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www.ProlongedFieldCare.org Medical Planning Tool
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Couldn’t get a ventilator to bring?
Use the 10 Capabilities Grid to Figure out what capability you are deficient on and then Identify what asset in your AO has it available. Couldn’t get a ventilator to bring? Make finding one a priority in your planning and note it on your grid and map
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GAP 10 Essential PFC Capabilities - Example of GAP ID Minimum Better
1. Monitoring 2. Resuscitate 3. Ventilate and oxygenate 4. Control the Airway 5. Sedation and Analgesia 6. Physical Exam and Diagnostics 7. Nursing and Hygeine 8. Surgical Interventions 9. Telemedical Consult 10. Package and Prepare for flight Minimum BP Cuff, Stethescope, Pulse Ox, Foley Fresh Whole Blood Kit Bag-Valve-Mask with PEEP Valve Awake Ketamine Cric Opiate Analgesics titrated through IV Physical Exam without advanced clean, warm, dry, padded, catheterized Chest tube, cric Make comms, present patient and key vitals Be familiar with stressors of flight Better Capnometry 2-3 cases of LR for Burn Resus O2 Concentrator Long duration sedation Sedation with Ketamine/option of midazolam Ultrasound and point of care labs Elevate head of real beddebride, washout NG/OG Fasciotomy debridement, amputation Add labs and ultrasound video Trained in critical care transport Best Vital Signs Monitor PRBS, FFP, Type specific donors Portable Ventilator Proficient in Rapid Sequence Intubation Educated and practiced imulti drug sedation Experienced and trained in above Experienced in all nursing care concerns Trained and experienced in above Real time video conference Experienced in critical care transport Ruck Pulse Ox, Head Lamp 1 FWB Kit per man, 2 250cc bag NS BVM with PEEP Valve Cric Kit, LMA/SGA, lidocaine and ketamine IM Fentanyl TML, Perc PO, Ketamine IM/ IV Urinalysis test strips, fluorescein strips Compct Foley kit, Sterile kerlix, litter padding Cric, 10gNeedle D Scalpel Cell Phone and call sheet Have checklist available Truck BP Cuff, Stethescope, capnometry, small monitor Casre LR, Additional FWB Kits, 3% Saline SAVent or SAVE 2 RSI, LMA/SGA, Cric kit ketamine bag IV Ketamine IV with midazolam Blood tubes to drop off labs at HN clinic on the way Padded litter, NG, Sterile Chest Tube Kit with drapes Cell phone and call sheet, sat phone, radio Checklist plus flight evac kit House Add defibrillation 2 additional cases LR, Case NS, Additional 3% Saline No Ventilator; Available with SURG team at capitol GAP All from above Add Benzo if not available for truck Same as above No Lab capability; Available with SURG team at capitol Real matress with head elevated, nursing care kit sleeping bg Sterile Surgical Kit with Drapes, Gowns and scrub soap Secure comms, Extensive evac kit Plane Take all of above All of above SAVent on O2 All above calculate for flight and double All above calculate for flight time and double Padded Litter, Sleeping Bag 10g needle D Chest tube kit Cric kit Through aircraft From Above
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10 Essential PFC Capabilities
1. Monitoring 2. Resuscitate 3. Ventilate and oxygenate 4. Control the Airway 5. Sedation and Analgesia 6. Physical Exam and Diagnostics 7. Nursing and Hygeine 8. Surgical Interventions 9. Telemedical Consult 10. Package and Prepare for flight Minimum BP Cuff, Stethescope, Pulse Ox, Foley Fresh Whole Blood Kit Bag-Valve-Mask with PEEP Valve Awake Ketamine Cric Opiate Analgesics titrated through IV Physical Exam without advanced clean, warm, dry, padded, catheterized Chest tube, cric Make comms, present patient and key vitals Be familiar with stressors of flight Better Capnometry 2-3 cases of LR for Burn Resus O2 Concentrator Long duration sedation Sedation with Ketamine/option of midazolam Ultrasound and point of care labs Elevate head of real beddebride, washout NG/OG Fasciotomy debridement, amputation Add labs and ultrasound video Trained in critical care transport Best Vital Signs Monitor PRBS, FFP, Type specific donors Portable Ventilator Proficient in Rapid Sequence Intubation Educated and practiced imulti drug sedation Experienced and trained in above Experienced in all nursing care concerns Trained and experienced in above Real time video conference Experienced in critical care transport Ruck Truck House Plane
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Now on to the moving pieces…
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Team Members/ Organic Assets
Type and Name Telephone Radio Freq / Call Sign Medical Capabilities Limitations Special Equipment Senior Medic: John Smith 18D1 Junior Medic: RFR: TCCC/MARCH: CLS First Aid/Buddy Aid NO MEDICAL TRAINING (liabilities)
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Surgical Assets Type Of Team / Number Pax? Telephone /
Date Last checked Radio Freq / Call Sign Blood Available? Highest Trained Person Surgical Capabilities Surgical Limitations Able to Travel? How Far? With whom? Battalion FAS FWB Kits SOST MFST CSH Local Surgeon
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CasEvac Platforms Type Vehicle / Aircraft / Location Telephone
Date Last called Radio Freq / Call Sign Capablities / Distance / Speed / Equipment Limitations (Contract, Weather etc..) Military or Civilian? Country of Origin? Medic On Board? Contract Info Distance, Cash Other Good to Know Info Razor / ATV Team Truck HN Ambulance Civilian Helo Casa 212 Twin Otter Cessna
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Strategic Evacuation Platforms
Type Vehicle / Aircraft / Location Telephone Date Last called Radio Freq / Call Sign Capablities / Distance / Speed / Equipment Limitations (Contract, Weather etc..) Military or Civilian Contract Info Distance, Cash Other Good to Know Info C-146 C-130 C-17 Civilian Air Evac
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Refueling Stations / FARPs
Name Telephone / Date Last Checked? By Whom? Radio Freq / Call Sign Location Country / State / City / Address / Grid Manned? Limitations Evaluation Last Done. By whom? Other Good to Know Info MSS 1 MSS 2 Airstrip A Airstrip B Main Airport FARP I FARP II
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Telemedicine Contacts
Who Telephone / Date last checked Radio Freq / Call Sign Last time checked? By whom? Level of Training / Specialty Location
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Facilities Name Telephone / Date Last Checked? By Whom?
Radio Freq / Call Sign Location Country / State / City / Address / Grid Capabilities Surg? Blood? Imaging Limitations Evaluation Last Done. By whom? Other Good to Know Info MSS 1 MSS 2 Team House / Aid Station Battalion FAS CSH Local Clinic Local Hospital
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Add Regional Map And Locations
Clinic Coalition Med Facility / Team Host Nation Med Facility Air Port / Landing Strip Team Houses / Bases H LZ / FARP MSS 600km LZ 143 C-130 600km Range / Distance Scale
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Add Local Map and Locations
Clinic Coalition Med Facility / Team Host Nation Med Facility Air Port / Landing Strip Team Houses / Bases H LZ / FARP MSS H 50 km LZ 143 MI 17 Helo 50km Range / Distance Scale
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Medical Risk Slide Tool
Medical Concept Brief Phases of Operation Primary Alternate Contingency Emergency Reserve Treatment Facility Evacuation Regional Map Local Map Legend Legend Medical Risk Slide Tool “Golden Hour” Unconventional Warfare <1Hour 2-6 Hours 6-12 Hours >12 hours
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