1st JMSB
QV/07.05Guide
MIST report
The casualty hand-over: mechanism, injuries, symptoms and vitals, treatment given.
G1GuideWhat it is
A MIST report is the casualty hand-over: four lines that tell the next person what happened and what you did.
- CLS sends it every time a casualty changes hands: to the Medic, to another CLS, or to the CASEVAC crew.
- In Quiver it is the MIST report card. Every card ends with a REMARKS field.
- Keep it short. The Medic re-checks everything anyway. The report tells them where to start.
G2GuideThe four lines
| Line | Means | What to say |
|---|---|---|
| M | Mechanism of injury and time | What hit them and how long ago: gunshot, blast, crash, gas |
| I | Injuries sustained | Wounds by body part, chest injury, fractures, bruising |
| S | Symptoms and vitals | Conscious or not, breathing, pulse, oxygen saturation, pain |
| T | Treatment given | Tourniquets, bandages, airway, chest seal, NCD, CPR and shocks, every drug with dose and time |
| Remarks | Anything else | What the casualty needs next that you cannot give |
- Time matters in M. A casualty who has been unconscious for a long time will have a collapsing airway and may vomit.
- In T, say opioids and naloxone first. They change how the Medic handles a cardiac arrest.
- In T, say where every tourniquet is. They block IVs on that limb.
G3GuideWhere each line comes from
Every line of the report comes from a check you already did during MARCH.
| Line | ACM check | What it gives you |
|---|---|---|
| I | Medical menu, each body part | Wounds, bleeding, bruising |
| I | Inspect chest | Uneven chest, tracheal deviation, bruising on the upper chest |
| I | Check for fracture | Bruised, mild, severe or complex fracture |
| S | Check breathing | Not breathing, shallow, slow or rapid, normal |
| S | Carotid pulse | Pulse or cardiac arrest |
| S | Radial and femoral pulse | Weak or missing means low blood volume |
| S | Pulse oximeter | Saturation. Under 80 unconscious, under 67 arrest, under 55 death |
| S | Look at the face and arms | Cyanosis |
| T | Your own actions | Everything you applied, inserted or gave |
The oximeter reads wrong at low blood volume. With a weak radial pulse, report the number and say it is unreliable.
G4GuideFormat and examples
Say the letter, then the content. One breath per line.
Example 1, conscious casualty:
- M: gunshot, right leg, 3 minutes ago.
- I: two wounds right leg, severe fracture. No other wounds.
- S: conscious, breathing normal, pulse present, in pain.
- T: tourniquet right leg, both wounds bandaged and wrapped, SAM splint, not realigned. Penthrox, 3 uses, 1 minute ago.
- Remarks: needs realignment.
Example 2, unconscious casualty:
- M: blast, 6 minutes ago. Unconscious since.
- I: wounds to chest, left arm and head. Chest uneven on the left. Bruising on the torso.
- S: unconscious, breathing shallow, carotid pulse present, radial weak, saturation 84 and unreliable.
- T: all wounds bandaged, tourniquet left arm. Suctioned twice, NPA in. Chest seal left side, NCD done. No drugs.
- Remarks: needs fluids and TXA. Airway will need an i-gel.
G5GuideSeveral casualties
Report the one who will die first, first.
- No pulse.
- Not breathing, or airway held open by hand.
- Bleeding you could not stop.
- Chest injury, or weak radial pulse.
- Unconscious but stable.
- Conscious.
Give each casualty a name or number at the start of their report so the Medic can match report to body.