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REMOTE MEDICAL PRACTITIONER

COPYRIGHT MATERIALS 2009 - 2018

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ATP PROTOCOLS 2009 - 2018

GORGRP, Inc. Global Operational Resources Group  ATP Protocols   Notes Latest Revision  2009

REVISED 2009 - 2018

NOTE  Proprietary   Confidential Material Copyright    GORGRP, Inc. 2009 of proprietary and unique GORGRP, Inc. materials ...
NOW ISRMP INCORPORATED 2009 - 2018
1. The Advanced Tactical Practitioner  ATP  protocols are given here, with short Chief Medical Officer  CMO  notes. These ...

PLEASE EMAIL ADMIN@ISRMP.ORG FOR MEDICAL ADVISORY GROUP ANSWERS TO ALL PROTOCOLS.

TABLE OF CONTENTS Don   t Forget    Clinical Pearls ----------------------------------------------------------------------...
Smoke Inhalation---------------------------------------------------------------------------------------------- 48 aTMEP Sp...
DON   T FORGET     CLINICAL PEARLS      When IV route is recommended, but not obtainable, consider IO, IM, or PO unless co...
CMO Notes  Serial abdominal examinations     every 30-120 minutes as indicated - is the key to diagnosing serious abdomina...
CMO Notes  Sinus pressure, significant post-nasal drip, and sore throat from the PND are common.  CMO Notes  Use of both a...
CMO Notes  The    Sharpened Romberg    and    Lake Louise Altitude Score Protocol    are excellent diagnostic tests to ser...
IM injection should go in any large central muscle group. Any fast acting steroid may be used. Albuterol in any form may b...
CMO Notes  Any fast acting steroid may be used. Primatine Mist is Epinephrine 1 000 dispensed as 0.22 ml per squirt and is...
CMO Notes  Steroids may be combined with local anesthetics for trigger point injections  if trained . A variety of muscle ...
CMO Notes  Patients may be nearly deaf with ear injury   unable to hear instructions.       Patients with lung barotrauma ...
CMO Notes  Critical to ensure that there is not an underlying medical condition. The combination of a benzodiazipine with ...
CMO Notes  Recall that most bronchitis and many uncomplicated pneumonias are viral infections. Low grade fevers and colore...
CMO Notes  Doxycycline is also a good choice.
CMO Notes  Rapid tests for cardiac enzymes are part of the GORGRP RMP Protocols, as are micro-size cardiac monitors   addi...
CMO Notes  The only definitive test for cardiac chest pain is clear evidence of Acute Coronary Syndrome or frank infarctio...
CMO Notes  Rolling bowel sounds, ballotable gas, and palpable stool are often found on exam.
CMO Notes  Essentially any steroid and non-sedating antihistamine are the mainstays of treatment. Many topical agents are ...
CMO Notes  The field ENT  Corpsman  kit should be considered a high priority item due to the frequency of EENT problems in...
CMO Notes  Countless treatments are available. Very small doses of narcotics such as Codeine may be helpful without produc...
GORGRP, Inc. Global Operational Resources Group  ATP Protocols   Notes Part 2 Latest Revision  2009
NOTE  Proprietary   Confidential Material Copyright    GORGRP, Inc. 2009 of proprietary and unique GORGRP, Inc. materials ...
MATERIAL NOW COPYRIGHT UNDER WWW.ISRMP.ORG

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1. The Advanced Tactical Practitioner  ATP  protocols are given here, with short Chief Medical Officer  CMO  notes. These ...
CMO Notes  Do not confuse DVTs with superficial blood clots or thrombophlebitis. Patients need to be anticoagulated before...
CMO Notes     Gatorade    is UNACCEPTABLE as an ORS. Learn how to make ORS from available resources. Hydralyte   Ceralyte ...
CMO Notes  Topical Benzocaine is the drug of choice for dental pain. PO meds may be required for more severe pain. Tea bag...
CMO Notes  Do not use Azithromycin CONUS due to high bacterial resistance rates. A variety of antibiotic ear drops are ava...
CMO Notes  See the GORGRP Antivenin Administration Protocol for detailed treatments.
CMO Notes  Epinephrine 1 5000 or weaker or Phenylephrine may also be used as a topical application. Chemical or heat caute...
CMO Notes  Antibiotic coverage is critical for both renal and gallbladder problems, perforated ulcer, and other issues tha...
CMO Notes  Simple field laboratory testing may be helpful.  CMO Notes  Potassium Permanganate or Gentian Violet soaks BID ...
CMO Notes  Fever and    Strawberry Jam    stools  not the occasional drop of bright red blood     typical of a minor fissu...
CMO Notes  Dehydration may be the  1 cause of headaches in the field   .  CMO Notes  Steroids are often helpful in treatin...
CMO Notes  Needle aspiration of a peritonsillar   submandibullar abscess     if trained  may be considered. Odontogenic ab...
CMO Notes  The patient MAY or MAY NOT be sweating     do not assume that sweating means this is not heat stroke   CMO Note...
CMO Notes  Patients with altered mental status should be internally rewarmed if possible, using warm IV fluids, warm gastr...
CMO Notes  Joint aspiration   drainage  if trained  should be considered. History, lack of fever, and appearance of joint ...
CMO Notes  Dehydration predisposes patients to orthostasis and vasovagal syncope. Treat per the Dehydration Protocol. Cons...
CMO Notes  Dengue Fever presents almost identically to Malaria, however it may be associated with serious body aches  Brea...
CMO Notes  Steroids may aid nausea control. Zofran may be given up to QID. Any antihistamine can be substituted for Diphen...
CMO Notes  Steroids are superior to NSAIDs for moderate   severe musculoskeletal pain. A combination of IV and IM or SQ in...
CMO Notes  Epi Sub-dural hematoma evacuation  if trained  should be considered for a classic inter-cranial bleed presentat...
CMO Notes  Elimination of an obvious source of infection e.g. debriding wounds etc.  if trained  should be accomplished. R...
CMO Notes  Monitor for development of pulmonary edema and infection. Chemical pneumonitis and toxicity may occur from burn...
CMO Notes  A heated paper clip or needle will pass through the nail very easily with minimal pressure. Avoid damaging the ...
CMO Notes  Heavy lifting with a full bladder predisposes to epididymitis, especially in patients over 40 y o.
CMO Notes  Acidifying the urine with PO intake of acid juices may be helpful. Pyridium 200 mg PO TID provides symptomatic ...