M.O.L.L.E. MEDIC BAG

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M.O.L.L.E. MEDIC BAG
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Purpose

• The purpose of this tutorial is to familiarize
  the student with the Modular Light Weight Load
  Bearing Equipment (MOLLE) Medic Bag and its
  equipment.

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Components

• The MOLLE Medic Bag consist of
• Eight external pouches.
• Two detachable flaps.
• One detachable IV bandoleer.
• Approx. weight 22 lbs. full load
• Physical characteristics
• Length 22 in.
• Width 16 in.
• Height 12 in.

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EIGHT EXTERNAL POUCHES
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DETACHABLE FLAP

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DRESSING, BURN 4X16 SATURATED WITH WATER/GEL

• Purpose- specifically intended for the use in
  treating white phosphorus burns (WP).

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DRESSING, CHEST WOUND SEAL

• Purpose- treating sucking chest wounds.

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LARYNGOSCOPE
Purpose- for introducing endotrachael tubes. The
set contains a handle with fiber optic light and
two blades (curved and straight).

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CHEMICAL COLD PACK, REUSABLE, DUAL ICE

• Purpose- for use on sprains and blunt trauma
  injuries. The packs can be used in the field
  where ice is not available.

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BASIC CORPSMAN ENT KIT

• Otoscope.
• Speculums.
• Fiberoptic nose light.
• Red light lens.
• Cobalt blue light.
• Flour-I strips.
• Fiberoptic wands.
• Vortec Headlamp/red lens.

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VORTEC HEADLAMP

• Purpose- provides no-hands way of lighting the
  area to examine battle injuries.

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Packing/Configuration of the M.O.L.L.E. Bag

• Type of Mission.
• Duration of Mission.
• Environment (Urban, Jungle, Desert, Mountain).
• Casualty estimation.
• CASEVAC time.
• Resupply.
• Level of training.
• Weather (Cold, Hot)

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The Field Medical Card DD 1380
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Purpose

• Furnishes the attending physician with essential
  information about the diseases, injuries and
  treatment provided to the casualty during
  evacuation through the various echelons of care.
• Records disposition of patient, including death.
• Utilized by all U.S. and NATO Forces.

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Disposition of the DD Form 1380

• Transferred Cases
• Remains with the patient when transferred from
  one MTF to another.
• It should be attached to the patient or with
  established health record until the patient
  reaches hospital, dies, is buried, or returns to
  duty.

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Carbon Copies

• In the U.S., the Senior Command Surgeon
  prescribes the use of these through the SOP or
  the administrative or logistics order.
• Overseas commands they are used as the Senior
  Command Surgeon prescribes.
  

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Accuracy

• The DD Form 1380 is the first and sometimes the
  only record of combat casualty treatment.
• Accuracy and completion is of utmost importance.

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Required Information on the DD Form 1380
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Block 1

• Personal Identification
• Name.
• Rank.
• SSN.
• Sex.
• Specialty Code.
• Religion.

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Block 2

• Unit Information
• Unit.
• Nationality.
• Force.

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Block 3

• Injury identification
• Mark appropriately on diagram.

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Block 4

• Level of Consciousness
• Mental status.
• AVPU.

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Block 5

• Pulse
• Record time.
• Pulse characteristics and location.
• Block 6
• Tourniquet
• Indicate with yes or no and time if applied .

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Block 7

• Morphine
• Record dose and time .
• Block 8
• IV
• When.
• Where.
• What size IV catheter

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Block 9

• Treatment/Observations/Medications/Allergies/NBC
  Antidote
• Block 10
• Disposition of the patient , I.e. SIQ, light
  duty, MEDEVACd
• Block 11
• Provider Signature.

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The backside of the DD-1380 is used for
reassessment and follow-up.
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• STANDARD
• ISSUE
• PHARMACEUTICALS

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Morphine (MSO4)
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Accountability

• During time of war, HMs will be issued Morphine
  injectors under very strict controlled
  procedures.
• Possession is a medical responsibility and must
  not be taken lightly.

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Indications include

• Relief of severe pain.
• Contraindications
• Allergy to morphine or any other opiate.
• Airway and respiratory related injuries.
• Head injuries.
• Loss of consciousness, Altered mental status.
• Massive hemorrhage.
• Evidence of severe or deepening shock.

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Dosage

• Adult dosage 10mg Q4hrs
• Autoinjector is given intramuscularly which may
  be repeated, if necessary, in no less than 4
  hours.

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NOTE

• In the past, morphine came in the form of a
  syrette (similar to a small toothpaste tube).
• Dosage was 16mg (1/2 grain).
• NO LONGER USED !!!

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AUTOINJECTOR
Syrette
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Procedures

• Remove the safety cap and inject into a large
  muscle, i.e thigh or buttocks. Hold in place 10
  seconds.
• Massage the area in which the morphine was
  injected to increase the absorption into the
  circulatory system.
• After the morphine has been administered it is
  important to attach the spent injector to the
  pocket flap of the uniform blouse or blouse
  lapel. This is to show conspicuously that
  morphine has been given.

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Procedures (contd)

• The letter M and the Time that the morphine was
  administered must also be written on the
  patients forehead.
• Lastly, it is important to document the
  administration of morphine on the DD-1380 in
  Block 7.

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Morphine Poisoning

• Constricted pupils.
• Slowed respirations less than 12.
• Progressive fall in blood pressure.

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Treatment

• Oxygen.
• Pain stimulants.
• Administer Narcan.

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Narcan

• Drug of choice.
• Located in the BAS .
• Adult dosage is 0.4 mg, I.V.
• repeated every 2 -3 minutes.
• Can be given SQ

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M.O.L.L.E. Medic Bag Standard Issue Drugs
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Diphenhydramine Hyrdochloride (Benadryl)

• Is a antihistamine drug with anti-cholinergic
  (drying) and sedative effects.
• In oral form it is effective in the treatment in
  the following indications
• Skin allergies.
• Anaphylactic reactions.
• Food allergies.
• Motion sickness.

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Contraindications

• Hypersensitivity to diphenhydramine hydrochloride
  and other antihistamines of similar chemical
  structure.
• Dosage and Administration
• A single oral dose of 50mg is quickly absorbed
  with maximum activity occurring in approximately
  one hour.

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Epinephrine Injection, USP 11000 (Ana-Guard)

• The most valuable drug for the emergency
  treatment of severe allergic reactions is
  epinephrine

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Principle Indications

• Allergic reactions. Anaphylactic shock.
• Severe reactions due to allergy injections.
• Exposure to pollens, dust, molds, foods, drugs or
  unknown substances.
• Severe, life threatening asthma.
• Other symptoms
• bronchoconstriction,
• wheezing,
• sneezing,
• erythemia and pruritis

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Contraindications

• Cardiogenic, traumatic, or hemorrhagic shock.
• Cardiac dilation.
• Cerebral arteriosclerosis.
• Organic brain damage.

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Dosage and Administration

• Epinephrine Injection USP 11000
• 1 ml syringe, designed to deliver 2 doses of 0.3
  ml each
• ( 0.3 ml - 0.5 ml recommended dose )
• Intended for SQ or IM.

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Dosage and Administration

• Epinephrine Injection USP 11000 also comes in a
  Auto-Injector, which delivers a 0.3 ml dose.
• Also called an EpiPen.
• You may see both types of Epinephrine in the
  Supply system.

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Atropine

• Is the drug of choice for treating nerve agent
  poisonings. Atropine will dry secretions
  (including those in the airway), reduce
  bronchoconstriction, and decreases
  gastrointestinal motility.

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Indications

• Exposure to a nerve agent
• Contraindications
• None for emergencies

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Characteristics and Components of the Individual
First Aid Kit (IFAK)
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• Old
• 1-Eye Patch Dressing
• 1-Battle Dressing with Tie Ends
• 1-Bottle of Iodine Water Purification Tablets
• 1-Bottle of Wound Disinfectant
• 1-Lip Balm
• 2-Cravats
• 10-Adhesive Bandages

• New
• 1-Packet of Adsorbent Hemostatic Agent (QuikClot)
• 1-Package of Burn Gel (Water-Jel)
• 1-Bottle of Iodine Water Purification Tablets
• 1-Bottle of Wound Disinfectant
• 1-Tourniquet
• 2-Pressure Dressings
• 2-Bulky Gauze Rolls
• 10-Adhesive Bandages

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Components and Characteristics

• 1-Packet Adsorbent Hemostatic Agent
• Granular mineral powder
• Sterile
• Stops high volume venous and arterial bleeding
  through rapid absorption of liquid
• Clot remains in the wound until removed by
  medical personnel
• Food and Drug Administration (FDA) approved

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Quikclot Precautions

• Adsorption is physical, not chemical in nature
• (Adsorption-physical adhesion/ Absorption-chemical
  reaction)
• In presence of normal blood, this absorption
  causes only a slight body temperature increase to
  approximately 109-114 degrees F
• In presence of very non-viscous/adhesive liquids
  like WATER, MORE EXTREME HEAT CAN BE GENERATED by
  this adsorption. This reaction lasts
  approximately 4 to 5 seconds and then ENDS!

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Quikclot Precautions (cont.)

• Once granules have adsorbed all of the liquid
  possible, they go INERT.
• Prior to application, REMOVE water and excess
  blood from wound area.
• Caregivers hands should not be wet.
• Exothermia (production of heat) is controlled by
  adjusting the balance between volume of water and
  volume of product.

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Quikclot Precautions (cont.)

• Exothermic reaction and adsorption can be
  instantly arrested by flooding the granules with
  water.
• If blood is extremely diluted, the exothermic
  reaction can be more extreme!
• Quikclot may be applied in small amounts, rather
  than dumping all at once if blood is extremely
  diluted.

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Components and Characteristics (Cont)

• 1-Bottle of Wound Disinfectant
• Betadine solution
• Cleansing of Minor Wounds

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Components and Characteristics (Cont)

• 1-Tourniquet
• One Handed Use
• Use on arterial and venous blood
• For Moderate to Severe Bleeding only
• For use on Extremities only

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Components and Characteristics (Cont)

• 2-Pressure Dressings
• Vacuum Packed
• 8 x 10 Absorbent Pad
• 4 Wide elastic wrap with Velcro strip on both
  ends
• Coated Steel tension hook for individual
  application

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Components and Characteristics (Cont)

• 2-Bulky Gauze Rolls
• Gauze roll
• Absorbent Material
• 10-Adhesive Bandages

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Components and Characteristics (Cont)

• 1-Package 4x16 Sterile Burn Dressing
  (Water-Jel)
• Extinguishes white phosphorous burns
• Cools burn area
• Reduces chance for hypothermia
• Prevents burn from further progression
• Protects against infection and eases pain
• FDA approved
• Do not use for other than intended use

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Components and Characteristics (Cont)

• 1-Bottle of Iodine Water Purification Tablets
• To purify non potable water for consumption
• After handling the tablets, wash hands
  thoroughly. If eyes come in contact with the
  tablets or residue, it could cause temporary
  blindness