This Role 1, prolonged field care (PFC) guideline is intended to be used after Tactical Combat Casualty Care (TCCC) Guidelines when evacuation to a higher level of care is not immediately possible. A provider of PFC first must be an expert in TCCC. The intent of this guideline is to provide medical professionals who encounter extended casualty evacuation times in austere environments the evidence-based guidance for nursing interventions necessary to improve patient outcomes. Recommendations follow a “minimum, better, best” format that provides alternate or improvised methods when optimal hospital options are unavailable.
Basic activities of daily living become impaired or nonexistent depending on the severity of wounds. Simple tasks such as brushing teeth, breathing, drinking, coughing, moving extremities, and turning become impossible for an injured or unconscious patient. Thus, the patient requires regular assessments and nursing interventions to monitor their condition and prevent the development of complications.
Nursing interventions may not appear important to the medical professionals caring for a patient, but such interventions greatly reduce the possibility of complications such as deep vein thrombosis (DVT), pneumonia, pressure sores, wound infection, and urinary tract infection. Critically ill and injured casualties are at high risk for complications that can lead to adverse outcomes such as increased disability and death. Nursing care is a core principle of PFC to reduce the risk of preventable complications and can be provided without costly or burdensome equipment.
Using a nursing care checklist assists with developing a schedule for performing appropriate assessments and interventions.
Cross-training all team members on these interventions prior to deployment will lessen the demand on the medic, especially when caring for more than one patient.