PFC Lecture Series Episode 1: Documentation In a Prolonged Field Care Situation

(Re-recorded for better audio quality)In this episode I talk about different documents and checklists available on www.prolongedfieldcare.org and ways they can help organize medical care for a critically injured patient in an austere and resource devoid environment.

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PFC Lecture Series Episode 1: Documentation In a Prolonged Field Care Situation

Created 3 years ago

Duration 0:24:12
lesson view count 118
(Re-recorded for better audio quality)In this episode I talk about different documents and checklists available on www.prolongedfieldcare.org and ways they can help organize medical care for a critically injured patient in an austere and resource devoid environment.
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Slide Content
  1. Slide 1

    • 38 hours until CASEVAC?!? Now what!?!
    • Prolonged Field Care
    • Downloadable Resources Subscribe Now
    • Instant Updates
    • www.ProlongedFieldCare.org
    • Improving Far Forward Medicine
    • www.ProlongedFieldCare.org
    • Why We Started This
    • -Fills gaps in current protocol and references
    • -Reach out and get a question answered by the community
    • -Download resources to any mobile device eReader
    • -Join the working group and let your voice be heard
    • -Your chance to contribute to your own training and
    • education before it becomes mandatory from above
    • -In partnership with SOF Medics and Docs in 40 countries
    • -Access to Training resources and Recommendations
    • Get the Info You Need Now!
    • PFC Videos on our YouTube Channel
    • 10 Essential Capabilities - you must have
    • Tourniquet Conversion Paper - Answers nagging questions
    • Analgesia and sedation Paper - Easy, long term sedation
    • Airway Recommendation Paper – Best practices
    • PEEP Valve - Are you using them?
    • Long-Term Patient Care Flowsheet – Easy to trend vitals
    • Fresh Whole Blood Trans. FAQs – Answered
    • Get
    • Prepared
    • @PFCwgMedicine
    • @FOAMedPFC
  2. Taking Aggressive “Upstairs”

    Slide 2 - Taking Aggressive “Upstairs”

    • Medicine…
    • Around the World.
    • Improving Far Forward Medicine
    • by
  3. Slide 3

    • My Tips and lessons Learned For Using Documentation in a Prolonged Field Care Situation
    • By: Paul
    • What I hope to add to your toolbox:
    • It Starts with Planning
    • 10 Capabilities checklist
    • How we got to where we are
    • Using documentation throughout a PFC scenario
    • Trending to anticipate
    • Incorporating Monitors
    • Share your mental model and Lead
    • Identifying injuries and making a plan
    • Implementing a care plan
    • Medical Checklists
  4. Before you go…

    Slide 4 - Before you go…

    • Meds
    • FWB Kits, Eldon Cards Done, Fluids
    • Specialty Equipment
    • Power supply and cables
    • Get O2 Bottles filled
    • Team familiarized, trained and practiced
    • Telemedicine planned and practiced
    • Multiple Evac Platforms planned for
    • PFC Planning Tool
  5. Minimum

    Slide 5 - 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 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
    • Impact Vent and O2 bottle
    • All from above
    • Add Benzo if not available for truck
    • Same as above
    • Blood tubes to run labs to local clinic
    • Real matress with head elevated, nursing care kit sleeping bg
    • Sterile Surgical Kit with Drapes, Gowns and scrub soap
    • Secure comms, email
    • Extensive evac kit
    • Plane
    • Take all of above
    • All of above
    • Impact vent on O2
    • All above calculate for flight and double
    • All above calculate for flight and double
    • Padded Litter, Sleeping Bag
    • 10g needle D Chest tube kit
    • Cric kit
    • Through aircraft
    • From Above
    • 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
    • 10 Essential PFC Capabilities worksheet
  6. When you get there…

    Slide 6 - When you get there…

    • Meds locked up
    • FWB Kits, Eldon Cards Done, Fluids distributed
    • Specialty Equipment in the right platform
    • Power supply and cables ready and out
    • Oxygen available
    • Team walked through placement of each bag and layout of aidstation
    • Telemedicine rehearsed using live numbers
    • Evac PACE Rehearsed
  7. Using documentation efficiently

    Slide 16 - Using documentation efficiently

    • throughout a PFC scenario
  8. USE           THIS           FIRST!

    Slide 17 - USE THIS FIRST!

  9. Teams who use some kind of casualty card are far more efficient and effective

    Slide 18 - Teams who use some kind of casualty card are far more efficient and effective

    • -They do not duplicate their efforts by evaluating the same patients multiple times
    • -Overdoses on pain meds are less likely
  10. Move on to flowsheets once in the proper setting

    Slide 19 - Move on to flowsheets once in the proper setting

  11. Slide 22

    • Large Versions Are Easily Seen by All
  12. Slide 24

    • x
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    • 11
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    • 99.2
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    • 98.1
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    • 2
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    • Cx tUBE
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    • Foley
  13. Slide 25

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Tips When Trending
  14. Slide 26

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Tips When Trending
  15. Slide 27

    • x
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    • 11
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    • 00
    • 00
    • 15
    • 15
    • 30
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    • 45
    • 45
    • 99.2
    • 98.5
    • 98.0
    • 97.7
    • 97.4
    • 2
    • 5
    • 7
    • 4
    • 5
    • 120
    • Cx tUBE
    • 300
    • Foley
  16. Slide 28

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Tips When Trending
  17. Slide 30

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Create a threshold or red flag as to when you will act and share them
    • -Mark them on the chart
    • Tips When Trending
  18. Slide 31

    • x
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    • 11
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    • 00
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    • 15
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    • 30
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    • 45
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    • 99.2
    • 98.5
    • 98.0
    • 97.7
    • 97.4
    • 2
    • 5
    • 7
    • 4
    • 5
    • 120
    • Cx tUBE
    • 300
    • Foley
    • Threshold or Red Flag
    • to initiate treatment
    • drawn on the chart
  19. Slide 32

    • x
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    • 99.2
    • 98.5
    • 98.0
    • 97.7
    • 97.4
    • 97.1
    • 96.8
    • 96.9
    • 97.1
    • 97.2
    • 97.5
    • 97.7
    • 97.9
    • 98.1
    • 98.2
    • 98.1
    • 98.0
    • 97.8
    • 97.7
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    • 2
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    • Cx tUBE
    • 300
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    • Foley
    • Threshold or Red Flag
    • to initiate treatment
    • drawn on the chart
  20. Slide 33

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Create a threshold or red flag as to when you will act and share them
    • -Mark them on the chart
    • Prepare equipment checklists for your intervention
    • Tips When Trending
  21. Slide 35

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Create a threshold or red flag as to when you will act and share them
    • -Mark them on the chart
    • Prepare equipment checklists for your intervention
    • Brief your team on what to expect while you have time.
    • -Ask for other ideas now while you have time
    • -Don’t accept them later when it’s time to act
    • Tips When Trending
  22. Slide 36

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Create a threshold or red flag as to when you will act and share them
    • -Mark them on the chart
    • Prepare equipment checklists for your intervention
    • Brief your team on what to expect while you have time.
    • -Ask for other ideas now while you have time
    • -Don’t accept them later
    • Don’t second guess your plan once it’s time to act
    • -Stress and the gravity of the situation will play devil’s advocate
    • Tips When Trending
  23. Slide 37

    • If you are manually trending vital signs stand back and look at what is going on with your patient
    • -Does it match his clinical appearance?
    • -Does it matter in that case?
    • Anticipate what is happening and devise a plan
    • Teleconsult before there is an emergency
    • Create a threshold or red flag as to when you will act and share them
    • -Mark them on the chart
    • Prepare equipment checklists for your intervention
    • Brief your team on what to expect while you have time.
    • -Ask for other ideas now while you have time
    • -Don’t accept them later
    • Don’t second guess your plan once it’s time to act
    • -Stress and the gravity of the situation will play devil’s advocate
    • When it’s time… Act without hesitation
    • Tips When Trending
  24. Continue to manually trend vital signs by marking on a flowsheet even if monitoring electronically.

    Slide 38 - Continue to manually trend vital signs by marking on a flowsheet even if monitoring electronically.

  25. Slide 39

    • Problem List
    • Plan
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
    • 7
    • 8
    • 9
    • 10
    • Name: _________________________________ Age:___
    • Weight: _______Lbs _______Kg
    • Allergies: ______________________________________
    • Past Med Hx:___________________________________
    • Past Surg Hx:___________________________________
    • Incident History: I have (# patients), stable/unstable, Incident occurred: ______________________________
    • Mechanism of injury was _________________________
    • ______________________________________________
    • I am expecting to evac the patient to:________________
    • ______________________________________________
    • Estimated time to evacuation is now: ________________ ETA at definitive care is: __________________________ CASEVAC POC is: ________________________________
    • Tourniquet Time:__________ Time Converted:___________
  26. Identify injuries and make a plan

    Slide 40 - Identify injuries and make a plan

  27. Slide 41

    • Problem List
    • Plan
    • 1
    • Clean
    •  Suture
    • 2
    •  Clean
    • Suture
    • 3
    • Maintain Occlusive Dressing 
    • Monitor For Tension
    • 4
    • Clean
    •  Suture
    • 5
    • Convert to pressure dressing 
    • Clean 
    • 6
    • Maintain Occlusive Dressing  
    • 7
    • 8
    • 9
    • 10
    • Name: _________________________________ Age:___
    • Weight: _______Lbs _______Kg
    • Allergies: ______________________________________
    • Past Med Hx:___________________________________
    • Past Surg Hx:___________________________________
    • Incident History: I have (# patients), stable/unstable, Incident occurred: ______________________________
    • Mechanism of injury was _________________________
    • ______________________________________________
    • I am expecting to evac the patient to:________________
    • ______________________________________________
    • Estimated time to evacuation is now: ________________ ETA at definitive care is: __________________________ CASEVAC POC is: ________________________________
    • Tourniquet Time:__________ Time Converted:___________
    • GSW L Chest
    • TQ L Leg
    • 0330
    • 1.
    • 3.
    • 2.
    • X
    • X
    • X
    • Facial Lac
    • Cric
    • X
    • 4.
    • X
    • 5.
    • X
    • Shrapnel
    • L Arm
    • 6.
    • Exit L Back
  28. TIME       →

    Slide 42 - TIME →

    • BP
    • ˅
    • 220
    • ˄
    • 200
    • 180
    • HR
    • 160
    • 140
    • 120
    • Respirations
    • R
    • 100
    • 80
    • ET CO2
    • o
    • 60
    • 40
    • 20
    • Eyes
    • 4
    • Verbal
    • 5
    • Motor
    • 6
    • GCS
    • 15
    • Fluid IN
    • Output ml/hr
    • KETAMINE
    • DOSE:
    • TIME:
    • VERSED
    • DOSE:
    • TIME:
    • FENTANYL
    • DOSE:
    • TIME:
    • OTHER DRUGS
    • DOSE:
    • TIME:
    • OTHER DRUGS
    • DOSE:
    • TIME:
  29. Pt Comfort / Positioning

    Slide 43 - Pt Comfort / Positioning

    • TALK TO THE PATIENT – orient to time and place, explain procedures, elevate HOB,
    • Baby-wipe bath, pad: occiput, spine, sacrum, elbows, heels, Reposition Q2H, insert wedges and pillows,
    • Vital Signs
    • Q 15, report as a trend, trend full GCS if applicable, pulse ox is 3-4 minutes old info
    • Tubes
    • ET placement – cuff pressure esp. IN FLIGHT! Place NG & remove contents, secure Foley
    • Pulmonary status
    • Supplemental O2, monitor SpO2, Lung sounds, can he posture/position on his own? Pursed lip breathing
    • Ventilations
    • Reinforce BVM principles with helpers, end point is patient comfort, just enough to expand the chest, one hand!
    • Hydration
    • Maintenance fluids 125cc/h, Measure In and outs
    • Wounds and dressings
    • Irrigate and dress, replace wet to dry, inspect for rashes and sores, antibiotics
    • Splints
    • circulation check, tighten or loosen
    • Bladder care
    • Last void, distended? Clean Foley site
    • Eye Care
    • Contacts? Tape eyes? Drops or Ointment
    • Mouth
    • Loose teeth, mucous membranes moisturized, cleaning/ brushing
    • Skin
    • Pressure sores? Maceration due to incontinence, diaper rash?
    • DVT
    • Calf massage every Hr
    • Head injury
    • MACE Card
    • Acts of daily living: breathing, swallowing, coughing, drinking, eating, re-positioning, toileting, hygeine
    • Nursing care items: Blankets, pillows, gowns, towels, sheets, basins, trash bags, irrigation water
    • Use Reminders for things you don’t usually do
  30. Glasgow Coma Scale

    Slide 44 - Glasgow Coma Scale

    • TIME
    • Eye Opening Response
    • Spontaneous
    • 4
    • To Verbal Command
    • 3
    • With Painful Stimulus
    • 2
    • No Response
    • 1
    • Best Verbal Response
    • Oriented
    • 5
    • Confused
    • 4
    • Inappropriate words
    • 3
    • Incomprehensible Sounds
    • 2
    • No Response
    • 1
    • Best Motor Response
    • Obeys Commands
    • 6
    • Localizes Pain
    • 5
    • Withdraws (Pain)
    • 4
    • Flexion (Pain)
    • 3
    • Extension (Pain)
    • 2
    • No Response
    • 1
    • Call script:
    • “THIS IS _________________, (JOB/POSITION):___________________.
    • I HAVE A PATIENT WITH ___________ WHO I THINK HAS ___________,
    • AND I NEED _____________________________________________________.”
    • CHIEF COMPLAINT: ______________________________________________
    • BRIEF HISTORY:__________________________________
    • PE: VITALS: HR:____________ BLOOD PRESSURE: _________________
    • RESPIRATION RATE: _________ OXYGEN SATURATION: ____________
    • TEMPERATURE: _________ MENTAL STATUS (AVPU): ______________
    • BRIEF EXAM: ____________________________________________________
    • _________________________________________________________________.
    • “I NEED _______________.” (CONSULTATION, HELP, ADVICE, TRANSPO…)
    • TeleMed Recommendations:
    • 1.Fluids/Meds:
    • 2.Interventions:
    • 3.Procedures:
    • 4.Red Flags:
    • 5.Other:
  31. Implement a Treatment/Care Plan

    Slide 45 - Implement a Treatment/Care Plan

    • to Share Your Mental Model
    • And Expectations
  32. Slide 46

    • Problem List
    • Plan
    • 1
    • Clean
    •  Suture
    • 2
    •  Clean
    • Suture
    • 3
    • Maintain Occlusive Dressing 
    • Monitor For Tension
    • 4
    • Clean
    •  Suture
    • 5
    • Convert to pressure dressing 
    • Clean 
    • 6
    • Maintain Occlusive Dressing  
    • 7
    • 8
    • 9
    • 10
    • Prioritized Procedures
    • Convert to pressure dressing
    • Maintain Occlusive Dressings
    • Monitor For Tension
    • etc…
    • Brainstorm everything
    • that needs done on this side
    • Prioritize everything
    • on this side and
    • work your way down
    • GSW L Chest
    • TQ L Leg
    • Facial Lac
    • Cric
    • Shrapnel
    • L Arm
    • Exit L Back
  33. All 6 Pages Laminated for Continuity

    Slide 47 - All 6 Pages Laminated for Continuity

    • And Z-Folded for ease of Transport
  34. Slide 48

    • Will work well if no walls are available
  35. Slide 49

    • Laminated for use on the wall
  36. Slide 50

    • PATIENT / INCIDENT HISTORY:
    • MASCAL
    • Casualty-Nr.:
    • Kat.:
    • Precedence
    • A
    • URGENT
    • 90 min. Role 2 or 3
    • B
    • PRIORITY
    • 4 hrs. Role 2 or 3
    • C
    • ROUTINE
    • 24 hrs. Role 2 or 3
    • NAME
    • FIRST NAME
    • DATE OF BIRTH
    • MALE
    • FELMALE
    • adress / email
    • BODY-WEIGHT
    • KG
    • health - insurance
    • TACTICAL CASUALTY RESPONSE – PROLONGED CARE DOCUMENTATION – GERMAN SOF
    • TIME OF INJURY
    • Date and Time
    • POINT
    • OF INJURY
    • MECHANISM
    • OF INJURY
    • TREATMENT FACILITY
    • MEDIC NAME
    • TELEMED
    • POINT OF CONTACT
    • INJURIES
    • INITIAL TREATMENT
    • EYE SHIELD
    • OPA / NPA
    • LARYNX-TUBE
    • CRIC
    • NEEDLE DECOMPRESSION
    • CHEST SEAL /-DRAIN
    • BANDAGE
    • I.V. / I.O. ACCESS
    • TOURNIQUET
    • WOUND PACKING
    • HEMOSTATIC AGENT
    • BURNS TREATMENT
    • SPLINT
    • TBI
    • EYE – INJURY
    • AIRWAY OBSTR.
    • BLEEDING
    • ART. BLEEDING
    • AMPUTATION
    • FRACTURE (OPEN/CLOSE)
    • BURNS
    • HEMATOMA
    • INITIAL VITAL PARAMETERS
    • A V P U
    • Resp. Rate
    • /min.
    • Pulse
    • /min.
    • SpO2
    • %
    • BP
    • mmHG
    • TQ Time
    • ND Time
    • MEDICATION
  37. Slide 51

    • TACTICAL CASUALTY RESPONSE – PROLONGED CARE DOCUMENTATION – GERMAN SOF
    • TIME OF ACTION
    • A V P V / Kat. A B C
    • /
    • /
    • /
    • /
    • /
    • /
    • /
    • RespRate (spont./ventilator) /min.
    • Ventilator Vol. ( l/ min.)
    • Ventilator Pressure ( mbar ) / PEEP
    • /
    • /
    • /
    • /
    • /
    • /
    • /
    • RESPIRATORY SOUNDS (stethoskop)
    • SpO2 (%)
    • PULSE (measuerement point) /min.
    • BLOOD PRESSURE ( xx/yy mmHg )
    • BODY- CORE – TEMP. ( °C / °F )
    • PMS (perfusion / motoric / sensitivity)
    • ACTIONS TAKEN:
    • OXYGEN - INHALATION ( l/ min.)
    • FLUID IN
    • (Type ?)
    • p.o.
    • i.v.
    • i.o.
    • FLUID OUT
    • ANALGESIC
    • (Type ?)
    • p.o.
    • i.v.
    • i.m.
    • i.o.
    • ANTIBIOTIC
    • (Type ?)
    • p.o.
    • i.v.
    • i.m.
    • i.o.
    • Other MED. (Type / mg / i.v. i.o. p.o.)
    • TQ release / replacement time
    • BANDAGE change / clean wounds
    • CATHETER / TUBE desinfection
    • Splinting / check SPLINT
    • WASH Patient / Tooth-brush
    • POSITIONING
    • HYPOTHERMIA - PREVENTION
    • TELEMED
    • OTHER
    • TREATMENT FACILITIY
    • MEDIC NAME
    • °C / °F
    • NAME OF PATIENT
    • ROOM TEMPERATURE
    • DATE:
  38. Specialty Flowsheets and Checklists

    Slide 52 - Specialty Flowsheets and Checklists

    • JTTS CPG Burn Patient Appendix A Nursing care
    • 5 Pages of nursing care checklists and recommendations
    • JTTS CPG Burn Patient Appendix B Flowsheet
    • 72 hour fluid admin flowsheet
    • MACE TBI Neuro Exam Card
    • Can give serial exams after baseline
    • SORT Nursing Care Checklist
    • Ketamine Drip
    • Multiple or Mass Casualty Checklist
  39. JTTS CPG Apendix A-5 Pages Nursing Checklist

    Slide 53 - JTTS CPG Apendix A-5 Pages Nursing Checklist

  40. JTTS CPG Apendix B - 72 Hour Fluid Admin Flowsheet

    Slide 54 - JTTS CPG Apendix B - 72 Hour Fluid Admin Flowsheet

  41. 8 Pages with easy to follow instructions

    Slide 55 - 8 Pages with easy to follow instructions

    • MACE Exam
  42. SORT Prolonged Field Care Checklist

    Slide 56 - SORT Prolonged Field Care Checklist

  43. Ketamine Drip Flowsheet

    Slide 57 - Ketamine Drip Flowsheet

  44. Slide 60

    • My Tips and lessons Learned For Using Documentation in a Prolonged Field Care Situation
    • By: Paul
    • What I hope you’ve learned
    • Planning
    • 10 Capabilities checklist
    • How we got to where we are
    • Using documentation throughout a PFC scenario
    • Trending to anticipate
    • Incorporating Monitors
    • Share your mental model and Lead
    • Identifying injuries and making a plan
    • Implementing a care plan
    • Medical Checklists
  45. Slide 61

    • 38 hours until CASEVAC?!? Now what!?!
    • Prolonged Field Care
    • Downloadable Resources Subscribe Now
    • Instant Updates
    • www.ProlongedFieldCare.org
    • Improving Far Forward Medicine
    • www.ProlongedFieldCare.org
    • Why We Started This
    • -Fills gaps in current protocol and references
    • -Reach out and get a question answered by the community
    • -Download resources to any mobile device eReader
    • -Join the working group and let your voice be heard
    • -Your chance to contribute to your own training and
    • education before it becomes mandatory from above
    • -In partnership with SOF Medics and Docs in 40 countries
    • -Access to Training resources and Recommendations
    • Get the Info You Need Now!
    • PFC Videos on our YouTube Channel
    • 10 Essential Capabilities - you must have
    • Tourniquet Conversion Paper - Answers nagging questions
    • Analgesia and sedation Paper - Easy, long term sedation
    • Airway Recommendation Paper – Best practices
    • PEEP Valve - Are you using them?
    • Long-Term Patient Care Flowsheet – Easy to trend vitals
    • Fresh Whole Blood Trans. FAQs – Answered
    • Get
    • Prepared
    • @PFCwgMedicine
    • @FOAMedPFC