Appendix C: Class VIII And Additional Medical Materiel

The Joint Trauma System (JTS) Clinical Practice Guideline (CPG) for Aural Blast Injury and Acoustic Trauma provides comprehensive guidance on the evaluation and management of blast-induced hearing loss.

1. Topical Medications

Fluoroquinolone and Steroid Combination Ear Drops: For cases with debris in the external auditory canal or middle ear. Note: Debris should not be removed, and the ear should not be irrigated to prevent further complications.

2. Systemic Medications

- Corticosteroids:
  - Oral Prednisone: 1 mg/kg daily, up to 60 mg, for 7-10 days. Ensure to assess for co-morbidities (diabetes, gastric ulcers)
  - Transtympanic Dexamethasone: 24 mg/mL concentration, administered within 10 days for up to 3 doses. This should only be performed by an ENT specialist with a microscope; and there are other formulations and durations that could be considered.
- N-Acetylcysteine (NAC): An antioxidant that may offer protective effects against hair cell damage.
- Fluoroquinolone
  - Ciprofloxacin
  - Ofloxacin

3. Diagnostic and Monitoring Equipment

- Otoscope: For visual examination of the ear canal and tympanic membrane.
- Portable Boothless Audiometer: To assess hearing thresholds.
- Tuning Forks: For bedside evaluation of hearing loss type.
- Vital Signs Monitor: To monitor patient stability.

4. Durable medical equipment

- Hearing aids
- Hearing aid batteries
- Other portable amplification devices such as a pocket talker or similar device.

5. Referral and Follow-Up Tools

- ENT Consultation Protocols: For patients with persistent symptoms such as hearing loss beyond 72 hours, tympanic membrane perforation not resolved in 3 months, or vertigo lasting more than 7 days.

6. Personal Protective Equipment (PPE)

- Gloves, Masks, Eye Protection: Standard PPE to ensure safety during examination and treatment.

For a comprehensive and standardized list of medical supplies, including National Stock Numbers (NSNs), it is advisable to consult the Joint Trauma System’s official resources or contact the Logistics Plans & Readiness office.

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.