APPENDIX I: CLASS VIII MEDICAL MATERIEL

1. Antivenom & Snakebite-Specific Medications

Primary therapeutic agents

  • Antivenom - Minimum: 2 high doses OR 4 low doses per Antivenom needed.
  • Epinephrine 2mg (1:1000 (IM anaphylaxis), 1:10,000 (IV))
  • Atropine (Multidose vials 8mg/20mL, or 4x 1mg/mL vials)
  • Neostigmine

Anaphylaxis medications:

  • Epinephrine (1:1000 (IM anaphylaxis), 1:10,000 (IV))
  • Corticosteroids (e.g., methylprednisolone or dexamethasone)
  • H1 antihistamines (e.g., diphenhydramine)
  • H2 antihistamines (e.g., famotidine)

Special ophthalmic medications (Spitting Cobra exposures)

  • Tetracaine ophthalmic
  • Phenylephrine 10% ophthalmic
  • Antibiotic eye drops (e.g. oxfloxacin or moxifloxacin gtts)
  • Lubricating eye drops

2. Adjunct Medications

  • Ketamine 
  • Fentanyl
  • Acetaminophen (PO/IV)
  • Antibiotics (IV and ophthalmic as needed)
  • Benzodiazepines (for seizures)
  • Etomidate (If not using Ketamine)
  • Paralytics (If considering RSI + Trained )
  • Tetanus vaccine
  • Antibiotics (IV and ophthalmic as needed)

3. Blood Products

  • Whole Blood 

4. Intravenous Fluids & Administration

  • Normal Saline (preferred; flushes for rapid mix/push + bag for mixing & antivenom infusion, if given by infusion)
  • Lactated Ringer’s (alternative)
  • Bag sizes: 250mL Preferred
    • Alternate: 100mL, or SIVP only if supplies are low.
    • 500 and 1000 mL, adds unneeded time and fluid, especially for pediatrics.
    • 10 cc syringes (or saline flushes) + fill needles

5. IV / IO Access Equipment

  • Peripheral IV catheters - Various sizes (22–18g)
  • IV start kits
  • IO access kits
  • Coban for IVs on diaphoretic patients
  • Central line kits
  • Tegaderm
  • Medical tape
  • Syringes – (1, 3, 5, 10, and 20 mL)
  • Needles
  • Tape 

6. Airway & Ventilation Equipment

  • Cricothyroidotomy kit
  • Endotracheal tubes
  • Supraglottic airway (iGel)
  • Bag Valve Mask (BVM)
  • PEEP valve
  • Ventilator
  • Oxygen supply (O2 tanks, Oxygen concentrator, and Masks/NRB)
  • Laryngoscope (VL preferred)
  • Powered suction unit
  • Backup manual suction device
  • Assorted suction catheters
  • NG and OG tubes (various sizes)

7. Monitoring & Diagnostic Equipment

  • Sharpies 2-3
  • Pulse oximeter
  • Non-invasive blood pressure monitor
  • ECG monitor
  • Temperature monitor
  • Respiratory rate monitoring
  • Capnography
  • Peak flow meter
  • Spirometer
  • Glucometer

8. Laboratory Capability

  • iSTAT system (CBC, CMP, Hemoglobin / Hematocrit, PT / PTT / INR, Fibrinogen, Creatine Kinase (CK)
  • Test strips / lancets
  • Vacutainer tubes (red-top)
  • Clean, dry, 100% glass tubes for WBCT
  • Blood draw needles

9. Ophthalmic Diagnostic Equipment

  • Fluorescein stain kit
  • Slit lamp (if available)
  • Ophthalmoscope

10. Wound Care & Limb Management

  • Bandages
  • Sterile dressings
  • Splints

For additional information including National Stock Number (NSN), please contact dha.ncr.med-log.list.lpr-cps@health.mil

DISCLAIMER: This is not an exhaustive list. These are items identified to be important for the care of combat casualties.