Wilderness Medicine, First Aid, and Outdoor Skills
Rescue Procedures

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US Army First Aid Manual
Fundamental Criteria for First Aid
Basic Measures for First Aid
First Aid for Special Wounds
First Aid for Fractures
First Aid for Climatic Injuries
First Aid for Bites and Stings
First Aid in Toxic Environments
First Aid for Psychological Reactions
Appendix A: First Aid Case and Kits, Dressings, and Bandages
Appendix B: Rescue and Transportation Procedures
Appendix C: Common Problems/Conditions
Appendix D: Digital Pressure
Appendix E: Decontamination Procedures
Appendix F: Glossary

Rescue Procedures

B-1. General

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:

  • Identify the task.

  • Evaluate circumstances of the rescue.

  • Plan the action.

B-3. Task (Rescue) Identification

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.

  • Weather.

  • Terrain.

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

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