Catalog Taca Med

MissionProducts with a MissionProducts with a

NORTH AMERICAN RESCUE north american rescue

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WVSM Wireless Vital Signs Monitor

Item# 20-0078

Dimensions: L 5.4 in. x W 4 in. x D 2.6 in.

Weight: 16 oz

Wireless Vital signs MonitorWVsM

2012 Product catalogtable of contents

mini-Medic

The WVSM from Athena GTX is designed to move with the casualty from point of injury through the phases of care and finally, when the casualty reaches definitive care (Advance Care) wirelessly transmits patient data.

Provides non-invasive blood pressure, pulse oximetry & electrocardiogram capabilities

Attaches onto a standard blood pressure cuff & stays with the patient

Software displays the patient vital signs trends & wirelessly streams patient data allowing for Glasgow Coma Score, temperature & respiration rate inputs

Multiple WVSM units can simultaneously connect to the same display

Up to 4.5 hours of patient data can be recorded

mini-MEDIC Kit

Item# 20-0079

Dimensions:

Forehead Monitor L 3.3 in. x W 2.1 in. x D 1 in. Weight: 3 oz

Handheld Reader L 3.4 in. x W 2.5 in. x D 0.8 in. Weight: 3.8 oz

Total Device Weight: 12.8 oz

Forehead monitors and a handheld unit utilize wireless technology to simultaneously sense, view and monitor up to 10 patients

Provides SpO2, Pulse Rate, Heart Rate & Skin Temperature

Embedded algorithms calculate pulse wave transit time & Murphy Factor

Has input parameters for TBSA, ABC, GCS, Drugs, MOI, Fluids, BP, EtCO2, Respiration, & Call Sign

Gives the medical provider unparalleled view of vital signs trends across the spectrum of care

Athena GTXs mini-Medic is a highly compact, lightweight monitor system that easily fits into the medics and corpsmens aid bag

north aMerican rescue 2012 | narescue.coM

Includes Handheld and Forehead monitors

MADE INAmerICA

STERILE

2012 Product catalogtable of contents

march

training suPPortc-a-t trainer ..........................................................................60

Hemostatic trainer .............................................................60

HyFin trainer ........................................................................61

I/O trainers .............................................................................61

casualty resPonse KitsMilitary Kits ......................................................................64-77

ReSupply Kits ..................................................................78-79

Kit carriage Platforms .............................................. 80-81

Unconventional Medic custom Kits ..................82-83

Law Enforcement Kits ............................................... 84-91

Range Kit ...........................................................................92-93

K-9 Kit................................................................................. 94-95

taceVacSPEER Operational Rescue Gear ..................... 100-105

ctOMS Rescue Harness................................... 106-107

NaR assault Rescue Gear ...................................108-111

Evacuation Platforms & accessories ............112-122

MaRK IV Field Hospital Bed .........................................123

sPlinting & immobilizationSpine Boards & accessories .............................126-129

Splints ............................................................................130-131

accessoriesPersonal Protection ............................................... 134-137

triage Systems .......................................................... 138-141

Diagnostic Equipment ............................................142-143

casualty Management accessories ..............144-147

tactical apparel ........................................................148-149

References & Publications .................................. 150-153

Patient Monitors athena GtX ................. Inside cover

indexcustomer Service & Ordering Information ...........154

Index by Product Name ......................................... 155-157

Index by SEL# ........................................................................157

Index by Product# .............................................................158

Index by NSN# ....................................................................159

Berry amendment/Made in america ....2-3

tactical combat casualty care ................. 4-5

M.a.R.c.H. Protocol ...........................................6-7

c-a-t tourniquet Product History .............10

Hemostatics & tccc .................................14-15

2012 ONR Hemostatic Study ..............15

tension Pneumothorax....................................32

Intraosseous (I/O) access .............................40

Preventing Hypothermia ................................44

aRctc technology ...................................46-47

Battery Powered Heaters .............................54

NaR training with Grey Group & acI ......58

tourniquet training ............................................59

Evolution of Operational Rescue ..........98-99

Rangers Lead the Way ................................. 151

D5 New Product Forecast .........................160

Featuresicons

massiVe hemorrhagec-a-t tourniquet Gen 6 ............................................. 10-13

Hemostatic Dressings ............................................... 14-17

Bandages & Gauze ........................................................18-19

airway managementBasic ...................................................................................22-23

advanced ...........................................................................24-27

resPirationHyFin chest Seals ........................................................30-31

aRS Needle Decompression Kits .......................32-33

circulationSaline Lock Kits ............................................................. 36-37

Vascular access accessories ............................... 38-39

I/O Devices .......................................................................40-41

hyPothermia PreVentionHPMK .......................................................................................45

aRctc Suite ................................................................. 46-53

aRctc Power Options ............................................. 54-55

Products1Foreword | table oF contents

compliant with the Buy american act mandating substantially all materials, manufacturing & labor are of U.S. content (not to exceed 50% foreign content).

compliant with the trade agreements act specifying articles, materials & supplies to be acquired for public use must be produced or undergo

substantial transformation within the U.S. or from a designated country with reciprocal trade agreements with the U.S.

the NaR Benchmarks of Quality: Exact (optimized for priority usability), Extreme (ruggedized for unconventional environments) & Extraordinary (tested & proven in combat for unsurpassed quality)

Engineered to mitigate the effects of Rescue Human Factors & thereby increase the end users ability to excel in the midst of combat stressors

Protected by mPale antimicrobial with GIS Microbe Shield

Demos & Videos available online

Latex Free

Sterile

compliant with the Berry amendment requiring fabric materials, manufacturing & labor are 100% U.S. content.

Field tested & recommended by the National tactical Officers association (NtOa)

Meets the requirements of the European Medical Device Directive & appropriate Quality System standards

Not all medical equiPment is created equal...

1. DMMPO JMt&E UPDatE, cDR tyson Brunstetter, MSc, USN chief, Joint Medical test & Evaluation, tES Summit 06 March 2012.

Fig. 1

2 north american rescue 2012 | narescue.com

the increased need for inventive devices specifically designed to treat modern battlefield injuries has led to a flurry of new medical devices

flooding todays market. the paradigm

shift to point of injury treatments such as

the use of hemostatics, gauze, pressure

bandages, the c-a-t tourniquet, chest

seals and needle decompression devices,

have significantly increased the number of

soldiers surviving injuries that would have

historically lead to combat related death.

as budgetary concerns and the demand

for point of injury devices continues

to increase, some medical device firms are supplementing their supply chain with low cost, foreign sourced materials. What should be limited to extreme circumstances based on

domestically unavailable materials, has

for some firms flourished into a business

strategy which delivers inferior grade medical devices manufactured by unvalidated suppliers in

second and third world countries.

the quality of materials is paramount to the safety of the medical devices used to treat injuries sustained in austere

conditions. Serious consideration should

be taken to minimize risk when selecting

lifesaving equipment for the battlefield.

In the process of manufacturing medical devices to meet the Department of Defense requirements, some companies have sourced materials outside of the U.S.a. in order to cut cost, but the result is that these materials are not in compliance with the Food and Drug administration (FDa) and congressional requirements. the american warrior should be supported by americans, who are fully committed to medical devices Made in america. american innovation has created american made medical devices to be the best in the world, with their assembly, manufacture,

sterilization and distribution governed by the global leader in regulatory oversight, the FDa.

Recognizing casualty needs and legal requirements, North American Rescue has developed a supply chain of medical devices made in America. We have partnered with many of the civilian worlds premier manufacturers to offer a product line of devices sourced, assembled, packaged and sterilized domestically. this approach to made in america sourcing was recently validated when another firms

foreign sourced gauze was identified by the DMMPO in deployed IFaKs as contaminated with Pyromena domesticum1, a mold found in chinese cotton and known to the FDa as resistant to the sterilization process (see fig.1). this inferior product not only poses a direct threat to the health and safety of compromised american casualties, it also violates congressional requirement 10 U.S.c. 2533a, also known as the Berry amendment, specifically legislating that firms supplying materials to the DoD must source domestic materials in lieu of low cost, foreign goods.

Berry-amendment compliant S-Rolled Gauze from NaR is made with american cotton & sterilized for safety

DMMPO has identified foreign sourced contaminated gauze found

in deployed IFaKs that contain sterilization resistant mold.1

* 21 cFR 820, Quality System Regulation, ISO 13485:2003- Medical Devices--Quality management systems, and ISO 11137-1:2006, Sterilization of healthcare products RadiationPart 1: Requirements for development, validation and routine control of a sterilization process for medical devices

3

Needle thoracostamy should be performed with quality surgical steel to avoid health risks

the Berry amendment was originally enacted to protect U.S. industry in the event of war and/or adversity by lessening

our dependence on foreign sources, this law governs DoD preferences & contract purchases of specific products, the most notable of which are textiles. the requirement mandates that certain clothing, fabrics, fibers and yarns be 100% domestic meaning all materials, manufacturing and labor related to these items must be of U.S. origin. For your safety, it is recommended you confirm whether your gauze & bandages are compliant.

critical to GSa Schedules and most DoD contracts, is adherence to the trade agreements act (19 U.S.c. & 25012581)

or taa, which is intended to foster fair and open international trade. taa requires that end products originate from either the U.S. or other approved country. taa compliance mandates articles, materials and supplies to be acquired for public use must be produced or undergo substantial transformation within the United States or from a designated country with reciprocal trade agreements with the U.S.. to that end, you can be assured that all NaR products supplied for GSa Schedules and other applicable government contracts are 100% taa compliant.

Buying quality american-made products not only means you are getting the highest quality products to help save lives around the

world, you are also investing in the american economy in our people, our communities and our future. Being american-made is the gold standard against which NaR products are measured. Not all competitors in our market space can truly say that. all items marked Made in america are at the very least fully compliant with the requirements of the Buy american act (Baa) which mandates substantially all materials, manufacturing and labor are of U.S. content (not to exceed 50% foreign content). In many cases these products actually exceed those requirements by being 100% domestically produced.

MADE INAmerICA

the quality of medical devices, such as the needles used to treat a tension pneumothorax (2nd leading cause of preventable combat death), is regulated by the FDa, requiring compliance with Federal Law through supplier evaluation and post manufacturing device functionality testing. Some medical equipment containing sub-quality stainless steel may result in safety or efficacy concerns as noted in the FDa Import alert #76-01 (which is intended by the FDa to prevent the importation of inferior grade materials). When purchasing medical equipment that is manufactured offshore, exposure to inferior grade materials is a risk factor that must be considered.

Because the quality of medical device materials has a direct impact on the safety of the equipment used to treat an already compromised patient, utilizing 100% made in America equipment such as NaRs aRS Needle Decompression Kits ensures the greatest level of safety, confidence and efficacy. these devices are manufactured and sterilized by U.S. firms registered with the FDA according to rigorous national and international standards.* the metal used in the manufacture of the needle is U.S. surgical stainless steel grade 304,

the material of choice for civilian medical devices due to its history of safe and effective applications.

american innovation has created american made medical devices to be the best in the world, with their assembly, manufacture, sterilization and distribution governed by the global leader in regulatory oversight, the FDa. NaR is committed to saving lives around the world by supplying safer medical equipment:

Berry Amendment Compliant

Made in America/TAA Compliant

Registered with the FDA.

Manufactured & sterilized according to rigorous national & international standards,* aRS Needle Decompression Kits from NaR are 100% made in america of grade 304 surgical stainless steel by U.S. firms registered with the FDa

Foreword | made in america | taa comPliant | berry amendment comPliant

Dr. Russ S. Kotwal

The following is intended as a general overview and not an all-inclusive review of TCCC.

t he Warriors that defend our country at home and abroad deserve

the best Combat Medics,

Corpsmen, Tactical Medics

and First Responder

healthcare providers that

our military and civilian

institutions can train.

North American Rescue

(NAR) is proud to support

our Warriors, whether on

battlefields abroad or at

home providing homeland

defense. Saving lives is a team effort. Rarely does any single

aspect stand out from the

chain of survival provided

to our warriors, though it

has been said many times

that the first to provide medical aid often makes the biggest impact.

a dynamic set of battlefield trauma guidelines designed to provide tactical Medics & Corpsmen with tactically appropriate casualty trauma management strategies Phases of careCare under Fire Suppress enemy fire & move casualty to safe position Minimal care is provided due to hostile environment (Effective Enemy Fire)

Early management of significant external hemorrhage is critical (Tourniquet)

tactical Field Care Provide casualty care while maintaining situational awareness Consider patients mental status if altered, remove weapons

Provide treatment and reassess interventions

tactical Evacuation Care (taceVac) Provide Casualty Evacuation & Medical Evacuation Casualty Evacuation (CASEVAC) utilizes non medical platforms (unregulated - Tactical)

Medical Evacuation (MEDEVAC) utilizes dedicated medical assets (regulated - Red Cross)

goals of tcccTreat the casualty Prevent additional casualtiesComplete the missionNote: the Phases of Care should not be confused with the Goals of TCCC

saVing More liVesThe success of TCCC has had a great impact at increasing survivability rates on the battlefield. There have been several articles recently published, but of particular note, is the article by Dr. Russ S. Kotwal, et al. Eliminating Preventable Death on the Battlefield. The data in Dr. Kotwals study showed that a unit with the discipline to incorporate the TCCC guidelines in their training doctrine could effectively reduce preventable death. In 1998, then Col Stanley McChrystal made medical training one of the big four priorities for the 75th Ranger Regiment. This level of command endorsement, combined with the right training and the right gear, allowed the 75th Ranger Regiment to save all potentially survivable prehospital casualties. The Rangers were able to attain zero preventable deaths in the prehospital environment due to exsanguination, compromised airway or tension pneumothorax, which have previously been identified as the three leading causes of preventable combat death. The battlefield data was collected from October 1, 2001 to March 31, 2010. Out of the 419 casualties sustained, there were 32 fatalities. In the prehospital setting, none of the 32 fatalities were from potentially survivable causes of death.

Tactical line commanders who understand the requirements and importance of the casualty response system will provide the time, training and equipment necessary to ensure that medical personnel, and ultimately all assigned personnel, are sufficiently prepared to receive combat casualties.1

4 north aMerican rescue 2012 | narescue.coM

1 (Eliminating Preventable Death on the Battlefield, August 15, 2011) (page E7, Paragraph 3) 2 (Naval Medical Research Unit San Antonio, Technical Report # TR-2012-22) (Executive Summary, Conclusion, page 6)

researchThe recent research conducted by the Naval Medical Research Unit San Antonio (Technical Report #TR-2012-22) adds to this body of research. It addresses the ever-changing technology of hemostatic agents, which are engineered to compliment the other tools designed to address severe bleeding. This study compares five currently available hemostatic gauzes: Combat Gauze, Combat Gauze XL, Trauma Gauze, Celox Gauze, and ChitoGauze. The currently approved CoTCCC agent is Combat Gauze. The study concludes that, These results suggest that the current standard for point-of-injury control (Combat Gauze) may need to be re-evaluated or alternatively the standard of care expanded to include... the other products that were tested.2

The overall success of TCCC and the technology advances for point of injury devices has shifted military medicine to look into new areas that previously were not addressed. The success of the Combat Application Tourniquet (C-A-T) as the militarys primary tourniquet and the only tourniquet recommended by both the U.S. Army Institute of Surgical Research (USAISR) and CoTCCC, has successfully provided a solution for extremity hemorrhaging.

Having established an effective solution to extremity hemorrhage, the new #1 preventable cause of death is junctional hemorrhaging, which seems to lack an ideal solution. New research is generating several devices that are based on technologies dating back to the 1800s. By the end of 2012 there will be several devices out in the market that warrant an independent comparative study to determine efficacy and safety. An early challenge for a valuable comparative study is to define an accurate method for evaluating the effectiveness. Since there is no current perfect model to determine effectiveness that addresses all desirable features, the baseline testing is simply addressing, Does it stop the bleeding? To answer this question, the utilization of fluid dynamic

The committee on Tactical Combat Casualty Care (CoTCCC), a subcommittee of the Defense Health Board, has a charter to provide medical advice to the Surgeons General of the three armed services and to the Assistant Secretary of Defense for Health Affairs. It has tri-service representation (Army, Navy, & Air Force) and includes experienced combat medical personnel. The practical experience of combat medics and corpsmen help provide boots-on-the-ground truth and balance to the academic/research aspect of the committee. This unique and rare combination has strengthened the success of this vitally important committee in their dedication to the improvement of tactical medicine.

guideline uPdatesThe CoTCCC continues to evaluate and update their guidelines based on the following sources:

Ongoing review of the published civilian and military combat casualty prehospital trauma literatureOngoing interaction with military combat casualty care research laboratoriesDirect input from experienced Combat Medics, Corpsmen & PJsDirect input from Service Medical Lessons Learned centersCase reports discussed at the weekly Joint Theater Trauma System (JTTS) process improvement video-teleconferences

Expert opinion from both military and civilian trauma expertsThis process ensures that knowledge builds on itself and encourages new ways to look at how we can improve all efforts to bring back alive as many of our warriors as possible.

cadavers is being employed by the manufactures of these devices as an initial benchmark of efficacy.

As medical operators, our number one goal is to bring our battle brothers and sisters back home, so we tend to focus only on efficacy. But, safety is a vital part of the balance of an ideal device. One component of safety is found in a device that attains hemostasis (Occlusion of Bleeding) at lower pressures, thereby minimizing complications and potential morbidities associated with these devices. Another issue to take into account is whether the device succeeds in both a static/stationary and a dynamic/mobile environment. Placing a device while at a fixed facility, like a Forward Surgical Team (FST) where the patient will be stationary, is completely different than deploying it at the point of injury, where you can expect several casualty movements before they reach the medical facility. Successful devices will need to be able to maintain hemostasis throughout patient movement to effectively function in the tactical environment.The U.S. military has learned many medical lessons. Their historic achievements of bringing our warriors back alive and improving quality of life have never been better in the history of the United States of America. The challenge and goal of TCCC is to maintain focus and not lose these lessons learned as we pull out of theaters of operation during times of less conflict. These lessons will also continue to enhance civilian care over time, as the successes of Tactical Combat Casualty Care (TCCC) are employed in the civilian environment, thanks to data returning from the battlefield such as Dr. Russ S. Kotwals article.

5ForeWord | tactical coMbat casualty care oVerVieW

march

MassiVe heMorrhageC-A-TTourniquet, Hemostatics, Gauze, Pressure Bandages

airWay Nasopharyngeal Airway, King-LTS-D, BVM, Suction Device, Surgical Cricothyroidotomy

resPiration HyFin Chest Seal, Air Release System (ARS)

circulation Saline Lock Kits, BOA IV Constricting Band

hyPotherMia HPMK, ARCtc Hypothermia Prevention Suite

Controlling massive hemorrhaging is critical in a trauma patient. The number one cause of preventable death on the battlefield is bleeding

from extremities. The PreHospital Trauma Life Support book (PHTLS Military Seventh Edition) states, Perhaps the most successful single TCCC intervention has been the widespread reintroduction of tourniquet use on the battlefield. (page 594)

NAR strives to assist our customer by providing training and products that are best of breed. TCCC is an evolving set of guidelines and like all medical knowledge it builds on itself. As you read our catalog please feel free to provide input on how we can continue to improve service to you by contacting us through our NAR website, Facebook, or twitter locations.

FREE MARCH Poster inside


at North American Rescue (NAR) we are continually looking at ways to improve our customers experience and make locating products easy when ordering from our catalog.

To that end, we have a new format this year in our catalog that organizes products according to the MARCH acronym for the order of treatment. This forward-thinking methodology prioritizes the treatment of massive hemorrhaging before Airway, Breathing and Circulation (A, B, C) based on the leading causes of preventable battlefield death and the need to address severe bleeding even during Care Under Fire. Operators must maintain situational awareness at all times when providing care in the constantly changing tactical environment. This is why the tenets of TCCC provide recommendations of treatment modalities based on the tactical situation that both the medical care provider and the casualty find themselves in at the time.

marchTo create a framework for treatment during combat, the Committee on Tactical Combat Casualty Care (CoTCCC) has provided 3 phases of care: Care Under Fire, Tactical Field Care and TACEVAC. Each of these phases identifies the type of treatment that might be rendered depending on the tactical situation. During

Care Under Fire the only care that should be attempted while the casualty

and you are under effective hostile fire is to stop life-threatening external hemorrhagingand that, only if

tactically feasible. Only the operator on the ground can make the determination of what is feasible while they are under effective hostile

fire. The simplest and quickest intervention in combat will be the application of a tourniquet.Generally, airway management, respiration, circulation, and hypothermia should be addressed once you are no longer under effective hostile fire.

This care is usually done in the Tactical Field Care phase while you are behind cover and concealment. Once these treatments are complete, an operator should reassess all medical interventions and provide further evaluation prior to casualty movement. Time is a factor based on the tactical situation. However, given an opportunity, always consider hypothermia prevention and pain management. Hypothermia is common among casualties that enter shock due to severe blood loss or trauma and is much more difficult to reverse than to prevent. With that in mind, it is always prudent

to package your casualty to prevent hypothermia prior to TACEVAC.

The movement of casualties across the

battlefield is addressed by the TACEVAC phase of care. This might include CASEVAC assets which are usually part of the mission vehicle/aircraft platform package. The CASEVAC vehicles tend to be armed or have combatants on board. The MEDEVAC vehicles/aircraft are dedicated medical assets and bear the Red Cross markings. The MEDEVAC crews have dedicated medical personnel and additional medical equipment.

7foreword | TacTical combaT casualTy care | m a r c h

narescue.com/hemorrhage


8

C - A -t t o u R n i q u E t G E n 6

H E M o s tAt i C d R E s s i n G sc e l o x

c h i t o g a u z e p r o

c o m b at g a u z e

E t d B A n d A G E s

G A u z E

MassiVe heMorrhagemassive hemorrhage

9 c-a-t tourniquet | heMostatics | Pressure bandages & gauze

2004 2005 2008 2011

ExtrEmity HEmorrHagE

60%tEnsion PnEumotHorax

airway obstruction

6%33%

extreMit y heMorrhageExtrEmit y hEmorrhagE

Leading cause of preventabLe death in tacticaL environments

USAISR (u.S. army institute of Surgical research) conducts laboratory testing of battlefield tourniquets on human volunteers and recommends the c-a-t as the primary battlefield tourniquet.

CoTCCC (committee on tactical combat casualty care) recommends the c-a-t as the tourniquet of choice.

USSOCOM issues the c-a-t as part of TCCC Initiative.

USAISR Study is published scientifically proving the c-a-t

100% effective in occluding blood flow in both upper & lower extremities and the most safe and comfortable field tourniquet. its superior mechanism (inner band) optimizes the right amount of force to stop bleeding while minimizing damage to the underlying tissue.

Army Surgeon General selects the c-a-t to be issued to every deployed U.S. soldier.

Study of battlefield data published in the Journal of Trauma validated the uSaiSr conclusions and identified the c-a-t as the best prehospital tourniquet and more effective in real world situations by a 13 point difference (20% better) compared to other tourniquets utilized on the battlefield improving survival rates of casualties with major limb trauma.

Study published in Military Medicine offers concrete data verifying the c-a-t as the safest and most effective field tourniquet requiring 30% less pressure to achieve success further validating the original 2005 uSaiSr study.

The besT&

mosT effecTive field TourniqueT

time after time...FOR MORE ON THE STORy

w w w.NARescue.com/CAT

3 Leading Causes ofPreventable Combat Death

MILITARy MEDICINE, Vo l . 176, Oc t ober 2011


Trainer

MADE INAmerICA

The #1 laboratory tested, combat proven C-A-T (Combat Application Tourniquet) with Red Tip Technology is a true one-handed windlass tourniquet with a free-moving internal band for extremely effective circumferential pressure on extremities compromised by penetrating trauma. Its unique dual securing system uses aggressive hook & loop for easier application & added security. The C-A-T is the U.S. Armys tourniquet of choice and is trusted by law enforcement and EMS professionals everywhere to control extremity hemorrhage in combat casualties and other traumatically injured patients.

Combat appliCation tourniquet

Rugged Berry Amendment construction branded with NARs signature Red Tip Technology

C-a-t Gen 6 taCtiCalC-A-T

Gen 6 TACTiCAl

Enhanced composite Windlass with increased diameter & improved grip

Other

specialized versions of the C-A-T are also

available

Writeable time stamp to document time of application

Designed for simple threading during leg applications

CAT Combat Application Tourniquet

Item# 30-0001 (Black) NSN# 6515-01-521-7976

SEL# 09MS-04-BAND

Dimensions: Packaged - L 6.5 in. x W 2.4 in. x D 1.5 in. Open Length: 37.5 in.

Weight: 2.7 oz

Scientifically proven 100% effective in occluding blood flow in both upper & lower extremities by the USAISR & recommended by CoTCCC

Can be applied around entrapped limbs

Affordable, lightweight & rugged; suitable for use in all kinds of weather

Requires minimal cube space

Enhanced composite Windlass with increased diameter & improved grip

Reinforced Windlass Clip for security

Security Tab with writeable area to record the time of application

C-A-T Gen 6 resCue Combat Appl icat ion Tourniquet I tem# 30-0023 (Orange)NSN# 6515-01-612-7129 See Massi ve Hemorrhage, page 12

C-A-T Gen 6 trainer Combat Appl icat ion Tourniquet I tem# 30-0033 (Blue) NSN# 6910-01-560-2972See Training Suppor t , page 60

11massive hemorrhaGe | Combat appliCation tourniquet

MADE INAmerICA

MADE INAmerICA

Trainer

CAT Combat Application Tourniquet

Item# 30-0023 (Orange) NSN# 6515-01-612-7129

SEL# 09MS-04-BAND

Dimensions: Packaged - L 6.5 in. x W 2.4 in. x D 1.5 in. Open Length: 37.5 in.

Weight: 2.7 oz

C-A-T Holder

Item# 30-0057 (Black)

Item# 30-0044 (Coyote)

Item# 30-0059 (MultiCam)

Item# 30-0053 (ODGreen)

Dimensions: L 6.25 in. x W 1.75 in. x D 1.5 in.

Weight: 1.26 oz Same great features of the C-A-T but in high-visibility rescue orange color for civilian EMS or hospital settings

Tailored specifically for your C-A-T, to protect it from exposure to the elements

PALS/MOLLE-style connectors for versatile attachment to the duty vest, gear or belt (mounted horizontally or vertically) for rapid & easy access

500D IR Signature Reduced Nylon

Easy-open pull elastic tab with tourniquet ID patch TQ

NATO stock numbers available for COY and ODG. Contact Customer Service for details.

C-a-t holder

Combat appliCation tourniquet

C-a-t Gen 6 resCue

Easy visual identification of tourniquet placed on an extremity

The best pre-hospital tourniquet and 100% effective in occluding blood flow in both upper and lower extremities

Quickly controls life-threatening extremity bleeding when direct pressure is not successful or applicable

Can be applied around entrapped limbs

Security Tab with writeable area to record time of application

C-A-T Gen 6 trainer Combat Appl icat ion Tourniquet I tem# 30-0033 (Blue) NSN# 6910-01-560-2972See Training Suppor t , page 60

C-A-T Gen 6 taCtiCal Combat Appl icat ion Tourniquet I tem# 30-0001 (Black) NSN# 6515-01-521-7976 See Massi ve Hemorrhage, page 11

NOTE: Tourniquet sold separately

12 north ameriCan resCue 2012 | naresCue.Com

Ankle Tourniquet Holster


Dimensions: Packaged - L 16 in. x W 4 in. x D 0.25 in.

Weight: 2.5 oz Securely holds a C-A-T

on a duty belt up to 2.25 inches wide

Made of 093 vacuum-formed KyDEX material

Includes a removable first aid identifier patch (blue cross)

Hardware can be positioned for vertical or horizontal mounting

c-a-t Kydex belt holder

anKle tourniquet holster

Allows easy access & rapid deployment of tourniquet from the ankle with either hand

Made of lightweight 3mm perforated neoprene

Hook & loop attachment ensures that Holster stays in place

A lightweight, comfortable tourniquet carriage solution designed for wear directly over your high top duty boot or on your ankle.

Carry the life-saving equipment you need on your duty/patrol/pistol belt where it belongs. The strength and retention of KyDEX material allows the tourniquet to be held tightly in place with no straps or covers, but allows swift removal by grabbing and pulling the exposed part of the tourniquet.

NOTE: Tourniquet sold separately

NOTE: Tourniquet sold separately. Duty belt not included

C-A-T KyDEX Belt Holder


Dimensions: L 4.75 in. x W 2.25 in. x D 2 in.

Weight: 3.8 oz

13MassiVe heMorrhage | coMbat aPPlication tourniquet & accessories

1996 2003 20082006-07



airway obstruction

6%33%

heMostatic agents in the tccc guidelines

No hemostatic agents had been approved by FDA at this time. the only treatment to control hemorrhage was to apply direct pressure.

both the Chitosan-based Bandage hemcon and the Zeolite Powder Quikclot were judged to be effective based on study findings to date. although cotccc was not able to identify a clear winner based on efficacy, there were concerns about burns from the exothermic reaction produced by Quikclot and HemCon bandage was selected as the initial tccc hemostatic agent of choice.

Feedback from seasoned combat 1st responders & trauma surgeons on the efficacy of QuikClot and HemCon prove inconclusive. CoTCCC recommends both agents for the battlefield with the

HemCon Bandage being primary for treatment of severe external bleeding not amenable to a tourniquet. During Tactical Field Care & CASEVAC, both agents were recommended, with QuikClot being secondary if HemCon proved ineffective or unavailable.

Based on field experience of combat medical personnel, a strong preference for a gauze-type hemostatic agent rather than a powder or granule, especially in wounds where the bleeding is at the bottom of a narrow wound tract. CoTCCC recommends Combat Gauze as 1st line treatment for life-threatening hemorrhage with WoundStat granules as the backup

when the 1st line agent has been ineffective or the wound characteristics are more amenable to a granular agent.

2008 TCCC Guidelines replace the HemCon Bandage due to 2 research studies finding Combat Gauze & WoundStat had an increased ability to stop bleeding over all other available hemostatics. The gauze-type form & lower cost were also significant competitive advantages regarding the newer products.

3 Leading Causes of Preventable Combat Death


20122009-11Office of Naval Research (ONR) performs a study to compare four other FDA-approved hemostatic gauzes to the current standard (Combat Gauze). The results suggest that the current standard for point-of-injury hemorrhage control may need to be re-evaluated or alternatively the standard of care expanded to include Combat Gauze XL, Celox Gauze, Trauma Gauze, and ChitoGauze pro.1

In our mission to save more lives on the battlefield, NAR now offers the full spectrum of the most effective hemostatic agents found in this ONR Study...

Safety and clotting effectiveness studies conducted by the U.S. Army Institute of Surgical Research determines that WoundStats clotting granules poured directly into a wound could cause damage to blood vessels as they travel to other parts of the body. Combat Gauze becomes the only hemostatic agent approved for use within the DoD.

uncontrolled hemorrhage is the most common cause of death on the battlefield, and a majority of these deaths are associated with wounds that are either non-compressible or not amenable to a tourniquet. Establishing early hemostasis is paramount to reducing mortality caused by these kinds of wounds. In recent years, many novel hemostatic agents such as gauzes, sponges, powders, and granules have been developed with the aim of reducing hemorrhaging. Specifically, hemostatic gauze has shown superiority in treating uncontrolled external hemorrhage because of its

familiarity, ease of application, and ability to conform to an injury site.

Currently, the Committee on Tactical Combat Casualty Care (CoTCCC) recommends Combat Gauze as the standard hemostatic agent in the U.S. military. However, the Office of Naval Research (ONR) recently performed a study to compare four other FDA-approved hemostatic gauzes to the current standard. The gauzes chosen were Combat Gauze XL, Celox Gauze, Trauma Gauze, and ChitoGauze pro along with the standard Combat Gauze. All of the hemostatic agents except Trauma Gauze utilize a traditional gauze in conjunction with either kaolin or chitosan. Trauma Gauze is made entirely of chitosan and does not contain a cotton or poly-rayon component. One other important note is that both Combat Gauze XL and Celox Gauze had about twice the mass of any of the other test gauzes. Therefore, any performance difference could be due to an increase in mass, but the current experiment design did not focus on determining the specific means of achieving hemostasis.

In a standardized swine model for hemostatic gauze efficacy testing, the ONR concluded that all test objects examined in this study performed at least as well as the current standard of care. Although none of the gauzes tested were concluded to be inferior to the current standard, some did excel in specific tests. In both immediate and eventual hemostasis tests, Combat Gauze XL, Celox Gauze, and ChitoGauze pro all outperformed the current CoTCCC-recommended Combat Gauze. Also, at the end of testing, animals treated with

Combat Gauze XL and Celox Gauze only lost around half the amount of blood as animals with Combat Gauze or Trauma Gauze. Figure 1 shows the blood loss at different time points. Over the duration of the experiments, 90% of animals treated with Celox Gauze survived, and 70% survived with Combat Gauze XL and ChitoGauze pro. Figure 2 shows the full survival analysis graph.

Some other important observations were noted during the study. Every gauze tested retained hemostasis during leg movement, and all test objects also allowed for free bleeding when removed from the wound site. Furthermore, none of the gauzes showed significant damage to any of the tissues, but foreign material (likely chitosan which is biodegradable and bio-compatible2) was found in all tissues in the Celox Gauze group. No foreign material was found in blood vessels for any of the gauze products.

The ONR did not conclude that one hemostatic gauze product was statistically better than another, but it showed that novel FDA-approved hemostatic dressings exist that perform equally to the current

standard of care based on hemostasis, survival, and blood loss. The results

suggest that the current standard for point-of-injury hemorrhage control (Combat Gauze) may need to be re-evaluated or alternatively the standard of care expanded to include Combat Gauze XL, Celox Gauze, Trauma Gauze, and ChitoGauze pro

Figure 1

Figure 2

rEFErEncEs:

1. rall, Jason m., Jennifer m. cox, adam songer, James a. comeaux, J. s. Estep, ramon F. cestero, and James D. ross. comparison of novel Hemostatic gauzes to Quikclot combat gauze in a standardized swine model of uncontrolled Hemorrhage. technical report #2012-22. naval medical research unit, san antonio. Print.

2. Keong, Lim chin, and ahmad sukari Halim. in Vitro models in biocompatibility assessment for biomedical-grade chitosan Derivatives in wound management. international Journal of molecular sciences 10.3 (2009): 1300-313. Print.

*Products available from NAR

** **

15MassiVe heMorrhage | history oF heMostatics

STERILE

STERILE

North American Rescue is pleased to expand our growing product line of hemostatic dressings to include CELOX, a clinically-proven family of chitosan-based products certified safe-to-use and successful in stopping life threatening hemorrhage on the battlefield, in serious emergencies and in the workplace. From the original granular form to the various CELOX gauzes, NAR offers the full spectrum of this trusted hemostatic to meet every medics need in the pursuit of saving lives from severe trauma.

Not available to all countries. Contact Customer Service to verify availability in your country.

NEW to the CELOX family is the Z-fold gauze. The Z-fold offers the same high performance as CELOX roll gauze but in a smaller, lighter form that ensures easier-to-handle, straightforward application in an easy-to-carry slim line pack. Available in 5 & 10 ft lengths.

The power of CELOX now available on a Gauze - CELOX Gauze is an instinctive way of using CELOX to stop even severe high pressure bleeding & hemorrhage. Just pack the wound & apply pressure its very effective, easy-to use & safe.

CELOX Roll Hemostatic Gauze

Item# 30-0066

Dimensions: Packaged - H 7 in. x W 4.25 in. x D 2 in. Gauze - L 10 ft x W 3 in. Weight: 2.1 oz

Other CeloX Hemostatics also available from NAR

hemostatiC Gauze

CeloX roll

hemostatiC Gauze

CeloX z-fold

The most effective dressing for immediate hemostasis

Stops life-threatening bleeding resulting from shock as found in severe traumatic injuries

Works independently of the bodys normal clotting mechanisms

Published success in the field

Generates no heat

Available in 3 convenient configurations: 10 ft roll, 5 ft Z-fold & 10 Z-fold

CELOX Z-fold Hemostatic Gauze

Item# 30-0064 (5 ft length)

Dimensions: Packaged - H 5.25 in. x W 4.25 in. x D 0.5 in. Gauze: W 3 in. x L 5 ft Weight: 1.1 oz

Item# 30-0065 (10 ft length)


Proven the most successful in the recent ONR Study

(see page 15)

Versatile 5 ft CELOX Z-fold Gauze branded with NARs signature Red-Tip Technology packaging

* Contact Customer Service for NATO stock number

CELOX-A Hemostat ic Granules wi th Appl icator I tem# 30-0067

CELOX Granules 35g* Hemostat ic Wound Treatment I tem# 30-0068

16 north ameriCan resCue 2012 | naresCue.Com

STERILE

MADE INAmerICA

The proven hemostatic properties of chitosan and the familiar convenience of non-woven, polyester/rayon blend medical gauze

Conforms into irregular wound surfaces to rapidly staunch bleeding & seal the wound

Offers antimicrobial properties against 26 bacterial organisms

Small cube maximizes storage space

Generates no heat

Z-folded in a vacuum-sealed pouch featuring NARs signature Red-Tip Technology packaging

hemostatic GauzechitoGauzePRo

ChitoGauzePRO Hemostatic

Item# 30-0049 NSN# 6510-01-591-7740

Dimensions: Packaged - H 6 in. x W 5 in. x D 0.65 in. Gauze - L 4 yd x W 3 in. Weight: 0.7 oz

CELOX Rapid Hemostatic Gauze

Item# 30-0069


Combat Gauze Hemostatic Gauze

Item# 30-0039 Z-folded

Item# 30-0048 Rolled

Dimensions: Packaged - H 5.75 in. x W 4.5 in. x D 0.65 in. Gauze - L 4 yd x W 3 in. Weight: 0.8 oz

Combat Gauze XL (2-ply) Hemostatic Gauze

Item# 30-0070 Z-folded

Dimensions: Packaged - H 6 in. x W 5 in. x D 0.75 in. Gauze - L 4 yd x W 4 in. Weight: 1.75 oz

Provides aid in hemostasis of traumatic injuries

Z-fold vacuum-packed for easy application

Can be fitted to any size or shape wound

Easily removed once clotting occurs

Generates no heat

Stops severe arterial bleeding with only one minute of compression applied

Independent in vivo testing showed 100% success in achieving hemostasis & reduced blood loss compared to other treatments

Compact Z-folded format making it easy to use & carry

Generates no heat

Tested in a model of casualty evacuation, achieving 100% successful transport without re-bleeding

hemostatic Gauzecombat Gauze

hemostatic GauzeceLoX RaPid

The next generation Z-folded Hemostatic Chitosan Dressing

Combat Gauze XL features 2-ply, oversized hemostatic gauze: 4 in. x 4 yd

Stop severe arterial bleeding with this new generation of CELOX technology offering even faster packing time & reduced compression time in an emergency.

Coming Soon!

17massive hemoRRhaGe | hemostatic dRessinGs

MADE INAmerICA

MADE INAmerICA

STERILE

Branded with NARs signature Red Tip

Technology

packaging

The ETD series of pressure bandages consists of a resilient elastic wrap equipped with a sterile non-adherent pad, durable securing device and innovative Quick-Grip Roll Control configuration. This combination facilitates a rapid, controlled and extremely effective application process even in the most demanding conditions. The ETD can also be used to sling and swath an arm, to secure splints to an extremity or to perform in any other function requiring an elastic wrap. Available in 3 convenient sizes.

Sterile bandage dressing Made with U.S. cotton and Berry Amendment Compliant

Resilient elastic wrap in 3 sizes with integrated sterile non-adherent pad: 6 x 4 in. pad (4 in.), 6 x 6 in. pad (6 in.) & 12 x 12 in. pad (Abdominal)

Innovative Quick-Grip tabs keep the bandage from unrolling during application

Durable easy-to-use C-clasp secures device without confusing pressure bars or hooks

Vacuum-sealed, low-cube package with easy-open tear notches

The Abdominal ETD has a 12 x 12 in. oversized pad, ideal for dressing penetrating abdominal trauma, amputations, burns & large pattern wounds

Made in aMERiCa / BERRy aMENDMENt Compliant. . . Quality you can tRuSt in the heat of battle

ETD Emergency Trauma Dressing

Item# 30-0031 (4 inch) NSN# 6510-01-558-4108

Dimensions (4 in.) : Packaged - L 4.5 in. x W 2.5 in. x D 1.75 in. Bandage - L 70 in. x W 4 in. Pad - H 6 in. x W 4 in.

Weight: 2.6 oz

Item# 30-0032 (6 inch) NSN# 6510-01-558-4114

Dimensions (6 in.) : Packaged - L 6 in. x W 2.5 in. x D 2.1 in. Bandage - L 70 in. x W 6 in. Pad - H 6 in. x W 6 in.

Weight: 4 oz

Item# 30-0012 (Abdominal/Stump) NSN# 6510-01-541-8121

Dimensions (ABD) : Packaged - L 5.25 in. x W 6 in. x D 1.5 in. Bandage - L 70 in. x W 6 in. Pad - H 12 in. x W 12 in.

Weight: 5 oz

eMergency trauMa dressing

etd (4 inch, 6 inch & abdoMinal /stuMP)

Engineered using data from over 63 After Action Reviews (AARs) of real-world battle dressing applications


STERILE STERILEMADE INAmerICA MADE IN

AmerICA

Sterile, 6-ply cotton gauze, Made in the U.S.A. and Berry Amendment Compliant

Ideal for wound bandaging and wrapping of injuries

High quality U.S. cotton provides maximum absorption to help control bleeding.

Small, compact size that expands to cover larger wound areas.

Used as backing gauze for hemostatic agents, in conjunction with a compression bandage to control hemorrhage, or for minor wound bandaging.

Low-cube, rugged, vacuum-sealed pouch features easy-open tear notches

Branded with NARs signature Red Tip Technology packaging

coMPressed gauze

Sterile, 6-ply cotton gauze Made in the U.S.A. and Berry Amendment Compliant

Unique, convenient packaging configuration and dispenser allows controlled application as a complete unit or in a continuous linear feed for wound packing.

Unused portion remains protected from contamination during application

Used as backing gauze for hemostatic agents, in conjunction with a compression bandage to control hemorrhage, or for minor wound bandaging

Low-cube, rugged vacuum-sealed outer pouch features easy-open tear notches

Branded with NARs signature Red Tip Technology packaging

s-rolled gauze

Made in aMERiCa / BERRy aMENDMENt Compliant. . . Quality you can tRuSt in the heat of battle

S-Rolled Gauze

Item# 30-0003 NSN# 6510-01-605-2234

Dimensions: Packaged - H 3 in. x W 2.5 in. x D 1.63 in.. Gauze (6 ply) - W 4.5 in. x L 4.1 yd

Weight: 1.2 oz

Compressed Gauze

Item# 30-0052 NSN# 6510-01-503-2117

Dimensions: Packaged - H 3 in. x W 2 in. x D 1.5 in. Gauze (6 ply) - W 4.5 in. x L 4.1 yd

Weight: 1.2 oz

MassiVe heMorrhage | Pressure bandages & gauze 19

narescue.com/airway


20

a irWaya irway

C y C l o n E B v M

n A s o P H A R y n G E A l

tA C t i C A l s u C t i o n d E v i C E

tA C t i C A l C R i C k i t

s u P R A G l o t i C A i R wAy s

l A R y n G o s C o P E & B l A d E s

21 basic & adVanced airWay ManageMent

This compact, fully functional adult BVM reduces storage space by up to 75% compared to traditional manual resuscitators. The Cyclone New & Improved Pocket BVM is todays most compact, easy-to-use BVM, providing ventilatory support to patients who are not breathing or who are in respiratory distress.

Unique collapsible design is quick-to-deploy, easy-to-operate & needs no manual inflation prior to use

Requires minimum pressure for compression of the bag to ventilate & quickly recovers its shape, which reduces rescuer fatigue during use

Packaged in a rugged, hard plastic, twist-top case

Contains 6 ft, 6 in. of oxygen tubing for delivering supplemental oxygen when available

neW & iMProVed PocKet bVM

cy

clo

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Cyclone New & Improved Pocket BVM

Item#10-0019 NSN# 6515-01-568-0193

SEL# 09ME-02-AWMG

Dimensions: Packaged - L 6 in x W 6 in x D 2.5 in.

Weight: 14.7 oz

(1) Rugged, t w is t - top

Hard Case w i th ins truct ions

(1) Ful l y - funct ional, Adul t

Collapsible BVM

(1) Ergonomic cushioned, see - through, molded s i l icone mask

Face Mask

Inc ludes Oxygen Inlet, Reservoir Bag and 6 f t 6 in. o f Oxygen Tubing

Rugged hard case protects the device & is ideal for the tactical environment

Oxygen Inlet

Reservoir Bag

Oxygen Tubing

The compact, fully functional adult BVM that reduces storage space by up to 75% compared to traditional manual resuscitators


Nasopharyngeal Airway with attached lubricant

Item# ZZ-0424 (22F)

Item# ZZ-0422 (24F)

Item# ZZ-0387 (26F)

Item# ZZ-0034 (28F) NSN# 6515-01-529-1187

Item# ZZ-0423 (30F)

Item# ZZ-0388 (32F)

SEL# 09MS-02-AWMG

Dimensions: Packaged - L 6 in. x W 1.6 in. x D 0.5 in.

Weight: 0.5 oz

NAR Tactical Suction Device

Item# 10-0018 NSN# 6515-01-540-7206

SEL# 09ME-02-SUCT

Dimensions: Packaged - L 9.75 in. x W 3.75 in. x D 3 in. Suction Capacity: 1000 mL

Weight: 7.3 oz

Pull both end valves [Front patient valve housing (air/O

2 exit

port) and rear air/O2

inlet valve] outwards in opposite directions while twisting the Patient Valve

nasoPharyngeal airWay With attached lube nar tactical

suction deVice

Not easily dislodged during casualty transport

Can be used for both semi-conscious or unconscious patients

Available in sizes 22F 32 French

Compact emergency tool for the effective clearing of airway obstructions due to blood, vomitus or other secretions

Double-valved design for one-handed operation

Vacuum force of approximately 100 mmHg

Clear collection bag & bulb hold over 1000 mL to effectively evacuate the oropharynx

Contoured suction tip prevents tissue damage

Reliable, simple, rugged & inexpensive

Separate the Face Mask from the folded Resuscitator Bag

hoW to dePloy the cyclone bVM:

1.

2.

3. Attach the Face

Mask to the Patient Valve Housing

Conveniently packaged with surgical lubricant (0.09 oz)

A must for basic airway management available in 6 sizes

airWay | basic 23

All of the critical components needed to effectively perform a surgical cricothyroidotomy

Includes ideal length and size tracheal tube with securing device

Components are configured in the sequence of use and ideal for low-light, austere environments

Lightweight, ruggedized and minimal in weight & cube

500 Denier, Berry Amendment compliant Rolled Pouch designed to provide a clean working surface

Tactical CricKit Tactical Surgical Cricothyroidotomy Kit

Item#10-0017 (Coyote) NSN# 6515-01-540-7568

Dimensions: Packaged - H 6.5 in. x W 2.5 in. x D 1.25 in. Kit Unrolled - H 6.5 in. x W 7.5 in. x D 1.25 in.

Weight: 3.7 oz

Provides the medical care provider with all the necessary tools to perform an emergency cricothyroidotomy. Packaged in a compact and rugged pouch, the Tactical CricKit is the ideal kit for performing a cricothyroidotomy in austere environments. This compact, all-in-one kit integrates all of the CoTCCC preferred features of a surgical airway kit for the tactical setting. Designed for ease of use in emergency situations, its components are arranged in the order of use.

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(1 pair) Bear ClawNitr i le Trauma Gloves I tem# ZZ-0248 NSN# 6515-01-600-0262

(1) Rolled PouchTact ical Ny lon

(1) Cricothyroidotomy Tube Flex ib le, Cuf fed 6mm with Obturator

(1) Gauze Pad 4 in. x 4 in.

(1) NAR Tracheal Hook I tem# 10-0020 NSN# 6515-01-562-9734

(1) #10 Scalpel Protected

(1) Tube Securing Strap

(2) Antimicrobial Packets (1 alcohol & 1 pov idone)

(1) Luer-Lock 10cc Syringe

NAR Tracheal Hook provides maximum access and visualization during the procedure

the tactical

tactical surgical cricothyroidotoMy Kit


*NOTE: Kit contents subject to change without notice dependant upon DoD requirements. Visit our website for the most up-to-date information.

MADE INAmerICA

MADE INAmerICA

PatiENt ColoR SizE HEigHtyEllow 3 71 in.

Unique dual channel design allows positive pressure ventilation and the passage of a gastric tube into the esophagus & stomach

Versatile, simple-to-use airway tool that provides a patent airway and positive pressure ventilation

Anatomically shaped distal tip & cuff assist in the airways passage behind the larynx and into the normally collapsed esophagus

New tapered ramp design provides additional ventilation outlets

Second lumen is open at the distal tip of the tube providing a channel for the passage of a gastric tube (up to 18 French), for regurgitation and also provides a vent for gastric pressure & stomach decompression

Custom packaged in a rugged, vacuum-sealed bag

lts

-d c

on

ten

ts

(1) Sterile Lubricant

(1) Vacuum-sealed Bag

(1) King LTS-D

(1) 18F Gastric Tube

(1) Ventilation Extension Tube

(1) 60cc Syringe

King lt-d suPraglottic airWay

Compact packaging for storage in your kit

Smooth insertion with minimal movement of the head in an average time of less than 15 seconds

Convenient two-cuff inflation through a single pilot balloon

Pliable fabrication withstands extreme environmental conditions

Includes surgical lubricant & 60cc syringe

King LT-D Supraglottic Airway

Item# 10-0002 Size 3 (yellow) NSN# 6515-01-515-0146

Item# 10-0003 Size 4 (Red) NSN# 6515-01-515-0151

Item# 10-0004 Size 5 (Purple) NSN# 6515-01-515-0161

SEL# 09ME-02-AWMG

Dimensions: Packaged - H 5.75 in. x W 12.25 in. x D 1.75 in.

Weight: 6.6 oz

King lts-d suPraglottic airWay Kit

This exclusive supraglottic airway kit is packaged especially for tactical medics and offers the unique

ability to suction gastric contents or air from the stomach by easily passing a gastric tube

through a second channel of the airway device directly into the esophagus and stomach.

Gastric Diverter

*NOTE: Kit contents are subject to change without notice. Visit our website for the most up-to-date information.

King LTS-D Supraglottic Airway Kit

Item# 10-0025 Size 3 (yellow)

Item# 10-0026 Size 4 (Red) NSN# 6515-01-591-1578

Item# 10-0027 Size 5 (Purple) NSN# 6515-01-591-0397

Dimensions: Packaged (Folded) - H 4 in. x W 11.43 in. x D 1.92 in. Packaged (Unfolded) - H 8 in. x W 13.36 in. x D 1.22 in.

Weight: 5.7 oz

25airWay | adVanced

Lightweight, compact kit rolls up for easy storage in your kit

Resistant to dust, sand & water

Operates in severe environmental conditions

Textured, water-proof & dust-proof handle

Removable light source works with any standard fiber optic blade

Single-use fiber optic blades of enhanced polymer for exceptional strength and rigidity

Special Operations Laryngoscope Set

Item#10-0001 (Black) NSN# 6515-01-450-9790

SEL# 09MS-02-AWMG

Kit Dimensions: Open - L 8 in. x W 5.5 in. x D 2 in. Rolled - L 8 in. x W 2 in. x D 2 in.

Weight: 10 oz

Lightweight, compact, & highly innovative, the Special Operations Laryngoscope Set from North American Rescue is designed to equip medical care providers with tools to perform direct visual laryngoscopy to secure an airway in a roll-up carrying pouch. These effective laryngoscopy tools work in the most severe environmental conditions.

sP

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(1) Pocket Exam Light(2 AA Bat ter ies inc luded)I tem# 10-0007 NSN# 6515-01-460-9605

(1) Laryngoscope Pouch I t em# 10-0006 NSN# 6515-01-467-7624

(1) Laryngoscope Handle I t em# 10-0005 NSN# 6515-01-460-4736

(1) Laryngoscope Blade Size 3, Mi l ler I tem# 10-0011 NSN# 6515-01-460-4681

(1) Laryngoscope Blade Size 3, Mac I tem# 10-0013 NSN# 6515-01-460-4685

(1) Spare Bulb (Pocket Exam Light)

(2) AA Batteries(replacement)

Special OperatiOnS

laryngOScOpe Set

sPecial oPerations laryngoscoPe set


Single-use laryngoscope blades compatible with any standard fiber optic handle

Enhanced polymer construction for less risk of damage to patients teeth or soft tissues

Exceptional strength & rigidity plus superior illumination

Designed for safety and convenience

Miller Laryngoscope Blade

Item# 10-0009 (Size #1) NSN# 6515-01-460-4724

SEL# 09ME-02-AWMG


Weight: 0.6 oz


Item# 10-0010 (Size #2) NSN# 6515-01-460-4725

SEL# 09ME-02-AWMG


Weight: 1 oz


Item# 10-0011 (Size #3) NSN# 6515-01-460-4681

SEL# 09ME-02-AWMG


Weight: 1.2 oz

Mac Laryngoscope Blade

Item# 10-0013 (Size #3) NSN# 6515-01-460-4685

SEL# 09ME-02-AWMG

Dimensions: L 5.25 in. x W 1.5 in. x D 1 in.

Weight: 1 oz


Item# 10-0014 (Size #4) NSN# 6515-01-460-4672

SEL# 09ME-02-AWMG

Dimensions: L 6 in. x W 2.5 in. x D 1 in.

Weight: 1 oz


Item# 10-0012 (Size #2) NSN# 6515-01-460-4686

SEL# 09ME-02-AWMG


Weight: 0.8 oz

Miller & Mac, disPosable

Fiber oPtic laryngoscoPe bladesDisposable, safe and convenient laryngoscope blades that provide superior illumination

Handle and exam light sold separately.


Item# 10-0008 (Size #0) NSN# 6515-01-460-4718

SEL# 09ME-02-AWMG


Weight: 0.4 oz

27airWay | adVanced

narescue.com/respiration

28

north aMerican rescue 2012 | narescue.coM28

resP irat ionresp irat ion

H y F i n C H E s t s E A l s T w i n Pa c k i n d i v i d u a l v e n T X T r e m e

A R s n E E d l E d E C o M P R E s s i o n

PneuMothorax | tension PneuMothorax 29

Hyfin Twin pACk

trainer I tem# 10-0032

See Training Suppor t , page 57MADE INAmerICA

Trainer

Made in AMericA ...QuAlity you can trustThe HyFin series of occlusive chest seals from North American Rescue offers a wide spectrum of innovative treatment options. All HyFins feature advanced adhesive technology for a superior seal in the most adverse conditions, a transparent backing that easily conforms to the casualtys chest, a large and easily-visible red elliptical tab for single step peel-and-apply application, and rugged, compact easy-to-open foil pouch featuring NARs signature Red Tip Technology quality brand packaging.

Includes gauze pad for cleansing site to ensure

best possible seal.

Twin Pack for treatment of both entry/exit wounds or multiple penetrating injuries

Advanced adhesive technology for a superior seal

Oversized red elliptical tab for single step, peel-and-apply application and allows for burping of the wound if required

Larger size (6 in. x 6 in.)

Unique perforated packaging that allows the provider to open only one chest seal if needed

occlusiVe chest seals

hyFin tWin PacKThe new HyFin Chest Seal Twin Pack was developed to provide two individual chest seals in one unique package for entry and exit wounds or to treat multiple penetrating injuries to the chest. In addition to all the great features of the HyFin Series, the Twin Pack contains two large 6 in. x 6 in. chest seals, each with its own gauze pad to wipe the wound surface prior to application. The unique dual perforated foil pouch allows the provider to open only one chest seal if needed, without compromise to the second seal. Reduced cube space doubles the treatment capability in the tactical environment where storage is at a premium.

Trainer with specially formulated adhesive

is also available

HyFin Twin Pack

Item# 10-0031

SEL# 09MS-02-THOR

Dimensions: Packaged (folded for storage) - H 7.5 in. x W 4.5 in. x D 0.25 in. Packaged (unfolded) - L 7.5 in. W 9 in. x D 0.13 in. Each Chest Seal (excluding tab) - H 6 in. x W 6 in.

Weight: 2.5 oz

Patents: Patent(s) Pending


6 in.

6 in.

MADE INAmerICA

6 in.

6 in.

8 in.

9.25 in.

Made in AMericA ...QuAlity you can trust

A larger sized occlusive dressing designed to treat multiple penetrating chest injuries due to IEDs and multiple fragment peppering wounds or large exit wounds

Provides superior occlusive coverage over more than twice the surface area of other chest seals on the market

Delivers the same great features as the trusted HyFin with the added capability of a pressure relief vent

Ideal for those treatment protocols specifying the use of a dressing secured on 3 sides or a vented/valve-type chest seal

Adding the capability of a vented, valve-type pressure relief vent

Offering twice the surface coverage for multiple penetrating injuries commonly generated from explosions

The original, combat proven HyFin occlusive chest seal sold as an individual unit

Large size covers 6 in. x 6 in. area

hyFin x-treMe

hyFin Vent

hyFin indiVidual

HyFin Chest Seal Individual

Item# 10-0015 NSN# 6515-01-532-8019

SEL# 09MS-02-THOR

Dimensions: Packaged - H 7.5 in. x W 7.5 in. x D 0.1 in. Chest Seal (excluding tab) - H 6 in. x W 6 in.

Weight: 1.5 oz


HyFin Vent Chest Seal

Item# 10-0029

Dimensions: Packaged - H 7.5 in. x W 7.5 in. x D 0.1 in. Chest Seal (excluding tab) - H 6 in. x W 6 in.

Weight: 1.31 oz

Patents: U.S. Patent 7,504,549 & Patent(s) Pending

HyFin X-treme Chest Seal

Item# 10-0030

Dimensions: Packaged - H 5.25 in. x W 11 in. x D 0.1 in. Chest Seal (excluding tab) - H 8 in. x W 9.25 in.

Weight: 2.7 oz


resPiration | PneuMothorax | chest seals 31

Second leading cauSe of preventable death in tactical environmentS

a penetrating chest wound creates an opening in the chest wall through which air may enter the chest cavity during the normal respiration cycle. Commonly referred to as a sucking chest wound, this injury results in a condition known as an open pneumothorax.

An open pneumothorax occurs when there is a persistent communication between the internal thoracic cavity and the environment through a defect in the chest wall. Though this interferes with normal physiological ventilation, it should not create a tension pneumothorax as the intrathoracic pressure and atmospheric pressures equalize across the open wound.

The initial management of an open and/or sucking chest wound is to immediately apply an occlusive dressing to cover the defect and secure it in place. The casualty should then be monitored closely for any progressive signs of respiratory distress.

A tension pneumothorax can develop with a sucking chest wound when the chest wall defect creates a one-way valve in which air can be drawn into the pleural space but cannot exit. Since the air cannot escape, the intrathoracic pressure increases which, in turn, results in progressive respiratory distress, shock and ultimately the compromise of the hearts ability to pump blood effectively.

The treatment of this life threatening condition requires a needle chest decompression.

To perform this procedure, the rescuer inserts the needle into the skin over the superior border of the third rib, midclavicular line, and directs it into the 2nd intercostal space at a 90 angle to the chest wall. An audible rush of air may be heard from the needle as the chest decompresses. The needle is then removed, leaving the catheter in place. Consider securing the catheter to the chest with tape.

tension PneuMothora xtension pneumothora x



airway obstruction

6%33%


MADE INAmerICA

STERILE

Made in AMericA . . . QuAlity you can trust

Our patented ARS Needle Decompression Kits are designed to provide the appropriate length needle/catheter to penetrate the pleural space in 99% of patients. With its built-in failsafe characteristics, the ARS improves the probability of success when treating casualties who present with signs and symptoms of a tension pneumothorax. Now also available with the same quality and reliability as our current 14 gauge version, the new 10 gauge ARS provides the option of a needle/catheter that is approximately 60% larger in diameter for those customers looking for a larger gauge needle/catheter.

ARS Needle Decompression Kit

Item# ZZ-0298 10 ga x 3.25 in.

Item# ZZ-0056 14 ga x 3.25 in. NSN# 6515-01-541-0635

Dimensions: Packaged - L 5.5 in. x W 0.7 in. x D 0.8 in.

Weight: 0.5 oz

Patents: U.S. Design Patents: D584,409 S; D595,847 S; D584,410S; U.S. Patent 7,874,426B2

North American Rescue, LLC., 127820, 127822, 127823, 001002372-0001, 001013940 0001, 001013940-0002

The appropriate length needle/catheter (3.25 in.) to effectively treat tension pneumothorax

Available in two sizes: 14 ga x 3.25 in. & 10 ga x 3.25 in.

10 ga features a 60% increase in diameter for the option of a larger gauge needle/catheter

Capless flash chamber for immediate confirmation of needle placement

Packaged in an easy-to-open, crush-proof protective tube featuring easy-to-identify textured twist top with clip

3.25 in. needle decoMPression Kits

33resPiration | tension PneuMothorax | needle decoMPression Kits

narescue.com/circulation


north aMerican rescue 2012 | narescue.coM34

circul at ioncirculat ion

s A l i n E l o C k k i t s

B o A i v C o n s t R i C t i n G B A n d s

i/ o d E v i C E s Fa S T -1

e z i / o

35Vascular access 35

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(1) Gauze Package (2 pads per pack) 2 in. x 2 in.

(1) Hypodermic Needle 18G x 1.5 in.

(1) Locking Saline Plug

(1) Needle/Catheter 18G x 1.25 in.

(2) Alcohol Pads


(1) Raptor IV Secur ing Dev ice I tem# 30-0006 NSN# 6515-01-523-3317

(1) Clear Adhesive Dressing 4 in. x 4.75 in.

(1) IV Constricting Band (Latex-Free) 18 in. x 1 in.

North American Rescues Saline Lock Kit contains all the essential tools for successful extremity venous cannulation under the most demanding conditions. Designed to perform to the highest standards in the harshest environment, this IV kit has proven extremely effective for starting and securing a saline lock during casualty treatment & evacuation. Packaged in a vacuum-sealed, rugged pouch, the contents of the kit remain in prime condition until needed.

nar saline locK Kit

Featured in PHTLS 6th Edition (Military) as a system that has proven successful in the field

Meets all requirements for U.S. ARMy TASK: 081-831-1011 Establish a Saline Lock

Packaged in a compact, vacuum-sealed, rugged pouch with clear backing for rapid equipment inspection without compromising the package

Includes NARs Raptor IV Securing Device NAR Saline Lock Kit

Item# 30-0013 NSN# 6515-01-537-4094

SEL# 09MS-05-IVSA

Dimensions: Packaged - H 5.5 in. x W 3.25 in. x D 1 in.

Weight: 1.3 oz

NAR SAliNe

lock kit

Featured in PHTLS 7th Edition (Military)


need

leles

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Kit

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(1) Gauze Package (2 pads per pack) 2 in. x 2 in.

(1) Hypodermic Needle 18G x 1.5 in.

(1) Needle Free Valve Port

(1) IV Safety Catheter 18G x 1.25 in.

(2) Alcohol Pads


(1) Raptor IV Secur ing Dev ice I tem# 30-0006 NSN# 6515-01-523-3317

(1) Clear Adhesive Dressing 2.38 in. x 2.75 in.

(1) IV Constricting Band (Latex-Free) 18 in. x 1 in.

NAR Needleless Saline Lock Kit

Item# 30-0046 NSN# 6515-01-607-1943

Dimensions: Packaged - H 5.5 in. x W 3.25 in. x D 1 in.

Weight: 1.3 oz

NARs Needleless Saline Lock Kit is engineered to reduce or eliminate accidental needle-stick exposures to tactical healthcare providers even under the most demanding conditions. It comes conveniently packaged in a compact, vacuum-sealed, rugged pouch, to keep its contents in operational condition until needed for use. An IV safety catheter and a needle-free valve port allow for safer, quicker and more effective IV cannulation in less than optimal conditions.

All-in-one solution that is convenient, efficient and reliable.

Contains an IV safety catheter & a needle-free valve port to reduce or eliminate accidental needle-sticks

Provides essential components for establishing a saline lock in the most demanding conditions

Includes a clear, adhesive dressing and NARs Raptor IV Securing Device

Packaged in a compact, vacuum-sealed, rugged pouch

nar needleless saline locK KitNAR Needleless

sAliNe lock kit

circulation | Vascular access 37

MADE INAmerICA

For improved peripheral venous access every time, the BOA IV Constricting Band uses a rolling action to transfuse venous blood to the distal veins while still allowing arterial flow. For maximum effect, the BOA should be placed as high up on the extremity as allowable. This technique distends the veins to make IV access quicker and more effective even in the most challenging patients.

Increases proficiency in gaining direct peripheral IV access...everytime

Quick, effective IV access even under challenging circumstances

Utilizes a revolutionary rolling action for transfusing venous blood to the distal veins while still allowing arterial flow

Quick Click connector & two-finger Quick Release for improved time on task

Rugged, vacuum-sealed packaging designed to maintain sanitation & provide quick access

BOA IV Constricting Band

Item# 30-0009 NSN# 6515-01-537-2611

SEL# 09MS-05-IVSA

Dimensions: Packaged - L 4 in. x W 3 in. x D 0.9 in. Device Length: 7.5 in. extending to 18 in.

Weight: 1.2 oz

U.S. Patents: 5,304,202 & 5,607,448

BOA XL IV Constricting Band

Item# 30-0071

SEL# 09MS-05-IVSA

Dimensions: Packaged - L 4 in. x W 3 in. x D 0.9 in. Device Length: 10 in. extending to 27 in.

Weight: 1.2 oz

U.S. Patents: 5,304,202 & 5,607,448

iv constricting band

boa

iv constricting band

boa

The NEW BOA XL utilizes the same technology for quick and easy IV access on patients that might be uncomfortable wearing an original BOA. We designed the BOA XL to accommodate a larger body type and fit a greater range of arm sizes as it stretches approximately 50% longer than the original BOA.

Individually packaged


iV securing deVicenar raPtor(PacK oF six)

nar sharPs container(box oF six)

Engineered specifically to quickly secure an IV line in the most difficult conditions

Works well in conjunction with Saline Locks

Secures IV tubing without tape and/or on wet skin

Sold 6 per pack

Convenient point of use containment for used needles & small syringes

Clear container for fill-level monitoring

Vertical point first design for easy storage

Holds up to 6 needles

Tapered body fits snugly into your medical kit

Quick-tab locking top secures contaminants until disposal

NAR Raptor IV Securing Device

Item# 30-0006 (Black) NSN# 6515-01-523-3317

Dimensions: Packaged (Individual) - L 3.75 in. x W 1 in. Packaged (Pack of 6) - L 6 in. x W 4.8 in. x D 0.5 in. Device Length (Fully Extended) - L 19 in.

Weight: 1.9 oz each

NAR Sharps Container (Box of 6)

Item# 30-0014

Dimensions: L 6.38 in. x Diameter 1.11 in.

Weight: 1.5 oz

To find the correct size, place the BOA (in its relaxed state) gently around the arm. It should measure to / around the extremity

Stretch BOA straight out & place as high as possible around upper arm

Keep fingers underneath the connectors as you secure in place to prevent pinching of the skin

Roll BOA gradually down the arm Insert IV/Saline Lock in accordance with your protocol

Simple, yet effective solution offers a rapid, non-invasive advantage to obtaining venous access, even in a patient with little or no peripheral perfusion or cardiac output

Two-finger

Quick Release

hoW to dePloy the boa:circulation | Vascular access 39

The severity and type of injuries that are sustained in the tactical environment can frequently lead to shock and hypovolemia, requiring the immediate infusion of fluids to increase the likelihood of survival. With low blood volumes and shock, combined with severe injuries including amputations, comes the increased likelihood that traditional fluid insertion sites for standard cannulation will have experienced venious collapse, making it difficult and/or impossible to introduce fluids in this manner.

Intraosseous (I/O) infusion is possible because of the presence of veins that drain the medullary sinuses in the bone marrow of long bones. These veins, supported by the bony matrix, do not collapse in patients with shock or hypovolemia. If unable to start an IV and fluids or meds are needed urgently, medics can insert an I/O device to rapidly provide fluids directly into the marrow of the bone.

Seven sites have been cleared by the FDA for recommended I/O insertion points at the sternum, humerous and tibia. (see figure)

Intraosseous (I/o) access When normal peripheral intravenous access fails or is not available, the FAST-1 Intraosseous Infusion System helps emergency care providersin a hospital or during pre-hospital environmentquickly establish vascular access and administer emergency fluids and medications safely and effectively through the bone marrow of the manubrium (upper sternum).

1 & 2 Proximal Tibia (Left & Right)

3 Upper Sternum

4 & 5 Distal Tibia (Left & Right)

6 & 7 Proximal Humerous (Left & Right)

FDA-cleared I/O sites

Deliver any fluids or medications that can be delivered via an IV

Safe to use in patients 12 years of age and older

Access can be achieved in 10 seconds and deliver fluids to the heart within 30 seconds

Automatic depth control prevents over penetration (Insertion depth 6mm from surface of manubrium)

Simple to use and does not require a removal tool

Sterile, Single-use product that can be left in place for up to 24 hours

Soft, low-profile, secure tubing with Protector Dome that protects the infusion site

Lightweight design allows portability in medic packs

I/O Training Devices are also available. See Training Support, page 61 for more information.

cleared

Intraosseous InfusIon system

fast-1

Patented, notched Target Patch precisely identifies the correct insertion site for accurate placement

FAST-1 Intraosseous Infusion System

Item# 30-0073 (for sternal use only)

Unit Dimensions: L 8.7 in. x W 8.3 in. x D 1.6 in.

Unit Weight: 6.1 oz

40 north amerIcan rescue 2012 | narescue.com

dIscontInued

The EZ-IO Intraosseous Infusion System is a complete solution for emergency vascular access providing the medical professional with a rapid, smooth entry into the central circulation system within seconds. Featuring patented I/O needle tips, manual driver and small power driver, the EZ-IO system allows the clinician complete control of insertion depth avoiding the use of force.

Patented needle tip with asymmetrical bevels (stylet), 2 cutting tips (catheter) & markings every 5 mm for a smooth, accurate insertion

Contains 15 gauge, 304-stainless steel needle, NeedleVise sharps block, I/O wristband & EZ-Connect (IV extension with standard Luer connector)

EZ-IO G3 Power Driver

Item# 30-0075 (Black) (Not for sternal use)

Unit Dimensions: H 4.5 in. x W 6.5 in. x D 2.5 in

Unit Weight: 15 oz

EZ-IO Manual Needle Set

Item# 30-0078 (Blue) 25mm (for extremity)

Dimensions: Packaged L 6 in. x W 3.25 in

Weight: 1.4 oz

EZ-IO Sternal Manual Needle Set

Item# 30-0087 (Green) 7.5mm (for adult sternal use)

Dimensions: Packaged - L 6 in. x W 3.25 in.

Weight: 1.6 oz

EZ-IO G3 Power Driver Needle Sets

Item# 30-0081 PD 15 mm

Item# 30-0083 AD 25 mm

Item# 30-0085 LD 45 mm

Dimensions: H 4.75 in. x W 4.25 in x 0.7 in.

Weight: 1 oz

intraosseous inFusion systeM

ez-io Manual needle set (15 g x 25 mm)

ez-io g3 PoWer driVer

ez-io PoWer driVer needle sets* 15mm,25mm & 45mm

ez-io sternal Manual needle set (15 g x 7.5 mm)

Battery-powered solution for providing rapid peripheral I/O access within 10 seconds

Multiple insertion sites in humerus & tibia with three needle sets (15, 25 & 45mm)

Trigger guard prevents accidental activation of the device when stored in kits

Standard Luer-Lock catheter for fast, easy removal

Molded Hard Side Carrying Case (Item# 30-0077) also available for separate purchase

Manual sets include 15 gauge, 304 stainless steel needle/catheter, alcohol pads, sharps protector, EZ-Connect IV extension with standard Luer connector, I/O wristband & device instructions

Manual device is silent & well adapted for confined space

Body armor can remain intact/in place if needed

Requires minimal pressure

for patients > 40 kg excessive tissue over the

targeted insertion site

for patients > 39 kg with too much tissue over the insertion site for use

of 15 mm

for patients from 3-39 kg with minimal tissue over

insertion sites

*Designed for use with any EZ- IO Power Driver

Contains Lancet & EZ-Stabilizer

45 mm25 mm15 mm

If the extremity sites are not available or preferred, the EZ-IO Manual Needle Set contains a specially designed sternal needle & all the other components required for safe & effective manual I/O insertion in less than 30 seconds.

The EZ-IO Manual Needle Set allows medical personnel to immediately secure vascular access (Proximal Tibia, Proximal Humerus & Distal Tibia) manually in less than 30 seconds without removing body armor & exposing the operator to additional risk of injury.

Fluids, medications & drugs delivered immediately to central circulation

Sleek, compact & tactical black in color, the EZ-IO G3 Power Driver was designed specifically for tactical medical use & can provide vascular access to peripheral intraosseous access sites (humerus & tibia) in less than 10 seconds for both adult and pediatric patients.

cleared

intraosseous inFusion systeM

Fast-1

NOTE: Needles sold separately

circulation | Vascular access 41

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A R C t c S u i t eT h e r m a l w r a p B a

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43hypothermia prevention

Hypothermia is a common finding among combat and civilian casualties, often complicating the management of those with severe trauma. Although permissive hypothermia may be protective in anoxic brain injury following resuscitation from non-traumatic prehospital cardiac arrest 1, secondary hypothermia associated with traumatic injuries and hemorrhagic shock is often overlooked and can be fatal.

Hypothermia is defined as a core temperature of less than 95F (35C) 2 and is referred to as secondary hypothermia in the trauma casualty. It is caused by an underlying pathology that prevents the body from generating enough core heat. Body heat is generated as a result of oxygen consumption, which is reduced during conditions of shock and results in a decrease in core temperature.3 Hypothermia is the third most serious condition in a trauma casualty, ranking close to hypoxia

and hypovolemia.4 The lethal triad of hypothermia, acidosis and coagulopathy is a significant contributing factor to the mortality of trauma casualties and has been noted as a major reason for resistance to resuscitation after trauma. 5, 6

A core body temperature less than 89.6F (32C) in trauma

Catalog Taca Med

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Transcript of Catalog Taca Med