Emergency War Surgery NATO Handbook: Part II: Response of the Body to Wounding: Chapter IX: Shock and Resuscitation

Equipment and Supplies

United States Department of Defense

Equipment and Supplies

1. The frames upon which stretchers will be placed should always be in position, carefully arranged to allow enough space between patients for easy movement. A minimum of other furnishing is necessary. Aside from a desk or countertop work space for record keeping, there should be no chairs or furniture about the working area. Stethoscopes, sphygmomanometers, intravenous administration sets, IV fluids, and devices for suspension of IV bottles or bags should be at every stretcher position.

2. Sterile prepacked sets for emergency procedures, such as cutdowns, tracheostomies, insertions of chest tubes, and control of bleeding, should be conveniently located. These sets must include all of the instruments, sutures, and fittings needed for the purpose and should be plainly marked.

3. Suction equipment must be immediately available for airway aspiration.

4. Laryngoscopes and endotracheal tubes with inflatable cuffs should be conveniently located in the resuscitation area. Oropharyngeal airways prevent the tongue front obstructing the oropharynx in the unconscious patient. Insertion of the endotracheal tube is a rapid means of assuring upper airway integrity and facilitates the later performance of a tracheostomy under more controlled circumstances. A ventilating bag with mask and endotracheal tube fittings for manual ventilation should be available at numerous locations.

5. Large bandage scissors should be in each corpsman's pocket and at numerous other places to allow quick removal of the clothing.

6. Intravenous fluids, in large quantities, should be immediately available in the triage area. One bottle of Ringer's lactate with tubing inserted should be hung in place over each set of litter frames. A blood filtration set should be at hand for those who require subsequent administration of blood.

7. Percutaneous venous catheters are preferable to needles in administering intravenous fluids. The intravenous pathway should be at least 18 gauge.

8. Large-bore catheters for chest drainage and sterile tubing for insertion of underwater drainage or suction should be available. Heimlich one-way valves attached to chest tubing are acceptable only for temporary purposes.

9. Quantities of prepackaged sterile dressings in various sizes should be in ample supply at every stretcher.

10. Prepackaged sterile syringes in 5, 10, and 20 ml sizes should he within reach. In addition, preheparinized 5 ml syringes should be available for blood gas determination samples.

11. Sterile prepackaged sets of urinary catheters will be needed and should be available. Only large balloon Foley catheters should be used.

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Operational Medicine 2001

Health Care in Military Settings

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