 All right, I'm Staff Sergeant Gaitan, and this is M6, which is to evaluate intrudicality for spinal injury and shock. All right, the task is to identify the signs and symptoms of shock, evaluate intrudicality for spinal injury and shock. Conditions, you are a member of a platoon within a secure forward operating base in a non-sebran environment. You are assisting another soldier with an injury to a fellow service member and preparing him or her for evacuation while waiting on the medevac. The other soldier states that he or she witnessed the casualty fall from a guard tower. Here she suspects internal bleeding on a spinal injury. Here she goes on to state that after initially I can find the injured soldier began complaining of nausea, difficulty breathing, and abdominal pain. The injured soldier is laying on a litter with a long spine board when you arrive and is alert to pain only. The injured soldier is available to assist you with spinal stabilization and movement of the casualty while you provide treatment. The standard is to identify at least six signs and symptoms of shock with no incorrect answers within one minute. Apply a cervical collar, treat for shock and prepare for transfer. Two standard in sequence within seven minutes without causing further injury. So your first task is to identify six signs and symptoms of shock. There are 12 of them. They are sweaty but cool skin, pale skin, restlessness or nervousness, thirst, severe bleeding, confusion, rapid breathing, blotchy blue skin, nausea and or vomiting, low blood pressure, absence of distal pulse, capillary reflux delay more than three seconds. They do have to be verbatim, but if you do misspell a word, we won't spell check. After you get a go on that, then you're going to apply cervical collar and treat for shock and prepare for transfer. Two standard in sequence within seven minutes without causing further injury. So your first step is gonna be to reassure the casualty and let them know that you're gonna apply a C collar. Hey man, you're gonna be okay. I'm gonna put a C collar on you. You'll take your collar, size it to the casualty. You can use your fingers and then compare them to the amount of circles. You'll then slide it the Velcro through the back of his neck. You do have your assistant notionally holding his head and neck inline and stabilized. When you apply the collar, you wanna make sure it fits between the chin and the chest, fully seats on his shoulders, supports his mandible, doesn't restrict his airway or any ventilation efforts. Next, you can move into securing him to the spine board. So you'll grab your litter straps, correction your spine board straps, ensuring his arms are in the straps. Next, you wanna come to the head and apply the improvised head immobilization blocks. You do have two straps, one's gonna go over his forehead and one's gonna go over his chin. While you do this, you do not wanna restrict his airway or tighten this on his chin, a correction on his throat. Now that he's on his chin, I'm gonna go ahead and make sure it's tight and immobilizes his head. Once he's immobilized to the spine board and his head and neck are also immobilized, you're then going to start assessing for shock. So your first step is to check his level of consciousness. So you start with AFPU, so you check if he's alert. Hey man, are you okay? Can you respond? You try to ask him a question, either his name, do you know where he is? Or try to get a response from him. And I will state back that the catalysis does not respond but reacts to pain. So as you go through AFPU, he is not alert, he is not verbal. So then you go to pain, you give him a quick pinch, catalysis will react to pain. Once he reacts to pain, then you will check his skin condition. So you can look at his hand or his face and I will tell you that his skin is pale and moist, abdomen is distended. You'll then check his capillary refill. So you give his fingernail a squeeze, wash the blood, return back to his capillaries and his finger. And I'll tell you the capillary refill takes four seconds. Next, you'll move on to checking pulses. So if you need to, you're going to loosen his boots. You're gonna go skin to skin contact. You're gonna try to check his pulse at the top of his foot. And I'm going to tell you that you do not feel a pulse. Next, you're going to check his femoral for a pulse. It's skin to skin, no thumb. And I'm gonna tell you you do not feel a pulse. You're then gonna check his radio, which is on his wrist. Skin to skin, no thumb. And I'm going to tell you you do not feel a measurable pulse. You'll then check his carotid. And I'm gonna tell you you feel a weak but measurable pulse. You will then measure for 30 seconds. Once 30 seconds has elapsed, I will give you a pulse. And I'll tell you that his pulse is between 30 and 50. So I'll give you a number. Pulse is 35 beats per minute. And then you will assess respirations. So you come down, listen to his breathing, look at the rise and fall of his chest. And I will tell you respirations are rapid but shallow. You will then measure respirations for 30 seconds. After 30 seconds has elapsed, I will give you his respirations. So 30 seconds has elapsed, respirations are 60 per minute. Once you've assessed for shock, you will then move the cavity to a shaded area in order to treat for shock. So I need to strap him down to the litter. Once he is secured to the litter, you and your assistant are going to notionally move him to a shaded area. So now I am moving him to a shaded area. He is now in a shaded area. I will then treat for shock by loosening all clothing that is binding. Then loosen his top, loosen his cuffs, notionally loosen his belt and pants, loosen his boots and boot blouses. Once all clothing that is binding is loosened, you will then loosen the litter straps in order to apply a blanket to prevent him from being chilled or overheated. So ensuring I grab my litter straps, I loosen them. I then take my blanket, ensuring that I go up to at least name-tape deflate and I do not cover his face. The cavity is in shock and you do not want to work in this condition by restricting his airway or making the cavity think that he is in a body bag. You want to ensure that no parts of his uniform are showing on his sides or on his feet and then resecure him to the litter. Once he's been secured to the litter, you're then going to reassure the cavity and continue monitoring for life-threatening conditions. Hey, man, you're gonna be okay. I'm monitoring you for life-threatening conditions. You'll then come over to your T3C card and you'll begin filling it out. You'll start with the EVAC, which is gonna be urgent. The date and the time, today is 04 October 22. Current time is 08.20. You'll put a Lima after that because we are using local time. Your mechanism of injury is fall. He fell out of a guard tower, put an X on his abdomen and an X on his spine for internal bleeding and spinal injury. For signs and symptoms, for the time, it will be earlier than the time that you started filling out the card. We'll do 08.15. Again, Lima for local time. Your pulse. You put down the pulse that I gave you, 35, and then a Charlie because you checked it on his carotid. Restatory rate was 60. Apu is papaw. He reacted to pain. Flip it around. Again, put an X on EVAC for the urgent. You'll come down to where it says other and then the type, you will write C-collar. In the notes, you will put showing, signs, and symptoms of shock. You will then fill out your information, which is your last name, first name, and last four. You will then take your TCCC card. You will put it in its top or where your respected unit SOP is and time will stop.