Sergeant’s Time Training.COM

1. Sergeant’s Time Training.Com Sergeant’s Time Training.COM

2. OVERVIEW OF CTL CTL 1 Evacuate Casualties Using Two Person Carries or Drags (Two Person Fore and Aft & Supporting Carry) Make 2 loops Loop 1 is initial Assessment Loop 2 is Rapid Trauma Assessment Treat All Wounds/Conditions Give MED SITREP (Time for TCCC is stopped) “Putting the M in EFMB” CCP Load Casualties onto Ground Evacuation Platform (M997 FLA) (15min) KEY Phase 2 of TCCC “Tactical Field Care” Casualty Collection Point (CCP) Patient 1 “Bleeder” Loop 2 Patient 2 “Chest” Loop 1 Evacuate Casualties Using One Person Carries or Drags (One Person Drag & Supporting Carry) Patient 3 “Abdominal” Patient 4 “Eye, Head, Arm” SP Carries or Drags Pack Aid Bag (20min) M997 (FLA) Perform a TCCC Patient Assessment (Phase 1 Care under Fire) Control Bleeding Using a Tourniquet (CAT) CCP CCP Direction of Travel Triage Casualties Gain Fire Superiority, BSI, “Call Out” SP Start Point Disassemble/ Assemble M16/M4 (4 Minutes) Give Acronyms (Time for TCCC Begins 1hr30min) Move Under Direct Fire “SPORTS” (10 Seconds) Phase 1 of TCCC “Care Under Fire” Sergeant’s Time Training.COM

3. CTL 1 Packing your aid bag “Putting the M in EFMB” You will be given 20 minutes, a list of supplies and one 68J, medical supply specialist Remember to ensure you have extra. Check the label on each item. If you are unsure talk to the 68J. They can not pack your aid bag or hand you items but they can tell you what is what. Keep the Combat Application Tourniquet (CAT) with tape and BSI wrapped together in your cargo pocket and an ETD with a HEMCON bandage & more gloves in your other cargo pocket. This will prevent you from using your aid bag until you need to do the saline/IV thus saving you time on the lane. Have strips of tape pre torn and placed on & in your aid bag & under your knee pads on the area above the knee. Pack according to patient and the order in which you use the items. Pack gloves everywhere so you don’t forget Body Substance Isolation (BSI). The following is a suggested list in the order that the items are used. YOU MUST ensure you have enough for every intervention necessary to successfully negotiate the lane! Items in red type are durable and you will reuse the same one throughout the lane • Patient 1 (Bleeder/Shock): • 1. Loop 1 • Gloves x 3-pr • CAT x 2 • HEMCON x 2 • Emergency Trauma Dressing (ETD) x 4 • Constricting band x 2 • Alcohol Pads x 10 • 18 Gauge (Green) Needle Cath x 3 • Saline Lock x 2 • Tape x 1 roll • 5cc Syringe x 2` • Normal Saline (1000ml) x 2 • IV Tubing x 2 • HEXTEND (500ml) x 2 • 2x2 x 4 • ETD x 2 • Casualty Blanket x 2 • 2. Loop 2 • Gloves x 2 pair • Stethoscope x 1 • BP Cuff x 1 • Pen light x 1 • Bandage Shears x 1 • DD1380 x 1 book • Patient 2 (Chest): • 1. Loop 1 • Gloves x 2pr • Asherman Chest Seal (ACS) x 2 • Tape x 1 roll • Occlusive dressing (field dressing) x 2 • Stethoscope x 1 • BP Cuff x 1 • Pen light x 1 • Bandage Shears x 1 • DD1380 x 1 book • Nasopharyngeal Airway (NPA) x 2 • 2. Loop 2 • Gloves x 2 pair • 14 Gauge (orange) needle/Catheter x 4 • Tape x 1 roll • DD1380 x 1 book • Patient 4 (Eye/Head/Arm): • 1. Loop 1 • Gloves x 2 pair • Pen light x 1 • 2. Loop 2 • Gloves x 2 pair • 2 x 2 x 2 • 4 x 4 x 2 • Field dressing x 2 • ETD x 2 • Structural Aluminum Malleable (SAM) Splint x 2 • Elastic Wrap x 2 • Coban x 2 rolls • Kerlix x 2 rolls • Cravats x 4 • Tape x 1 roll • Stethoscope x 1 • BP Cuff x 1 • Pen light x 1 • Bandage Shears x 1 • DD1380 x 1 book • Patient 3 (Abdominal): • 1. Loop 1 • Gloves x 2 pair • 2. Loop 2 • Gloves x 2 pair • Abdominal Dressing x 2 • DD1380 x 1 book

4. CTL 1 Disassemble/ Assemble/ Functions Check your M16 Rifle or M4 Carbine “Putting the M in EFMB” • You will have four (4) minutes to disassemble, reassemble and functions check your rifle. • This task begins when you touch the rifle. This will also begin the 1hr30min to complete TCCC • The rifle will be disassembled into thirteen (13) parts. 1. Upper receiver. 2. Lower receiver. 3. Sling. 4. Charging Handle. 5. Buffer 6. Bolt carrier. 7. Buffer spring. 8. Firing pin retaining pin. 9. Bolt cam pin. 10. Bolt. 11. Firing pin. 12. Extractor. 13 Extractor pin. • You WILL NOT remove the hand guards. You must place all parts on the table before reassembling and conducting the functions check • A good idea is to have the sling loosened and a pen readily available • Disassemble M16 • Clear the rifle • Slector to “SAFE” • Drop magazine • Inspect the chamber • Remove the sling • Separate upper and lower receiver • Pull back charging handle • Remove bolt carrier • Remove charging handle • Lock the bolt assembly • Remove firing pin retaining pin • Remove firing pin • Remove bolt cam pin • Remove bolt assembly • Remove extractor pin • Remove extractor • Remove buffer spring assembly and separate • Disassemble M4 • Clear the rifle • Drop magazine • Cock the Carbine • Slector to “SAFE” • Lock bolt open • Inspect the chamber & receiver • Let bolt move forward • Remove the sling • Separate upper and lower receiver • Pull back charging handle • Remove bolt carrier • Remove charging handle • Lock the bolt assembly • Remove firing pin retaining pin • Remove firing pin • Remove bolt cam pin • Remove bolt assembly • Remove extractor pin • Remove extractor • Remove buffer spring assembly and separate • Assemble • Insert spring and buffer • Insert extractor and spring into bolt • Insert extractor pin into bolt • Insert bolt into bolt carrier • Insert bolt cam pin and turn ¼ • Insert and seat firing pin • Insert firing pin retaining pin into bolt carrier • Insert charging handle part way into upper receiver • Slide bolt carrier group and charging handle into upper receiver • Join the upper and lower receiver • Ensure selector switch is on “SAFE” • Replace sling • Functions Check • Charge rifle, place on “SAFE”, pull trigger (Hammer should not fall) • Place on “SEMI”, pull and hold trigger (Hammer should fall) • While holding trigger, charge rifle. • Release trigger slowly “metallic click” (hammer should not fall) • Pull trigger (hammer should fall) • Place on “BURST”, Charge rifle, Pull and hold trigger (hammer should fall) • While holding trigger, charge rifle three (3) times. • Release trigger slowly “metallic click” (hammer should not fall) • Pull the trigger (hammer should fall) • Inform evaluator if there is a malfunction • Insert magazine (time stops) • Place weapon on safe and readjust sling

5. CTL 1 Move Under Direct Fire “SPORTS” Movement into Phase 1 of TCCC “Putting the M in EFMB” • You have packed your aid bag, disassembled/reassembled & functions checked your rifle or Carbine. You will now link up with a fire team and move down your designated Combat Testing Lane (CTL) • As you move down the lane you will be engaged by Opposing Forces (OPFOR). This is your cue to begin your Individual Movement Techniques (IMT) and Move under Direct Fire task. • You must use available cover and concealment to determine which movement technique best fits the situation. Upon being engaged immediately get down, take cover return fire and move to another fighting position using IMT’s advancing towards the OPFOR. Either low crawl, high crawl or 3 – 5 second rush. Terrain dictates. • During this time you will randomly have a stoppage in your rifle which you must clear using Slap, Pull, Observe, Release, Tap, Shoot (SPORTS) in 10 seconds or less. • Continue returning fire and conducting IMT until you are close enough to hear your casualties screaming and you are able to see them. Continue to return fire until you have been told that you have gained fire superiority. • Call out to your casualties stating “If you can hear the sound of my voice and can move, move to me, If you can hear my voice but can not move raise your hand” (This is part of the triage task) • Put on your Body Substance Isolation (BSI) (Gloves), using IMT’s move to your casualties and conduct blood sweep on Patient 1. • If at anytime during Phase 1 OPFOR begins firing you must stop what you are doing and return fire. A dead or injured medic will not be able to successfully save his fellow Soldiers on the battlefield. • Patient 1 will have a femoral bleed which will need a tourniquet. EXPOSE the wound! Remove the CAT and tape from your cargo pocket. With the CAT laced through both eyelets loop the CAT over the casualties boot and up the leg until it is 2” above the wound. Pull Velcro tight. Twist until bright red bleeding stops. Secure rod and Velcro. Using the tape mark a “T” on the casualties forehead and the date and time. Finish blood sweep. • IMT to patient 2 . Start your blood sweep. You may find a non life threatening bleed on the chest. Do not treat it, it is not life threatening and the area is too dangerous. Carry patient to the CCP utilize the fireman's carry or drag • Go back and carry Patient 1 to the CCP utilize the support carry (drunk buddy hop). This ends Phase 1 of TCCC and begins Phase 2 of TCCC

6. Patient 1 – “Bleeder” CTL 1 “Putting the M in EFMB” Phase 1 – Care under fire – not at the CCP Gain fire superiority Call out – “if you can hear my voice and can move, move to me. If you can hear my voice and cant move, raise your hand” Two hands will go up Put on your gloves / Body Substance Isolation (BSI) Move to patient 1 keeping low profile and conduct blood sweep Find femoral artery bleed Expose the wound and Apply tourniquet (“T”, Date and Time) Move to patient 2 Blood Sweep Note chest bleeding (do not initiate treatment) One person carries or drags to Casualty Collection Point (CCP) (Move Patient 2 first then Patient 1 ) Phase 2 – Tactical Field Care – At the CCP – Loop 1 – Initial Assessment (HABC) Reassess tourniquet Develop general impression Determine responsiveness using AVPU (Alert, alert to Verbal stimuli, alert to Painful stimuli, Unresponsive) scale (patient is yelling so they’re Alert) Determine chief complaint Begin HABC – Assess for Hemorrhage by conducting blood sweep, remove ACH, sweep for blood from head to toe, treat all life threatening bleeding Find life threatening bleed in Armpit – expose the wound, apply HEMCON, Hold 2 – 4 min, apply ETD, Continue and finish blood sweep. Assess the Airway – look, listen, feel (patient is yelling so airway is patent) Assess Breathing - Expose the chest – inspect and palpate for Deformities, Contusions, Abrasions, Punctures or Penetrations, Burns, Tenderness, Lacerations and Swelling (DCAP-BTLS), Auscultate the four quadrants of the chest (Apex, Apex, Base, Base), Look for equal and bilateral rise and fall, Palpate for Tenderness, Instability & Crepitous (TIC) Assess Circulation – Perform 2nd blood sweep, Convert tourniquet to pressure dressing – expose wound, loosen tourniquet, “brisk bleeding does not return”, apply ETD using the pressure bar covering edges of wound pad, check distal pulse – finish blood sweep Check Pulse – pulse will be weak and thready Check skin CCT (color, condition and temperature) – Pale, cool and clammy Pulse and CCT indicate that patient is going into hypovolemic shock Initiate a saline lock and convert to IV infusion – Assemble and inspect equipment, explain to casualty, select site, prep site, draw skin tight below puncture site, bevel up insert needle/cath, “FLASH”, lower needle & advance ½”, advance cath, remove constricting band, remove needle (hold pressure above the puncture site), maintain control of cath, tape down hub, Apply saline lock, secure with tape, flush w/ 5cc sterile fluid, look for signs of infiltration, convert to IV – Explain to casualty, assemble & inspect equipment, prep equipment, clamp 6 – 8 in. below drip chamber, remove covers, spike bag (keep sterile), give bag to fire team member, prime tubing, clean saline lock, attach tubing, check for normal flow, Apply 2x2 “window”, loop tubing onto extremity, readjust the flow, open “window” & check for infiltration. Treat for shock/prevent hypothermia – reassure casualty, loosen boots, belt, blouse, elevate legs, (injured on top of uninjured), wrap rescue blanket around casualty, monitor every 5 – 15 min. Grab aid bag and weapon and move to patient 2

7. Patient 2 – “Chest” CTL 1 “Putting the M in EFMB” Phase 1 – Care under fire – not at the CCP Gain fire superiority Call out – “if you can hear my voice and can move, move to me. If you can hear my voice and cant move, raise your hand” Two hands will go up Put on your gloves / Body Substance Isolation (BSI) Move to patient 1 keeping low profile and conduct blood sweep Find femoral artery bleed Expose the wound and Apply tourniquet (“T”, Date and Time) Move to patient 2 Blood Sweep Note chest bleeding (do not initiate treatment) One person carries or drags to Casualty Collection Point (CCP) (Move Patient 2 first then Patient 1 ) Phase 2 – Tactical Field Care – At the CCP – Loop 1 – Initial Assessment (HABC) Develop general impression Determine responsiveness using AVPU (Alert, alert to Verbal stimuli, alert to Painful stimuli, Unresponsive) scale (patient is yelling so they’re Alert) Determine chief complaint Begin HABC – Assess for Hemorrhage by conducting blood sweep, remove ACH, sweep for blood from head to toe, treat all life threatening bleeding Find life threatening bleed on Chest– expose the wound, You see a penetrating chest wound, cover it immediately with a gloved hand, Inspect back for an exit wound, Remove ACS, Use 4 x 4 to clean and dry area around wound, expose adhesive side, tell casualty to exhale, place directly over wound, Assess flutter valve, Monitor breathing, Inspect for DCAP-BTLS, TIC, Equal bilateral rise and fall, Auscultate, Check vital signs, Blood Pressure, Respirations, Pulse & PERRL, Observe for signs of shock, check pulse and skin CCT (BRPPS). Assess the Airway – look, listen, feel. This patient will go Unconscious, This is you cue to insert an NPA – Place casualty supine with head in neutral position, Assess nasal passages for obstructions, measure NPA against nostril to earlobe or nostril to angle of jaw, Lube NPA, “pig nose” casualty, insert into right nostril with bevel to septum until flange rests against nostril, look, listen and feel, air way will be patent. Assess Breathing - Expose the chest – inspect and palpate for Deformities, Contusions, Abrasions, Punctures or Penetrations, Burns, Tenderness, Lacerations and Swelling (DCAP-BTLS), Auscultate the four quadrants of the chest (Apex, Apex, Base, Base), Look for equal and bilateral rise and fall, Palpate for TIC Assess Circulation – Perform 2nd blood sweep. Check Pulse Check skin CCT (color, condition and temperature) Place casualty on their injured side Grab aid bag and weapon, Call out to check on patient 1 and move to patient 3

8. Patient 3 – “Abdominal” CTL 1 “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 1 – Initial Assessment (HABC) Develop general impression Determine responsiveness using AVPU (Alert, alert to Verbal stimuli, alert to Painful stimuli, Unresponsive) scale (patient is yelling so they’re Alert) Determine chief complaint Begin HABC – Assess for Hemorrhage by conducting blood sweep, remove ACH, sweep for blood from head to toe, treat all life threatening bleeding Find blood on abdomen – expose the wound, You see a non life threatening open abdominal wound, Finish blood sweep. Assess the Airway –look, listen, feel (patient is yelling so airway is patent) Assess Breathing - Expose the chest – inspect and palpate for Deformities, Contusions, Abrasions, Punctures or Penetrations, Burns, Tenderness, Lacerations and Swelling (DCAP-BTLS), Auscultate the four quadrants of the chest (Apex, Apex, Base, Base), Look for equal and bilateral rise and fall, Palpate for TIC Assess Circulation – Perform 2nd blood sweep. Check Pulse Check skin CCT (color, condition and temperature) Place casualty with head to side, knees flexed and remove all sources of food and water. Tell casualty you will be back to check on them Grab aid bag and weapon, Call out to check on patient 1 and patient 2 move to patient 4 Sergeant’s Time Training.COM

9. Patient 4 – “Eye/Head/Arm” CTL 1 “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 1 – Initial Assessment (HABC) Develop general impression Determine responsiveness using AVPU (Alert, alert to Verbal stimuli, alert to Painful stimuli, Unresponsive) scale (patient is yelling so they’re Alert) Determine chief complaint Begin HABC – Assess for Hemorrhage by conducting blood sweep, remove ACH, sweep for blood from head to toe, treat all life threatening bleeding, you will note a fractured arm. Find blood on head and eye – expose the wound, You see a non life threatening laceration on head and eye, Finish blood sweep. Assess the Airway –look, listen, feel (patient is yelling so airway is patent) Assess Breathing - Expose the chest – inspect and palpate for Deformities, Contusions, Abrasions, Punctures or Penetrations, Burns, Tenderness, Lacerations and Swelling (DCAP-BTLS), Auscultate the four quadrants of the chest (Apex, Apex, Base, Base), Look for equal and bilateral rise and fall, Palpate for TIC Assess Circulation – Perform 2nd blood sweep. Check Pulse Check skin CCT (color, condition and temperature) Check pulse on fractured arm, Have casualty hold fractured arm against their chest with their good arm, check fractured arm pulse, have casualty sit-up, check fractured arm pulse. Check PMS and PERRL, check pulse on fractured arm Grab aid bag and weapon, Call out to check on patient 1, 2 and 3. Move to patient 1 to begin loop 2 Sergeant’s Time Training.COM

10. CTL 1 Patient 1 – “Bleeder” “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 2 – Rapid Trauma Assessment (DCAP-BTLS) Uncover casualty Assess the head – Inspect and palpate for DCAP-BTLS, use pen light to inspect eyes for PERRL (Pupils Equal Round and Reactive to Light, inspect for raccoon eyes & battle signs behind the ears, inspect mouth for broken teeth or airway obstructions, inspect nose, mouth and ears for CSF and/or blood Assess the neck – DCAP-BTLS, TIC & step offs, JVD (Jugular Vein Distention), Tracheal Deviation Assess the chest – DCAP-BTLS, equal bilateral rise and fall, Auscultate, TIC Assess the abdomen – DCAP-BTLS, TRD (Tenderness, Rigidity & Distention) Assess the pelvis – DCAP-BTLS, Gently compress for TIC, Priaprism sweep (back of hand) (males only) Assess the lower extremities – DCAP-BTLS, TIC, PMS (Pulse, Motor & Sensory) Assess the upper extremities – DCAP-BTLS, TIC, PMS Assess the posterior – DCAP-BTLS, TIC, Step offs, rectal bleeding, call litter team and log roll patient back down onto a litter. Reassess all interventions Check pulse, blood pressure, respirations, skin CCT, & PERRL (BRPPS) Gather AMPLE history (Allergies, Medications, Past prior medical history, Last oral intake, Events leading up to injury) Initiate FMC (Field Medical Card) DD Form 1380 – remove protective sheet, complete blocks 1,3,4,7,9 & 11, Secure correctly completed FMC to the casualty Administer appropriate medications – verbalize “ I will give 5milligrams of morphine, 25milligrams of phenergen & 2grams of cefotetan via IV” Package patient for transport – re-wrap the patient with casualty blanket and secure them to the litter correctly Perform ongoing assessment – verbalize “ I will repeat initial assessment, vital signs, focused assessment and I will reevaluate all interventions, treatments and CASEVAC (Casualty Evacuation) category every 5 – 15 minutes” Grab aid bag and weapon, call out to check on patient 4, 3 and 2 Move to patient 2

11. CTL 1 Patient 2 – “Chest” “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 2 – Rapid Trauma Assessment (DCAP-BTLS) Casualty states they are having a hard time breathing. This is your cue to do Needle Chest Decompression (NCD). – Check for JVD and Tracheal deviation, It will be present, Expose the chest and look for insertion site, locate the 2ndIntercostal Space (ICS), Between second and third rib mid clavicle, in line with the nipple, on the same side as the penetrating chest wound. Approx. two finger widths below the clavicle. Remove plastic cap from front and back of 14 Gauge (orange) needle catheter. Firmly insert into chest at a 90 degree angle, you will hear a pop and hiss, remove the needle, maintain control of catheter, secure hub of catheter to the chest with tape. Reassess all interventions Check pulse, blood pressure, respirations, skin CCT, & PERRL (BRPPS) Gather AMPLE history (Allergies, Medications, Past prior medical history, Last oral intake, Events leading up to injury) Initiate FMC (Field Medical Card) DD Form 1380 – remove protective sheet, complete blocks 1,3,4,7,9 & 11, Secure correctly completed FMC to the casualty Administer appropriate medications – verbalize “ I will give 5milligrams of morphine, 25milligrams of phenergen & 2grams of cefotetan via IV” Perform ongoing assessment – verbalize “ I will repeat initial assessment, vital signs, focused assessment and I will reevaluate all interventions, treatments and CASEVAC (Casualty Evacuation) category every 5 – 15 minutes” Place casualty on injured side. Grab aid bag and weapon, call out to check on patient 4, 1 and 3 Move to patient 3 Sergeant’s Time Training.COM

12. CTL 1 Patient 3 – “Abdominal” “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 2 – Rapid Trauma Assessment (DCAP-BTLS) Re expose the wound if it has been covered Dress the wound with a sterile abdominal dressing and secure ties loosely at the side in a non slip knot Reassess all interventions Check pulse, blood pressure, respirations, skin CCT, & PERRL (BRPPS) Gather AMPLE history (Allergies, Medications, Past prior medical history, Last oral intake, Events leading up to injury) Initiate FMC (Field Medical Card) DD Form 1380 – remove protective sheet, complete blocks 1,3,4,7,9 & 11, Secure correctly completed FMC to the casualty Administer appropriate medications – verbalize “ I will give 5milligrams of morphine, 25milligrams of phenergen & 2grams of cefotetan via IV” Perform ongoing assessment – verbalize “ I will repeat initial assessment, vital signs, focused assessment and I will reevaluate all interventions, treatments and CASEVAC (Casualty Evacuation) category every 5 – 15 minutes” Place casualty on injured side. Grab aid bag and weapon, call out to check on patient 1, 2 and 4 Move to patient 4 Sergeant’s Time Training.COM

13. CTL 1 Patient 4 – “Eye/Head/Arm” “Putting the M in EFMB” Phase 2 – Tactical Field Care – At the CCP – Loop 2 – Rapid Trauma Assessment (DCAP-BTLS) Re expose the head and eye wound if it has been covered Check PERRL, ask casualty their name, the date and the presidents name, check pulse on fractured arm, check PMS, Ask the casualty if they are wearing contacts, check eye for any obstructions or anything protruding, ask casualty to close their eye, cover eye with a 2 x 2 gauze then a 4 x 4 gauze and then a field dressing, tie in back of head in non slip knot. Re expose the head wound if the field dressing has covered it, wrap an ETD around the head wound, do not use pressure bar, cover edges of wound pad, uncover the good eye, uncover the ears and ensure the casualty can still open and close their mouth with out issue. Check a pulse on the fractured arm, fold a SAM splint in half and roll up one end of it to fit in a palm, concave the center of the splint to cradle the forearm and measure it against the good arm, take a pulse on the fractured arm, place fractured arm in the SAM splint and have casualty continue to hold against their chest, take pulse on fractured arm, take an elastic wrap and starting at the elbow wrap the arm and splint together snugly to immobilize the fractured arm, secure elastic wrap with provided fasteners and tape then take a pulse on fractured arm, using 2 cravats tied together secure the arm against their chest and tie it on the uninjured side (under the armpit of the unbroken arm), take a pulse on fractured arm, now using another cravat create a sling to hold the arm up and tie on the uninjured side against the neck, tuck the corner of the sling at the elbow, check the pulse of the fractured arm. Reassess all interventions Check pulse, blood pressure, respirations, skin CCT, & PERRL (BRPPS) Gather AMPLE history (Allergies, Medications, Past prior medical history, Last oral intake, Events leading up to injury) Initiate FMC (Field Medical Card) DD Form 1380 – remove protective sheet, complete blocks 1,3,4,7,9 & 11, Secure correctly completed FMC to the casualty Administer appropriate medications – verbalize “ I will give 5milligrams of morphine, 25milligrams of phenergen & 2grams of cefotetan via IV” Perform ongoing assessment – verbalize “ I will repeat initial assessment, vital signs, focused assessment and I will reevaluate all interventions, treatments and CASEVAC (Casualty Evacuation) category every 5 – 15 minutes” Place casualty on injured side. Grab aid bag and weapon, call out to check on patient 1, 2 and 4 Move to center of CCP

14. CTL 1 CCP Report the medical situation Triage task Stops TCCC time (1hr30min) “Putting the M in EFMB” • By now you should have four casualties that have been treated and are prepared to be evacuated • Patient 1 should be on a litter and all patients have all interventions finished and a DD1380 FMC completed • You are now prepared to give the medical situation report to your evaluator. This will complete your triage task and will stop the time for TCCC which is 1 hour and 30 minutes maximum • You will state “I am ready to give the medical situation” then verbalize the following information: • # of casualties • Each casualties priority for treatment (Immediate, delayed, minimal, expectant) • Special equipment required to evacuate • # of casualties by type, litter and/or ambulatory • Casualties’ nationality and status • MED SITREP • I have four (4) casualties • One (1) Immediate, two (2) delayed and one (1) minimal • I need no special equipment • I have three (3) litter and one (1) ambulatory • I have three (3) KATUSA ROK Soldiers and one (1) U.S. Soldier MED SITREP Number of casualties: 4________ PT1 PT2 PT3 PT4 Each casualties priority for treatment determined during triage: D I D M Special equipment required to evacuate the casualties:_____________NONE________________ Number of casualties by type, litter and/or ambulatory: Litter:___3___ Ambulatory:___1___ Casualties’ nationality and status: _________________ Sergeant’s Time Training.COM

15. CTL 1 Two person carries Load an M997 (FLA) (15min) “Putting the M in EFMB” • Now that you have given your MED SITREP you need to transport your casualties from the CCP to the M997 or Front Line Ambulance (FLA), Ensure you take your weapon with you and utilize the litter team provided to you and take a second to drink some water. • You are graded on two, two person carries. Patient 1 is on a litter and does not count, patient 4 is ambulatory (able to walk) and also does not count, this leaves patient 2 and patient 3 for you to be evaluated on, however, you must transport all four casualties safely. • Patient two can be carried using the two person support arms carry AKA drunk buddy hop and patient 3 can be carried using the two person fore and aft carry (one bearer in front of casualty facing forward (away from casualty) holding casualties legs with left hand under left knee and right hand under the right knee and one bearer (YOU) behind the casualty facing forward (Towards casualty)holding your arms under the armpits with your hands crossed over casualties chest and your fingers interlaced) • Once all four patients are transported behind the FLA your evaluator will tell you that your abdominal patient has been taken by another team of medics, leaving you with 2 litter and 1 ambulatory patient to load onto the FLA. • Time for loading the FLA begins when you start strapping casualties to litter, start prioritizing casualties or touch the FLA. You can place your weapon against the back of the FLA for this task but must have it in your hand when you close the FLA doors, which stops the time. • Call litter team over and have them watch you strap a litter strap over the casualty then instruct them to strap in the rest. While they strap in the casualties you can configure and clear the FLA. • Open the doors and secure them to the side of the FLA, remove all debris and trash from the back of the FLA, Drop the left berth and place all straps behind the berth, ensure all hooks hanging down are secured to the ceiling. Lower the rear end of the right berth and ensure all loose straps are tucked away and hooks are secured. • Load patient 2 on the upper right berth head first (1st patient in), raise the berth and immediately hook the ceiling strap to the berth, click the “no-go” switch and tighten the tension strap, Using the hooks provided secure the litter to the berth ensuring they are tight and that the litter will not move or bounce and the hooks wont slip or slide off of the litter during transport. • Load patient 1 into the bottom right berth head first(due to IV bag) (2nd patient in), use the hooks provided and secure the litter to the berth ensuring they are tight and that the litter will not move or bounce and the hooks wont slip or slide off of the litter during transport. • Now walk patient 4 to the steps and into the FLA (last patient in)and have them hold a strap on the ceiling • Double check all straps for tightness, exit the FLA, PICK UP YOUR WEAPON! and close the doors of the FLA(left door first then the right door). Time will be stopped and the CTL will be complete!

16. ACRONYMS CTL 1 “Putting the M in EFMB” Combat Application Tourniquet (CAT) Body Substance Isolation (BSI) Combat Testing Lane (CTL) OPposing FORces (OPFOR) Individual Movement Techniques (IMT) Slap, Pull, Observe, Release, Tap, Shoot (SPORTS) Casualty Collection Point (CCP) Alert, alert to Verbal stimuli, alert to Painful stimuli, Unresponsive (AVPU) Hemorrhage Airway Breathing Circulation (HABC) Deformities, Contusions, Abrasions, Punctures or Penetrations, Burns, Tenderness, Lacerations & Swelling (DCAP-BTLS) Tenderness, Instability & Crepitous (TIC) Color Condition & Temperature (CCT) Asherman Chest Seal (ACS) Pupils Equal Round & Reactive to Light (PERRL) Tactical Combat Casualty Care (TCCC) Allergies, Medications, Past prior medical history, Last oral intake, Events leading up to injury (AMPLE) CASualty EVACuation (CASEVAC) MEDical EVACuation (MEDEVAC) Field Medical Card (FMC) IntraVenous (IV) Structural Aluminum Malleable (SAM) Front Line Ambulance (FLA) MEDical SITuation REPort (MED SITREP) Emergency Trauma Dressing (ETD) Pulse, Motor & Sensory (PMS) InterCostal Space (ICS) Needle Chest Decompression (NCD) Nasopharyngeal Airway (NPA) Jugular Vein Distention (JVD) Tenderness, Rigidity & Distention (TRD) Blood pressure, Respirations, Pulse, PERRL, Skin CCT (BRPPS)

17. CTL 1 Questions Sergeant’s Time Training.COM