Max D
Corvus Training Group
Source: http://prolongedfieldcare.org/2015/03/15/ravine-mnemonic-for-prolonged-field-care/
The Prolonged Field Care Working Group has just posted up another great product.
The most resonant point in this post for me was the definition of "therapeutic pause" as that moment after finishing an algorithm and thinking "I've done everything on the list...". I know I've had those moments on extended transports. I can only imagine what that feels like when you're going to sit on a guy for a while.
I really like the MARCH your PAWS to the RAVINE approach and I can't wait to see how this develops.
Source: http://prolongedfieldcare.org/2015/03/15/ravine-mnemonic-for-prolonged-field-care/
RAVINE Mnemonic for Prolonged Field Care
The RAVINE Mnemonic was created to help the medical provider on the ground in an austere environment with a very sick patient. Most medics will do an amazing MARCH survey and when they get to the end of that either repeat the MARCH survey again or add on PAWS which stands for Pain control, Antibiotics, Wounds and Splinting. These are all the right answer but at some point the provider will run out of things to do and there will be a therapeutic pause as he gathers himself and thinks of what he should be doing next. This will help keep the thought process moving in the right direction and in an appropriate order while serving as a reminder of some critical steps that we have identified such as reducing tourniquets to pressure dressings and making a telemedicine/evac call along with others that may be overlooked such as nursing care and environmental considerations. Mnemonics should be just cheesy enough but memorable in any situation so remember this; RAVINEs or deep draws are places that a small unit would hide a patrol base while in enemy territory to rest and prepare for the next leg of the mission. Just as draws and RAVINEs offer relative safety and piece of mind in a dire situation so too will this memory aid:
MARCH your PAWS to the RAVINE…
Emergency Whole Blood Protocol
PFC Fresh Whole Blood Transfusions FAQ
PFC WG Tourniquet Conversion recommendations (June, 14)
Post Cric Checklist
PFC WG analgesia and sedation comments (Feb, 14)
Scott Weingart’s Dominating the Ventilator Handout
LRMC TH – SOCOM AFRICOM Policy
Medical Planning Tool
6 Page PFC Patient Care Flowsheet and Documentation
PFC Casualty Card version 15
Everything You Need to Know About Foley Catheters
The Prolonged Field Care Working Group has just posted up another great product.
The most resonant point in this post for me was the definition of "therapeutic pause" as that moment after finishing an algorithm and thinking "I've done everything on the list...". I know I've had those moments on extended transports. I can only imagine what that feels like when you're going to sit on a guy for a while.
I really like the MARCH your PAWS to the RAVINE approach and I can't wait to see how this develops.
Source: http://prolongedfieldcare.org/2015/03/15/ravine-mnemonic-for-prolonged-field-care/
RAVINE Mnemonic for Prolonged Field Care
The RAVINE Mnemonic was created to help the medical provider on the ground in an austere environment with a very sick patient. Most medics will do an amazing MARCH survey and when they get to the end of that either repeat the MARCH survey again or add on PAWS which stands for Pain control, Antibiotics, Wounds and Splinting. These are all the right answer but at some point the provider will run out of things to do and there will be a therapeutic pause as he gathers himself and thinks of what he should be doing next. This will help keep the thought process moving in the right direction and in an appropriate order while serving as a reminder of some critical steps that we have identified such as reducing tourniquets to pressure dressings and making a telemedicine/evac call along with others that may be overlooked such as nursing care and environmental considerations. Mnemonics should be just cheesy enough but memorable in any situation so remember this; RAVINEs or deep draws are places that a small unit would hide a patrol base while in enemy territory to rest and prepare for the next leg of the mission. Just as draws and RAVINEs offer relative safety and piece of mind in a dire situation so too will this memory aid:
MARCH your PAWS to the RAVINE…
- Resuscitation with fresh whole blood, Reduce Tourniquets as soon as possible
Emergency Whole Blood Protocol
PFC Fresh Whole Blood Transfusions FAQ
PFC WG Tourniquet Conversion recommendations (June, 14)
- Airway and Cric care package including Capnography,Sedation drip, Sterile suctioning, Heat moisture exchanger/Filter, Check cuff Pressure, Tube depth
Post Cric Checklist
PFC WG analgesia and sedation comments (Feb, 14)
- Ventilate or oxygenate- Positive pressure with PEEP using a lung protective strategy
Scott Weingart’s Dominating the Ventilator Handout
- Initiate telemedicine and evacuation early
LRMC TH – SOCOM AFRICOM Policy
Medical Planning Tool
- Nursing care including Monitoring and trending of vitalsand ins and outs especially urine output, Positioning patient up, DVT Prophylaxis massage, turn patient 30 degrees to the sides, Passive ROM exercises, Oral Hygiene
6 Page PFC Patient Care Flowsheet and Documentation
PFC Casualty Card version 15
Everything You Need to Know About Foley Catheters
- Environmental Considerations - Hypo/Hyperthermia, Ear plugs for flight, Sun screen and chapstick, Padding the litter and pressure points, Motion sickness prophylaxis