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Trauma- Focused Individual Training

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Title: Trauma- Focused Individual Training


1
Trauma- Focused Individual Training
  • Revised and Updated
  • January 2005

2
Trauma Focused Individual TrainingT-FIT
3
What is T-FIT?
  • Focused medical training for non-medical
    personnel designed to provide critical medical
    intervention at the site of injury.

4
Who Developed the Course?
  • COL Cliff Cloonan, Assistant Professor Military
    Emergency Medicine Department Developed the
    course based on his operational experience as
    SOCOM Surgeon .

5
Command Emphasis
  • 1st Brigade (Warrior) Brigade Commander COL
    William Garrett (2003) directed implementation
    and fielding of program within Warrior Brigade.

6
10050252 Rule
  • 100 of unit strength CLS trained
  • 50 of unit strength T-FIT trained
  • 25 (approx) Combat Medics assigned
  • 2 Advanced Trauma Management (ATM) Providers

Based on Battalion/Squadron sized element
7
Course History
  • The first formal class was taught to soldiers
    assigned to 1-32 Infantry Battalion, 1st Warrior
    Brigade, 10th Mountain Division in February 2003

8
Initial Course Developers
  • Major Chadwick- 1st Brigade Surgeon
  • CPT Pataky- Battalion Physician Assistant
  • Medics of 1-32 Infantry

9
Baptism Under Fire
  • The courses further development began in
    Operation Iraqi Freedom for Task Force Chosin.
    Training was developed based on requirements as
    identified during combat operations beginning
    October 2002

10
Course Improved Development
  • MAJ Jack Hurley- 82nd Airborne Division
  • CPT Michael Franco- 82nd Airborne Division
  • 1LT Edwin Guiterrez- 10th MTN DIV
  • 1LT Thomas Moody 10th MTN DIV
  • SFC Douglas Mack- 10th MTN DIV
  • SSG Conway Halladay- 10th MTN DIV
  • SGT Joshua Pierrpont-10th MTN DIV

11
Program of Instruction Writers
  • 1LT Edwin Gutierrez
  • 1LT Thomas Moody

12
DEDICATION
  • This course is dedicated to all soldiers of Task
    Force Chosin and most importantly to those who
    made the ultimate sacrifice.

13
Prerequisites
  • Successfully complete the Combat Life-Savers
    course.
  • Passing CLS written examination of 90 or better
    on written exam.
  • Top 25-50 of CLS course.

14
Course Requirement
  • Pass all individual practical skills testing
  • Pass all group practical skills
  • Score 80 or better on written examination

15
Individual Practical skills
  • Maintain an open airway
  • Perform mouth-to mask ventilation
  • Insert an oral pharyngeal airway
  • Insert a nasal pharyngeal airway
  • Apply dressing for sucking chest wound
  • Perform trauma patient assessment
  • Perform I.V. administration
  • Apply tourniquet
  • Request MEDEVAC
  • Perform patient triage

16
Team Practical skills
  • Manage trauma patient
  • Manage mass casualty

17
Lectures
  • Introduction to T-FIT
  • Combat Casualty care/Tactical Care Under Fire
  • Triage/Mass Casualty Management
  • Patient Assessment Trauma Patient
  • Airway management

18
Lectures (Continued)
  • Head Trauma
  • Chest/Abdominal Trauma
  • Extremity Trauma
  • Burns
  • Altitude Sickness
  • MEDEVAC Procedures

19
Course Comparison (Lectures)
Class T-FIT RFR
Airway Management Y Y
Patient Assessment Y Y
Thoracic Trauma Y Y
Abdominal Trauma Y Y
IV Management Y Y
Tactical Combat casualty care Y Y
Extremity Trauma Y Y
Altitude Medicine Y N
Triage Y Y
Burns Y N
Shock Y Y
Heat Injuries N Y
20
Course Comparison (Practical Skills)
Skill T-FIT RFR
Airway Management Y Y
Patient Assessment Y Y
Seal Open Chest wound Y Y
Needle Decompression Tension Pneumothorax Y Y
IV Management Y Y
Tactical Combat casualty care Y Y
Hemorrhage Control Y Y
Triage Y Y
MEDEVAC Procedures Y N
21
Recommended Course length
  • 2- 15 hour/ Day
  • 3- 12.5 hour/Day
  • 4- 10 hour/Day
  • 5- 8 hour/Day

22
Recommend Supplies
  • IV fluid (NS)-100
  • IV Tubing- 100
  • Needle Catheter-200
  • Alcohol pads-200
  • Tourniquets-20
  • Gloves- 100
  • Band Aid- 100
  • Sharp Container- 5
  • Chux- 100
  • CLS bags- 25
  • Asherman Chest seal-25
  • Ratchet Tourniquet-5
  • Quik Clot- 2(demonstration only)
  • Airway Mannequin- 1

Based on class size of 25 soldiers
23
Recommend Supplies
  • Tape 1 inch- 15
  • Field Dressing- 25
  • Cravats- 25
  • Israeli Dressing- 25
  • Kerlix- 50
  • FAST-1(demonstration only)
  • Litters- 4
  • ACE Wrap 3 inch- 5
  • Oral Pharyngeal - 10
  • Nasal Pharyngeal- 10
  • Laptop-1
  • Proxima-1

Based on class size of 25 soldiers
24
Training Schedule
DAY TIME CLASS FORMAT INSTRUCTOR
1 0900 INTRODUCTION LECTURE ATM PROVIDER
1000 Tactical Combat Casualty Care LECTURE ATM PROVIDER
1100 Triage LECTURE ATM PROVIDER
1200 LUNCH
1300 Patient Assessment LECTURE ATM PROVIDER
1400 Skills Station 1) Airway Management 2)Needle decompression 3) Hemorrhage Control 4) Seal Open Chest Wound 5) Triage Hands-on Practice MEDICAL NCO
1700 End of Training Day
25
Training Schedule
DAY TIME CLASS FORMAT INSTRUCTOR
2 0600 Shock Management
0700 Airway Management LECTURE ATM PROVIDER
0800 Head Trauma Management LECTURE ATM PROVIDER
0900 Chest/Abdomen Trauma Management LECTURE ATM PROVIDER
1000 Extremity Trauma Management LECTURE ATM PROVIDER
1100 Burns LECTURE ATM PROVIDER
1200 LUNCH
1300 Altitude Sickness LECTURE ATM PROVIDER
1400 Skills Station 1) Airway Management 2)Needle decompression 3) Hemorrhage Control 4) Seal Open Chest Wound 5) Triage Hands-on Testing MEDICAL NCO
1700 End of Training Day
26
Training Schedule
DAY TIME CLASS FORMAT INSTRUCTOR
3 0700 Written Exam
0800 Trauma Challenge Prep ATM PROVIDER
1000 Trauma Challenge Graded Practical Exercise Hands-on MEDICAL NCO
1200 LUNCH
1300 Trauma Challenge Graded Practical Exercise Hands-on MEDICAL NCO
1700 Certificate Issue Commanders Comments After-Action Review
1700 End of Training Day
27
Certificate of Training
presented by
1st Squadron, 71st Cavalry 10th Mountain
Division, Fort Drum New York
To
PV2 John David 111-111-1111
For
Successful completion of 40 hours of Trauma Focus
Individual Training
________________________________ Thomas U. Moody,
MPAS, RPA-C 1LT, SP Physician Assistant
________________________________ Mark
Meadows LTC, IN Commanding
09 Nov. 2003 13 Nov. 2003
28
T-FIT Packing List
Adhesive tape, surgical porous woven 1in.x10yrds
1 Airway, pharyngeal
large adult
1 Airway, pharyngeal small
adult
1 Bandage adhesive 3/4inx3in chest
flesh (band-aid)
18 Bandage muslin compressed (cravat) 37x37x52
triangular 4 Case medical
instrument and supply (CLS bag)
1 Catheter needle unit d121 V 18ga

4 Bandage, pressure, Israeli

2 Dressing, first aid, field camouflaged
4x6.25x7.25 lg abs 6 Gloves
patient exam-large (latex)
2 Intravenous inj
set 7compmacrodrip10drops/ml
2 Catheter 14ga 2.5in

2 Asherman chest dressing

2 Pad povidone-iodine impre ster2x1 375brown
(iodine pads) 12 Povidone-iodineointUSP1
0 1/8oz. (3.54 gram) (iodine ointment) 8 Ringers
lactate injection USP 500ml plastic bag
2 Scissors, bandage 1.5 cut
large 7.25
7 Alcohol preps

25 Field dressing, first aid 7x2x8

2 Sam splint

1 Nasopharyngeal airway

4 2x2 gauze sponges

12 Tourniquet Ratchet
1
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