Fill in all sections on a regular basis

MEDICAL RECORD OF PATIENT — 1 card per patient

NAME OF CASUALTY FIRSTAIDER / MEDIC

by copyright: A.P. Sherriff 2008

This Record Card is protected
SEX MALE FEMALE AGE
ADDRESS
TIME OF ACCIDENT / TIME FOUND DAY MONTH YEAR
HOW ACCIDENT OCCURRED / ILLNESS

KNOWN MEDICATIONS, ILLNESSES, ALLERGIES, ETC.

DETAILS OF ANY MEDICATIONS TAKEN — DOSE & TIME

ENSURE THAT THIS CARD GOES TO HOSPITAL WITH THE CASUALTY

IS THE PATIENT WEARING AN "SOS. TALISMAN" OR A "MEDI-ALERT" BRACELET / TAG?

YES NO REFERENCE NUMBER

INDICATE
123456789INJURIES FOUND:- SUSPECTED INTERNAL INJURIES
123456789 = WOUND / GUNSHOT — Circle those that apply
123456789
123456789
= FRACTURE / DISLOCATION
= BURN / FROSTBITE HEAD NECK & SPINE CHEST ABDOMEN PELVIC

www.andysherriff.co.uk
COMA SCALE / RESPONSE TO STIMULI
A = ALERT (NORMAL) V = VOCAL P = TO PAIN U = UNRESPONSIVE

TIME PULSE RESPIRATION PUPIL SIZE DETAILS & COMMENTS PUPIL 2

RATE RATE / SIGNS LEFT RIGHT CONSCIOUSNESS LEVEL SIZES
3
SIZE 4
IN
MM. 5
6

YES NO
HAS THE PATIENT EVER — BEEN UNCONSCIOUS, VOMITED,
COMPLAINED OF HEADACHE, EXPERIENCED AMNESIA ?

I confirm that I have been

advised to attend a Hospital
but do not wish to do so. ®©2008 Andy Sherriff First Aid Training
Signature Phone / Fax 01824 - 790195
 Mountain Rescue Casualty Card
(to be completed as fully as possible by first aider, and to remain with casualty on transfer)
© KERRY MOUNTAIN RESCUE TEAM
This form may be duplicated for personal use only. Commercial distribution of any description is not permitted.

Personal Details Next of Kin Details

Name: Name:
Date of Birth: Relationship:
Home Address / Telephone: Telephone:
Address:

Medical Details Description of Accident / Complaint

Known Allergies: Time:
Description:
Past Medical History:

Medications:

Last fluid / food consumed:

Injury / Illness Report

Nature and extent of injuries / illness:
(please indicate wound, fracture, pain or other opposite)

Treatment given to date (if any):

Vital Signs
Level of Respiratory Pupillary
Heart Rate
Consciousness Full/weak?
Rate Blood Skin Colour Reaction
Laboured?
Capillary Refill Normal = equal
Time (Alert, responds Regular/irregular Pressure (normal = less
and
to Verbal ? Shallow/Deep? (normal for Temperature and reacting to
than 2 secs)
stimulus, (normal adult = Regular/Irregular systolic BP = light.
responds to 60-80/min) ? approx. 100 + If not please
Pain, (normal adult = Age) specify
Unresponsive) 12-20/min)

Other Information
 First Aid
This information is intended to serve as a ‘memory jogger’ only. You should attend a recognised First Aid course at least once every three years.
Rescue Emergency Care (REC) first aid courses are specifically focused on an outdoor environment. See the MCI website (www.mountaineering.ie) for
details of courses.

SCENE ASSESSMENT
Ensure that it is safe to approach the casualty, and deploy body substance isolation procedures if possible (eg. latex gloves).

PRIMARY ASSESSMENT
A irway (with c-spine control) – Ensure that the casualty’s airway is patent using a head tilt-chin lift manoeuvre (spinal injury not suspected) or a
tongue-jaw lift (spinal injury suspected). Check to make sure the airway is clear and unobstructed. Remove any obvious obstructions if it is safe to do
so (ie. there is no possibility of obstructions being pushed deeper into the airway).

Breathing – Check respiratory function, ie. breathing rate, depth, regularity, clarity. The decision on whether to commence CPR is discussed below.
Circulation – Check pulse characteristics, ie. rate, strength, regularity. The decision on whether to commence CPR is discussed below. Check for
bleeding and control severe blood loss as soon as possible using direct pressure. If this fails, use indirect pressure. Check capillary refill time at the
extremities (eg. nail beds). Assess skin colour and temperature. Note any cyanosis.

D isability – Assess level of consciousness using the AVPU scale (alert, responds to verbal, responds to pain, unresponsive). Check for pupillary
reaction. Check sensory and motor function of all extremities. Note any obvious fractures.

SECONDARY ASSESSMENT
Perform full casualty examination:
Start from the head and work downwards, checking for blood/other body fluid, deformities, pain, obvious wounds, swelling, bruising, tenderness,
medic-alert jewellery, limb function etc..

Treat Injuries:
Do the best you can using the resources available to you. Do not attempt to move the casualty if you suspect spinal injury, unless you are fully
practiced in spinal lifting techniques. Treat for shock if necessary.

Promote Recovery:
Ensure that the casualty is kept warm and reassured. Place a casualty with a reduced level of consciousness in the safe airway position (recovery
position) if it is safe to do so. It is acceptable to give a conscious casualty hot drinks if surgery will not be necessary. Use plenty of dry warm clothing,
sleeping bag, survival bag / survival shelter / tent. Consider moving to a more sheltered location if it is safe to do so.

HYPOTHERMIA
Possible signs and symptoms: physical and mental lethargy, slurred speech, shivering (early stages), cyanosis, uncharacteristic
behaviour, dizziness, blurred vision, feelings of warmth and denial that anything is wrong, stupor, collapse.

Treatment: give hot sweet drinks and energy food, use additional dry clothing (especially hat and outer shell layer), find a sheltered
location, use survival bag, sleeping bag, tent etc., use a fit party member to share body warmth, do not give alcohol, do not rub the casualty.

Caution: If one party member is suffering from hypothermia, it is likely that others in the party may also suffering to a greater or lesser
degree - including yourself! Be aware of the ‘bigger picture’!

LOWER LEG INJURY

Lower leg injury is an extremely common injury for walkers, and therefore warrants particular mention here. In the mountain environment the
treatment basically consists of bandaging any open wound to prevent blood loss and minimise the risk of infection, re-aligning the limb to a
neutral position if possible, and immobilising it. Typically, the limb will be immobilised by splinting it to the ‘good’ leg. Circulatory, sensory and
motor function in the limb (particularly distal to the fracture site) should be checked initially, immediately after every intervention made, (ie. after
moving the limb, after bandaging, after splinting etc.), and periodically thereafter. The vital signs of the casualty should be monitored carefully.

Upper leg injury (eg. fractured femur) is less common but more serious, and may require treatment for shock, as internal blood loss into the
tissues of the thigh can be severe. Strong muscle spasms/cramps may occur, causing severe pain and possible distortion of the fractured
limb.

CPR IN THE MOUNTAIN ENVIRONMENT

The decision on whether to commence CPR on a non-breathing pulseless casualty in a mountain environment is never easy. You should be
aware that:
1) Depending on your location, it may be several hours before medical help is available.
2) Once you have commenced CPR it should be continued until you are physically unable to continue (eg. exhaustion).
3) If you commence CPR it will prevent you from calling for help for, or assisting, any other injured party members.

Disclaimer – The information contained herein is provided for reference purposes only. Kerry Mountain Rescue Team or the authors of this document cannot be held liable
in any way for any claims arising out of the use of this information, howsoever caused. The reader is advised to seek approved first aid training and to act on his / her
training, knowledge and experience at all times when treating casualties.
TCCC CASUALTY
CARD
DA FORM 7656
 Documentation of Care
• Most casualties injured on the battlefield
do not have their initial care documented
prior to evacuation.
• DD form 1380 is an outdated cumbersome
form to fill out. Much of the information is
unnecessary
• Electronic forms are not compatible with
the battlefield environment
 TCCC Casualty Card
• A new casualty card is available to help
document the care for injured Soldiers at
the point of wounding. This card is based
on the principles of TCCC.
• This new card addresses the initial
lifesaving care provided at the point of
wounding. Filled out by whomever is
caring for the casualty.
• Its format is simple, with a circle or “X” in
the appropriate block.
TCCC Casualty Card
Front Back
 Instructions
• Follow the instruction on the following
slides for how to use this form.
• This casualty card will be found in each
Soldiers IFAK
• Use an indelible marker to fill it out
• Attach it to the casualty’s beltloop, or place
it in their upper left sleeve, or the left
trouser cargo pocket
• Include as much information as you can
 New Casualty Card Front

Individuals
name and
allergies should
already be filled
in. This should be
done when
placed in IFAK.
 New Casualty Card Front

• Add date-time,
group
• Cause of injury,
and whether
friendly,
unknown, or
NBC.
 New Casualty Card Front
• Mark an “X” at the
site of the injury/ies
on body picture.
• Note burn
Percentages on
figure
 New Casualty Card Front
• Record casualty’s
level of consciousness
and vital signs
with time.
A Alert
V Responds to verbal
P responds to pain
U Unresponsive
 New Casualty Card Back
• Record airway
interventions.
 New Casualty Card Back
• Record breathing
interventions.
 New Casualty Card Back
• Record bleeding
control measures,
don’t forget
tourniquet time on
front of card.
 New Casualty Card Back
• Record route
of fluid, type,
and amount given.
 New Casualty Card Back
• Record any
drugs given:
pain meds,
antibiotics,
or other.
 New Casualty Card Back
• Record any
pertinent notes.
 New Casualty Card Back
• Sign card.
• Does not have
to be a medic
to sign
 New Casualty Card
• Record each specific intervention in each
category.
• If you are not sure what to do, the card will
prompt you where to go next.
• Simply circle the intervention you
performed.
• Explain any action you want clarified in the
remarks area.
 Documentation
• You may not be able to perform all the
interventions on the card or that the
casualty needs.
• However, when the medic is available he
can add additional treatments to the card.
• This card can be filled out in less than two
minutes
• It is important that we document the care
given to the casualty.
 TCCC Card Abbreviations
• DTG = Date-Time, Group (e.g. – 160010Oct2009)
• NBC = Nuclear, Biological, Chemical
• TQ = Tourniquet
• GSW = Gunshot Wound
• MVA = Motor Vehicle Accident
• AVPU = Alert, Verbal stimulus, Painful stimulus, Unresponsive
• Cric = Cricothyroidotomy
• NeedleD = Needle decompression
• IV = Intravenous
• IO = Intraosseous
• NS = Normal Saline
• LR = Lactated Ringers
• ABX = Antibiotics