CENTER FOR ARMY LESSONS LEARNED
•• Airway management: Consider the following for a casualty with a current or impending airway obstruction:
○○ Supraglottic airway (King LT, iGel, etc.). ○○ Endotracheal intubation (suction, Tube Tamer, bag-valve mask, bougie, GlideScope).
•• Respirations: ○○ Consider a chest tube insertion if the casualty has no improvement and/or if a long transport is anticipated. ○○ Administer oxygen when possible for the following types of casualties:
** Low oxygen saturation by pulse oximetry (shock, chest wound, etc.).
** Injuries associated with impaired oxygenation. ** An unconscious casualty. ** A casualty with TBI (maintain oxygen saturation over 90 percent).
** Casualty at altitude (over 5,000 feet above sea level).
•• Circulation: Continuously reassess IV or IO access for patency and security.
•• Head injury/hypothermia: ○○ Casualties with moderate to severe (penetrating) TBI should be monitored for:
** Decreases in level of consciousness. ** Pupillary dilation. ** SBP over 90 mmHg or mean arterial pressure over 60. ** Oxygen saturation (pulse oximetry) over 90 percent. ** Hypothermia (core temperature under 96 F [35.5 C]). ** Partial pressure of carbon dioxide (if capnography is available, maintained between 35 to 40 mmHg).
90