Тактична невідкладна допомога

Друге видання посібника «Тактична невідкладна допомога» (ТНД) навчає надавати долікарняну допомоги, реагувати на виклики та доглядати за пацієнтами під час надзвичайних ситуацій, включаючи терористичні акти та катастрофи. Ця публікація призначена для підготовки працівників екстреної медичної допомоги (ЕМД), які надають до допомогу постраждалим у цивільних умовах. Друге видання TECC, розроблене Національною асоціацією спеціалістів екстреної медичної допомоги (NAEMT) та схвалене Американським коледжем хірургів, охоплює сучасні сфери тактичної екстреної медичної допомоги (TEMS) та відповідає чинним рекомендаціям Комітету з питань TECC (Tactical Emergency Casualty Care). Перш ніж публікувати книжку, ці структури превіряють свої настанови у реальних ситуаціях.

Посібник роз’яснює та закріплює ключові поняття курсу, має цікавий, інтерактивний дизайн; написаний таким чином, щоб читачеві здавалося, що він бере участь у бесіді, а не слухаєте лекцію.

Посібник має такі ключові особливості:

допомагає прийняти найкращі рішення стосовно сортування постраждалих на місці події
містить контрольні питання для перевірки засвоєння знань та навичок
станції навичок – покроковий огляд того, як використовувати навички з порятунку життя в умовах надзвичайних ситуацій.

S 12289
Tactical emergency casualty care (TECC): course manual / National Association of Emergency Medical Technicians, Pre-Hospital Trauma Life Support Committee. – 2nd ed. – Burlington: Jones and Bartlett Learning, 2020.

Lesson 1 Introduction to Tactical Emergency Combat Care
Introduction to Tactical Emergency Casualty Care
Where Did the Tactical Emergency Casualty Care Course Come From?
What Does the Tactical Emergency Casualty Care Course Cover?
Tactical Care Situations
Resuscitation Zones: Phases of Care
NAEMT TECC Course Goals
TECC Guiding Principles
Response and Arrival-Scene Assessment
Other Elements Operating Within a Tactical Environment
Rescue Task Force
Tactical Emergency Medical Support
Summary
References and Resources

Lesson 2 Direct Threat Care/Hot Zone
Direct Threat Care/Hot Zone
Operating in the Direct Threat Care/Hot Zone
Get Off the X
Constantly Changing Threat Environment
Cover Versus Concealment
Mitigation of Direct Threats
Rescue Considerations
Rapid and Remote
Assessment Methodology
Operational Performance
Drag and Carry Options
Medical Interventions in the Direct Threat Care/Hot Zone
Place Patient in the Recovery Position
Controlling Massive Hemorrhage
Types of Tourniquets
Summary
Skill Stations
Casualty Drags and Carries
Tourniquet Application
References and Resources

Lesson 3 Indirect Threat Care/Warm Zone: MARCH-Patient Assessment and Massive

Hemorrhage Interventions
Indirect Threat Care/Warm Zone
Scene Safety
Asymmetrical Response
Threat Management
Assessment and Intervention Priorities
Bleeding Assessment
Progressive and Aggressive Intervention Plan Direct Pressure
Extremity Tourniquets
Tourniquet Optimization
Venous Tourniquets
Tourniquet Conversion Contradictions
Junctional Hemorrhage
Junctional Tourniquets
The Combat Ready Clamp
The Junctional Emergency Treatment Tool
The SAM Junctional Tourniquet
Hemostatic Dressings
Combat Gauze Directions
Summary
Skill Stations
Inguinal Hemorrhage
Axillary Hemorrhage
References

Lesson 4 Indirect Threat Care/Warm Zone: MARCH-Airway

Overview of Airway in the Indirect Threat Care/Warm Zone
Trauma Jaw Thrust and Chin Lift Maneuvers
Nasopharyngeal Airway
Recovery Position
The Sit-Up/Lean Forward Position
Complex Airways
Supraglottic Airways
Orotracheal and Nasotracheal Intubation
Surgical Cricothyrotomy
Cricothyrotomy Surface Landmarks
Cricothyrotomy Incision
Insert and Secure Endotracheal Tube
Bougie-Assisted Placement of ET Tube in Surgical Airway
Pediatric Airways
Pediatric Nasopharyngeal Airway
Pediatric Supraglottic Airway
Advanced Pediatric Airways
Summary
Skill Sheets
Nasopharyngeal Airway
Supraglottic Airway
Emergency Surgical Airway
References

Lesson 5 Indirect Threat Care/Warm Zone: Respiration/Breathing

Overview of Respiration/Breathing Indirect Threat Care/Warm Zone
Anatomy and Physiology of Breathing
The Oxygenation and Ventilation Process
Pathophysiology
Open Pneumothorax
Assessment and Management of an Open Pneumothorax
Chest Seals
Tension Pneumothorax
Assessment and Management of a Tension Pneumothorax
Needle Decompression
TECC Needle Decompression Procedure
Assessing the Effectiveness of Needle Decompression
Bilateral Needle Decompression for Traumatic Cardiac Arrest
Pediatric Tension Pneumothorax
Summary
Skill Station
Needle Decompression
References and Resources

Lesson 6 Indirect Threat Care/Warm Care: MARCH-Circulation

Overview of Circulation Indirect Threat Care/Warm Zone
Tourniquet Assessment and Application in Indirect Threat Care/Warm Zone
Tourniquet Application
Application Tightness
Time Limit
Pelvic Binders
Stabilization of Pelvic Fractures
Control of Pelvic Hemorrhage
Indications and Contradictions for Pelvic Binder Use
Application of Pelvic Binder
Shock Assessment
Hypovolemic Shock
Hemorrhagic Shock
Fluid Resuscitation of Hemorrhagic Shock
Neurogenic Shock
Intravenous Access
Intraosseous Access
Tranexamic Acid
TXA Administration
Damage Control Resuscitation
Coagulopathy and the “Lethal Triad”
TECC Damage Control Resuscitation
Traumatic Brain Injury
Summary
Skill Stations
Intraosseous Access
IV Administration of TXA
References

Lesson 7 Indirect Threat Care/Warm Zone: Hypothermia and Head Injury

Overview of Circulation Indirect Threat Care/Warm Zone
Hypothermia
Hypothermia Aspect of the Lethal Triad
Preventing Hypothermia
Hypothermia Prevention and Management Kits
Traumatic Brain Injury Assessment and Intervention
Glasgow Coma Scale
Cushing’s Triad
Intracranial Hypertension
TBI Intervention
Reassess, Monitor, and Document Patient
Secondary Survey
Obtaining Vital Signs
Monitoring
Documentation
Analgesia
Ketamine
Fire and Bombs as Weapons
Public Safety Fire Ignition Sources
Explosives
Burn Care
Assessment of Burn Injury
Fluid Resuscitation of Burned Patients
Smoke Inhalation: Fluid Management Considerations
Analgesia
Penetrating Eye Trauma
Care for Penetrating Eye Trauma
Moving and Communicating with the Patient
Communicating with the Patient
Communicating with Receiving Hospitals
CPR in a Multicasualty Event
Correct Tension Pneumothorax
Summary
References

Lesson 8 Evacuation Care/Cold Zone

Overview of Evacuation Care/Cold Zone.
Differences Between Indirect Threat Care/Warm Zone and Evacuation Care/Cold Zone
Situational Awareness in Evacuation Care/Cold Zone
Have Primary, Secondary, and Tertiary Evacuation Plans
Evacuation Care Transport Resources
Evacuation Care: Reassessment Airway
Supraglottic Airways
Breathing
Needle Decompression
Evacuation Care: Hemorrhage Control
Tranexamic Acid
Tourniquet Assessment and Conversion
Tourniquet Conversion Procedures
Plus-1 Tourniquet
Contraindications for Tourniquet Conversion
Evacuation Care: Shock Management
Establish IV or Intraosseous (IO) line
Evacuation Care. Traumatic Brain Injury
Altered Mental Status with Suspected TBI
Fluid Resuscitation of TBI
Evacuation Care: Burns
CYANOKIT
Amyl Nitrite
Sodium Thiosulfate
Example of a Hydrogen Cyanide Poisoning Protocol
Evacuation Care: Analgesia
Evacuation Care: CPR
Evacuation Care: Hypothermia
Evacuation Care-. Reassess, Document Communicate, and Prepare for Movement
Communicating With the Patient
Communicating With Receiving Hospitals
Preparing for Patient Movement
Summary
References and Resources

Lesson 9 Triage

Overview of TECC Triage
Triage Concepts
Primary Triage
Limitations of Triage Systems
START Triage
SALT Triage
Sacco Triage Method
Secondary Triage Decision
Tactical Situation
Casualty Response to MARCH Treatments
Summary
References

Lesson 10 Summation

esson 10 Summation
Overview of Summation Lesson
Importance of Immediate Responders
Phases of TECC Care
Direct Threat Care/Hot Zone
Indirect Threat Care/Warm Zone
Evacuation Care/Cold Zone
Direct Threat Care/Hot Zone Coals
Rapid and Remote Assessment Methodology
Stop the Bleeding
Drags and Carries
Indirect Threat Care/Warm Zone Coals
Indirect Threat/Warm Zone Triage
Indirect Threat Care/Warm Zone Bleeding Control
Indirect Threat Care/Warm Zone: Airway Control
Recovery Position
Cricothyrotomy
Tension Pneumothorax
Open Pneumothorax
Indirect Threat Care/Warm Zone: Shock Control
Indirect Threat Care/Warm Zone: Analgesics
Evacuation Care
Summary
Reference
Index

допомагає прийняти найкращі рішення стосовно сортування постраждалих на місці події
містить контрольні питання для перевірки засвоєння знань та навичок
станції навичок - покроковий огляд того, як використовувати навички з порятунку життя в умовах надзвичайних ситуацій.

S 12289 Tactical emergency casualty care (TECC): course manual / National Association of Emergency Medical Technicians, Pre-Hospital Trauma Life Support Committee. - 2nd ed. - Burlington: Jones and Bartlett Learning, 2020. Lesson 1 Introduction to Tactical Emergency Combat Care Introduction to Tactical Emergency Casualty Care Where Did the Tactical Emergency Casualty Care Course Come From? What Does the Tactical Emergency Casualty Care Course Cover? Tactical Care Situations Resuscitation Zones: Phases of Care NAEMT TECC Course Goals TECC Guiding Principles Response and Arrival-Scene Assessment Other Elements Operating Within a Tactical Environment Rescue Task Force Tactical Emergency Medical Support Summary References and Resources Lesson 2 Direct Threat Care/Hot Zone Direct Threat Care/Hot Zone Operating in the Direct Threat Care/Hot Zone Get Off the X Constantly Changing Threat Environment Cover Versus Concealment Mitigation of Direct Threats Rescue Considerations Rapid and Remote Assessment Methodology Operational Performance Drag and Carry Options Medical Interventions in the Direct Threat Care/Hot Zone Place Patient in the Recovery Position Controlling Massive Hemorrhage Types of Tourniquets Summary Skill Stations Casualty Drags and Carries Tourniquet Application References and Resources Lesson 3 Indirect Threat Care/Warm Zone: MARCH-Patient Assessment and Massive Hemorrhage Interventions Indirect Threat Care/Warm Zone Scene Safety Asymmetrical Response Threat Management Assessment and Intervention Priorities Bleeding Assessment Progressive and Aggressive Intervention Plan Direct Pressure Extremity Tourniquets Tourniquet Optimization Venous Tourniquets Tourniquet Conversion Contradictions Junctional Hemorrhage Junctional Tourniquets The Combat Ready Clamp The Junctional Emergency Treatment Tool The SAM Junctional Tourniquet Hemostatic Dressings Combat Gauze Directions Summary Skill Stations Inguinal Hemorrhage Axillary Hemorrhage References Lesson 4 Indirect Threat Care/Warm Zone: MARCH-Airway Overview of Airway in the Indirect Threat Care/Warm Zone Trauma Jaw Thrust and Chin Lift Maneuvers Nasopharyngeal Airway Recovery Position The Sit-Up/Lean Forward Position Complex Airways Supraglottic Airways Orotracheal and Nasotracheal Intubation Surgical Cricothyrotomy Cricothyrotomy Surface Landmarks Cricothyrotomy Incision Insert and Secure Endotracheal Tube Bougie-Assisted Placement of ET Tube in Surgical Airway Pediatric Airways Pediatric Nasopharyngeal Airway Pediatric Supraglottic Airway Advanced Pediatric Airways Summary Skill Sheets Nasopharyngeal Airway Supraglottic Airway Emergency Surgical Airway References Lesson 5 Indirect Threat Care/Warm Zone: Respiration/Breathing Overview of Respiration/Breathing Indirect Threat Care/Warm Zone Anatomy and Physiology of Breathing The Oxygenation and Ventilation Process Pathophysiology Open Pneumothorax Assessment and Management of an Open Pneumothorax Chest Seals Tension Pneumothorax Assessment and Management of a Tension Pneumothorax Needle Decompression TECC Needle Decompression Procedure Assessing the Effectiveness of Needle Decompression Bilateral Needle Decompression for Traumatic Cardiac Arrest Pediatric Tension Pneumothorax Summary Skill Station Needle Decompression References and Resources Lesson 6 Indirect Threat Care/Warm Care: MARCH-Circulation Overview of Circulation Indirect Threat Care/Warm Zone Tourniquet Assessment and Application in Indirect Threat Care/Warm Zone Tourniquet Application Application Tightness Time Limit Pelvic Binders Stabilization of Pelvic Fractures Control of Pelvic Hemorrhage Indications and Contradictions for Pelvic Binder Use Application of Pelvic Binder Shock Assessment Hypovolemic Shock Hemorrhagic Shock Fluid Resuscitation of Hemorrhagic Shock Neurogenic Shock Intravenous Access Intraosseous Access Tranexamic Acid TXA Administration Damage Control Resuscitation Coagulopathy and the “Lethal Triad” TECC Damage Control Resuscitation Traumatic Brain Injury Summary Skill Stations Intraosseous Access IV Administration of TXA References Lesson 7 Indirect Threat Care/Warm Zone: Hypothermia and Head Injury Overview of Circulation Indirect Threat Care/Warm Zone Hypothermia Hypothermia Aspect of the Lethal Triad Preventing Hypothermia Hypothermia Prevention and Management Kits Traumatic Brain Injury Assessment and Intervention Glasgow Coma Scale Cushing’s Triad Intracranial Hypertension TBI Intervention Reassess, Monitor, and Document Patient Secondary Survey Obtaining Vital Signs Monitoring Documentation Analgesia Ketamine Fire and Bombs as Weapons Public Safety Fire Ignition Sources Explosives Burn Care Assessment of Burn Injury Fluid Resuscitation of Burned Patients Smoke Inhalation: Fluid Management Considerations Analgesia Penetrating Eye Trauma Care for Penetrating Eye Trauma Moving and Communicating with the Patient Communicating with the Patient Communicating with Receiving Hospitals CPR in a Multicasualty Event Correct Tension Pneumothorax Summary References Lesson 8 Evacuation Care/Cold Zone Overview of Evacuation Care/Cold Zone. Differences Between Indirect Threat Care/Warm Zone and Evacuation Care/Cold Zone Situational Awareness in Evacuation Care/Cold Zone Have Primary, Secondary, and Tertiary Evacuation Plans Evacuation Care Transport Resources Evacuation Care: Reassessment Airway Supraglottic Airways Breathing Needle Decompression Evacuation Care: Hemorrhage Control Tranexamic Acid Tourniquet Assessment and Conversion Tourniquet Conversion Procedures Plus-1 Tourniquet Contraindications for Tourniquet Conversion Evacuation Care: Shock Management Establish IV or Intraosseous (IO) line Evacuation Care. Traumatic Brain Injury Altered Mental Status with Suspected TBI Fluid Resuscitation of TBI Evacuation Care: Burns CYANOKIT Amyl Nitrite Sodium Thiosulfate Example of a Hydrogen Cyanide Poisoning Protocol Evacuation Care: Analgesia Evacuation Care: CPR Evacuation Care: Hypothermia Evacuation Care-. Reassess, Document Communicate, and Prepare for Movement Communicating With the Patient Communicating With Receiving Hospitals Preparing for Patient Movement Summary References and Resources Lesson 9 Triage Overview of TECC Triage Triage Concepts Primary Triage Limitations of Triage Systems START Triage SALT Triage Sacco Triage Method Secondary Triage Decision Tactical Situation Casualty Response to MARCH Treatments Summary References Lesson 10 Summation esson 10 Summation Overview of Summation Lesson Importance of Immediate Responders Phases of TECC Care Direct Threat Care/Hot Zone Indirect Threat Care/Warm Zone Evacuation Care/Cold Zone Direct Threat Care/Hot Zone Coals Rapid and Remote Assessment Methodology Stop the Bleeding Drags and Carries Indirect Threat Care/Warm Zone Coals Indirect Threat/Warm Zone Triage Indirect Threat Care/Warm Zone Bleeding Control Indirect Threat Care/Warm Zone: Airway Control Recovery Position Cricothyrotomy Tension Pneumothorax Open Pneumothorax Indirect Threat Care/Warm Zone: Shock Control Indirect Threat Care/Warm Zone: Analgesics Evacuation Care Summary Reference Index

Тактична невідкладна допомога

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