OBJECTIVE

TO IMPART TO THE STUDENTS THE MILITARY KNOWLEDGE OF WHAT IS FIRST AID

SCOPE
INTRODUCTION GENERAL LIFE SAVING MEASURES KIND OF WOUNDS AND FRACTURES THAT CAUSE FROM INJURIES BANDAGING SPLINTING TOURNIQUET Do's AND Don'ts OF FIRST AID WAYS OF TRANSPORTING WOUNDED PERSON

INTRODUCTION
If a casualty is loosing blood from a wound, you must take measures to control the bleeding. A field dressing can be applied to any wound which is bleeding heavily. If the wound is on an arm or leg, a pressure dressing can also be applied. If the bleeding still doesn't stop, a tourniquet can be placed around an upper arm or thigh, then tightened to stop the flow of blood below the band.

GENERAL
First aid is the care and treatment you give a casualty before medical personnel arrive.
Personal hygiene is the steps you take to protect your own health and that of others. Your personal-hygiene and first-aid skills could save your life or the life of a buddy.

By knowing what to do, and by getting medical help quickly, you may be able to save lives, prevent permanent disabilities, and prevent long periods of hospitalization.

GENERAL: cont.
The field first-aid packet issued to you should be carried at all times for personal use. It contains one or two field first-aid dressings. Use the first-aid dressings on wounds. When giving first aid to a casualty, you should use the casualty's first-aid items. You may need your own items later if you become injured.

Questions

LIFESAVING MEASURES

LIFESAVING MEASURES
When you or your buddy is wounded, first aid must be given at once. The first step is to apply (as needed) the four life-saving measures. These measures are: Clear the airway; check and restore breathing and heartbeat. Stop the bleeding. Prevent shock. Dress and bandage the wound.

CLEAR THE AIRWAY; CHECK AND RESTORE BREATHING AND HEARTBEAT

Clear the Airway. The lack of oxygen intake through breathing and lack of heartbeat leads to death in a very few minutes. When treating a casualty, first find out if he is breathing. If he is not breathing: Place him on his back and kneel beside his head. Clear his airway by removing any obstruction in his mouth. Place your hand (the hand nearest his feet) under his neck and put your other hand on his forehead. Extend his neck by lifting with the hand under the neck and pushing down on the forehead. This also lifts the tongue away from the back of the throat, opening the airway.

CLEAR THE AIRWAY; CHECK AND RESTORE BREATHING AND HEARTBEAT cont.

Check for Breathing. After opening the airway, LOOK, LISTEN, and FEEL to find out if the casualty is breathing. The following procedures should be used: Put your ear near the casualty's mouth and nose: hold this position for about 5 seconds. LOOK to see if the casualty's chest is rising and falling. LISTEN and FEEL for breathing.

RESTORE BREATHING
Restore Breathing. IF THERE ARE NO SIGNS OF BREATHING, START MOUTH-TOMOUTH RESUSCITATION AT ONCE. The following procedures should be used: Put a hand under the casualty's neck to keep the head tilted far back. Press down on his forehead with the other hand. Move this hand and pinch his nostrils between your thumb and index finger. Open his mouth wide.

RESTORE BREATHING
Take a deep breath and place your mouth over his, making an airtight seal with your lips. Blow into his mouth. Give four or five quick but full breaths to make sure his lungs are full. Remove your mouth, turn your head, and LOOK, LISTEN, and FEEL for exhaled air. Repeat this procedure once every 5 seconds until the casualty exhales.

RESTORE BREATHING cont.

If you feel strong resistance when you first blow air into the casualty's mouth, quickly reposition his head and try again. If the airway is still not clear, roll him onto his side. Hit him sharply between his shoulder blades with the heel of your hand to dislodge any foreign objects. If the casualty's abdomen bulges (air going into stomach), apply gentle pressure on his abdomen with one hand to force the air out. If this makes the casualty vomit, quickly turn him onto his side, clean out his mouth, and continue giving mouth-to-mouth resuscitation.

Check for Heartbeat.

Check for Heartbeat. When you find an unconscious casualty, check to see if he has a heartbeat and if he is breathing. To check for heartbeat, use the following procedures: Tilt the casualty's head back. Place your fingers on his throat. Feel for the Adam's apple. Slide the fingers down from the Adam's apple to the side of the throat. This will place the fingertips over an artery, where the pulse can be felt.

Restore Heartbeat.
Restore Heartbeat. You must start external heart massage quickly, as permanent damage to the brain may occur if it is deprived of oxygenated blood.
External heart massage provides artificial circulation by squeezing the heart between the breastbone and the backbone, forcing blood through the lungs, brain, and body.

Examples of times without oxygen and likelihood of brain damage are listed below:

To perform mouth-to-mouth resuscitation and external heart massage at the same time:
Kneel at the casualty's side. Blow four quick but full breaths into the casualty (as described earlier) to fill the lungs with air (his head must be tilted back and his airway open). Locate the tip of the breastbone and measure two finger-widths up from that tip. Place the heel of the other hand along side the fingers. Then, put both hands together and interlace the fingers. Push downward on the chest 15 times at a rate of 80 counts per minute. Lean forward with the elbows locked.

To perform mouth-to-mouth resuscitation and external heart massage at the same time:
That will compress the casualty's chest about 11/2 to 2 inches. Then release the pressure on the chest. After each 15 compressions, shift positions slightly and give him 2 quick, but full, breaths. Continue this 15 to 2 ratio: Until the casualty can breathe by himself and his pulse returns. Until relieved by someone. Until the casualty is dead.

To perform mouth-to-mouth resuscitation and external heart massage at the same time: cont.
If two of you are present, one should give mouth-to-mouth resuscitation and the other should give heart massage. In that case, the procedure is slightly different. The soldier giving the heart massage should change the number of compressions from 15 at a time to 5, keeping the 80-per-minute rate. The soldier giving mouth-to-mouth resuscitation, should give 2 breaths after each 5 compressions.

STOP THE BLEEDING

If the casualty is breathing and his heart is beating, the next thing to do is to stop the bleeding of the wound. Before you stop the bleeding, you must find all wounds. Look for both entry and exit points. This is to see that nothing is overlooked, as a bullet usually makes a smaller wound where it enters than where it exits.

STOP THE BLEEDING cont.

After finding all wounds, stop the bleeding by using the following procedure: Without touching or trying to clean the wound cut and lift the clothing away from the wound to expose it. Do not touch the wound or try to remove objects from it. Put a field first-aid dressing on the wound, trying not to contaminate the dressing or the wound.

STOP THE BLEEDING cont.

To put on the dressing: Remove the dressing from its plastic envelope and twist it to break the paper wrapper. Grasp the folded dressing with both hands (do not touch the side of the dressing that goes on the wound). Place the dressing on the wound without letting it touch anything else. Wrap the dressing around the wound and tie the ends securely with a square knot. If possible, tie the knot directly over the wound.

STOP THE BLEEDING cont.

To put on the dressing: cont. If the bleeding continues after the dressing is secured on the wound, press the bandage for 5 to 10 minutes. If more pressure is needed to stop the bleeding, put a thick pad or stone on top of the dressing and tie the ends of the dressing over the pad or stone. This is called a pressure dressing. If the wound is in an arm or leg and the bleeding has not stopped, raise the injured limb above the level of the heart. This helps to slow down or stop the bleeding. Do not, however, raise a limb with a broken bone unless it is properly splinted.

STOP THE BLEEDING cont.

To put on the dressing: cont. If blood is spurting from the wound, there is bleeding from an artery. To stop it, press on the point of the body where the main artery supplying the wounded area with blood is located This pressure should shut off or slow down the flow of blood from the heart to the wound until a pressure dressing can be put on it. In some cases, you may have to keep pressure on the pressure paint even after the drawing is put on. The best pressure points of the body to use in stopping arterial bleeding are shown in the following

illustration.

STOP THE BLEEDING cont.

To put on the dressing: cont.

If the wound continues to bleed after you apply pressure to a pressure point and apply a pressure dressing, use a tourniquet. This should be a LAST RESORT ONLY. Put the tourniquet between the wound and where the injured limb joins the trunk. Put it 2 to 4 inches above the wound, not over it. Never loosen or remove a tourniquet once it has been put on. If possible, mark a "T" on the casualty's fore head at the time the tourniquet is put on. Then get the casualty to an aid station quickly.

PREVENT SHOCK
Unless shock is prevented or treated, death may result, even though the injury would not otherwise be fatal. Shock may result from any injury, but is more likely to result from a severe injury. Warning signs of shock are restlessness, thirst, pale skin, and rapid heartbeat. A casualty in shock may be excited or appear calm and tired. He may be sweating when his skin feels cool and clammy. As his condition worsens, he may take small, fast breaths or gasps; stare blindly into space or become blotchy or bluish around his mouth.

PREVENT SHOCK cont.

After giving the casualty the first two lifesaving measures, look for signs of shock. If the casualty is in shock or is about to go into shock, treat him at once for shock. To treat for shock, proceed as follows: Loosen the casualty's clothing at the neck, waist, and wherever it restricts circulation. Reassure the casualty by being calm and selfconfident. Assure him that he will be taken care of.

PREVENT SHOCK cont.

Place the casualty in a comfortable position. His position depends on his condition. If he is conscious, place him on his back with his feet raised 15 to 20 cm (6 to 8 in). If he is unconscious, place him on his side or abdomen with his head turned to the side. If he has a head wound, raise his head higher than his body. If he has a wound of the face and/or neck, set him up and lean him forward with his head down or in the position for an unconscious casualty. If he has a sucking chest wound, set him up or lay him down on the injured side. If he has an abdominal wound, lay him on his back with his head turned to the side. Keep the casualty warm. It may be necessary to place ponchos or blankets under and over him.

Questions

KIND OF WOUNDS AND FRACTURES THAT CAUSE FROM INJURIES

Open Wounds

Closed Wounds

Acute Sprains and Strains

Trauma

Compound Fracture of the Ankle

Fractures
Any break in the continuity of a bone May vary from a simple crack to a completely shattered bone

FX Femur

Open Fracture

Compound Fracture of the Ulna

Other Injuries

Blast Injury

De-gloving Injury

Ecchymosis
Discoloration caused by bleeding in tissue Blood migrates toward skin and changes color with time

Joints
Surrounded by joint capsule and ligaments, muscles and tendons

Dislocations
Disruption of a joint such that the bone ends are no longer in contact Torn ligaments and capsule

Common Dislocations
Fingers Shoulder Hip Elbow Ankle

Dislocated Elbow

Knee Joint
Femur, Tibia, and Patella Largest hinge joint in body Held together by complex ligaments Susceptible to injury

Knee Injuries
Ligaments and cartilage injuries are common Swelling, pain, limited ROM Frequent athletic injury Splint entire femur and tibia

Dislocation of the Knee

Severe deformity Popliteal artery commonly injured If pulse is present, splint in deformed position If pulse is absent, attempt once to realign limb and splint where pulse is strongest (RGR MEDIC)

Dislocation of the Knee

Ankle Injuries
Usually result from twisting, indirect force Fracture, dislocations, sprains can occur Swelling and deformity Note circulation Immobilize with padding and splint

Sprain
Partial, temporary joint dislocation Ligaments torn or stretched May produce discoloration

Management of Closed Injuries

R - Rest I - Ice C - Compression E - Elevation S - Splint (SAM Splints and cravats or ACE wraps) R/O fracture

Soft Tissue Injuries

Open - Violation of overlying skin or mucous membrane

Management Stop the bleeding and bandage

Questions

BANDAGING

DRESS AND BANDAGE THE WOUND

The healing of wounds and recovery depend a lot on how well you initially protect the wound from contamination and infection. A wound must be dressed and bandaged to protect it from further contamination, as well as to stop the bleeding. Use the field first-aid dressing in the first-aid packet to dress' and bandage a wound. A dressing is any sterile pad used to cover a wound. A bandage is any material used to secure a dressing to a wound. The field first-aid dressing already has bandages attached to it. Use the dressing to cover a wound and the bandages to secure the dressing to it.

EXPOSE THE WOUND

Cut (with scissors), tear, push, and/or lift the casualty's clothing from the area around the wound. If clothing is stuck to the wound area, cut around the stuck material and leave that part of the clothing stuck to the wound. If you are in a chemical environment, do not expose the wound. Apply the field dressing over the wound and clothing; then evacuate the casualty. Expose the entire wound area so you can see the full extent of the injury. Do not remove objects from the wound. Look for both entry and exit wounds.

APPLY AND SECURE FIELD DRESSING

Use the casualty's field dressing. If no field dressing is available, improvise a dressing and bandage using the cleanest cloth available. If an impaled object is sticking out of the wound, stabilize the object with bulky dressing made from the cleanest material available. Then apply a bandage over the dressing. Tear the plastic envelope of the field dressing and remove the field dressing, which is wrapped in paper. Twist the paper wrapper until it breaks or tear it open. Remove the field dressing. Grasp the folded bandages/tails with both hands.

APPLY AND SECURE FIELD DRESSING

Hold the field dressing above the exposed wound with the white side of the dressing material toward the wound. Pull on the tails so the dressing opens and flattens. Do not touch the white sterile side of the dressing.

APPLY AND SECURE FIELD DRESSING

Wrap one of the bandages around the injured limb with your free hand. As you wrap, cover one of the exposed sides of the dressing with the bandage. Bring the tail back over the dressing. Wrap the other bandage around the injured limb in the opposite direction. As you wrap, cover the remaining exposed side of the dressing with the bandage. Bring the tail back to the dressing.

APPLY AND SECURE FIELD DRESSING

Tie the tails into a nonslip knot over the outer edge of the dressing, not over the wound itself. The bandage should be tight enough to keep the dressing from slipping, but not tight enough to interfere with blood circulation. You should be able to slip two fingers under the knot.

APPLY AND SECURE FIELD DRESSING

Check the circulation below the bandage. If the area below the bandage previously had adequate blood circulation but is now cool to the touch, bluish, or numb or if a pulse can not be detected below the bandage, the bandage may be interfering with blood circulation. Loosen and retie the tails without disturbing the dressing. Recheck the circulation. If circulation is not restored, evacuate the casualty.

APPLY MANUAL PRESSURE

Apply direct pressure over the dressing with your hand. If possible, maintain this pressure for 5 to 10 minutes. The casualty may be able to apply the manual pressure himself. If the limb is elevated, apply manual pressure and elevation at the same time.

ELEVATE THE INJURED LIMB

Examine the injured extremity for fractures before elevating the limb. If a fracture is suspected, do not elevate the wound until the limb has been splinted. Elevate the injured limb above the level of the casualty's heart.
Elevate a leg by placing the foot and ankle on a pack, log, rock, or other object. Elevate an arm by placing the forearm on the casualty's chest if lying on his back or by placing the wrist on top of the casualty's head if he is sitting.

APPLY A PRESSURE DRESSING

If blood continues to seep from the dressing applied to a limb, apply a pressure dressing. A pressure dressing is applied only to a wound on an arm or leg. Place a wad of material (folded muslin bandage) on top of the dressing and directly over the wound.

APPLY A PRESSURE DRESSING

Place a muslin bandage folded into a cravat over the wad and wrap the cravat tightly around the limb.

APPLY A PRESSURE DRESSING

Tie the ends of the cravat in a nonslip knot directly over the wound. You should be able to insert the tip of one finger under the knot.

APPLY A PRESSURE DRESSING

Check the circulation below the pressure dressing. If the area below the pressure dressing previously had adequate blood circulation but is now cool to the touch, bluish, or numb or if a pulse can no longer be detected below the pressure dressing, loosen and retie the tails. This should not disturb any blood clot forming under the dressing. Recheck the circulation. If circulation is not restored, evacuate the casualty. Apply manual pressure over the pressure dressing. If the wound continues to bleed, apply a tourniquet.

Questions

Other Dressings
The following dressings are found in FM 21-11.

Questions

TOURNIQUET

DETERMINE WHEN A TOURNIQUET IS NEEDED

Needed for a complete amputation of the upper arm, forearm, thigh, or lower leg (limb has been completely severed). Apply tourniquet to amputated limb without applying field and pressure dressings. Apply even if stump is not bleeding heavily. Do not apply for amputation of a part of a hand or part of a foot. Bleeding from these wounds can be controlled by a pressure dressing. Needed if the bleeding from a limb is severe and cannot be stopped by the application of a field dressing, manual pressure, elevation, and pressure dressing.

GATHER MATERIALS FOR MAKING A TOURNIQUET Tourniquet Band Fold muslin bandage or other strong, pliable material into a cravat at least two inches wide.
Do not use wire or shoestrings for a tourniquet band.

Rigid Object A rigid object, usually a stick, is used to tighten the tourniquet.

GATHER MATERIALS FOR MAKING A TOURNIQUET Securing Materials (if needed) Additional cravat or securing material may be needed to secure the rigid object if the tourniquet band is not long enough. Padding Soft, smooth material to place between the limb and the tourniquet band. The casualty's shirt sleeve or trouser leg can be used.

SELECT A TOURNIQUET SITE Select an upper arm or thigh site. If the wound is in the upper arm or thigh, select a site that is two to four inches above the edge of the wound or amputation site. If the wound is in the lower extremity, the ideal sites are still the upper arm and thigh just above the joint (elbow or knee). Do not apply a tourniquet band over a joint or a fracture site.

APPLY A TOURNIQUET
Place padding around the limb where the tourniquet band will be applied to protect the skin from being pinched and twisted when the band is tightened. Smoothing the casualty's shirt sleeve or trouser leg over the tourniquet site is sufficient. Place the tourniquet band material around the tourniquet site. Tie the band with a half knot (like first part of tying a shoestring). Place the rigid object on top of the half knot. Tie a full knot that will not come undone over the rigid object.

APPLY A TOURNIQUET
Twist the rigid object (clockwise or counterclockwise) until the tourniquet is tight and the bright red bleeding has stopped. Generally, darker blood is from a vein and may continue to ooze even after the tourniquet has been properly applied. There should be no pulse below the tourniquet.

APPLY A TOURNIQUET
Wrap the tails of the tourniquet band around the end of the rigid object so the rigid object will not untwist, bring the tails under the limb, and tie the tails in a nonslip knot.

APPLY A TOURNIQUET
If the rigid object cannot be secured with the tails of the tourniquet band, wrap a piece of material around the limb below the tourniquet, wrap the material around one end of the rigid object so the tourniquet will not unwind, and tie the tails of the material in a nonslip knot.

Do not loosen the tourniquet once it is in place and has stopped the blood flow. Loosening the tourniquet band would allow the wound to start bleeding again, which could be fatal. Do not cover the tourniquet. Leave it in full view so it can be located quickly by medical personnel.

DRESS AN AMPUTATION If the tourniquet is applied to an amputation, protect the amputation site (wound) from further contamination. Place a dressing made of soft, absorbent material over the end of the stump and secure the dressing with bandages.

MARK THE CASUALTY

Write a "T" and the time of application on the casualty's forehead with a pen, the casualty's blood, mud, or other substance. The "T" alerts medical personnel that a tourniquet is present.

PUT ON A FIELD DRESSING, PRESSURE DRESSING, AND TOURNIQUET CLOSING Failure to control bleeding in the field is the major cause of death among casualties who could be saved. It is vital that all soldiers learn the procedures for controlling bleeding presented in this lesson.

PUT ON A FIELD DRESSING, PRESSURE DRESSING, AND TOURNIQUET CLOSING A tourniquet is to be applied to an amputated limb (not part of a hand or foot). When the wound on the extremity does not result in amputation, a tourniquet is used only as a last resort when blood loss from the wound endangers the casualty's life and the bleeding cannot be controlled by other methods. The portion of the limb below the tourniquet may need to be amputated when the casualty reaches a medical treatment facility.

Questions

Do's AND Don'ts OF FIRST AID

Do's AND Don'ts OF FIRST AID

When giving first aid to a casualty, remember the following: DO act promptly but calmly. DO reassure the casualty and gently examine him to determine the needed first aid. DO give lifesaving measures as required. DON'T position a soldier on his back if he is unconscious or has a wound on his face or neck. DON'T remove clothing from an injured soldier by pulling or tearing it off.

DOs AND DON'Ts OF FIRST AID cont.

When giving first aid to a casualty, remember the following: cont. DON'T touch or try to clean dirty wounds, including burns. DON'T remove dressings and bandages once they have been put on a wound. DON'T loosen a tourniquet once it has been applied. DON'T move a casualty who has a fracture until it has been properly splinted, unless it is absolutely necessary. DON'T give fluids by mouth to a casualty who is unconscious, nauseated, or vomiting, or who has an abdominal or neck wound.

Do's AND Don'ts OF FIRST AID cont.

When giving first aid to a casualty, remember the following: cont. DON'T permit the head of a casualty with a head injury to be lower than his body. DON'T try to push protruding intestines or brain tissue back into a wound. DON'T put any medication on a burn. DON'T administer first-aid measures which are unnecessary or beyond your ability. DON'T fail to replace items used from the firstaid case.

Questions

WAYS OF TRANSPORTING WOUNDED PERSON

Transportation of Casualties
When the situation is urgent you may have to transport the casualty. For this reason, you must know how to transport him without increasing the seriousness of his condition. Transporting a casualty by litter is safer and more comfortable for him than by manual means; it is also easier for you. Manual transportation, however, may be the only feasible method because of the terrain or the combat situation.
Transportation of the sick and wounded is the responsibility of medical personnel who have been provided special training and equipment. Therefore, unless a good reason for you to transport a casualty arises, wait for some means of medical evacuation to be provided.

Standard Evacuation Types

UH-60A/Q Ambulance
*An M113 series Armored Ambulance can carry 4 litters

UH-60Q Interior

Non-Standard Evacuation Types

Non-Standard Evacuation Types cont.

Non Standard Assets- Always plan for non-standard evacuation assets. There should already be a plan in place for casualty incidents at Camp Roberts and the surrounding camps, however, it is the duty of each leader to be highly familiar with those plans and ensure that they are adequate for his particular mission. (FYI)The leader should emphasize that non-standard evacuation means should be planned for (especially for MASCALs) and rehearsed, if possible. This will decrease the number of DOW casualties. SOPs for casualty marking should be common and known to all, even supporting units providing the non-standard evacuation means (for example, red chem light during hours of limited visibility, VS-17 panel for day time operations). These techniques need to be rehearsed and provided to both internal and external units supporting the battalion. Air evacuation should always be planned for and rehearsed. (FYI) LMTV=12 litter or 16 ambulatory; CH-47=24 litter or 33 ambulatory

Casualty Evacuation TTPs

USE SPECIALIZED EQUIPMENT
POLELESS LITTER SKED LITTER DESIGNATE AND TRAIN AID AND LITTER TMS

Casualty Evacuation TTPs cont.

The leader should emphasize that ground casualty evacuation techniques include, but are not limited to using the following items:
Poleless litter- easy to carry on person, takes 6-soldiers (almost a squad sized element) to carry casualty once inflicted. This is the preferred and commonly used item in casualty evacuation. It is cumbersome when evacuating a casualty, but light and easy to carry when in the carrying configuration (fits in ruck sack flap, butt pack or soldier cargo pocket). Sked litter- bulky and not conducive for light forces. Approximately 2.5 feet in length when in the carrying configuration. Takes only four personnel to carry a casualty (has handles on the four corners, as opposed to six carrying straps like the poleless litter). Poncho- another technique is using soldier OCIE. A poncho is conducive to combat operations, easy to carry on the soldier, but cumbersome to carry when a casualty is inflicted and placed on the poncho litter. Like the poleless litter, it is cumbersome and takes up to six soldiers to carry. A key to success is training aid and litter teams down to the squad level on the various casualty evacuation equipment. Platoon leaders should designate both a primary and alternate aid and litter team within each squad.

The rapidly employable lightweight litter, referred to as the SKEDS litter, is designed to be used as a rescue system in most types of terrain, including mountains, jungle, waterborne, and on snow or ice.

When conducting patrols, it is possible that you could receive a casualty due to either an accident or hostile action. One rapid method of transporting a casualty with minimal use of personnel is the SKED litter. If at all possible at least one should be taken while on dismounted patrol.(FYI for instructor)The SKEDS litter is made of durable plastic. It can be rolled and carried in a camouflage case. The basic litter weighs 16 pounds complete with carrying case, straps, snap link, and a 30-foot kernmantle rope.The SKEDS litter enables a single soldier to pull a casualty over most types of terrain; a field-expedient poncho litter requires two soldiers or more. Up to four soldiers can use hand loops to carry a SKEDS litter containing a seriously injured casualty across difficult terrain.

Manual Carries: One-man carries

Two-man carries

Casualties carried by manual means must be carefully and correctly handled, otherwise their injuries may become more serious or possibly fatal. This carry can be used to assist him as far as he is able to walk or hop. Other one-man carries include the Firemans carry, the Saddleback carry, the Arms carry, and etc. (Support carry ) The casualty must be able to walk or at least hop on one leg, using the bearer as a crutch.

Manual Carries (One Man)

Firemans Carry Support Carry Arms Carry Pistol-belt Carry and Drag Neck Drag

TWO-MAN SUPPORT CARRY

TWO-MAN SUPPORT CARRY (cont)

Other two-man carries include the two-man arms carry, the two-man fore and aft carry, and so on. These carries can be practiced as part of a normal battle-focused PT program.

Manual Carries (two man)

Two man support carry Two man arms carry Two man fore-and-aft carry Two hand seat carry

CATEGORIES OF PRECEDENCE FOR EVACUATION

URGENT-PATIENT WHO SHOULD BE EVACUATED AS SOON AS POSSIBLE AND WITHIN TWO HOURS TO SAVE LIFE, LIMB, OR EYESIGHT. PRIORITY-PATIENT WHO SHOULD BE MOVED WITHIN FOUR HOURS OR HIS/HER CONDITION WILL DETERIORATE TO SUCH A DEGREE THAT HE WILL BECOME URGENT. ROUTINE-PERSONNEL WHOSE CONDITION IS NOT EXPECTED TO WORSEN SIGNIFICANTLY AND WHO WILL REQUIRE EVACUATION IN THE NEXT 24 HOURS.
The leader should emphasize the listed categories of precedence and the criteria used in their assignment. The following slides cover these three categories of precedence for evacuation. URGENT-The leader should emphasize that these types of casualties should be evacuated to prevent complications of serious illness, or to avoid permanent disability.

LINE ITEM/BREVITY CODES ITEM/BREVITY CODES 7 Method of marking pickup site 1 Location of pickup site 2 Frequency/Call sign of pickup site A - PANELS 3 Number of patients by precedence B - PYROTECHNICS A - URGENT C - SMOKE C - PRIORITY D - NONE D - ROUTINE E - OTHER
8 Patient nationality and status

MEDEVAC REQUEST FORMAT

4 Special equipment A - US MILITARY A - NONE B - US CIVILIAN B - HOIST C - NON US MILITARY C - EXTRACTION EQUIPMENT D - NON US CIVILIAN D - VENTILATOR E - EPW 5 Number of patients by type 9 NBC contamination L + # LITTER N - NUCLEAR B - BIOLOGICAL A + # AMBULATORY C CHEMICAL 6 Security of pickup site N - NO ENEMY P - POSSIBLE ENEMY E - ENEMY IN AREA X - ARMED ESCORT NEEDED

The leader should emphasize that battle roster numbers reduce the amount of time spent sending in soldier demographics. Company battle roster numbers are maintained by the company CP.

LINE 1

LOCATION OF THE PICKUP SITE

The leader should transmit the grid coordinates of the pickup site by the most secure type of communications available or by whatever means and been coordinated with the element the requester is to call. This is required so evacuation vehicles know where to pickup patients. Also, so that the unit coordinating the evacuation mission can plan the route for the evacuation vehicle (if the evacuation vehicle must pick up from more than one location).

LINE 2

RADIO FREQUENCY/CALL SIGN AND SUFFIX

The leader should encrypt( or by secure means) the frequency of the radio at the pickup site, not a relay frequency. The call sign (and suffix if used) of person to be contacted at the pickup site may be transmitted in the clear. This information is required so that evacuation vehicle can contact requesting unit while enroute (obtain additional information or change in situation or directions).

SOI and ANCD

LINE 3

NUMBER OF PATIENTS BY PRECEDENCE

BREVITY CODES:

A- URGENT
C -PRIORITY D -ROUTINE
The leader should report only applicable information and encrypt the brevity codes (ACD). If two or more categories must be reported in the same request, insert the word BREAK between each category. This is required by unit controlling the evacuation vehicles to assist in prioritizing missions.

LINE 4

SPECIAL EQUIPMENT REQUIRED

BREVITY CODES:
A NONE B HOIST

C EXTRACTION EQUIPMENT
D VENTILATOR The leader should utilize the applicable brevity codes (ABCD). This is required so that the equipment can be placed on board the evacuation vehicle prior to the start of the mission.

LINE 5

NUMBER OF PATIENTS BY TYPE

BREVITY CODES: L + #Patients Litter A + #Patients Ambulatory
The leader should report only applicable information and encrypt the brevity code. If requesting MEDEVAC for both types, insert the word BREAK between the litter entry and ambulatory entry. This is required so that the appropriate number of evacuation vehicles may be dispatched to the pickup site. They should be configured to carry the patients requiring evacuation.

LINE 6

SECURITY OF PICKUP SITE (WARTIME)

BREVITY CODES: N NO ENEMY P POSSIBLE ENEMY TROOPS IN AREA (APPROACH WITH CAUTION) E ENEMY TROOPS IN AREA (APPROACH WITH CAUTION) X ENEMY TROOPS IN AREA (ARMED ESCORT REQUIRED)
The leader should emphasize that the information for security of pickup site should be given in brevity codes (NPEX). This information is required to assist the evacuation crew in assessing the situation and determining if assistance is required. More definitive guidance can be furnished the evacuation vehicle while it is en route (specific location of enemy to assist an aircraft in planning its approach).

LINE 6

NUMBER AND TYPE OF WOUND, INJURY, OR ILLNESS (PEACETIME)

GIVE SPECIFIC INFORMATION, GUNSHOT WOUND, BLEEDING AND BLOOD TYPE IF KNOWN
The leader should emphasize that information specifically regarding patient wounds by type (gunshot or shrapnel) should be transmitted. Report serious bleeding, along with patient blood type, if known. Required to assist evacuation personnel in determining treatment and special equipment needed.

LINE 7

METHOD OF MARKING PICKUP SITE

BREVITY CODE: A PANELS B PYROTECHNIC SIGNAL C SMOKE SIGNAL D NONE E OTHER
The leader should emphasize the method of marking the pickup site should be encrypted in brevity codes (ABCDE). This information is needed to assist the evacuation crew in identifying the specific location of the pickup site. Note that the color of panels or smoke should not be transmitted until the evacuation vehicle contacts the unit (just prior to its arrival). For security, the crew should identify the color and the unit verify it.

LINE 8

PATIENT NATIONALITY AND STATUS

ENCRYPT BREVITY CODE: A FIL MILITARY B FIL CIVILIAN C NON-FIL MILITARY D NON-FIL CIVILIAN E EPW (Detainee)
The leader should emphasis that the number of patients in each category need not be transmitted. Encrypt only the applicable brevity codes (ABCDE). This information is required to assist in planning for destination facilities and need for guards. Unit requesting support should ensure that there is an English speaking representative at the pick-up site.

LINE 9

NBC CONTAMINATION (Wartime)

ENCRYPT BREVITY CODE:
N B C NUCLEAR BIOLOGICAL CHEMICAL

The leader should include this line only when applicable. Encrypt the applicable brevity codes of NBC. Required to assist in planning for the mission. (Determine which evacuation vehicle will accomplish the mission and when it will be accomplished).

LINE 9

TERRAIN DESCRIPTION
(PEACETIME)

INCLUDE DETAILS OF TERRAIN FEATURES IN AND AROUND PROPOSED LANDING SITE

The leader should emphasize that this includes details of terrain features in and around proposed landing site. If possible, describe relationship of site to prominent terrain feature (lake, mountain, tower). Required to allow evacuation personnel to assess route/avenue of approach into area. Of particular importance if hoist operation is required.

Example
Badger03 this is Badger76 MEDEVAC 9 line followsover
This is Badger03 send it over

line 1-- UV 8945 4452 line 2-- 30300 in the red, badger76 line 3-- 1C line 4-- A line 5-- 1A line 6-- N line 6-- 1, broken ankle compound fracture (peacetime) line 7-- C line 8--A line 9-- NONE line 9-- Open field no power lines.(peacetime) Over This is Badger03 roger out

SUMMARY
INTRODUCTION GENERAL LIFE SAVING MEASURES KIND OF WOUNDS AND FRACTURES THAT CAUSE FROM INJURIES BANDAGING SPLINTING TOURNIQUET Do's AND Don'ts OF FIRST AID WAYS OF TRANSPORTING WOUNDED PERSON PERSONAL HYGIENE

Questions???
Take a break

THE END

PERSONAL HYGIENE

SCOPE
DEFINITION OF TERMS COMMUNICABLE DISEASES CONTROL TRANSMITTING AGENTS PERSONAL HYGIENE PERSONAL CLEANLINESS FOOD AND DRINK EXERCISE REST MENTAL HYGIENE RULES FOR AVOIDING DISEASES IN THE FIELD PERSONAL HYGIENE

PERSONAL HYGIENE
Personal hygiene consists of practices which safeguard your health and that of others. It is often thought of as being the same as personal cleanliness. While cleanliness is important, it is only one part of healthy living.

PERSONAL HYGIENE contd

Personal hygiene is important to you because: It protects against disease-causing germs that are present in all environments. It keeps disease-causing germs from spreading. It promotes health among soldiers. It improves morale.

PERSONAL CLEANLINESS
Skin. Wash your body frequently from head to foot with soap and water. If no tub or shower is available, wash with a cloth and soapy water, paying particular attention to armpits, groin area, face, ears, hands, and feet. Hair. Keep your hair clean, neatly combed, and trimmed. At least once a week, wash your hair and entire scalp with soap and water. Also, shave as often as the water supply and tactical situation permit. Do not share combs or shaving equipment with other soldiers.

PERSONAL CLEANLINESS cont.

Hands. Wash your hands with soap and water after any dirty work, after each visit to the latrine, and before eating. Keep your fingernails closely trimmed and clean. Do not bite your fingernails, pick your nose, or scratch your body. Clothing and Sleeping Gear. Wash or exchange clothing when it becomes dirty (situation permitting). Wash or exchange sleeping gear when it becomes dirty. If clothing and sleeping gear cannot be washed or exchanged, shake them and air them regularly in the sun. That greatly reduces the number of germs on them.

CARE OF THE MOUTH AND TEETH

Regular and proper cleaning of the mouth and the teeth helps prevent tooth decay and gum disease. The most healthful oral hygiene is to clean your mouth and teeth thoroughly and correctly after each meal with a toothbrush and toothpaste. If a toothbrush is not available, cut a twig from a tree and fray it on one end to serve as a toothbrush. If mouthwash is available, use it to help kill germs in your mouth. To help remove food from between your teeth, use dental floss or toothpicks. Twigs can also be used for toothpicks.

CARE OF THE FEET

Wash and dry your feet daily. Use foot powder on your feet to help kill germs, reduce friction on the skin, and absorb perspiration. Socks should be changed daily. After crossing a wet area, dry your feet, put on foot powder, and change socks, as soon as the situation permits.

FOOD AND DRINK

For proper development, strength, and survival, your body requires: Proteins. Fats and carbohydrates. Minerals. Vitamins. Water.

FOOD AND DRINK cont.

Issued rations have those essential food substances in the right amounts and proper balance. So, eat primarily those rations. When feasible, heat your meals. That will make them taste better and will reduce the energy required to digest them. Do not overindulge in sweets, soft drinks, alcoholic beverages, and other nonissued rations. Those rarely have nutritional value and are often harmful. Drink water only from approved water sources or after it has been treated with waterpurification tablets.

To purify water from rivers or streams:

Fill your canteen with water (be careful not to get trash or other objects in your canteen). Add one purification tablet per quart of clear water or two tablets per quart of cloudy or very cold water. (If you are out of tablets, use boiling water that has been boiled for 5 minutes.) Replace the cap loosely. Wait 5 minutes. Shake the canteen well and allow some of the water to leak out. Tighten the cap. Wait an additional 20 minutes before drinking the water.

EXERCISE
Exercise of the muscles and joints helps to maintain physical fitness and good health. Without that, you may lack the physical stamina and ability to fight. Physical fitness includes a healthy body, the capacity for skillful and sustained performance, the ability to recover from exertion rapidly, the desire to complete a designated task, and the confidence to face any eventuality. Your own safety, health, and life may depend on your physical fitness. There are lulls in combat when you will not be active. During such lulls, exercise. That helps to keep the muscles and body functions ready for the next period of combat. It also helps pass the time in the lulls.

Your body needs regular periods of rest to restore physical and mental vigor. When you are tired, your body functions are sluggish, and your ability to react is slower than normal. That also makes you more susceptible to sickness. For good health, 6 to 8 hours of uninterrupted sleep each day is desirable. As that is seldom possible in combat, use rest periods and off-duty time to rest or sleep. Do not be ashamed to say that you are tired or sleepy. Do not, however, sleep when on duty.

REST

MENTAL HYGIENE
The way you think affects the way you act. If you know your job, you will probably act quickly and effectively. If you are uncertain or doubtful of your ability to do your job, you may hesitate and make wrong decisions. Positive thinking is a necessity. You must enter combat with absolute confidence in your ability to do your job.

MENTAL HYGIENE cont.

Fear is a basic human emotion. It is both a mental and physical state. Fear is not shameful if it is controlled. It can even help you by making you more alert and more able to do your job. Fear makes the pupils of your eyes enlarge, which increases your field of vision so you can detect movement more easily. Fear also increases your rate of breathing and heartbeat. That increases your strength. Therefore, control your fear and use it to your advantage.

MENTAL HYGIENE cont.

Do not let your imagination and fear run wild. Remember, you are not alone. You are part of a team. There are other soldiers nearby, even though they cannot always be seen. Everyone must help each other and depend on each other. Worry undermines the body, dulls the mind, and slows down thinking and learning. It adds to confusion, magnifies troubles, and causes you to imagine things which really do not exist. If you are worried about something, talk to your leader about it. He may be able to help solve the problem.

MENTAL HYGIENE cont.

You may have to fight in any part of the world and in all types of terrain. Therefore, adjust your mind to accept conditions as they are. If mentally prepared for it, you should be able to fight under almost any conditions.

RULES FOR AVOIDING ILLNESS IN THE FIELD

No matter how strong of well conditioned a man may be, if enough germs enter his body his resistance will be overcome and a disease will develop.

RULES FOR AVOIDING ILLNESS IN THE FIELD

Don't consume foods and beverages from unauthorized sources. Don't soil the ground with urine or feces. (Use a latrine or "cat-hole.") Keep your fingers and contaminated objects out of your mouth. Wash your hands following any contamination, before eating or preparing food, and before cleaning your mouth and teeth. Wash all mess gear after each meal. Clean your mouth and teeth at least once each day.

RULES FOR AVOIDING ILLNESS IN THE FIELD cont.

Avoid insect bites by wearing proper clothing and using insect repellents. Avoid getting wet or chilled unnecessarily. Don't share personal items (canteens, pipes, toothbrushes, washcloths, towels, and shaving gear) with other soldiers. Don't leave food scraps lying around. Sleep when possible. Exercise regularly.

SUMMARY
DEFINITION OF TERMS COMMUNICABLE DISEASES CONTROL TRANSMITTING AGENTS PERSONAL HYGIENE PERSONAL CLEANLINESS FOOD AND DRINK EXERCISE REST MENTAL HYGIENE RULES FOR AVOIDING DISEASES IN THE FIELD PERSONAL HYGIENE

Questions???
Take a break

THE END