancreas
• Esophagus

Question 13

Abdomen

Right Lower Quadrant (RLQ)

Answer 13

• Large Intestine

- Appendix

Question 14

Abdomen

Left Lower Quadrant (LLQ)

Answer 14

• Small

- Intestine

Question 15

What are 2 big considerations when working on patients?

Answer 15

• Body type

- Age

Question 16

In tactical combat casualty care rendering care is

Answer 16

the secondary mission

Question 17

Your first priority under fire

Answer 17

is to return fire

Question 18

90% of combat deaths

Answer 18

occur on the battlefield before the casualties reaches medical care

Question 19

15-18% of casualties that die before reaching medical care can be saved by

Answer 19

• Stopping severe bleeding (hemorrhage)
  
  • Relived tension pneumothorax
  • Restore airways
    MARCH:
    *Massive Hemorrhage, Airways, Respirations, Circulation, Hypothermia/Head Trauma

Question 20

.Lethal Triad

Answer 20

.Lethal Triad concentration
***Coagulation system: A temperature and pH dependent series of complex enzymatic reactions that result in the formation of blood clots to stop both internal and external hemorrhage

Question 21

Tactical Combat Casualty Care (TCCC )/Tactical Emergency Casualty Care (TECC) is divided into 3 phases (at any time the phases can change)

Answer 21

• Care Under Fire (1st Phase)
  You are under effective hostile fire and are very limited to the care you can provide. Primary objective is to stop life threatening bleeding using a tourniquet and moving casualty to cover
  
  • Take co er and return fire
  • Direct or expect casualty to remain engaged as a combatant
  • Direct casualty to move to cover and apply self-aid
    -try to keep casualty from sustaining any additional wounds
  • Tactical Field Care (2nd Phase)
    In this you and the casualty are no longer under effective enemy fire
    M.A.R.C.H/H
    - Massive Hemorrhage
    - Airway
    - Respirations
    - Circulation
    - Hypothermia/Head Trauma
  • Tactical Evacuation Care (3rd Phase)
    You render care during casualty evacuation
    - Recheck all previous interventions
    - Head to toe checks
    - Continuous monitoring
    - Document care
    - Package casualty for transport

Question 22

Before Approaching the Casualty

Answer 22

• Determine the best route of access and the best route of egress
  
  • Request covering fire to reduce the risk to you and the casualty
  • Anticipate the type of injuries the casualty may have received and what care is needed.
• If you decide to move the casualty (and yourself) to a safer location, and take the causality’s weapon and other mission essential equipment

Question 23

Massive Hemorrhage

Answer 23

• Not all massive hemorrhages are going to be spurting
  
  • Look in the area where major arteries are
  • Not all major bleeds are exposed
  • Control the Bleeding
  • Ensure there is no distal pulse on injured extremity
  • If there is a pulse, an additional tourniquet might be required

Question 24

Two types of Tourniquets

Answer 24

• Combat Application Tourniquet (CAT)

- Special Operations Forces – Tourniquet (SOF-T)

Question 25

Check the casualty for Responsiveness

Answer 25

- Ask casualty if it hurts or if they feel different (if conscience)

Question 26

Reassess Hemorrhage

Answer 26

- Reassess prior hemorrhage controls - Expose and assess wound. - Apply tourniquet 2-4 inches above the wound (High as possible) - Check distal pulse if the situation permits. - Appy a hemostatic agent or pressure bandage if tourniquet is not needed.

Question 27

Airway

Answer 27

- Head tilt chin lift - look for obstructions - Start interventions OPA, can only be used when the causality is unconscious or NPA if unable to sustain breathing alone

Question 28

Tension Pneumothorax (symptoms)

Answer 28

- Monitor Casualty’s respirations - Perform needle chest decompress - Insert 10-14 gauge 2.13 in the needle catheter into the 2nd inner costal space also the 4th and 5th inner costal space along the Anterior Axillary Line.

Question 29

Circulation

Answer 29

- Thorough blood sweeps and dress all wounds -Gain IV access Radial pulse is> 80mmHG Femoral pulse is >70mmHG Carotid pulse > 60 - Check Skin color, condition and temperature and capillary refill

Question 30

Hypothermia (Symptoms)

Answer 30

- Confusion, memory loss, or slurred speech - Drop in body temperature below 95*F - Exhaustion or drowsiness - Loss of consciousness - Numb hands or feet - Shallow breathing - Shivering

Question 31

CPT Frank Butler

Answer 31

“If during the next war you could only o two things (1) put a tourniquet on an (2) relieve a tension pneumothorax then you can probably save between 70-90% of all the preventable deaths on the battlefield.