201021U. S. Special Operations Command (USSOCOM)

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5. Chest pain with gradual onset and exacerbated by deep inspiration and accompanied by fever and productive cough MAY indicate lower respiratory tract infection. Consider treatment per Bronchitis/ Pneumonia Protocol. DISPOSITION: 1. Urgent evacuation. 2. Evacuation platform should include ACLS certified medical personnel and the equipment, supplies, and medications necessary for ACLS care. 3. Do not delay evacuation if unsure of chest pain etiology. Strongly consider early contact with a medical officer or medical treatment facility for consultation. Frequently reassess the patient suspected of a non-cardiac etiology to ensure stability and accuracy of the diagnosis. A26 Journal of <strong>Special</strong> <strong>Operations</strong> Medicine
CONSTIPATION/ FECAL IMPACTION SPECIAL CONSIDERATIONS: 1. Differential diagnosis includes acute appendicitis, volvulus, ruptured diverticulum, bowel obstruction, pancreatitis, or parasitic infections. 2. Acute onset, severe pain, point tenderness, and fever indicate etiologies other than constipation or fecal impaction. SIGNS AND SYMPTOMS: 1. Recent history of infrequent passage of hard, dry stools or straining during defecation. 2. Abdominal pain, which is typically poorly localized with cramping. 3. If pain becomes severe and is associated with nausea / vomiting and complete lack of flatus or stools, consider a bowel obstruction. MANAGEMENT: 1. Bisacodyl (Dulcolax) 10mg PO tid prn 2. Treat per Pain Protocol (no narcotics – they cause constipation) 3. For impacted stool or no relief with above measures, give normal saline enema 500ml via lubricated IV tubing. (Pt should retain solution for two minutes before evacuating contents). 4. If above measures fail, perform digital rectal examination to check for fecal impaction. If fecal impaction is present, perform digital disimpaction, if trained. 5. Increase PO fluid intake 6. Increase fiber (fruits, bran, and vegetables) in diet if possible. 7. If severe pain, rigid board-like abdomen, fever, and/ or rebound tenderness develop, or moderate to large amounts of blood are present in the stool, then treat per Abdominal Pain Protocol. DISPOSITION: 1. Evacuation is usually not required for this condition 2. Routine evacuation if no response to therapy Winter 2010 Training Supplement TMEPS A27
Page 1 and 2: Training Supplement Winter 10 Journ
Page 3 and 4: U.S. SPECIAL OPERATIONS COMMAND TAC
Page 5 and 6: HIV Post Exposure Prophylaxis 45 Hy
Page 7 and 8: Changes for 2009: A. Crush Protocol
Page 9 and 10: ABDOMINAL PAIN SPECIAL CONSIDERATIO
Page 11 and 12: ALTITUDE ILLNESS SPECIAL CONSIDERAT
Page 13 and 14: ANAPHYLACTIC REACTION SPECIAL CONSI
Page 15 and 16: BACK PAIN SPECIAL CONSIDERATIONS: M
Page 17 and 18: BEHAVIORAL CHANGES (INCLUDES PSYCHO
Page 19 and 20: Winter 2010 Training Supplement TME
Page 25 and 26: BRONCHITIS/ PNEUMONIA SPECIAL CONSI
Page 27: CHEST PAIN SPECIAL CONSIDERATIONS:
Page 31 and 32: CORNEAL ABRASIONS/ CORNEAL ULCERS/
Page 33 and 34: CRUSH SYNDROME PROTOCOL SPECIAL CON
Page 35 and 36: DEEP VENOUS THROMBOSIS (DVT) SPECIA
Page 37 and 38: DENTAL PAIN SPECIAL CONSIDERATIONS:
Page 39 and 40: EAR INFECTION (INCLUDES OTITIS MEDI
Page 41 and 42: EPISTAXIS SPECIAL CONSIDERATIONS: 1
Page 43 and 44: FUNGAL SKIN INFECTION SPECIAL CONSI
Page 45 and 46: HEADACHE SPECIAL CONSIDERATIONS: 1.
Page 47 and 48: HIV POST EXPOSURE PROPHYLAXIS SPECI
Page 49 and 50: HYPERTHERMIA SPECIAL CONSIDERATIONS
Page 51 and 52: INGROWN TOENAIL SPECIAL CONSIDERATI
Page 53 and 54: K-9 EVALUATION AND TREATMENT VITAL
Page 55 and 56: HYDRATION STATUS: 1. Normal Hydrati
Page 57 and 58: K-9 HIGH ALTITUDE SICKNESS AND PULM
Page 59 and 60: K-9 TRAUMA MANAGEMENT SPECIAL CONSI
Page 61 and 62: C. Chest tube and needle thoracente
Page 63 and 64: MALARIA SPECIAL CONSIDERATIONS: 1.
Page 65 and 66: NAUSEA AND VOMITING SPECIAL CONSIDE
Page 67 and 68: SEIZURE SPECIAL CONSIDERATIONS: 1.
Page 69 and 70: SMOKE INHALATION SPECIAL CONSIDERAT
Page 71 and 72: SPECIAL CONSIDERATIONS: None SUBUNG
Page 73 and 74: MILD TRAUMATIC BRAIN INJURY (MTBI)
Page 75 and 76: URINARY TRACT INFECTION SPECIAL CON
Page 77 and 78: Additional Contributors to Earlier
Page 79 and 80:
Joint Special Operations Tactical M
Page 81 and 82:
Pregnancy Category X Studies in ani
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o Increased fluid intake is require
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Pregnancy Category B Side-effects:
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Dosage of atovaquone/proguanil in p
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o Hepatitis Immune system disorder
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o o Gastroenteritis Protocol Urinar
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Benadryl® - See Diphenhydramine HC
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Pregnancy class: Generally consider
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2nd generation: Diminished Staph au
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o o o o o o o o Vomiting Diarrhea
Page 101 and 102:
Dextrose - See Glutose Diamox® - S
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o o o Contact Dermatitis Protocol E
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o Hypersensitivity to other carbape
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o Days 3 to 7: Instill 1 drop in af
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o Renal impairment o Not for use in
Page 111 and 112:
o Heme and lymphatic system Anemia
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on the label. DO NOT use solutions
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o Sodium depletion o Transient volu
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Abdominal pain Fatigue Loss of ap
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o Sedation in combination with anal
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o Ileus o Urinary retention TMEP Us
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o Swelling o Contact dermatitis o I
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Indications: o HAPE prophylaxis/tre
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o Ventilatory support o Intravenous
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Motion sickness: The average adult
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o GI: Nausea, vomiting, anorexia, d
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o Dry mouth o Nausea o Vomiting Adv
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o Respiratory: throat irritation, a
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Metabolism and nutrition disorders
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decrease the efficacy of tadalafil
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Acute renal failure Nephrogenic di
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Common Name Nomenclature AHFS Categ
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dextrose tablets 45gm multi-use squ
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plastic bag 12s (Hespan) 12s ibupro
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moxifloxacin hydrochloride (Avelox)
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Primaquine Phosphate tablets USP 15
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2009 Joint Formulary Authors U.S. S
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Pediatric Vital Signs Respiratory R
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systems. Through the medical threat
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Where do you foresee taking casualt
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Medics Advanced providers Casualty
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After Action Review in Training or
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Access to evacuation routes (foot,
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Winter 2010 Training SupplementTact
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Winter 2010 Training SupplementTact
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- Patient Treatment & Monitoring on
Page 173 and 174:
• Open HMMWV / GMV • Unit speci
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REHEARSALS Drive routes to hospital
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SEVERITY Minor: o partial thickn
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(Retrieved from http://www.nda.ox.a
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NOTES: Winter 2010 Training Supplem
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Winter 2010 Training Supplement 181
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201021U. S. Special Operations Command (USSOCOM)

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