medical planning tool - prolongedfieldcare.org...range / distance 50 km clinic lz 143 mi 17 helo...
TRANSCRIPT
-
PFC Medical Planning and Briefing Tool
Plans are uselessPlanning is everything-Dwight D. Eisenhower
-
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
-
MinimumBP Cuff, Stethescope, Pulse Ox, Foley
Fresh Whole Blood Kit
Bag-Valve-Mask with PEEP Valve
Awake Ketamine Cric
Opiate Analgesics titrated throughIV
Physical Exam withoutadvanced
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 ResusO2 Concentrator Long duration
sedation Sedation with Ketamine/option of midazolam
Ultrasound and point of care labs
Elevate head of real beddebride, washout NG/OG
Fasciotomydebridement,amputation
Add labs and ultrasound video
Trained in critical care transport
BestVital Signs Monitor
PRBS, FFP, Type specific donors
Portable Ventilator
Proficient in Rapid Sequence Intubation
Educated and practiced imultidrug 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 Foleykit, Sterile kerlix, litter padding
Cric, 10gNeedle DScalpel
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 labsat 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
All from aboveAdd Benzo if not available for truck
Same as above No Labcapability; Available with SURG team at capitol
Real matresswith head elevated, nursing care kit sleeping bg
Sterile Surgical Kit with Drapes, Gowns and scrub soap
Secure comms, email
Extensive evackit
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 kitCric kit
Through aircraft
From Above
1. Monitoring 2. Resuscitate3. Ventilate
and oxygenate4. Control the
Airway5. Sedation
and Analgesia
6. Physical Exam and
Diagnostics
7. Nursing and Hygeine
8. Surgical Interventions
9. TelemedicalConsult
10. Package and Prepare
for flight
10 Essential PFC Capabilities
-
MinimumBP Cuff, Stethescope, Pulse Ox, Foley
Fresh Whole Blood Kit
Bag-Valve-Mask with PEEP Valve
Awake Ketamine Cric
Opiate Analgesics titrated throughIV
Physical Exam withoutadvanced
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 ResusO2 Concentrator Long duration
sedation Sedation with Ketamine/option of midazolam
Ultrasound and point of care labs
Elevate head of real beddebride, washout NG/OG
Fasciotomydebridement,amputation
Add labs and ultrasound video
Trained in critical care transport
BestVital Signs Monitor
PRBS, FFP, Type specific donors
Portable Ventilator
Proficient in Rapid Sequence Intubation
Educated and practiced imultidrug 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
1. Monitoring 2. Resuscitate3. Ventilate
and oxygenate4. Control the
Airway5. Sedation
and Analgesia
6. Physical Exam and
Diagnostics
7. Nursing and Hygeine
8. Surgical Interventions
9. TelemedicalConsult
10. Package and Prepare
for flight
10 Essential PFC Capabilities
-
Team Members/ Organic Assets
Type and Name
Telephone Radio Freq/ Call SigneMail
Medical Capabilities
Limitations Special Equipment
Senior Medic:John Smith
+27 456-345-6789 18D1
Junior Medic:
RFR:
TCCC/MARCH:
CLS
First Aid/Buddy Aid
NO MEDICAL TRAINING (liabilities)
-
Surgical Assets
Type Of Team / Number Pax?
Telephone / Date Last checked
Radio Freq / Call SigneMail
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
-
CasEvac Platforms
Type Vehicle / Aircraft / Location
Telephone Date Last called
Radio Freq / Call SigneMail
Capablities / Distance /Speed /Equipment
Limitations(Contract, Weather etc..)
Military or Civilian?Country of Origin?
Medic On Board? Contract InfoDistance, Cash
Other Good to Know Info
Razor / ATV
Team Truck
HN Ambulance
Civilian Helo
Casa 212
Twin Otter
Cessna
-
Strategic Evacuation Platforms
Type Vehicle / Aircraft / Location
Telephone Date Last called
Radio Freq / Call SigneMail
Capablities / Distance /Speed /Equipment
Limitations(Contract, Weather etc..)
Military or Civilian
Contract InfoDistance, Cash
Other Good to Know Info
C-146
C-130
C-17
Civilian Air Evac
-
Refueling Stations / FARPs
Name Telephone / Date LastChecked?By Whom?
Radio Freq / Call SigneMail
Location Country / State / City / Address / Grid
Manned?By Whom?
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
-
Telemedicine Contacts
Who Telephone / Date last checked
Radio Freq / Call SigneMail
Last time checked?By whom?
Level of Training / Specialty
Location
-
Facilities
Name Telephone / Date LastChecked?By Whom?
Radio Freq / Call SigneMail
Location Country / State / City / Address / Grid
CapabilitiesSurg?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
-
Add Regional Map And Locations
Coalition Med Facility / Team
Host Nation Med Facility
Air Port / Landing Strip
Team Houses / Bases
LZ / FARP
MSS
Range / Distance
600km
Clinic
LZ 143C-130
600km
Scale
-
Add Local Map and Locations
Coalition Med Facility / Team
Host Nation Med Facility
Air Port / Landing Strip
Team Houses / Bases
LZ / FARP
MSS
Range / Distance
50 km
Clinic
LZ 143MI 17 Helo
50km
Scale
-
Medical/CASEVAC CONOP slide
• Why• Amount of force providers rotating
• Different medical plans
• Lack of research
• Mutual support
• Other COCOM priorities
• Squeezing the balloon
-
Header/top of slide
• Classification noted
• Country of operations. If it’s multiple countries, use SOCFWD flag
• SOCAFRICA flag on the right
• Title will be Operation/Team name MEDEVAC or CASEVAC CONOP
-
Medical Capabilities
• Focus to care is beyond the capabilities of SF/SOF medic
• “Self aid/buddy aid” and “all team members are TCCC qualified” are unacceptable - already assumed. Underwear goes on the inside.
• Designated numbers/letters within this block will correspond throughout the plan.
• Triangle will correspond with the medical risk scale at the bottom and the map
• The circled numbers will correspond where on the map they are located
-
CASEVAC PLATFORM:
Thought should be given to infil and exfil platform.
• Can they loiter if immediate exfil is needed?
• Include all platforms intended to be used in CASEVAC plan (Contract Aviation, Personal Recovery, SOCAF owned, Coalition and HN (if feasible).
• What is your platform’s spin up and launch times over the geographical distance?,
• Thought to platforms ability to land on improved/ unimproved surfaces and travel time and speed.
• This needs to be captured in a narrative portion of the plan and depicted on the map to the right.
-
PACE OPTIONS
• A coherent application of assets available to you
-
Considerations & Limitations
• Highlight relevant issues not noted• “Driving through Nairobi at night will
affect patient transportation to AGA KHAN
• “Pilots are not NVG qualified to fly at night”
• Relevant facts to this specific mission
• What are the refuel times if you have to “lily pad” across to your next destination?
• What are your patient transfer times?
• Expect changes due to operational needs
-
Medical Risk Scale
• This is in reference to your BEST plan; which is your “P.”
• “ER” is your primary ER
• “DCS” is your primary DCS
Definitions:
ER – Emergency Room is a facility/location that is able to stabilize a patient prior to surgery. It’s also a capability above the tactical element (ex: TCCET, MOG UN ER, CCET, SOST)
DCS- Damage Control Surgery is the rapid initial control of hemorrhage and contamination with packing and a temporary closure.
-
MAP
• This is a pictorial representation of all the information we had on the left translated onto the map
• A visual for your information
• Should systematically match what you have on the left
• The Blue triangles connote where your closets American DCS and ER assets are located and matches your medical risk scale
-
CONTACT INFORMATION
• Order of precedence of phone numbers
• Clear and concise
• Split up in 2 sections: Internal/External
• Internal should be “down and in”
• External should be “up and out”
• Phone numbers should be limited due to the SOCFWD JOC’s and the Surgeons will coordinate follow on care.