1-1. Casualty Evaluation
The time may come when you must instantly apply your knowledge of
lifesaving and first aid measures, possibly under combat or other adverse
conditions. Any soldier observing an unconscious and/or ill, injured, or
wounded person must carefully and skillfully evaluate him to determine
the first aid measures required to prevent further injury or death. He
should seek help from medical personnel as soon as possible, but must
NOT interrupt his evaluation or treatment of the casualty. A second
person may be sent to find medical help. One of the cardinal principles of
treating a casualty is that the initial rescuer must continue the
evaluation and treatment, as the tactical situation permits, until he is
relieved by another individual. If, during any part of the evaluation, the
casualty exhibits the conditions for which the soldier is checking, the
soldier must stop the evaluation and immediately administer first aid. In
a chemical environment, the soldier should not evaluate the casualty until the casualty has been masked and given the antidote. After
providing first aid, the soldier must proceed with the evaluation and
continue to monitor the casualty for further medical complications until
relieved by medical personnel. Learn the following procedures well. You
may become that soldier who will have to give first aid some day.
Remember, when evaluating and/or treating a
casualty, you should seek
medical aid as soon
as possible. DO NOT stop treatment, but if the
situation allows, send another person to find
Again, remember, if there are any signs of
chemical or biological agent
should immediately mask the casualty. If it is
poisoning, administer the antidote,
using the casualty's injector/ampules.
a. Step ONE. Check the casualty for responsiveness by gently
shaking or tapping him while calmly asking, "Are you okay?" Watch for
response. If the casualty does not respond, go to step TWO. If the casualty responds, continue
with the evaluation.
(1) If the casualty is conscious, ask him where he feels
different than usual or where it hurts. Ask him to identify the location(s)
of pain if he can, or to identify the area in which there is no feeling.
(2) If the casualty is conscious but is choking and cannot
talk, stop the evaluation and begin treatment.
IF A BROKEN NECK OR BACK IS
SUSPECTED, DO NOT MOVE THE
CASUALTY UNLESS TO SAVE HIS LIFE.
MOVEMENT MAY CAUSE PERMANENT
PARALYSIS OR DEATH.
b. Step TWO. Check for breathing.
(1) If the casualty is breathing, proceed to step FOUR.
(2) If the casualty is not breathing, stop the evaluation and
begin treatment (attempt to ventilate). If an airway obstruction is apparent,
clear the airway obstruction, then ventilate.
(3) After successfully clearing the casualty's airway
proceed to step THREE.
c. Step THREE. Check for pulse. If pulse is present, and the
casualty is breathing, proceed to step FOUR.
(1) If pulse is present, but the casualty is still not
breathing, start rescue breathing.
*(2) If pulse is not found, seek medically trained personnel for help.
d. Step FOUR. Check for bleeding. Look for spurts of blood or
blood-soaked clothes. Also check for both entry and exit wounds. If the
casualty is bleeding from an open wound, stop the evaluation and begin
first aid treatment in accordance with the following tasks, as
(1) Arm or leg wound--, Put on a Field
or Pressure Dressing.
(2) Partial or complete amputation--,
Put on a Tourniquet.
(3) Open head wound--, Apply a Dressing to an
Open Head Wound.
(4) Open abdominal wound--, Apply a
Dressing to an Open Abdominal Wound.
(5) Open chest wound--, Apply a
Dressing to an Open Chest Wound.
IN A CHEMICALLY CONTAMINATED
AREA, DO NOT EXPOSE THE WOUND(S).
e. Step FIVE. Check for shock. If signs/symptoms of shock are
present, stop the evaluation and begin treatment immediately. The
following are nine signs and/or symptoms of shock.
(1) Sweaty but cool skin (clammy skin).
(2) Paleness of skin.
(3) Restlessness or nervousness.
(5) Loss of blood (bleeding).
(6) Confusion (does not seem aware of surroundings).
(7) Faster than normal breathing rate.
(8) Blotchy or bluish skin, especially around the mouth.
(9) Nausea and/or vomiting.
LEG FRACTURES MUST BE SPLINTED
BEFORE ELEVATING THE LEGS
TREATMENT FOR SHOCK.
See Chapter 2, Section III for specific information regarding the causes and effects, signs/symptoms, and the treatment/prevention of shock.
| f. Step SIX. Check for fractures (Chapter 4).
(1) Check for the following signs/symptoms of a back or
neck injury and treat as necessary.
UNLESS THERE IS IMMEDIATE LIFE-THREATENING
DANGER, DO NOT
MOVE A CASUALTY WHO HAS A
SUSPECTED BACK OR NECK INJURY.
MAY CAUSE PERMANENT PARALYSIS OR DEATH.
(2) Immobilize any casualty suspected of having a neck or
back injury by doing the following:
(5) Check for signs/symptoms of fractures of other body
areas (for example, shoulder or hip) and treat as necessary.
|g. Step SEVEN. Check for burns. Look carefully for reddened,
blistered, or charred skin, also check for singed clothing. If burns are
found, stop the evaluation and begin treatment (Chapter 3, paragraph 3-14). See task 081-831-1007, Give First Aid for Burns.
h. Step EIGHT. Check for possible head injury.
(1) Look for the following signs and symptoms:
- Unequal pupils.
- Fluid from the ear(s), nose, mouth, or injury site.
- Slurred speech.
- Loss of memory or consciousness.
- Staggering in walking.
- Vomiting and/or nausea.
- Convulsions or twitches.
(2) If a head injury is suspected, continue to watch for signs
which would require performance of mouth-to-mouth resuscitation,
treatment for shock, or control of bleeding and seek medical aid. See
Chapter 3, Section I for specific indications of head injury and treatment. See task 081-831-1033, Apply a Dressing to an Open Head Wound.
1-2. Medical Assistance (081-831-1000)
When a nonmedically trained soldier comes upon an unconscious and/or
injured soldier, he must accurately evaluate the casualty to determine the
first aid measures needed to prevent further injury or death. He should seek
medical assistance as soon as possible, but he MUST NOT interrupt
treatment. To interrupt treatment may cause more harm than good to the
casualty. A second person may be sent to find medical help. If, during any
part of the evaluation, the casualty exhibits the conditions for which the
soldier is checking, the soldier must stop the evaluation and immediately
administer first aid. Remember that in a chemical environment, the soldier
should not evaluate the casualty until the casualty has been masked and
given the antidote. After performing first aid, the soldier must proceed with
the evaluation and continue to monitor the casualty for development of
conditions which may require the performance of necessary basic life saving
measures, such as clearing the airway, mouth-to-mouth resuscitation
preventing shock, and/or bleeding control. He should continue to monitor
until relieved by medical personnel.
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