PART 1: OPERATIONAL ISSUES
Care Under Fire 1-1
MedCAP (H/CA) Guide 1-2
Hospital Survey Form 1-4
General Medical Site Survey Checklist 1-8
Site Survey, Veterinary Annex 1-10
Pararescue Primary Medical Kit Packing List 1-12
USAF SOF Trauma Ruck Pack List 1-15
USAF SOF Trauma Vest Pack List 1-17
Suggested M5 Packing List 1-18
Naval Special Warfare Combat Trauma AMAL 1-20
Patient Considerations 1-22
9 Line Medevac Request 1-23
Helicopter Landing Sites 1-25
Semi-Fixed Base Operations (Day) 1-27
Semi-Fixed Base Operations (Night) 1-28
Field Expedient Landing Zone (Day) 1-29
Field Expedient (Y) LZ (Night) 1-30
CASEVAC with Fixed Wing Aircraft 1-31
Marking and Lighting of Airplane LZ (Day) 1-31
Marking and Lighting of Airplane LZ (Night) 1-32
Air Evacuation Telephone List 1-33
Aircraft Patient Loads 1-33
PART 2: CLINICAL PROCESS
Medical History and Physical Examination 2-1
PART 3: GENERAL SYMPTOMS
Acute Abdominal Pain 3-1
Anxiety 3-2
Back Pain, Low 3-6
Breast Problems
Mastitis in a Lactating Mother 3-7
Procedure – I & D of Breast Abscess 3-9
Chest Pain 3-10
Constipation 3-13
Cough 3-13
Depression and Mania 3-15
Diarrhea, Acute 3-18
Dizziness 3-20
ENT Problems 3-22
Eye Problems
Acute Vision Loss without Trauma 3-22
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Acute Red Eye without Trauma 3-24
Orbital or Periorbital Inflammation 3-26
Eye Injury 3-27
Fatigue 3-29
Fever 3-31
Gynecologic Problems
Pelvic Examination 3-37
Abnormal Uterine Bleeding 3-39
Pelvic Pain, Acute 3-41
Pelvic Pain, Chronic 3-43
Vaginitis 3-47
Vaginitis Chart 3-48
Bacterial Vaginosis 3-47
Candida Vaginitis/Vulvitis 3-49
Pelvic Inflammatory Disease 3-50
Bartholin’s Duct Cyst/Abscess and I & D Procedure 3-52
Headache 3-55
Jaundice 3-57
Joint Pain 3-59
Joint Dislocations 3-64
Shoulder Pain 3-70
Hip Pain 3-72
Knee Pain 3-74
Ankle Pain 3-76
Male Genital Problems
Male Genital Inflammation 3-77
Testis/Scrotal Mass 3-79
Prostatitis 3-80
Testis Torsion 3-82
Epididymitis 3-84
Memory Problems 3-85
Obstetric Problems
Pregnancy 3-87
Vaginal Delivery 3-87
Preterm Labor 3-93
Procedure: Shoulder Dystocia 3-95
Procedure: Breech Birth 3-96
Procedure: C-Section 3-100
Procedure: Episiotomy and Laceration Repair 3-102
Pre-eclampsia & Eclampsia 3-104
Palpitations 3-110
Rash with Fever 3-112
Itching 3-113
Shortness of Breath (Dyspnea) 3-115
Syncope (Fainting) 3-117
PART 4: ORGAN SYSTEMS
Chapter 1: Cardiac/Circulatory
Acute MI 4-1
Congestive Heart Failure (Pulmonary Edema) 4-3
Hypertensive Emergency 4-5
Pericarditis 4-6
Cardiac Resuscitation 4-7
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Chapter 2: Blood 4-8
Chapter 3: Respiratory
Common Cold and Flu 4-10
Pneumonia 4-12
Pleural Effusion 4-14
Thoracentesis 4-15
Empyema 4-17
Allergic Pneumonitis 4-18
Asthma 4-19
COPD 4-21
Pulmonary Embolism 4-23
Acute Respiratory Distress Syndrome 4-24
Apnea 4-25
Chapter 4: Endocrine
Adrenal Insufficiency 4-27
Diabetes Mellitus 4-28
Hypoglycemia 4-30
Thyroid Disorders 4-31
Chapter 5: Neurologic
Seizure Disorders and Epilepsy 4-34
Meningitis 4-35
Bell’s Palsy 4-37
Chapter 6: Skin
Introduction and Clinical Approach to Dermatology 4-38
Bacterial Skin Infections
Disseminated Gonococcal Infection 4-40
Meningococcemia 4-41
Erysipelas 4-41
Staphylococcal Scalded Skin Syndrome 4-42
Impetigo Contagiosa 4-43
Cutaneous Tuberculosis 4-44
Leprosy 4-45
Viral Skin Infections
Ecthyma Contagiosum: Milker’s Nodules (MN)/Human Orf (HO) 4-45
Herpes Zoster (Shingles) 4-47
Molluscum Contagiosum 4-47
Warts 4-48
Superficial Fungal Infections
Dermatophyte (Tinea) Infections 4-49
Pityriasis (Tinea) Versicolor 4-51
Parasitic Infections
Loiasis (loa loa) 4-52
Myiasis 4-52
Onchocerciasis 4-53
Swimming Dermatitis – Seabather’s eruption (salt water), Seaweed dermatitis (salt water),
Swimmer’s itch 4-54
Bug Bites and Stings
Bed Bug 4-55
Centipede 4-55
Millipede Exposure 4-56
Hymenoptera (Bee, Fire Ant, Hornet, Wasp) 4-57
Mites 4-59
Spiders (Black Widow, Brown Recluse) 4-60
Scabies 4-61
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Lice (Pediculosis) 4-62
Spirochetal Diseases
Yaws 4-63
Pinta 4-64
Skin Disorders
Psoriasis 4-64
Pseudofolliculitis Barbae 4-65
Skin Cancer (Basal Cell, Squamous Cell, Malignant Melanoma) 4-66
Seborrheic Keratosis 4-68
Contact Dermatitis 4-69
Chapter 7: Gastrointestinal
Appendicitis 4-70
Appendectomy 4-72
Acute Cholecystitis 4-78
Food Poisoning 4-79
Acute Gastritis 4-80
Pancreatitis 4-82
Acute Peritonitis 4-83
Acute Peptic Ulcer 4-84
Acute Organic Intestinal Obstruction 4-86
Chapter 8: Genitourinary
Urinary Tract Problems 4-87
Urinary Incontinence 4-90
Urolithiasis (Urinary Stones) 4-91
Urinary Tract Infection 4-93
PART 5: SPECIALTY AREAS
Chapter 9: Podiatry
Heel Spur Syndrome 5-1
Ingrown Toenail 5-2
Plantar Warts 5-3
Bunion 5-4
Corns/Calluses 5-5
Stress Fractures 5-6
Friction Blisters 5-7
Chapter 10: Dentistry
General Information 5-9
Dental Caries 5-12
Tooth/Crown Fractures 5-12
Acute Periapical Abscess 5-13
Untreated Acute Periapical Abscess 5-13
Luxated (Dislocated) Tooth 5-14
Avulsed (Completely Removed/Loss) Tooth 5-14
Periodontal Abscess 5-15
Acute Necrotizing Ulcerative Gingivitis 5-15
Herpetic Lesions 5-16
Aphthous Ulcers 5-16
Pericoronitis 5-17
Localized Osteitis (Dry Socket) 5-17
Dislocation of the Temporomandibular Joint(s) 5-18
Dental Antibiotics 5-19
Thermal Test for Caries 5-20
Dental Anesthesia 5-20
Temporary Restorations 5-24
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Tooth Extraction 5-25
Draining Abscess 5-26
Preserving/Transporting Avulsed Tooth 5-26
Chapter 11: Sexually Transmitted Diseases
Urethral Discharge 5-26
Genital Ulcers 5-28
Vaginal Trichomonas 5-30
Chapter 12: Zoonotic Diseases Chart 5-31
Chapter 13: Infectious Diseases
Parasitic Infections
Amebiasis 5-33
Ascariasis (Roundworm) 5-34
Babesiosis 5-34
Clonorchiasis 5-35
Cyclosporiasis 5-36
Enterobiasis (Pinworms) 5-37
Fasciolopsiasis 5-38
Fascioliasis 5-38
Filariasis 5-39
Giardiasis 5-40
Hookworm and Cutaneous Larvae Migrans 5-41
Leishmaniasis 5-42
Malaria 5-44
Paragonimiasis 5-45
Schistosomiasis 5-46
Strongyloidiasis (Cutaneous Larva Currens) 5-47
Taeniasis (Tapeworm) 5-48
Trichinellosis (Trichinosis) 5-50
Trichuriasis (Whipworm) 5-51
Trypanosomiasis, African (Sleeping Sickness) 5-52
Trypanosomiasis, American (Chagas’ Disease) 5-53
Mycobacterial Infections
Tuberculosis 5-54
Non-tuberculosis Mycobacterial Disease 5-56
Fungal Infections
Introduction 5-57
Candidiasis 5-57
Blastomycosis (North American Blastomycosis, Gilchrist Disease) 5-59
Coccidioidomycosis (Valley Fever) 5-60
Histoplasmosis (Darling’s Disease) 5-61
Paracoccidioidomycosis (South American Blastomycosis) 5-62
Viral Infections
Introduction 5-63
Adenoviruses 5-64
Dengue Fever 5-65
Arboviral Encephalitis (TBE, JE, WN, St Louis) 5-66
Hantavirus 5-68
Yellow Fever 5-69
Hepatitis A 5-71
Hepatitis B & D 5-72
Hepatitis C 5-73
Hepatitis E 5-75
Hepatitis Chart 5-74
Human Immunodeficiency Virus 5-77
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Infectious Mononucleosis 5-78
Poliovirus 5-80
Rabies 5-81
Rickettsial Infections 5-83
Q Fever 5-85
Spirochetal Infections
Leptospirosis 5-86
Lyme Disease 5-88
Relapsing Fever 5-89
Bacterial Infections
Anthrax 5-90
Bartonellosis 5-92
Brucellosis 5-94
Ehrlichiosis 5-95
Plague 5-95
Rat-bite Fever 5-97
Acute Rheumatic Fever 5-98
Streptococcal Infections 5-99
Tetanus 5-100
Tularemia 5-102
Typhoid Fever 5-104
Chapter 14: Preventive Medicine
Introduction 5-105
Immunizations 5-105
Surveillance for Illness and Injury 5-107
Field Sanitation 5-108
Waste Disposal 5-111
Field Water Purification 5-118
Malaria Prevention and Control 5-120
Pest Control 5-120
Rabies Prevention and Control 5-121
Landfill Management 5-121
Chapter 15: Veterinary Medicine
Antemortem Exam 5-123
Humane Slaughter & Field Dressing 5-123
Postmortem Exam 5-125
Food Storage & Preservation 5-126
Physical Exam & Restraint 5-128
Large Animal OB 5-130
Administer IV Infusion to an Animal 5-131
Animal Diseases
Bloat in Bovine 5-132
Colic in Equine 5-132
Foot Rot in Caprine 5-133
Equine Lameness 5-134
Mastitis 5-135
Diarrhea in Porcine 5-135
Conjunctivitis 5-136
Chapter 16: Nutritional Deficiencies
Vitamin and Mineral Chart 5-137
Chapter 17: Toxicology
Poisoning: General 5-140
Venomous Snake Bites 5-142
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Chapter 18: Mental Health
Operational Stress 5-147
Suicide Prevention 5-149
Substance Abuse 5-150
Psychosis vrs. Delirium 5-151
Recovery of Human Remains 5-153
Chapter 19: Anesthesia
Total Intravenous Anesthesia 5-155
Local/Regional Anesthesia 5-159
PART 6: OPERATIONAL ENVIRONMENTS
Chapter 20: Dive Medicine
Ears 6-1
Other (Dental, Sinus, GI, Skin, And Face Mask) 6-3
Decompression Injuries
Decompression Sickness 6-4
POIS (AGE, Pneumothorax, etc.) 6-7
Gas Problems
Hypoxia 6-8
Oxygen Toxicity 6-9
Carbon Monoxide Poisoning 6-11
Carbon Dioxide Poisoning 6-12
Marine Hazards
Dangerous Marine Lifez: Venomous 6-13
Dangerous Marine Life: Biting Animals (Trauma) 6-16
Blast/Explosion, Sound 6-18
Caustic Cocktail Chemical Burn 6-20
Disqualifying Conditions for Military Diving 6-21
Dive Treatment Tables 6-23
Chapter 21: Aerospace Medicine
Hypoxia 6-31
Barodontalgia 6-32
Barosinusitis 6-33
Barotitis 6-34
Decompression Sickness 6-35
Chapter 22: High Altitude Illnesses
Acute Mountain Sickness 6-37
High Altitude Cerebral Edema 6-38
High Altitude Pulmonary Edema 6-40
Chapter 23: Cold Illnesses and Injuries
Frostbite 6-42
Hypothermia and Chart 6-43
Non-freezing Cold Injury (Trenchfoot and Immersion Foot) 6-44
Chapter 24: Heat-Related Illnesses
Introduction 6-47
Heat Cramps 6-48
Heat Exhaustion 6-49
Heat Stroke 6-50
Chapter 25: Chemical
Nerve Agents 6-52
Blood Agents 6-52
Blister Agents 6-53
Set Up a Casualty Decontamination Station 6-54
Chapter 26: Biological
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Introduction/Suspected Biological Exposure 6-56
Inhalational Anthrax 6-56
Botulism 6-57
Pneumonic Plague 6-58
Smallpox 6-59
Tularemia 6-60
Viral Hemorrhagic Fevers 6-60
Chapter 27: Radiation
Radiation Injuries 6-61
PART 7: TRAUMA
Chapter 28: Trauma Assessment
Primary and Secondary Survey 7-1
Primary and Secondary Survey Checklists 7-5
Chapter 29: Human and Animal Bites 7-7
Chapter 30: Shock
Introduction 7-10
Anaphylactic Shock 7-10
Hypovolemic Shock 7-11
Fluid Resuscitation Tables 7-14
Routes of Fluid Administration Table 7-16
Chapter 31: Burns, Blast, Lightning, & Electrical Injuries
Burns 7-17
Blast 7-23
Lightning & Electrical 7-26
Chapter 32: Non-Lethal Weapons Injuries
Laser 7-28
PART 8: PROCEDURES
Chapter 33: Basic Medical Skills
Airway Management 8-1
Intubation 8-4
Cricothyroidotomy, Needle and Surgical 8-5
Thoracostomy, Needle and Chest Tube 8-7
Pulse Oximetry Monitoring 8-9
3 Lead EKG 8-10
Pericardiocentesis 8-12
Apply & Remove Pneumatic Anti Shock Garment 8-13
Assess and Perform Blood Transfusion 8-14
Field Blood Transfusion 8-18
Blood Transfusion Reactions 8-19
Intraosseous Infusion 8-21
Suturing 8-22
Wound Debridement 8-25
Surgical Treatment of Skin Masses 8-27
Joint Aspiration 8-29
Compartment Syndrome Management 8-30
Splint Application 8-32
Common External Traction Devices 8-33
Straight Urinary Bladder Catheterization 8-33
Suprapubic Bladder Aspiration (Tap) 8-35
Portable Pressure Chamber 8-36
Pain Assessment and Control 8-37
Chapter 34: Lab Procedures
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Specimen Transportation 8-40
Urinalysis 8-41
Wet Mount and KOH Prep 8-43
Gram’s Stain 8-44
Brucellosis Test 8-45
Wright’s Stain using Cameco Quick Stain 8-46
Ziehl-Neilson Stain 8-47
Giemsa Stain for the Presence of Blood Parasites 8-47
Tzanck Stain 8-48
Culture Interpretation 8-49
Macroscopic Exam of Feces 8-50
Feces for Ova & Parasites 8-51
Concentration Techniques for Ova & Parasites 8-52
Microhematocrit Determination 8-53
RBC Count/Morphology 8-54
WBC Count on Whole Blood 8-56
WBC Differential Count 8-58
ABO Grouping and Confirmation Tests 8-59
Rh Typing 8-59
Crossmatch Procedure 8-60
APPENDICES
Anatomical Plates A-1 to A-20
Color Plates A-21 to A-26
Identification of Cellular Blood Components A-27, A-28
Antibiotic Chart A-29 to A-31
Photosensitivity Drugs A-31
IV Drip Rates A-32
Glasgow Coma Scale A-33
Mini Mental Status A-33
Neurological Examination Checklist A-34
Dermatomes of Cutaneous Innervation A-36, A-37
Wind Chill Chart A-38
Temperature Guidelines for Physical Activity A-39
Fluid Replacement Guidelines for Warm Weather A-39
WBGT A-40
Do Not Resuscitate Guidelines A-41
Lab Values A-42
Abbreviations A-44 to A-49