Narrowing pulse pressure is the earliest vital-sign change — BP holds until class III. HR masked by β-blockers · elderly · pacemaker · athletes — don't trust a normal rate.
Hemorrhagic shock, on one dense field-kit card — the class I–IV table up front, massive transfusion and reassessment on the back. Built for ER and trauma nurses, paramedics, flight crews, and tactical medics who need the numbers at the bedside, not in a pocket guide.
Front
the full hemorrhagic shock I–IV table — blood loss %, heart rate, SBP, pulse pressure, respiratory rate, and mental status per class, with classes III–IV in amber and footnotes on pulse pressure as the earliest change and on masked tachycardia; a SHOCK TYPE differentiator — hypovolemic, cardiogenic, obstructive, distributive, each with its exam hallmark and first move; paired TARGETS panels — permissive hypotension (SBP 80–90 until surgical hemostasis) beside the amber TBI exception (SBP 90–100 minimum, GCS ≤8 airway trigger); the shock index one-liner; and an amber BLEEDING CONTROL ladder — direct pressure, wound packing, tourniquet high and tight with time marked, junctional/second tourniquet.
Back
MASSIVE TRANSFUSION essentials — the 1:1:1 PRBC:FFP:platelet ratio, the trigger criteria, TXA 1 g load inside 3 hours plus maintenance, and the calcium-with-transfusion rule; the amber LETHAL DIAMOND panel (hypothermia, acidosis, coagulopathy, hypocalcemia) paired with a keep-them-warm panel; a REASSESS table — lactate clearance, base deficit tiers, pulse pressure, urine output, EtCO₂; a WHERE THEY BLEED OUT table with compartment volumes and field moves; and the boxed rule: FIX THE BLEEDING, NOT THE NUMBER. Rigid PVC, water-resistant, standard CR80 badge size in the tan field-kit colorway with dark olive-and-amber print. Punched badge-reel slot at the top — clips behind your ID and holds up to shift work, wipe-downs, and field use. Content is clinician-reviewed against current textbook-standard values. Field reference only, not a protocol — always verify against your institution's protocols.