RAVINES Mnemonic for Prolonged Field Care

The RAVINES Mnemonic was created to help the medical provider on the ground in an austere environment with a very sick patient. Most medics will do an amazing MARCH survey and when they get to the end of that repeat the MARCH sequence while adding E-PAWS-B…

  • E for Eyes
  • P for Pain
  • A for Antibiotics
  • W for Wounds
  • S for Splinting
  • B for Burn treatments rounding out the MARCH E PAWS B acronym

These are all the right answer but at some point the provider will run out of things to do and there will be a therapeutic pause as he gathers himself and thinks of what he should be doing next. This will help keep the thought process moving in the right direction and in an appropriate order while serving as a reminder of some critical steps that we have identified such as reducing tourniquets to pressure dressings and making a telemedicine/evac call along with others that may be overlooked such as nursing care and environmental considerations. Mnemonics should be just cheesy enough but memorable in any situation so remember this; RAVINES or deep draws are places that a small unit would hide a patrol base while in enemy territory to rest and prepare for the next leg of the mission. Just as draws and RAVINES offer relative safety and piece of mind in a dire situation so too will this memory aid:

MARCHE your PAWS to the RAVINES…

  • Resuscitation with fresh whole blood, Reduce Tourniquets as soon as possible (within 4 hours)

PFC WG Fluid Therapy Recommendations (December, 2014)

Emergency Whole Blood Protocol

PFC Fresh Whole Blood Transfusions FAQ

PFC WG Tourniquet Conversion recommendations (June, 14)

  • Airway and Cric care package including Capnography, Sedation drip, Sterile suctioning, Heat moisture exchanger/Filter, Check cuff Pressure, Tube depth

PFC WG Airway recommendations (April, 14)

Post Cric Checklist

PFC WG analgesia and sedation comments (Feb, 14)

  • Ventilate or oxygenate- Positive pressure with PEEP using a lung protective strategy

Why we need PEEP valves on BVMs

Scott Weingart’s Dominating the Ventilator Handout

  • Initiate telemedicine and evacuation early

Telemed Script Cheat Sheet

Medical Planning Tool

  • Nursing care including Monitoring and trending of vitals and ins and outs especially urine output, Positioning patient up, DVT Prophylaxis massage, turn patient 30 degrees to the sides, Passive ROM exercises, Oral Hygiene. This is where our nursing care checklist and the nursing mnemonic HITMAN can help remind you of nursing care priorities.
  • Hydration
  • Infection
  • Tubes
  • Medications
  • Analgesia
  • Nutrition

Everything You Need to Know About Foley Catheters

  • Environmental Considerations – Hypo/Hyperthermia, Ear plugs for flight, Sun screen and chapstick, Padding the litter and pressure points, Motion sickness prophylaxis
  • Surgical Procedures – Cricothyroidotomy, Thoracostomy, Escharotomy, Fasciotomy, Lateral Canthotomy, Amputation, Debridement, Delayed Primary Closure, Shunting

Author: Staff

Medic

5 thoughts on “RAVINES Mnemonic for Prolonged Field Care”

  1. Paul – This is great. This is going to be my mantra for 1SFG medics…but I am going to add “and Teach” to the end as a reminder that this is also one of the roles of the 18D…something we have lost the bubble on…Thanks – Ramey

    1. Thanks Sir. I equate it to priorities of work. Once in nursing care you can then use the popular HITMAN mnemonic or Scott Weingart’s FAST HUGS IN BED… search Emcrit.org for that one.

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