1. PRIMARY SURVEY

2. CARE UNDER FIRE 1. Scene Assessment  Return fire as directed or required  Casualty should return fire if able  Keep yourself from getting shot  Prevent additional wounds to casualty  Maintain situational awareness! 2. Quickly Identify and Control Severe Bleeding With a Tourniquet 3. Move the Casualty to Cover

3. TACTICAL FIELD CARE 1. Primary Survey A - A irway B - B reathing C - C irculation D - D isability E - E xpose/ E nvironment

4. TACTICAL FIELD CARE A - A irway  Check for patent airway  Open with manual methods as needed  Insert simple airway adjunct if needed

5. TACTICAL FIELD CARE B - B reathing  Check for breathing, respiratory rate/depth  Check for tension pneumothorax and perform needle decompression if needed  Inspect/palpate entire thorax and seal open chest wound (Asherman Chest Seal) if needed

6. TACTICAL FIELD CARE C - C irculation  Check for pulse presence, quality, rate, and rhythm & skin capillary refill time, color, temperature, and moisture  Check for and control remaining external hemorrhage using necessary means 1) Pressure Bandage (Kerlex/Trauma Dressing) 2) Tourniquet

7. TACTICAL FIELD CARE C - C irculation (Cont’d)  Initiate fluid resuscitation as per: 1 - Controlled bleed/no shock=saline lock only 2 - Controlled bleed/shock=saline lock & IV fluids 3 - Uncontrolled bleed=saline lock

8. TACTICAL FIELD CARE D - Disability  Check level of consciousness: A - Alert V - responds to Verbal stimulus P - responds to Painful stimulus U - Unresponsive

9. TACTICAL FIELD CARE E - Expose/Environment  Expose only as needed for survey  Protect from the environment and prevent hypothermia

10. TACTICAL FIELD CARE 2. Secondary Survey  Head-to-toe evaluation “Where my hands go, my eyes follow”  Reassess ABC’s  “Look, listen, and feel” See, don’t just look! Hear, don’t just listen! Feel, don’t just touch!

11. CASEVAC 1. Package and prepare for casualty evacuation  Non-ambulatory via SKEDCO litter or field expedient means  Ambulatory 2. Aid and litter teams 3. Security teams

12. Questions?