A basic principle of first aid is to treat the casualty before moving him.
However, adverse situations or conditions may jeopardize the lives of
both the rescuer and the casualty if this is done. It may be necessary first
to rescue the casualty before first aid can be effectively or safely given.
The life and/or the well-being of the casualty will depend as much upon
the manner in which he is rescued and transported as it will upon the
treatment he receives. Rescue actions must be done quickly and safely.
Careless or rough handling of the casualty during rescue operations can
aggravate his injuries and possibly cause death.
B-2. Principles of Rescue Operations
a. When faced with the necessity of rescuing a casualty who is
threatened by hostile action, fire, water, or any other immediate hazard,
DO NOT take action without first determining the extent of the hazard
and your ability to handle the situation. DO NOT become a casualty.
b. The rescuer must evaluate the situation and analyze the
factors involved. This evaluation involves three major steps:
B-3. Task (Rescue) Identification
- Identify the task.
- Evaluate circumstances of the rescue.
- Plan the action.
First determine if a rescue attempt is actually needed. It is a waste of
time, equipment, and personnel to rescue someone not in need of
rescuing. It is also a waste to look for someone who is not lost or
needlessly risk the lives of the rescuer(s). In planning a rescue, attempt to
obtain the following information:
- Who, what, where, when, why, and how the situation happened?
- How many casualties are involved and the nature of their injuries?
- What is the tactical situation?
- What are the terrain features and the location of the casualties?
- Will there be adequate assistance available to aid in the rescue/evacuation?
- Can treatment be provided at the scene, will the casualties require movement to a safer location?
- What equipment will be required for the rescue operation?
- Will decon procedures and equipment be required for
casualties, rescue personnel and rescue equipment?
B-4. Circumstances of the Rescue
a. After identifying the job (task) required, you must relate to
the circumstances under which you must work. Do you need additional
people, security, medical, or special rescue equipment? Are there
circumstances such as mountain rescue or aircraft accidents that may
require specialized skills? What is the weather like? Is the terrain
hazardous? How much time is available?
b. The time element will sometimes cause a rescuer to
compromise planning stages and/or treatment which can be given. A
realistic estimate of time available must be made as quickly as possible
to determine action time remaining. The key elements are the casualty's
condition and the environment.
c. Mass casualties are to be expected on the modern battlefield.
All problems or complexities of rescue are now multiplied by the number
of casualties encountered. In this case, time becomes the critical element.
B-5. Plan of Action
a. The casualty's ability to endure is of primary importance in
estimating the time available. Age and physical condition will differ from
casualty to casualty. Therefore, to determine the time available, you will
have to consider--
- Endurance time of the casualty.
- Type of situation.
- Personnel and/or equipment availability.
b. In respect to terrain, you must consider altitude and
visibility. In some cases, the casualty may be of assistance because he
knows more about the particular terrain or situation than you do.
Maximum use of secure/reliable trails or roads is essential.
c. When taking weather into account, ensure that blankets
and/or rain gear are available. Even a mild rain can complicate a normally
simple rescue. In high altitudes and/or extreme cold and gusting winds,
the time available is critically shortened.
d. High altitudes and gusting winds minimize the ability of
fixed-wing or rotary wing aircraft to assist in operations. Rotary wing
aircraft may be available to remove casualties from cliffs or inaccessible
sites. These same aircraft can also transport the casualties to a medical
treatment facility in a comparatively short time. Aircraft, though vital
elements of search, rescue or evacuation, cannot be used in all situations.
For this reason, do not rely entirely on their presence. Reliance on aircraft
or specialized equipment is a poor substitute for careful planning.
B-6. Mass Casualties
In situations where there are multiple casualties, an orderly rescue may
involve some additional planning. To facilitate a mass casualty rescue or
evacuation, recognize separate stages.
- First Stage. Remove those personnel who are not trapped
among debris or who can be evacuated easily.
- Second Stage. Remove those personnel who may be
trapped by debris but require only the equipment on hand and a
minimum amount of time.
- Third Stage. Remove the remaining personnel who are
trapped in extremely difficult or time-consuming situations, such as
under large amounts of debris or behind walls.
- Fourth Stage. Remove the dead.
B-7. Proper Handling of Casualties
a. You may have saved the casualty's life through the
application of appropriate first aid measures. However, his life can be
lost through rough handling or careless transportation procedures.
Before you attempt to move the casualty--
- Evaluate the type and extent of his injury.
- Ensure that dressings over wounds are adequately reinforced.
- Ensure that fractured bones are properly immobilized
and supported to prevent them from cutting through muscle, blood
vessels, and skin. Based upon your evaluation of the type and extent of
the casualty's injury and your knowledge of the various manual carries,
you must select the best possible method of manual transportation. If the
casualty is conscious, tell him how he is to be transported. This will help
allay his fear of movement and gain his cooperation and confidence.
b. Buddy aid for chemical agent casualties includes those
actions required to prevent an incapacitated casualty from receiving
additional injury from the effects of chemical hazards. If a casualty is
physically unable to decontaminate himself or administer the proper
chemical agent antidote, the casualty's buddy assists him and assumes
responsibility for his care. Buddy aid includes--
- Administering the proper chemical agent antidote.
- Decontaminating the incapacitated casualty's exposed skin.
- Ensuring that his protective ensemble remains correctly emplaced.
- Maintaining respiration.
- Controlling bleeding.
- Providing other standard first aid measures.
- Transporting the casualty out of the contaminated area.
Back to Appendix B: Rescue and Transportation Procedures