FieldMedic — See It In Action

14:22

Initial Assessment

Something's wrong
with Marcus

On day 3, Marcus cut his hand on a crampon. Cleaned, dressed, seemed fine. But today he's confused, shivering despite the warmth, and breathing fast. The medic opens FieldMedic and starts the symptom checker — no need to know what's wrong to begin. Anyone on the team can drive it.

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Conditions

Symptom

Vitals

Meds

Step 1 — Chief Complaint

What is the patient's main problem?

Fever / feeling unwell / chills

Step 2 — Duration & Onset

How long has the patient been unwell?

12–48 hours — progressive deterioration

Step 3 — Associated Features

Which of the following is the patient experiencing?

Confusion or altered behaviour + known wound / infection site

Fever with rash — non-blanching or spreading

Fever with stiff neck or photophobia

Fever with cough and breathing difficulty only

Most likely cause

Sepsis — wound source

Clinical confidence

79%

Life-ThreateningImmediate ActionAntibiotics + Fluids

Open Protocol →

See other causes

Fever / unwell› Progressive 12–48h› Confusion + wound› Result

14:28

Patient Record

His records are
already here

Before departure Marcus completed FieldMedic's pre-expedition screening. His full record — blood type, conditions, medications, allergies — is on the medic's phone. Two things are instantly clear: he's diabetic (which explains the rapid deterioration), and there's no penicillin allergy. The right treatment decision is made in seconds, with confidence.

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Conditions

Symptom

Vitals

Patient

Marcus Webb

38 years · MaleBlood type: O+Bristol, UK

Existing Conditions

Type 2 Diabetes Hypertension (controlled)

Current Medications

Medication

Metformin 500mg

Frequency

Twice daily with food

Medication

Amlodipine 5mg

Frequency

Once daily

Drug Allergies

No known drug allergies — penicillins and co-amoxiclav safe to use

Pre-Expedition Baseline Vitals

Resting HR

68 bpm

Systolic BP

118 mmHg

SpO₂ (sea level)

98%

Weight

84 kg

Clinical note: Diabetes increases infection risk and impairs wound healing. Sepsis onset may be faster and presentation atypical. Metformin should be withheld immediately — risk of lactic acidosis in acute systemic illness.

Pre-departure

Kit List

Built before
they left

Before departure the medic entered the trip details and FieldMedic generated a clinically prioritised kit list — ranking every item by medical urgency, flagging exclusions with clear rationale, and keeping everything inside the weight limit. The antibiotics that are keeping Marcus alive were on that list. The IV cannula wasn't — and the handover note will explain why.

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Kit List

Conditions

Meds

Trip Configuration

Trip Type

High Altitude Trek

Group Size

6 people

Duration

12 days

Weight Limit

4.5 kg max

38 items · 3.8 kg

Auto-generated · clinically prioritised

✓ Within limit

Priority 1 — Life-Saving

Adrenaline 1:1000 (EpiPen ×2)

Emergency · Anaphylaxis

✓ Included

Co-amoxiclav 625mg (×2 courses)

Antibiotics · Sepsis, wound infection

✓ Included

Dexamethasone 4mg (×12 tabs)

Environmental · HACE, HAPE

✓ Included

Priority 2 — Essential Field Care

Doxycycline 100mg (×4 courses)

Antibiotics · Backup, tropical

✓ Included

Paracetamol 500mg (×40 tabs)

Analgesia · Pain and fever

✓ Included

Oral Rehydration Salts (×10)

Fluids · Dehydration management

✓ Included

Excluded — weight limit reached

IV Cannula + Giving Set

Fluids · IV access

✕ Excluded

Weight limit reached. ORS included for oral hydration support — not equivalent to IV resuscitation for septic shock. IV access unavailable; factor into evacuation urgency and document in handover.

14:31

Clinical Protocol

One tap to
the full protocol

The medic taps "Open Protocol" from the results screen. Every management step is numbered and right there — drug doses highlighted, the Metformin warning pulled automatically from Marcus's patient record. The evacuation criteria are clear from the moment the protocol opens: any suspicion of sepsis in a remote setting means evacuate urgently. Treatment begins immediately and evacuation is called — both happen in parallel.

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Conditions

Symptom

Vitals

Meds

Sepsis

Life-Threatening

Medical Emergencies

Assess using ABCDE. Shout for help — sepsis is time-critical, do not manage alone.

CO-AMOXICLAV 625mg oral — broad-spectrum antibiotic. Give immediately as bridging therapy. Do not wait for evacuation — IV antibiotics will be required at hospital.

Encourage oral fluids only if ACVPU A and able to swallow safely. Aim 200–300ml per hour — do not give oral fluids with any reduction in consciousness.

Monitor temperature, HR, RR, systolic BP, and consciousness (ACVPU) every 15–30 minutes.

PARACETAMOL 1g oral — fever and pain control. Avoid NSAIDs in sepsis: risk of renal impairment.

Withhold Metformin — patient record shows Metformin 500mg BD. Risk of lactic acidosis during acute systemic illness. Document time of last dose for handover.

Keep patient warm and supine if hypotensive. Reassess ACVPU every 30 minutes.

EVACUATION CRITERIA: Any suspicion of sepsis in a remote setting — evacuate urgently. Do not wait for confirmation or improvement. Begin evacuation while treating. IV antibiotics and fluids require hospital-level care.

Evacuation called — 14:31

Helicopter requested the moment sepsis was confirmed. Not after the vitals crashed. Treatment and evacuation run in parallel from here.

14:35

Kit Check

Co-amoxiclav
is running low

The medic reaches for co-amoxiclav and the kit shows one course left — already allocated to another patient. FieldMedic instantly suggests doxycycline as the available alternative and opens the pre-administration checklist. Tap the checklist items below — this is exactly how a medic works through it before giving any drug in the field.

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Kit List

Meds

Patient

Himalayan Trek Kit

6 people · Day 6 of 12

3.8 kg

Antibiotics — live status

Co-amoxiclav 625mg

Antibiotics · Consumable

⚠ 1 course left

→

Allocated to Patient B (chest infection). Consider: Doxycycline 100mg (4 courses available) — broad-spectrum field cover; reasonable alternative when first-line unavailable · open checklist →

Doxycycline 100mg

Antibiotics · Suggested alternative

→ Suggested

Paracetamol 500mg

Analgesia · Consumable

✓ In kit

Pre-Administration — Doxycycline 100mg Tap items to check off

Confirm allergy status

No tetracycline or doxycycline allergy documented — safe to administer. Not a penicillin-class drug.

✓

Correct dose confirmed

100mg twice daily (BD) for 14 days in severe infection. First dose: 100mg now.

✓

Give with food or milk — patient must remain upright

Reduces gastric irritation and prevents oesophageal ulceration. Patient must remain upright for 30 minutes — do not administer if unable to sit up due to hypotension or reduced consciousness.

Document time and dose given

Record precisely — critical for handover to receiving medical team.

Reassess in 30 minutes

Monitor for response. If consciousness deteriorates further, escalate evacuation immediately.

15:10

Vital Signs

Monitoring while
awaiting evacuation

The helicopter was called at 14:31 — 44 minutes ago — the moment sepsis was confirmed on the protocol screen. These vitals don't trigger the evacuation. The evacuation was already happening. What they do is document the deterioration trend for the receiving team and confirm the decision was right the first time.

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Conditions

Symptom

Vitals

Meds

Marcus Webb · Reading 4 of 415:10 · Day 6

–bpm

Critical

–/min

Elevated

SpO₂

–%

Declining

Temp

–°C

Fever

Systolic BP

–mmHg

Critical

Cap Refill

–sec

Slow

NEWS2 Aggregate0High risk · urgent response

Shock Index0.00HR ÷ SBP

ACVPU

New confusion — deteriorated from baseline A

Septic shock developing

HR 126, RR 26, and temperature 38.9°C meet three of four SIRS criteria confirming sepsis. SBP 84 mmHg and new confusion (ACVPU C) are indicators of septic shock — distinct from SIRS. Oral antibiotic absorption is substantially impaired at this blood pressure. IV fluids and vasopressors are needed — beyond field capability. Evacuate immediately.

Systolic BP — 4 readings over 90 min↓ Declining

15:14

Evacuation Module

One tool coordinates
the whole response

The evacuation was called at 14:31 — the moment sepsis was confirmed, not when Marcus hit critical. Now FieldMedic's evacuation module takes over: ETHANE sitrep logged, comms timestamped, PDF report pre-built for the receiving team. When the helicopter lands, the crew have everything before they open the door.

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Dashboard

ETHANE

Comms

Handover

Marcus Webb · Sepsis — wound source

Initiated 14:31

Exact Location

Langtang Valley, Nepal. Camp B3 at 3,800m, approx 200m NE of Kyanjin Gompa village. HLZ: clearing to SE of camp.

Type of Incident

Medical — suspected sepsis, septic shock. 38M, T2DM. ACVPU C, SBP 84 mmHg. IV access and vasopressors required.

Hazards

High altitude (3,800m) — AMS risk for rescue personnel with extended time at altitude; HACE risk low for brief visits. Rocky terrain. Helicopter approach from south only. No chemical hazards.

Access

HLZ 200m SE of camp. 10 min stretcher carry on rocky trail. Daylight only. Team ready to assist landing.

Number of Casualties

1 casualty. 6 expedition members total on scene. Expedition medic qualified and managing.

Emergency Services

HIAG helicopter requested 14:31 local. ETA 55 min from Kathmandu. Contact: 01-4416481 (HIAG dispatch).

Queued for transmit

Copy ETHANE

Export PDF

15:28

Medical Notes & Handover

The handover note
is already written

While waiting for the helicopter, FieldMedic compiles a structured MIST handover from everything logged — vitals, medications given, times, patient history. Hit Export. When the helicopter lands, the receiving team has everything they need before they've opened the door.

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Patient

Vitals

Meds

MIST Handover — Marcus Webb

Copy

Export PDF

Handover exported to PDF ✓

M — Mechanism / History

Patient

Marcus Webb, 38M, O+, Bristol UK

Background

Type 2 Diabetes (Metformin 500mg BD, withheld 14:40), Hypertension (Amlodipine 5mg OD)

Incident

Laceration right hand — crampon, Day 3. Wound dressed. Progressive deterioration over 12–48h.

Allergies

NKDA — no known drug allergies

I — Injuries / Findings

Clinical impression

Suspected sepsis — infected right hand wound

Wound

Purulent discharge, warmth and swelling. Lymphangitic tracking 4cm proximal — confirms sepsis source

Neurology

ACVPU C — new confusion, disoriented to time and place

S — Signs (Latest: 15:10)

HR 126 bpm ↑ · RR 26/min ↑ · SpO₂ 94% ↓ · Temp 38.9°C SBP 84 mmHg ↓ (critical) · Cap refill 3–4s · ACVPU: C Baseline (pre-expedition): HR 68, SBP 118, SpO₂ 98%

T — Treatment Given

14:35

Doxycycline 100mg oral — first dose of 100mg BD course. Co-amoxiclav unavailable (allocated to Patient B)

14:38

Paracetamol 1g oral — fever control and analgesia

14:40

Metformin withheld — acute illness protocol, lactic acidosis risk

14:40–15:10

Oral fluids encouraged — approx 400ml taken

14:31

Helicopter evacuation requested — sepsis confirmed, immediate evacuation criteria met

Receiving Team Notes

Known T2DM — impaired wound healing, atypical sepsis presentation expected. Metformin withheld 14:40 (last dose estimated 07:00 Day 6); do not restart until haemodynamically stable and oral intake established. Antibiotic cover: doxycycline 100mg BD started 14:35 (first dose given orally — absorption uncertain at SBP 84). Escalate to IV co-amoxiclav or piperacillin-tazobactam on arrival per local protocol. Blood cultures not obtained in field — take on arrival before escalating antibiotics. IV access unavailable in field — oral fluids only. Baseline vitals on file for reference.

09:03

Initial Assessment

Jordan's losing
blood — fast

A 4x4 rolled on a remote track, 40 km from the nearest road head. Jordan is pale and cold, with a pulsatile arterial bleed from the right thigh soaking through his trousers. The medic doesn't start with the airway — under MARCH, catastrophic haemorrhage is controlled first, before anything else. The symptom checker confirms what's already obvious and points straight to bleeding control.

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Conditions

Symptom

Vitals

Meds

Step 1 — Chief Complaint

What is the patient's main problem?

Major external bleeding

Step 2 — Mechanism

How did the injury happen?

High-energy trauma — vehicle rollover

Step 3 — Bleeding Character

Which best describes the bleeding?

Pulsatile / bright red — soaking through dressings

Steady dark ooze — controlled with pressure

Minor / superficial graze

No external bleeding — suspected internal

Most likely cause

Catastrophic external haemorrhage

Clinical confidence

95%

Life-ThreateningControl Bleeding FirstTourniquet

Open Protocol →

See other causes

Major bleeding› Vehicle rollover› Pulsatile / arterial› Result

09:04

Clinical Protocol

Tourniquet.
High, tight, timed.

One tap opens the Stop the Bleed protocol. Every step is numbered and immediate — get a tourniquet high and tight, and write down the time it went on. That single timestamp drives every decision the surgical team makes hours later. Treatment starts now; evacuation is called in parallel.

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Conditions

Symptom

Vitals

Meds

Catastrophic Haemorrhage — Stop the Bleed

Life-Threatening

Trauma Emergencies

Arterial bleed — active

Tourniquet time00:00

Expose the wound fully and apply firm direct pressure with a gloved hand or dressing while a tourniquet is prepared.

TOURNIQUET — HIGH & TIGHT. Apply 5–7cm above the wound (not over a joint). Tighten until bleeding stops and the distal pulse is lost.

NOTE THE TIME the tourniquet was applied — write it on the tourniquet and on the patient. This time is critical for the receiving surgical team.

Second tourniquet — if bleeding continues, apply a second one side-by-side, just proximal to the first.

Wound packing — for junctional bleeds not amenable to a tourniquet, pack the wound firmly with gauze and hold direct pressure for at least 3 minutes.

Do not remove or loosen the tourniquet once applied and bleeding is controlled. Do not periodically release in the field.

EVACUATION CRITERIA: Traumatic haemorrhage requiring a tourniquet is a surgical emergency — evacuate urgently. Definitive haemorrhage control and blood products require hospital-level care. Begin evacuation while treating.

09:07

Medications

TXA — and
the clock is running

With the bleed controlled, the medic gives tranexamic acid — TXA reduces death from bleeding when given early, but the window is unforgiving: within 3 hours of injury, or not at all. Tap the checklist items below — this is how a medic works through it before giving any drug.

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Meds

Kit List

Patient

Tranexamic Acid (TXA)

Antifibrinolytic · Injectable IV / IO

Injury 09:00

3-hour TXA window 2:53:00

Pre-Administration — Tranexamic Acid Tap items to check off

Within 3 hours of injury

⚠ Hard stop — do NOT give if more than 3 hours have passed: benefit is lost and harm is possible. Injury 09:00, now 09:07 — within window.

✓

No thromboembolic or clotting disorder

No history of DVT, PE, or active clotting disorder documented on the patient record.

✓

Correct dose confirmed

1 g IV/IO over 10 minutes, then 1 g infusion over 8 hours.

Give slowly — over 10 minutes

Rapid IV administration can cause hypotension. Deliver the loading dose over a full 10 minutes.

Document dose and time given

Record 1 g given and the exact time — critical for the receiving surgical team and to prove the window was met.

TXA 1 g administered · logged 09:07

09:12

Vital Signs

The numbers
say shock

The medic logs a set of vitals. They don't trigger the response — the bleed was already controlled and evacuation already called. What they do is quantify the shock for the receiving team and confirm how much blood Jordan has lost. A rising heart rate against a falling blood pressure tells the whole story.

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Conditions

Symptom

Vitals

Meds

Jordan Cole · Reading 3 of 309:12 · +12 min

–bpm

Critical

–/min

Elevated

SpO₂

–%

Declining

Temp

–°C

Low — triad

Systolic BP

–mmHg

Critical

Cap Refill

–sec

Slow

NEWS2 Aggregate0High risk · urgent response

Shock Index0.00HR ÷ SBP · >1.0 = major

Haemorrhagic shock

HR 128 and SBP 82 mmHg give a Shock Index of 1.56 (HR ÷ SBP). A Shock Index above 1.0 indicates significant haemorrhage and correlates with the need for massive transfusion. Cool peripheries, cap refill 4s, falling temperature. This is haemorrhagic shock — keep the bleeding controlled, keep him warm, evacuate for blood products and surgery.

Systolic BP — 4 readings over 9 min↓ Falling

09:15

The Lethal Triad

Keep him warm —
it matters

FieldMedic surfaces the physiology behind the vitals. Jordan is already cooling — and in a bleeding trauma patient, cold is not a comfort problem, it's a clotting problem. Hypothermia, acidosis and coagulopathy feed each other. The app spells out exactly how to break the cycle while awaiting evacuation.

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Conditions

Symptom

Vitals

Meds

The Lethal Triad

Life-Threatening

Trauma Physiology

Hypothermia, acidosis and coagulopathy reinforce one another in a vicious cycle. A cold patient can't clot; failure to clot means more bleeding; more bleeding drives acidosis and further cooling. Every degree of cooling makes the bleeding harder to stop.

Keep the patient warm — insulate from the ground, remove wet clothing, cover with a blanket or bivvy. Warm the environment, not just the casualty.

Minimise handling and exposure — expose only what you must to treat, then re-cover immediately.

TXA already given at 09:07 — reduces clot breakdown and supports what clotting factors remain.

Avoid over-transfusion of clear fluids — large volumes of cold crystalloid dilute clotting factors and cool the patient. Aim for permissive hypotension until surgical control.

TEMP 35.6°C — ACTIVELY WARM. Warming is haemorrhage control, not comfort care. Protect Jordan from the triad while awaiting evacuation.

09:18

Patient Record

Every action,
timestamped

Every action the medic has taken is logged automatically with its time. When the receiving team asks "when did the tourniquet go on?" the answer isn't a guess — it's a timestamp. Mechanism, triage priority and a full action timeline are all in one record, ready to hand over.

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Conditions

Vitals

Meds

Patient

Jordan Cole

29 years · MaleBlood type: A+Exeter, UK

Mechanism of Injury

High-energy vehicle rollover on a remote track. Partial ejection. Major arterial haemorrhage from the right thigh.

Triage Priority

T1 — RED · Immediate

Known History & Baseline

Drug Allergies

None known

Anticoagulants

None

Blood Type

A+

Weight

80 kg

Logged Actions — Incident Timeline