# BACK OF CARD

Battle Roster # - Write first letter of casualty’s first name, then first letter of casualty’s last name, and then write the last four numbers of casualty’s Social Security number. For example, John Doe 123-12-1234 is Battle Roster # “JD1234” .

Evacuation (EVAC) - Mark an “X” on the casualty’s evacuation priority/precedence (Urgent; Priority; or Routine).

C - Mark an “X” for all Circulation hemorrhage control interventions. For tourniquets (TQ), mark category (Extremity, Junctional and/or Truncal) and write name of TQ(s) used. For dressings, mark category (Hemostatic, Pressure, and/or Other) and write name of dressing(s) used.

A - Mark an “X” for all Airway interventions (Intact, NPA (nasopharyngeal airway), CRIC (cricothyroidotomy), ET Tube (endotracheal tube), SGA (supraglottic airway) and write type of device(s) used.

B - Mark an “X” for all Breathing interventions (O2 (oxygen), Needle D (needle decompression), Chest Tube, Chest Seal) and write type of device(s) used.

C: Fluid - Circulation resuscitation interventions. Write name, volume, route, and time of any fluids given.

C: Blood Product - Circulation resuscitation interventions. Write name, volume, route, and time of any blood products given.

Meds: Analgesic - Medications. Write name, dose, route, and time of any analgesics given.

Meds: Antibiotic - Medications. Write name, dose, route, and time of any antibiotics given.

Meds: Other - Medications. Write name, dose, route, and time of any other administered medications.

Other - Mark an “X” for other treatments administered (combat pill pack, eye shield (mark right (R) or left (L)), splint, hypothermia prevention) and type of device(s) used.

Notes - Use this space to record any other pertinent information and/or clarifications.

First Responder Name - Print the first responder’s name (Last, First).

First Responder Last 4 - Write last four numbers of first responder’s Social Security number