Tier 3 Curriculum 011

This casualty was near a drone explosion that occurred 14 minutes ago. You started by providing Care Under Fire, where you saw MASSIVE HEMORRHAGE from both of the patient’s legs. You placed two hasty high and tight tourniquets. Then you moved the patient to safety were able to treat the right lower extremity hemorrhage and take the tourniquet down. You replaced the left lower extremity tourniquet with a deliberate tourniquet. The patient is maintaining their AIRWAY for now. The patient’s chest is clear, and they do not have a RESPIRATORY injury. You identified that the patient’s pelvis was unstable and placed a pelvic binder. You just rechecked the patient’s pulse, and it is still increasing. The patient also seems a little less alert; they were VERBAL on the AVPU scale. The patient has a bruise behind their ear, some bleeding from the ear and mild head trauma on the forehead. Also, their skin feels a bit clammy as it is cold and sweaty. You are still worried the patient is entering shock. You now have two 18 gauge intravenous lines. You already have gloves on. It will take at least two hours to get the patient to a higher level of care. You are at a Casualty Collection Point that has a cooler stocked with a full range of blood products.

The primary learning objective is to continue reviewing more advanced approaches to managing hemorrhagic shock in the CIRCULATION section of MARCH, focusing on the use of blood products for resuscitation. The estimated time to complete this scenario is 15 minutes. This scenario occurs in the Tactical Field Care Phase.