FMF Tactical Combat Casualty Care 3 — Questions and Answers
Question 1: A casualty has a sucking chest wound. After applying a vented chest seal, his condition worsens with absent breath sounds and tracheal deviation. What should you do?
- Apply a second chest seal over the first
- Remove the chest seal and perform needle decompression (Correct answer)
- Perform CPR immediately
- Increase supplemental oxygen flow
Correct answer: Remove the chest seal and perform needle decompression
Worsening after chest seal application with signs of tension pneumothorax requires removal of the seal and needle decompression.
Question 2: Hypothermia prevention in TCCC is critical because hypothermia worsens the 'lethal triad.' What are the three components of the lethal triad?
- Hypothermia, hypovolemia, hypoxia
- Hypothermia, acidosis, coagulopathy (Correct answer)
- Hypotension, acidosis, hypoxia
- Hypothermia, hemorrhage, hypoglycemia
Correct answer: Hypothermia, acidosis, coagulopathy
The lethal triad of hypothermia, acidosis, and coagulopathy creates a cycle that severely impairs the body's ability to clot and survive.
Question 3: In TCCC, when is intravenous (IV) access typically established?
- Immediately upon contact with any casualty
- During Care Under Fire only
- During Tactical Field Care when needed for fluid resuscitation or medication (Correct answer)
- Only after evacuation begins
Correct answer: During Tactical Field Care when needed for fluid resuscitation or medication
IV access is established during Tactical Field Care when the tactical situation permits and resuscitation or medication administration is needed.
Question 4: What volume of Hextend (6% Hetastarch) is the recommended initial bolus for a hypotensive trauma casualty in TCCC?
- 250 mL
- 500 mL (Correct answer)
- 1,000 mL
- 2,000 mL
Correct answer: 500 mL
500 mL of Hextend is the recommended initial bolus, which can be repeated once if the casualty remains hypotensive.
Question 5: A marine sustains a blast injury with suspected eye damage. Which TCCC action is appropriate?
- Irrigate both eyes immediately with available water
- Cover both eyes with rigid eye shields and do not apply pressure (Correct answer)
- Apply direct pressure to the globe to stop bleeding
- Remove any visible foreign bodies from the eye
Correct answer: Cover both eyes with rigid eye shields and do not apply pressure
Suspected open globe injuries require rigid shields over both eyes to prevent further damage, with no pressure applied.
Question 6: What is the correct action if a properly applied tourniquet fails to stop bleeding after tightening?
- Remove and reapply the same tourniquet more distally
- Apply a second tourniquet proximal to the first
- Pack the wound with hemostatic gauze and bandage over the tourniquet
- Apply a second tourniquet just above the first (Correct answer)
Correct answer: Apply a second tourniquet just above the first
A second tourniquet should be placed just above (proximal to) the first tourniquet when initial application fails to control bleeding.
Question 7: Which medication is recommended in TCCC for pain management in casualties who can still fight?
- IV morphine
- Oral transmucosal fentanyl citrate (OTFC)
- Ketamine IV push
- Acetaminophen and meloxicam (Correct answer)
Correct answer: Acetaminophen and meloxicam
Acetaminophen and meloxicam (combat pill pack) are recommended for casualties who are still able to fight and do not require stronger opioid analgesia.
FMF Tactical Combat Casualty Care 3
A casualty has a sucking chest wound.
After applying a vented chest seal, his condition worsens with absent breath sounds and tracheal deviation.
What should you do?