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), refer to Logistics Plans & Readiness (sharepoint-mil.us)

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