Appendix A: Class VIII Medical Materiel

Here is a detailed list of essential medical equipment and supplies required for Amputation: Evaluation and Treatment.

Initial Hemorrhage Control

1. Tourniquets: For immediate control of life-threatening extremity bleeding.
2. Hemostatic Dressings: To promote rapid clotting at the wound site.
3. Pressure Bandages: To maintain hemostasis after initial bleeding control.

Resuscitation (Blood and Intravenous Access)

1. Blood tubing set
2. Rapid infuser
3. IV catheters: (16G, 18G, 20G)
4. Central venous catheter (CVC) kits: large bore (Cordis or MAC)
5. Intraosseous (IO) needles
6. Whole blood or packed red blood cells (PRBCs)
7. Fresh frozen plasma (FFP) or Freeze-Dried Plasma (when appropriate and/or available)
8. Cryoprecipitate
9. Platelets

Induction, Anesthetics, Vasopressors, Antibiotics

1. Induction Agents- Ketamine, midazolam, succinylcholine, rocuronium
2. Analgesia-Morphine sulfate, Fentanyl, ketamine, acetaminophen
3. Local anesthetics-Lidocaine 1% or 2%, Bupivacaine
4. Vasopressors-Epinephrine, Norepinephrine, Phenylephrine
5. Antibiotics-Cefazolin, Ertapenem, Vancomycin (for patients with allergy or specific indications)

Surgical Drapes and Sterile Field

1. Sterile drapes
2. Fenestrated drapes
3. Sterile gloves
4. Surgical gowns
5. Betadine or chlorhexidine prep solution
6. Sterile towels
7. Mayo stand cover

Surgical Instruments

1. Vascular Clamps: To control blood vessels during surgery.
2. Vessel Loops or Ligatures: For controlling or ligating blood vessels.
3. Scalpels and Blades: For incision/excision.
4. Bone Saws or Gigli Saws: For bone transection during amputation procedures.
5. Forceps, Clamps, and Needle Holders: For tissue handling and suturing.

Wound Management

1. Sterile Saline Solution: For irrigation and cleaning of the wound.
2. Debridement Tools: Such as curettes and scissors to remove non-viable tissue.
3. Negative Pressure Wound Therapy (NPWT) Devices: To promote wound healing and reduce edema.

Postoperative Care

1. Regional Anesthesia Kits: Including nerve block needles and catheters.
2. Analgesic Medications: Both opioid and non-opioid options for pain control.
3. Sterile Dressings and Bandages: For wound coverage and protection.
4. Compression Garments: To manage swelling and support residual limbs.
5. Splints/Casts: to prevent contractures
6. Venous Thromboembolism Prophylaxis: enoxaparin or heparin

Additional Considerations

1. Sterilization Supplies: Ensure availability of autoclaves or chemical sterilization agents to maintain instrument sterility.
2. Documentation Tools: Accurate record-keeping materials to document surgical procedures and postoperative care plans.

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.