Assumptions: One patient with a moderate to severe traumatic brain injury. To calculate the amount of fluid or medication you would need for a single TBI patient, use your worst case, longest possible evacuation extrapolated from your mission planning.  For example, if you think you might have a 36-hour evacuation, you might need 4,500mg levetiracetam (a 1,500mg loading dose and 1000mg every 12 hours)

 Minimum

  • Equipment: vital-sign trending chart, BP cuff, stethoscope, wrist watch, pulse oximeter, capnometer, cricothyroidotomy kit, bag-valve-mask with PEEP valve, nasopharyngeal airway, disposable thermometer, Nalgene bottle to measure urine
  • Medications/Fluids: ketamine, midazolam, lorazepam, acetaminophen, ceftriaxone, 3% hypertonic saline

 Better

  • Equipment: portable vital sign monitor, capnometer, cricothyroidotomy kit and/or ETT plus laryngoscope/glidescope and/or laryngeal mask airway, cold/ice packs, graduated cylinder to measure urine, oxygen concentrator
  • Medications/Fluids: ketamine, IV hydromorphone, IV fentanyl, midazolam

 Best

  • Equipment: portable monitor providing continuous vital-signs display with capnography, cricothyroidotomy kit, and/or ETT plus laryngoscope/glidescope, portable point-of care-testing device such as an iStat (Abbott Point of Care; https://www.pointofcare.abbott) or Epoch (Alere, http://www.alere.com) for arterial blood gas samples, and electrolyte monitoring, blood glucose monitor, Foley catheter kit, and supplemental oxygen or oxygen concentrator
  • Medications/Fluids: Fresh whole blood drawing supplies or stored blood products, 3% hypertonic saline, mannitol, ceftriaxone, metronidazole, levetiracetam or phenytoin, acetaminophen, dextrose 50% in water

Other  Packing  List  Considerations

  • Equipment: Portable ultrasound, nasogastric tube, red- (or red/yellow-speckled) top test tubes to test for electrolytes if a host-nation laboratory is available
  • Medications/Fluids: TXA