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50 Cards in this Set
- Front
- Back
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What is the leading cause of preventable death on the battlefield.
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Hemorrhage
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What percent of combat fatalities occur forward of medical care?
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90%
* Half of these casualties bleed to death,1/5 from extremity trauma (10%–15% of all deaths). |
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If you must remain under fire, stop external bleeding with?
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Use of a tourniquet
* Do not endanger the casualty or yourself with unnecessary treatment. Stay engaged in the firefight if necessary. Keep Your Head Down* |
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What is the most effective and
preferred method of hemorrhage control? |
Direct pressure at site of injury
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If direct pressure fails to stop the hemorrhage, it signifies?
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Deep, massive, or arterial injury, and will require surgery or advanced hemostatic agents.
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Apply direct pressure to the wound for how long before looking to
see if it is effective. |
At least 5 minutes
* Impaled foreign bodies should not be removed because profuse bleeding may occur. |
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What are the negative factors of bandages?
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A Bandage Does Not Equal Direct Pressure!
A bandage may wick blood from the wound without stopping the bleeding. A bandage hides ongoing bleeding. |
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__________ bandages currently being developed may stop bleeding.
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Hemostatic
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What will decrease most bleeding besides direct pressure?
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Elevation
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what method of hemostasis is more likley to cause additional injury than to control bleeding?
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Blind clamping
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how long may it take to provide hemostasis when compressing at a pressure point?
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20 mins.
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What is the pressure point and artery for the hand?
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Wrist
Radial/ulnar |
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What is the pressure point and artery for the forearm?
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inner upper arm
Brachial |
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What is the pressure point and artery for the lower arm?
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Axilla
Axillary |
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What is the pressure point and artery for the leg?
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Behind the knee
Popliteal |
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What is the pressure point and artery for the thigh?
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Below the groin crease
Femoral |
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If direct pressure, elevation, or point compression don't work then apply what?
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A tourniquet
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what are the placement rules for application of a tourniquet on the forearm and the leg?
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1. The tourniquet can not compress the vessels, which lie between the double long bones.
2. Place tourniquet on upper arm for upper extremities 3. If bleeding of the lower extremity can be be controlled by tourniquet on the leg then move to the thigh. |
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Application of a tourniquet for longer than _____ will increase limb loss.
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2 hours
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What may be used to clamp a vessel if the damage is easily identified?
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Hemostat
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What will decrease bleeding associated with fractures and soft tissue injuries by aligning, stabilizing, and returning limb to length?
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Limb Splints
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What does MAST stand for?
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Military Anti-Shock Trousers
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What are the possible uses for MAST? (Military Anti-Shock Trousers)
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1. Controls hemorrhage form mangled lower extremities
2. Provides temporary stabilization of pelvic fractures to decrease hemorrhage 3. Splints fractures of the lower extremities |
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What are the possible pitfalls of MAST? (Military Anti-Shock Trousers)
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1. Protracted MAST use leads to compartment syndrome and ischemic limbs
2. Respiratory compromise due to diaphragmatic elevation 3. Increased torso bleeding 4.requires close monitoring in aircrafts due to pressure changes |
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When ongoing direct pressure can not be applied, what should be used to control scalp bleeding?
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Compression dressing
* Requires circumferential head application |
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True or False? it is difficult to apply and maintain direct pressure to scalp injuries?
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True
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True or False? a readily identified bleeding vessel CANNOT be clamped, and the wound should generally be explored FIRST before applying direct pressure.
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False! A readily identified bleeding vessel CAN be clamped, but the wound should generally NOT be explored.
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True or False? avoid pushing fragments of the brain when applying direct pressure, but control bleeding even at the expense of the exposed brain.
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True
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Protection of exposed brain with what can minimize injury?
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Nonadherent gauze or plastic
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True or False? Internal blood loss into the abdomen or chest must be controlled in the field.
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False! Blood loss into the abdomen or chest cannot be controlled in the field and requires immediate
evacuation for salvage or definitive surgery. |
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What may reduce pelvic bleeding besides stabilization of pelvic fracture with MAST garment?
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Wrapping the pelvis tightly with a wide strap (such as a folded sheet)
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Open torso injuries. If direct pressure does not stop the hemorrhage, consider doing what method?
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inserting a tamponade with a balloon (Foley) catheter into the wound, and then with balloon inflated pulling back to compress
the bleeding site. |
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Name four benefits of dressings.
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1. They promote hemostasis
2. They protect wounds from mechanical injury and contamination 3. They immobilize tissues 4. They provide physical and psychological support to the patient. |
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What must be asses before and after applying a dressing or bandage?
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Neurologic status and circulation of extremity
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True or False? When reinforcing a dressing If at all possible, DO NOT remove the first dressing.
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True
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If the dressing becomes thoroughly saturated,reevaluate the wound for a source of bleeding amenable to direct pressure, and consider what?
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advanced hemostatic agents or a proximal tourniquet.
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What factors may lead to inability to form a blood clot?
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1. Bloodloss
2. Massive fluid resuscitation 3. Drop in body temperature |
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What four things should you remember concerning Coagulopathy?
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1. Keep patient warm (above34°C).
2. Use warm fluids. 3. Use crystalloid fluids sparingly. 4. Transfuse with fresh whole blood (lessthan24hold). |
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An advanced hemostatic agent is used after a tourniquet has been placed. What should you concerning the tourniquet?
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the tourniquet may be carefully removed after the agent has achieved hemostasis and the wound observed for hemorrhage. If hemorrhage recurs, return to the tourniquet.
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what two agents are recommended by the US Tactical Combat Casualty Care Committee?
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1. HemCon
2. QuikClot |
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If standard measures such as elevation and pressure dressings do not control bleeding, it is recommended that tourniquet be used and that the first agent be _____ . If this dressing fails, it should be removed and ______ used if the bleeding is life threatening.
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HemCon then QuikClot
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If the bleeding is external and not at a site where a tourniquet can be applied, what can be used if conventional pressure dressings fail.
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HemCon and QuikClot
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What dressing is a firm 4 x 4 inch dressing that is sterile and individually packaged. It works by adherence to the bleeding wound and has some vasoconstrictive properties.
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HemCon
* The blood and clot in the wound should be removed before application. |
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What is QuikClot?
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A granular zeolite that absorbs fluid and causes hemostasis. It has handling properties similar to sand.
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Pressure must be applied for how long at the bleeding site, after application of a hemostatic dressing?
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3–5 minutes
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What are the six field hemostatic dressings considerations?
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1. Use should be delayed until after a trial of conventional dressings.
2. Do not use on minor injuries. 3. Use on internal wounds is not yet recommended. 4. Must apply pressure to the bleeding site after application. 5. Risk of inadequate contact of HemCon to the bleeding tissues in deep wounds. 6. Heat generation from QuikClot. |
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Controlled resuscitation (hypotensive resuscitation). Resuscitation as a method of hemorrhage control. The needs of organ perfusion must be carefully balanced against the risk of increased bleeding as blood pressure rises. Excessive fluid resuscitation may increase bleeding and rebleeding. Prior to definitive hemorrhage control, a lower-than-normal blood pressure may be accepted. Small volumes of resuscitation fluid are still required in those casualties with decreased mentation due to hypotension (ie, decreased or absent radial pulse).
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Controlled resuscitation (hypotensive resuscitation). Resuscitation as a method of hemorrhage control. The needs of organ perfusion must be carefully balanced against the risk of increased bleeding as blood pressure rises. Excessive fluid resuscitation may increase bleeding and rebleeding. Prior to definitive hemorrhage control, a lower-than-normal blood pressure may be accepted. Small volumes of resuscitation fluid are still required in those casualties with decreased mentation due to hypotension (ie, decreased or absent radial pulse).
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