SOMA '09

[olhamada]

Presenter: Lt Col. Nick Withers MD – CCFP Canadian Forces Health Services GRP HQ
Lecture: Canadian Forces Approach to TC3

Canadian Forces number 70,000 with a Reserve of 30,000. 900 Med Techs. Tri-service and interchangeable. Budget $20 billion.

Compare to US – 3 million soldiers (AC/RC) with a budget of $480 billion.

CCC Training has three levels – Military Standard First Aid, Combat First Aid, and TCCC (11 day course).

Med Techs are all qualified as civilian Primary Care Paramedics and can advance their skills via three routes – Advanced Emergency Care, Tac Med Training, and/or PA.

TCCC 11 day course is broken down into 2 phases. Phase 1 includes topics such as Human Performance in TCCC, Critical Thinking, TCCC Paradigm (TCCC bubble, extraction techniques, Pluck lab, Tactical lab), Tactical training, Shooting, Live tissue training (swine). Phase 2 topics include the field portion and Mass Casualty.

Use the MARCHE acronym – Massive hemorrhage control, Airway, Respiratory control, Circulatory control, Hypothermia, and Eye trauma/Everything else.

For C-spine injuries, use the NEXUS criteria or the Canadian C-spine rules.

Re shock – use Hypertonic Saline 7.5% or Dextran 6%. 250 ml IV/IO q 10-15 min x 2.

Abx – Minofloxin 400 mq po q 24 hrs, Cefoxitin 2 g IV/IO/IM q 8 hrs, or Clinda 600 mg IV/IO/IM q 8 hrs (PCN alolergic).