APPENDIX J: CLASS VIII MEDICAL MATERIEL

Based on the CPG, below is an extensive list of medical supplies, fluid and blood requirements, monitoring equipment, pain medications, and antibiotics for managing burn injuries:

#### Medical Supplies

1. Sterile burn dressings
2. Burn sheets or blankets
3. Burn gel or ointment
4. Saline solution for irrigation
5. Tetanus prophylaxis
6. Antibacterial creams or ointments
7. Airway management equipment
8. Burn assessment tools (rule of nines and Modified Brooke)
9. Ambulance equipped with burn-specific supplies
10. Intravenous catheters
11. Blood pressure cuffs and monitors
12. Laboratory equipment for tests (iSTAT blood analyzer and cartridges)
13. Wound care supplies
14. Surgical instruments
15. Nutritional support
16. Psychological support services
17. Endotracheal tubes (size 8 or larger for adults)
18. Cotton umbilical ties for securing ETT
19. Stainless-steel wire for securing ETT, especially in extensive facial burns
20. Laryngeal mask airways (may be ineffective due to edema)
21. Foley catheters with urimeter chamber
22. Fox shields for eye protection
23. Syringes and IV tubing for fluid administration.

#### Fluid and Blood Requirements

1. Large-bore IV catheters
2. Central lines kits
3. A-line kits
4. IV fluids (e.g., LR, PlasmaLyte, normal saline)
5. Blood (Whole blood, component therapy)
6. Albumin

#### Monitoring Equipment

1. Portable monitor providing continuous vital signs display and invasive monitoring
2. Capnography or capnometry for intubated patients
3. Blood pressure cuff
4. Stethoscope
5. Pulse oximetry
6. Hourly urine output monitoring
7. Burn Resuscitation Worksheet
8. Burn Navigator for fluid rate recommendations
9. Stryker monitor for compartment pressures (can use arterial line setup though)

#### Other Equipment

1. Tonometer for measuring intraocular pressure
2. Handheld Doppler flowmeter for vascular exams
3. Telemedicine and associated equipment
4. Patient warming device (Bair Hugger)
5. Hypothermia prevention kit (HPMK)
6. Fluid warming devise (Belmont, buddy light)
7. Laryngoscope
8. Commercial intubation device (Glide scope)
9. Mechanical ventilator (Impact, Save 2, Sparrow)
10. Oxygen (concentrator, or tanks)
11. Vascular doppler
12. ISTAT blood analyzer and cartridges
13. Wood’s lamp for eye examination
14. Litmus pH paper for chemical injury

#### Surgical Debridement Supplies

1. Scalpel handles and blades
2. Surgical scissors
3. Forceps
4. Sterile drapes
5. Sutures or staples
6. Wound irrigation solution
7. Surgical suction device
8. Hemostatic agents
9. Dressing materials for post-debridement wound care
10. Electrocautery (Bovie)
11. Surgical scrub brush (chlorhexidine, Hibiclens)

#### Medications

1. Oral rehydration solutions
2. Aerosolized unfractionated heparin mixed with albuterol for inhalation injury
3. Hydroxocobalamin (Cyanokit) for cyanide toxicity
4. IV proton pump inhibitors for stress ulcer prophylaxis
5. Ophthalmic erythromycin ointment
6. Topical antimicrobials (mafenide acetate, silver sulfadiazine, chlorhexidine gluconate)
7. Bacitracin ointment for facial burns
8. Pain medications (e.g., morphine, fentanyl, ketamine, and benzodiazepines)
9. Prophylactic antibiotics not normally used unless other open wounds require them
10. Cefazolin or clindamycin for cellulitis development
11. Broad-spectrum antibiotics for invasive burn wound infection (e.g., ertapenem + ciprofloxacin)
12. Vasoactive medications (vasopressin, levophed)

This comprehensive list covers the necessary medical supplies, fluid and blood requirements, monitoring equipment, pain medications, and antibiotics for managing burn injuries as outlined in the CPG.

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.