PFC frequently involves the care of complicated, critically injured or sick casualties who are normally managed in medical treatment facilities. For patients that survive the initial trauma or sickness, the biggest risk of death is from circulatory shock and its complications. All severely injured and sick patients must be closely monitored for signs of shock and decompensation because the best treatment for shock is early recognition, treatment of the cause, and resuscitation. One method used by intensive care units to monitor critical patients is trending vital signs, physical exams, and fluid outputs recorded on a flowsheet that facilitates recognition of changes that could mark the early signs of decompensation.

In the PFC environment, one of the few techniques available to the medical provider that is identical to those used in hospitals is documentation of key clinical trends. It is critical that Medics are trained on the interpretation of clinical trends. It is also essential that Medics cross-train nonmedical teammates to take and record vital signs, outputs, key exam findings, and interventions to free the medic to do other tasks as well as to sleep if care of the casualty is especially prolonged.

Documentation that can help the medic and successive caregivers manage complicated patients includes:

- TCCC Card, DD1380
- PFC flowsheet
- Telemedicine guide
- Handoff report

Finally, completion of the PFC after-action report (AAR) will contribute greatly to performance improvement to develop training, tools, and techniques for improving the care of casualties in austere environments.