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TCCC Practice Test What Is The Principle of TCCC? - ANS Treat the Casualty, Prevent Additional Casualties and Complete the Mission. Which of the Following is the three phases of TCCC? - ANS Care Under Fire, Tactical Field Care, Tactical Evac Care. What Pain Medication is preferred for someone who has moderately painful wounds that are NOT life threatening who still has to operate as a combatant? - ANS Meloxicam and Tylenol ER The most common cause of preventable death on the battle field is blood loss from non-compressible (massive) hemorrhage? [T:F] - ANS True What are the BEST indicators for shock during Tactical Field Care? - ANS State of Consciousness and quality of the radial pulse All Combat casualties should have an IV started as soon as possible. [T:F] - ANS False Pt has a gunshot wound to the chest; She should be allowed to drink fluids if conscious and able to swallow. [T:F] - ANS True Giving large amounts of fluids to a casualty who has bleeding located on/in the abdomen or chest may worsen their hemorrhage by diluting clotting factors. [T:F] - ANS True Antibiotics should be given to all combatants who sustain open wounds. [T:F] - ANS True During the Care Under Fire phase of TCCC what are the appropriate steps of care? - ANS Control life-threatening extremity bleeding with a tourniquet and return fire as necessary. Moxifloxacin should be given how rapidly after a wound is sustained in order to be most effective at preventing infection? - ANS As soon as possible
During the Tactical Field Care phase, after a corpsman has performed the chin-lift/jaw-thrust to open the airway of an unconscious Pt, what is the next step in airway management? - ANS Insert a Nasopharyngeal Adjunct Which casualty should be cared for first? A-Shot in the head/Unconscious B-Heavy Bleeding, thigh wound C-Shot in the abdomen/Awake and Alert - ANS B- Heavy Bleeding, Thigh Wound The best way to manage a casualty in a combat setting is not necessarily the same for a civilian setting. [T:F] - ANS True The TCCC guidelines presented should be followed exactly, no matter the tactical context, in which the casualties must be treated. [T:F] - ANS False Pt suffered GSW to the chest, you watch him have more and more trouble breathing. What is the next best step? - ANS Needle-D for suspected tension pneumothorax Pt suffered GSW to the face. As the corpsman arriving on the scene, you note he is conscious and maintaining his airway by sitting up and leaning forward. How would you manage his airway? - ANS Let him continue to sit up and lean forward as care is rendered What is the best and quickest way to check for an adequate airway? - ANS Ask a question that requires them to respond The minimal amount of time needed for a Pt to bleed out from a heavy femoral wound (hemorrhage) - ANS 3 minutes A Pt who has suffered 1 litre of blood is in danger of dying from hemorrhagic shock/ [T:F] - ANS False In an average adult male, how much blood loss is likely to result in hemorrhagic shock? - ANS 2.5 liters
During the Tactical Field Care phase, the preferred antibiotic is moxifloxacin. Why? - ANS Is effective against most bacteria, has relatively mild side effects, can be taken by mouth and is inexpensive In the largest study done to date; Giving rapid infusions of IV fluids to Pt's with hemorrhaging was shown to increase the mortality rate. [T:F] - ANS True Which Pt has the greatest need of an emergency CASEVAC? A- Land mine/Amputation of the leg; controlled bleeding by tourniquet B- GSW Head/Unconscious; Significant brain tissue exposed C- GSW Abdomen/No radial pulse - ANS C- GSW Abdomen/No radial pulse The most important thing after splinting an open fracture is: - ANS Check to make sure the distal pulse is not reduced by the splinting When considering whether or not to give a casualty morphine what are some reasons to not give it to them? - ANS His wounds are minor and he can still fight, He is in shock or He has a chest wound and is in respiratory distress. During Tactical Field Care a Pt with a GSW to his lower jaw suddenly develops a complete airway obstruction, then loses consciousness. What is the best way to secure their airway? - ANS Surgical intervention using the Cric-Key method. During a firefight 15 minutes ago you sustained a GSW with heavy arterial bleeding to your thigh. Bleeding was controlled via CAT and you are the only medic, CASEVAC is 30 min out and the MTF is 20 minutes away. What is the best course of action in regards to the tourniquet on your leg? - ANS Leave it in Place which of the following are true? A- F.A.S.T.-1 is a good way to secure fluid access when an IV fails. B-Casualties Alert and able to swallow should not be given fluids oraly. C-All combat wounds produce severe pain D- Pulse Ox and other electronic monitoring devices are not useful during TacEvac in a helicopter. - ANS A- F.A.S.T.-1 is a good way to secure fluid access when an IV fails.
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Which of the following statements best applies to caring for hostile wounded combatants? A-Wounded combatants can still inflict deadly harm. B-No care should be given until the combatant has surrendered all weapons and been searched and secured. C-Once able to do so, render the same care as any U.S. or friendly forces. D-All the Above - ANS D-All the Above Fluid resuscitation to treat shock is considered part of Care Under Fire. [T:F] - ANS False You may only give a Pt Moxifloxacin once per day. [T:F] - ANS True Hextend is preferred when compared to Plasma-Lyte A and Lactated Ringer's for any combatants who have a prolonged delay before evac. Why? - ANS The intravascular volume expansion lasts much longer with Hextend compared to others. What is not included when gathering information and writing up a nine-line report? - ANS Age of the Casualty(s) What is NOT an advantage when using a fentanyl lozenge over morphine in a tactical setting? - ANS Both hold the potential for respiratory depression When performing Needle-D what is the correct landmark to use if the 5th intercostal space fails? - ANS 2nd intercostal space, Mid-Clavicular What is the best initial treatment for stopping extremity hemorrhage in a tactical environment? - ANS A Tourniquet What is Combat Guaze used for? - ANS Controlling severe external bleeding (not initial hemorrhage) During Tactical Field Care your Pt is suffering severe external bleeding from a injury to the groin. You apply Combat Gauze deep into the wound however it is
unsuccessful at stopping the bleed, What is the next step in care? - ANS Use a second roll of Combat Gauze on the bleeding site. Your Pt has a palpable radial pulse, this means their systolic BP is at least 80mm Hg. [T:F] - ANS True Your Pt has a sever crushing injury to the right knee. During Tactical Field Care the pain makes it so he can barely concentrate, he is answering questions appropriately despite this. His radial pulse is 120, strong, and you are in a secure area. Evac is about 20 minutes away, what is the best way to treat his pain? - ANS OTFC (fentanyl pop) 800 ug. Repeat after 15 minutes if necessary. You administered one unit of whole blood, however, your Pt's radial pulse remains absent and mental status hasn't improved. Next you should? - ANS Administer a second unit of whole blood. After treating a sucking chest wound your Pt begins showing signs of difficulty breathing and you suspect tension pneumothorax is developing. What is the preferred first step to manage this condition during Tactical Field Care? - ANS Lift one side of the occlusive dressing to allow air to escape. (Burping the wound) You should apply at least 3 minutes of direct pressure when using Combat Gauze. [T:F] - ANS True What is the preferred antibiotic given via IV/IM in TCCC? - ANS Ertapenem The leading cause of Late morbidity in combat casualties may be the delay in administering antibiotics. [T:F] - ANS True Meloxicam (Mobic) is preferred over other NSAIDs such as aspirin and ibuprofen. Why? - ANS It doesn't interfere with platelet function and clotting factors Why is preventing/treating hypothermia important to managing combat casualties? - ANS Shock interferes with heat production, leading to potential hypothermia which in turn prevents blood from clotting effectively
TCCC requires good tactical decisions as well as good medicine. [T:F] - ANS True What is the main thing to avoid doing for a Pt if you suspect a penetrating eye injury? - ANS Applying an eye patch to keep gentle pressure on the injury For a deep, narrow junctional wound what is the best hemostatic dressing to use? - ANS XStat Which analgesic we is NOT included in the TCCC-recommended Triple-Option analgesia plan? - ANS Morpine IM Opioid analgesics can lower BP and depress respirations whihc in turn will worsen hypovolemic shock. [T:F] - ANS True Ketamine will lower BP and suppress laryngeal reflexes if your Pt has hypovolemic shock. [T:F] - ANS True What is the initial dose of ketamine (IM) recommended by TCCC? - ANS 50 mg What is the initial dose of fentanyl (OTFC) recommended by TCCC? - ANS 800 ug Increases in PTSD cases has been associated with inadequate battlefield analgesia. [T:F] - ANS True Which of the following can make a TBI worse? - ANS Hypovolemic shock, Hypothermia and Hypoxia What is the most readily asses-able indicator of shock on the battlefield? - ANS Weak or absent radial pulse What is the target BP for a casualty WITHOUT an associated TBI? - ANS 80-90 mm Hg What is the target BP for a casualty WITH an associated TBI? - ANS 90 mm Hg or higher
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Which of the following is not a CoTCCC recommended junctional tourniquet? - ANS AAT As a corpsman, your first priority during Care Under Fire is? - ANS Return fire and take cover Who is the BEST person to move a Pt during CUF? - ANS The casualty themselves What is the top medical priority during CUF? - ANS Control life-threatening bleeding A CAT should be loosened for 1 minute every 30 minutes to prevent ischemic damage to the limb. [T:F] - ANS False What is the correct way to treat pain caused by a tourniquet that is controlling life-threatening bleeding? - ANS Analgesics following TCCC guidelines During CUF why should you avoid using hemostatic dressings? - ANS 3 minutes to apply direct pressure is a long time to be exposed During CUF, you should apply C-spine when? - ANS Never A NPA is preferred to an OPA because: - ANS It is unlikely to stimulate the gag reflex in a conscious Pt The best site(s) to insert a needle-D is: - ANS 2nd ICS along the MCL and the 5th/4th ICS along the AAL The most ideal dressing to put over a sucking chest wound is? - ANS A Vented chest seal Training tourniquets may be issued for a mission if they have not been used for more than 6 months. [T:F] - ANS False
Why would you consider not starting an IV during TFC? - ANS If Pt only has minor wounds, it would critically delay tactical movements or you need to reserve them for those that actually need them. Why would you not use a F.A.S.T.-1? - ANS Pt has a sternal fracture What is not true regarding TXA? - ANS It Promotes the formation of new clots When resuscitating a Pt with hemorrhagic shock, fluids take precedence over controlling hemorrhage. [T:F] - ANS False What doesn't cause inaccurate O2 readings on a pulse-Ox? - ANS High Altitude When a Pt has a suspected penetrating eye injury you should absolutely never give them ketamine. [T:F] - ANS False If a Pt has been given morphine or OTFC it is safe to give them a dose of ketamine. [T:F] - ANS True What is NOT true about ketamine? - ANS It presents no risk of respiratory depression what is NOT a sign indicating a closed fracture? - ANS A bounding pulse distal to the injury What is NOT a reason to splint a fracture? - ANS To reduce the chance of infection Under what circumstances during TFC would you consider starting CPR? - ANS Pt has Cardiac arrest due to electrocution The TCCC card (DD1380) should only ever be filled out by medical personell. [T:F] - ANS False For every casualty you should complete all interventions shown on the TCCC casualty card (DD1380). [T:F] - ANS False
What is NOT correct in regards to Casualty Collection Points (CCP)? - ANS They should be far away from fighting using JTS-recommended evac categories, which Pt should NOT be categorized as urgent? - ANS Extremity injury lacking a distal pulse Soft tissue injuries, while they look bad, generally only kill when associated with shock. [T:F] - ANS True What is the correct way to define TACEVAC? - ANS Evacuation of Pt's by both dedicated platforms and tactical vehicles of opportunity What is the main difference between Tactical Field Care and Tactical Evacuation Care? - ANS Extra medical personnel and equipment allowing for a greater level of care. What is a concern(s) associated with high altitude evacuation? - ANS Pulse-Ox readings drop, Air-filled cuffs may expand further causing damage and sucking chest wounds may develop tension pneumothorax Some Pt may benefit from sup. O2 during evac, which Pt below would not? - ANS below knee amp; normal mental status and bleeding controlled by tourniquet During TACEVAC a Pt suffering from a TBI should be monitored for? - ANS O2 sat>90%, sys BP >90 and a decreased LOC A Pt with a TBI may show signs of cerebral herniation. If you notice unilateral pupil dilation along with decreased LOC what should you NOT do? - ANS Cool them down by stripping them as well as removing HPMK (blanket) and gear When would you consider performing CPR during TACEVAC? - ANS The Pt's wounds are not obviously fatal and will get care soon, it will not deny other life saving care and it will not compromise the mission
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When should you provide care to wounded enemy combatants aside from life-saving interventions? - ANS Once they have reached a POW collection point You should leave a tourniquet in place unless: - ANS The casualty's vitals remain stable and normal after 3 hours Direct Pressure to control heavy bleeding while moving a PT has been proven effective and practical. [T:F] - ANS False During CUF, while under enemy fire, the best location to apply a tourniquet is: - ANS High & tight, over the uniform Tourniquet Conversion is referring to what? - ANS Transitioning from an effective tourniquet to an effective hemostatic and pressure dressing Once a tourniquet has been applied to a limb tight enough to stop bleeding and eliminate the distal pulse, it is uncommon to notice re-bleeding. [T:F] - ANS False When should you NOT convert a limb tourniquet? - ANS The tourniquet has been on for 6+ hours What is NOT a reason ondansetron was chosen to replace promethazine? - ANS The side-effects are about the same Ondansetron Oral Disintegrating Tablet (ODT) works just as quickly as the oral (PO) tablet. [T:F] - ANS False What is the preferred method to do a cricothyroidotomy? - ANS The Cric-Key technique The Cric-Key eliminates the need for an incision through the cricothyroid membrane. [T:F] - ANS False Your Pt suffered a shrapnel wound to the upper inside arm, mid axillary and blood is flowing heavily. The wound is both deep and narrow and too close to use
a CAT, you used your only CRoC earlier and need to leave ASAP. What is the best intervention in a TFC situation? - ANS XStat with a pressure dressing Your Pt suffered a deep narrow wound to the upper inner thigh and it is bleeding heavily. The best way to treat this is what? - ANS Pack with XStat and have helper hold pressure while you apply a junctional tourniquet The best time to give your first dose of TXA to a Pt with uncompressible hemorrhage is what? - ANS As soon as possible but within 3 hours of injury How many members are on the CoTCCC? - ANS 42 What percentage of CoTCCC have been deployed? - ANS 100%