1. SCENE SAFETY AND BSI: Don gloves at minimum before any patient contact. Confirm the scene is secure before approaching the patient.
2. INITIAL ASSESSMENT: Conduct a primary survey using the ABCDE framework, checking airway, breathing, circulation, disability, and exposure. Use the penlight with pupil gauge to assess pupillary response for potential head injury, and obtain baseline blood pressure and lung sounds using the BP cuff and dual-head stethoscope.
3. PATIENT EXPOSURE: Use bandage shears to cut away clothing near the skin when exposing injuries in sensitive areas. Reserve rescue shears for cutting through heavier material such as leather or outerwear when rapid exposure is required.
4. WOUND MANAGEMENT: Clean the skin around lacerations using antiseptic towelettes before dressing. Apply the appropriate dressing based on wound severity, using 4x4 or 2x2 gauze pads for minor wounds, 5-inch by 9-inch combi pads for moderate to severe bleeding, and the multi-trauma dressing for major wounds or eviscerations. Secure all dressings with conforming gauze rolls or 1-inch adhesive tape and apply direct pressure as indicated.
5. FRACTURE MANAGEMENT: Assess the injured extremity for distal pulse, motor function, and sensation before immobilization. Fashion a sling and swath using triangular bandages to immobilize an upper extremity injury and bind the arm to the body.
6. SWELLING CONTROL: Activate a cold pack by squeezing and shaking the chemical pack until fully mixed. Wrap the pack in conforming gauze and apply to the impact site. Do not apply directly to skin.
7. BURN MANAGEMENT: Cover large surface area burns with the sterile burn sheet to prevent contamination, reduce pain from air exposure, and maintain body temperature. Do not apply ointments or other topical agents to major burns in the field.
8. HYPOGLYCEMIC EMERGENCY: If a conscious and alert patient with a patent airway presents with suspected low blood sugar, administer 15g glucose gel orally. Do not administer to any patient who is not fully conscious, alert, and able to protect their airway.
9. AIRWAY ADJUNCT DEPLOYMENT: If an unresponsive patient without a gag reflex requires airway support, select the appropriately sized oral airway adjunct from the OPA set and insert using correct technique. This step is restricted to trained and certified personnel only.
10. CONTINUOUS MONITORING: Monitor the patient's vital signs and mental status continuously from initial contact through EMS arrival. Track any changes in blood pressure, pupillary response, or level of consciousness and document findings for handover.
11. EMS HANDOVER: Provide incoming EMS with a complete patient report including mechanism of injury, initial and current vital signs, interventions performed, and any changes in patient condition observed during monitoring.
12. POST-DEPLOYMENT RESUPPLY: Conduct a post-use inventory immediately after deployment. Decontaminate all reusable equipment, discard used or compromised consumables, and submit a restock request. The bag is non-mission-capable until fully resupplied and verified against the master component list.
