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Trauma- Focused Individual Training

Revised and Updated

January 2005

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Trauma Focused Individual Training“T-FIT”

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What is T-FIT?

• Focused medical training for non-medical personnel designed to provide critical medical intervention at the site of injury.

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Who Developed the Course?

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

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Command Emphasis

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

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100:50:25:2 “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

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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

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Initial Course Developers

• Major Chadwick- 1st Brigade Surgeon

• CPT Pataky- Battalion Physician Assistant

• Medics of 1-32 Infantry

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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

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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

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Program of Instruction Writers

• 1LT Edwin Gutierrez• 1LT Thomas Moody

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DEDICATION

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

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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.

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Course Requirement

• Pass all individual practical skills testing

• Pass all group practical skills

• Score 80% or better on written examination

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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

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Team Practical skills

• Manage trauma patient

• Manage mass casualty

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Lectures

• Introduction to T-FIT

• Combat Casualty care/Tactical Care Under Fire

• Triage/Mass Casualty Management

• Patient Assessment Trauma Patient

• Airway management

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Lectures (Continued)

• Head Trauma

• Chest/Abdominal Trauma

• Extremity Trauma

• Burns

• Altitude Sickness

• MEDEVAC Procedures

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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

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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

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Recommended Course length

• 2- 15 hour/ Day

• 3- 12.5 hour/Day

• 4- 10 hour/Day

• 5- 8 hour/Day

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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

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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

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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

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Training ScheduleDAY 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

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Training ScheduleDAY 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

Commander’s Comments

After-Action Review

1700 End of Training Day

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Certificate of Trainingpresented by

1st Squadron, 71st Cavalry

10th Mountain Division, Fort Drum New York

To

For

________________________________Thomas U. Moody, MPAS, RPA-C 1LT, SPPhysician Assistant

________________________________Mark MeadowsLTC, INCommanding

09 Nov. 2003 – 13 Nov. 2003

PV2 John David111-111-1111

Successful completion of 40 hours of Trauma Focus Individual

Training

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T-FIT Packing ListAdhesive tape, surgical porous woven 1in.x10yrds 1 Airway, pharyngeal large adult 1Airway, pharyngeal small adult 1Bandage adhesive 3/4inx3in chest flesh (band-aid) 18Bandage muslin compressed (cravat) 37x37x52 triangular 4Case medical instrument and supply (CLS bag) 1Catheter needle unit d121 V 18ga 4Bandage, pressure, Israeli 2Dressing, first aid, field camouflaged 4x6.25x7.25 lg abs 6Gloves patient exam-large (latex) 2Intravenous inj set 7compmacrodrip10drops/ml 2Catheter 14ga 2.5in 2Asherman chest dressing 2Pad povidone-iodine impre ster2x1 375”brown (iodine pads) 12Povidone-iodineointUSP10% 1/8oz. (3.54 gram) (iodine ointment) 8Ringers lactate injection USP 500ml plastic bag 2Scissors, bandage 1.5” cut large 7.25” 7Alcohol preps 25Field dressing, first aid 7x2x8 2Sam splint 1Nasopharyngeal airway 42x2” gauze sponges 12Tourniquet Ratchet 1