Army Manual - Combat Lifesaver Course Student Self Study


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If the fracture is in the thigh, the splint should extend above the hip and below the ankle hip, knee, and ankle will be immobilized. Make sure the ends of the splints do not press against the groin. Such pressure could interfere with blood circulation. Apply extra padding to joints and sensitive areas such as the groin. The knots are tied on the outer rigid object to make loosening and retying the cravats easier should that procedure be needed. The securing material should be tight enough to hold the rigid objects securely in place, but not tight enough to interfere with blood circulation.

If you detect signs of poor circulation such as coolness, numbness, or lack of pulse loosen the securing materials, make sure the ends of the rigid objects are not interfering with blood circulation, and retie the cravats. If the leg still has poor circulation, evacuate the casualty as soon as possible. Figure shows a splint applied to a fractured thigh. Splint applied to a fracture of the thigh. Applying a splint to an arm. If possible, place two cravats above the fracture site and two below the fracture site.

Immobilize the joint above the fracture site and the joint below the fracture site. Slings and swathes can be used to immobilize joints. If you detect signs of poor circulation such as coolness, numbness, or lack of pulse loosen the securing materials, make sure the ends of the rigid objects are not interfering with blood circulation such as pressing on the armpit , and retie the cravats.

If the arm or forearm still has poor circulation, evacuate the casualty as soon as possible. If the upper arm is fractured, apply a swathe above the fracture and a swath below the fracture. Figure A shows a forearm with a splint applied. Figure B shows a sling applied to the fractured arm. Figure shows a splinted forearm with the casualty's shirt tail used as a sling sharp stick stuck through shirt and tail to secure the tail and a swathe applied. Have the casualty take all four tablets with water from his canteen. The pack contains pain medications and antibiotics to help control infection.

Use the casualty's pack, not your own pack. You need your pack in case you are wounded.

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Study the information contained in this subcourse on your own before attending classroom instruction. Why should you push away any loose clothing near a casualty's open wound before applying a dressing? If a tourniquet applied below the knee or elbow does not control the arterial bleeding, apply another tourniquet two inches above the joint. Place one of your hands under the back of the casualty's head and neck for support. If needed, the thumb may be used to depress the casualty's lower lip slightly to keep his mouth open. Check the soldier for responsiveness. Begin administering fluids intravenously if the casualty's mental status AVPU decreases or his radial pulse is no longer detectable.

This pill pack is not part of the combat lifesaver MES. IS Figure Fractured forearm with splint A and sling B. Fractured forearm with shirt tail used for a sling and a swathe. This is usually caused by severe bleeding, but it can also be caused by severe burns second and third degree burns on 20 percent or more of the body surface , vomiting, diarrhea, and excessive sweating. Hypovolemic shock can result in the casualty's death. Hypovolemic shock can also result from blood loss due to internal bleeding bleeding into the abdominal or chest cavities.

You will not be able to treat internal bleeding. This condition requires rapid evacuation. Signs and symptoms of shock include the following. Take the following actions to treat shock. Do not wait for signs and symptoms of shock to occur. The same measures used to treat shock can be applied to help prevent shock from occurring.

This will help his blood circulation. A log, field pack, box, rolled field jacket, or other stable object can be used to elevate his feet. Some exceptions to placing the casualty in the shock position are given below. If the casualty vomits, quickly perform a finger sweep to clear his airway. Immobilize his head, neck, and back, if possible. Having the uninjured side up decreases pressure on the uninjured side of the chest and allows the uninjured lung to function easier. Do not elevate the casualty's legs until all lower limb fractures have been splinted.

If natural shade is not available, erect an improvised shade using a poncho and sticks or other available materials. Fan him if needed to promote the evaporation of perspiration. Blood loss can cause a significant drop in body temperature, even in hot weather. Do not cover a tourniquet.

Leave it so medical personnel can see it easily. Casualty in the shock position lying on a blanket. Casualty wrapped in blankets during cool weather. Tight clothing can interfere with blood circulation. Do not loosen or remove the casualty's clothing if you are in a chemical agent environment. IS 5 Reassure the casualty and keep the casualty calm.

Tell the casualty that you are helping him. Be confident in your ability to help the casualty and have a "take charge" attitude. Your words and actions can do much to reassure the casualty and reduce his anxiety. Be careful of any comments you make regarding the casualty's condition. The casualty may need intravenous infusion IV to replace lost fluid volume. Combat medics carry IV fluids and the supplies to administer the fluid. If you must leave the casualty alone in order to seek help, tell him you are going to get medical help and will return.

Turn the casualty's head to one side before you leave. This will help to keep the casualty from choking should he vomit. Check the casualty's level of consciousness every 15 minutes. A decrease in AVPU status could indicate that the casualty's condition is becoming worse. Monitor the casualty's respirations. If the casualty has suffered thoracic trauma, progressive severe respiratory distress breathing that becomes more labored and faster may indicate tension pneumothorax. This procedure described in Section II of Lesson 6 will allow the air trapped in the casualty's chest to escape and let the casualty breathe easier.

If a casualty becomes unconscious or his breathing rate drops below two respirations every 15 seconds, insert a nasopharyngeal airway. Monitor the casualty's wounds. If a tourniquet has been applied, make sure that arterial bleeding is controlled. If a pressure dressing is not controlling arterial bleeding, consider applying a tourniquet.

IS0871 COMBAT LIFESAVER COURSE: STUDENT SELF-STUDY

Reinforce dressings, if needed. Recheck your interventions every time you move the casualty. If medical help is not available, prepare the casualty for evacuation. Prepare the casualty so that he is protected from becoming chilled during transport. Initiate a DD Form , U. Attach the card to the casualty's clothing or place it in a pocket, as appropriate see Lesson 7.

This will provide medical personnel with a history of the casualty's injury and treatment. Use the radio to make a request for medical evacuation Lesson 8 , if appropriate. A medical evacuation vehicle ground or air ambulance will have medical personnel to care for the casualty during transport. If the casualty is to be transported by nonmedical means, prepare a litter, if appropriate Lessons 9 and Use a nonmedical military vehicle to transport the casualty to a medical treatment facility or collection point, if possible.

Perform additional care open the airway, insert a nasopharyngeal airway, perform needle chest decompression, and so forth as needed. Monitor wounds and take measures to control additional bleeding. Reinforce existing dressings with additional dressings and bandages as needed. If possible, rinse amputated part free of debris, wrap it loosely in saline- moistened gauze, seal the amputated part in a plastic bag or cravat, and place it in a cool container.

Do not freeze the amputated part. Do not place amputated part in water. Do not place the amputated part directly on ice. Do not use dry ice to cool the amputated part. Do not place the amputated part so that it is in view of the casualty. If you are to be the leader of a litter team, position yourself at the casualty's left shoulder.

This is the best position to monitor the casualty while transporting the casualty by litter. The litter bearers position themselves with the knee nearest the litter on the ground and grasp the litter handles figure A. Upon command of the leader, the four litter bearers lift the litter in unison figure B.

Upon command of the leader, the bearers move forward in unison and move the casualty to the aid station or collection point. Four-person litter squad leader at casualty's right shoulder. A Squad preparing to lift the litter. B Squad after lifting the litter and prepared to move forward. You are crossing a battlefield after the fighting has stopped and the enemy has retreated. A soldier steps on a land mine and it explodes, giving the soldier a severe wound in his thigh.

What type of care will you render the solder? A soldier in your squad has been injured. You are in a tactical field care situation. When should you notify your unit leader of the soldier's injury? As soon as you can. Only after you have performed a full examination of the casualty.

Only after you have completed your treatment of the casualty. Only if the casualty requires evacuation. You see a soldier sitting on the ground. Unable to tell without examining his ankle. When evaluating a casualty in a tactical field care setting, what position should the casualty be in?

On his back supine. On his chest prone. Lying on his injured side. Lying on his uninjured side. You are going to turn a casualty from a prone position to a supine position. Which of the following is a correct procedure? Use one hand to support the casualty's head and neck. With your free hand, grasp the casualty's clothing under the near arm. Then push steadily and roll away from you and onto his back.

Then pull steadily and roll the casualty toward you and onto his back. Use one hand to support the casualty's knees. You have turned a casualty onto his back. What should you do with his arms? Position both arms above his head. Position the near arm above his head and the other arm at his side. Position the near arm at his side and the far arm above his head.

Position both arms at his sides. Position both forearms on his chest. An unconscious casualty is breathing on his own and appears to have no other injuries. Which of the following should you treat first if you and the casualty are in a protected area? Severe arterial bleeding from a limb. Breathing difficulties with a penetrating chest wound. A casualty has a cut on his arm with heavy bleeding. Apply an Emergency Bandage from your aid bag. Tape an airtight seal over the wound. The look-listen-feel method is used to: See if the casualty is in shock.

Approximate the amount of blood loss. Test the casualty's level of consciousness. Determine if the casualty is breathing. Why must a penetrating chest wound be sealed? To keep air from entering through the wound. To keep air from escaping through the wound. The casualty has severe bleeding from a head wound. Should you apply a tourniquet to control the bleeding? You are treating a soldier with a fractured bone in the forearm.

The sharp end of the broken bone has pierced the skin and is sticking out through the wound. Should you attempt to force the bone back into alignment before applying a splint? You are applying a splint to a casualty's limb. Which of the following is a general rule to follow? Apply one cravat above the fracture and one cravat below the fracture.

Apply two cravats above the fracture and two cravats below the fracture. Immobilize the joint above the fracture. Immobilize the joint below the fracture. Immobilize the joint above the fracture and the joint below the fracture. Which of the following is true concerning a casualty with an injured thigh? Apply a splint only if the bone is fractured. Apply a splint if the thigh has a massive injury even if the bone is not fractured. What is in the combat pill pack that you and other soldiers may carry in combat?

You are going to administer a combat pill pack to a casualty. A pack from your aid bag. You have controlled the bleeding from a wound on the casualty's thigh. The casualty lost a good deal of blood. Also, the casualty's skin appears to be pale, cool, and clammy. His is breathing faster than normal and he is acting agitated. The casualty is probably suffering from: In most cases, the casualty's legs are placed on a stable object so that his feet are slightly higher than the level of his heart to help control shock.

In which of the following circumstances would another position be used? The casualty has an open abdominal wound. The casualty has an open chest wound. Either of the above. You have controlled the bleeding to a casualty with a severe wound to the leg and immobilized the leg. The casualty has been placed on a litter and will be evacuated by air ambulance. What else can you do to help the casualty?

You have applied a tourniquet to a casualty. Should you cover the tourniquet with a blanket, poncho, or similar material to protect it from contamination by dirt and dust? What Department of Defense document is used to record the care given to a casualty in the field? How does evaluation and treatment of a casualty in a tactical field care situation not under enemy fire differ from that in a care under fire situation?

You are accompanying an unconscious casualty during evacuation. Monitor the casualty's breathing. Monitor bleeding from the casualty's wounds. Reinforce dressings, as needed. All of the above. Insert a nasopharyngeal airway Place the casualty in the recovery position on his side paras d 1 , e 8.

Pain medications and antibiotics, para 1 Cover the casualty to keep him from being chilled. Loosen any binding clothing. DD Form , U. A tactical field care environment allows you to focus more on the evaluation, treatment, and evacuation of the casualty. While underfire, you are limited only to the treatment of life-threatening bleeding from a limb and movement to safety.

Additional injuries to the casualty are prevented. Bleeding hemorrhaging from an extremity can usually be controlled by applying a dressing and bandage, applying manual pressure, elevating the injured limb, and applying a pressure dressing. An Emergency Bandage serves as a dressing and bandage. It can also as a pressure dressing. If the casualty is bleeding from a limb and these methods do not control the bleeding, then a tourniquet must be applied to stop the loss of blood from the limb.

In an amputation of the arm, forearm, thigh or leg, a tourniquet is applied immediately since the other measures are inadequate to control the bleeding. In combat while under enemy fire, a rapidly applied tourniquet is the initial method used to control life-threatening bleeding from a limb. Once you and the casualty are in a safe location, you can reevaluate the tourniquet. This will enable you to better view the extent of the injury. Scissors, strap cutter, or a knife can be used to cut clothing. In the care under fire phase, do not take time to expose the wound.

Clothing or anything else stuck to the wound should be left alone to avoid further injury. Cut or tear around the stuck material so that the stuck material remains undisturbed. Do not attempt to clean the wound. Apply dressings over the protective clothing. A missile may have entered at one point and exited at another point.

The exit wound is usually larger than the entrance wound. If there is an entrance wound and an exit wound, both wounds need to be dressed and bandaged. If the missile such as a bullet or shrapnel lodges in the body fails to exit , do not attempt to remove the missile or probe the wound. If there is an object extending from impaled in the wound, do not remove the object. Apply a dressing around the object and use additional improvised bulky dressings made from the cleanest material available to build up the area around the object.

This will stabilize the object and help to prevent further injury. Apply a supporting bandage over the bulky materials to hold them in place. It can be used both as a field dressing and as a pressure dressing. Follow the procedures below when applying the Emergency Bandage to a wound on the casualty's extremity. Figure shows the Emergency Bandage applied to a forearm. Figure shows Emergency Bandages applied to various other wounds. Emergency Bandage packet opened with contents. If possible, put on examination gloves found in the soldier's Improved First Aid Kit and in the combat lifesaver aid bag to reduce contamination.

Use the gloves in the casualty's Improved First Aid Kit, if possible. Place the pad dressing directly on the wound. Wrap the elastic bandage around the wounded extremity figure A. Insert the elastic bandage completely into the pressure bar figure B. Pull the elastic bandage back over the top of the pressure bar reversing direction forces the bar down onto the pad figure C.

Wrap the elastic bandage tightly over the pressure bar. Continue to wrap the elastic bandage around the limb so that all edges of the pad are covered figure D. Secure the hooking end of the closing bar into the elastic bandage figure E. The bandage is now secure. Wrap bandage around B. Insert bandage into C. Pull bandage over top pad. Wrap bandage to seal the edges of the pad. Applying an Emergency Bandage to a wound on the forearm. Emergency Bandages applied to other injuries. This material is a pro-coagulant and will cause blood to clot when it comes into contact with the blood.

This action, along with the pressure of packing it into a bleeding wound and applying manual pressure, causes the wound to stop bleeding. Combat Gauze is used for serious arterial bleeding. Instructions for applying the Combat Gauze are given below. Use the casualty's Combat Gauze first.

Open the clothing around wound. If possible, remove any excess pooled blood from the wound while preserving any clots already formed in the wound. Locate the source of most active bleeding. Pack the Combat Gauze tightly into wound and directly onto the source of the bleeding. More than one Combat Gauze may be required to stem the blood flow. Combat Gauze may be repacked or adjusted into the wound to ensure proper placement. Quickly apply manual pressure until the bleeding stops. It is recommended that you apply continuous pressure for three minutes.

Reassess for proper and effective placement. Apply a pressure bandage to the wound to secure the Combat Gauze in the wound. This pressure will help to compress the damaged blood vessels and control the bleeding. Maintain this pressure for 5 to 10 minutes. If the casualty is conscious and can follow instructions, you can have him apply the manual pressure himself. If an Emergency Bandage has been applied, tighten the bandage to form a pressure dressing.

Otherwise, apply an improvised pressure dressing. The following instructions assume that an improvised pressure dressing is being applied after the lower limbs have been elevated to help prevent shock. The Emergency Bandage paragraph can be used both as a field dressing and as a pressure dressing. Place a wad of padding on top of the dressing and directly over the wound figure A. The wad can be made from a folded muslin bandage cravat from your aid bag, a rag, material torn from clothing, or other material that can be folded several times.

Place a cravat over the wad of padding figure B and wrap the cravat tightly around the limb over the dressing figure C. Other materials, such as a handkerchief, sock, or strip of cloth torn from a shirt, can also be used. Tie the ends of the cravat in a nonslip knot to secure the wad of padding figure D. Tie the nonslip knot directly over the wound. The cravat should be tight enough so only the tip of one finger can be inserted under the cravat. Do not tie the cravat so tight that it cuts off blood circulation.

The pressure on the wad of dressing helps to restrict the blood vessels and control the bleeding. Check the circulation below the pressure dressing. If the skin below the pressure dressing becomes cool to the touch, bluish, or numb, or if the pulse below the pressure dressing is no longer present, the pressure dressing may be too tight.

If circulation is impaired, loosen and retie the cravat. If circulation is not restored, evacuate the casualty as soon as possible. The pressure dressing can be loosened and retied without disturbing the blood clot forming under the dressing pad. IS B A. Applying a wad on top of the dressing.

Placing an improvised cravat over the wad. Wrapping the ends of the cravat around the limb. Nonslip knot tied over the wound. Applying an improvised pressure dressing, e. Apply manual pressure over the pressure dressing. If applying digital pressure is not possible or does not control the bleeding, apply a tourniquet as described in Section II. If the bleeding appears to be controlled, continue to check the distal end of wounded extremity fingers or toes periodically to ensure that adequate blood circulation is maintained. If the area below the dressing becomes cool, blue, or numb, loosen and reapply the pressure dressing.

If this does not restore circulation, evacuate the casualty as soon as possible. This method uses pressure from the fingers, thumbs, heel of the hand, or knee to press at the site or point where a main artery supplying the wounded area lies near the skin surface or over bone see figure This pressure may help shut off or slow down the flow of blood from the heart to the wound. Two pressure points are discussed below.

Digital pressure is used to control severe bleeding of the lower part of the arm and elbow. Digital pressure is used to control severe bleeding of the thigh and lower leg. Lean forward to apply pressure. Applying digital pressure to various pressure points. IS Section II. A tourniquet is only used on an arm, forearm, thigh, or leg when there is a danger of the casualty bleeding to death. Wound on an Extremity. Bleeding from a major artery of the thigh, lower leg, arm, or forearm and bleeding from multiple arteries may prove to be beyond control by the methods discussed in Section II. If you have applied a pressure dressing and firm hand pressure, but the dressing has become soaked with blood and the wound continues to bleed, apply a tourniquet.

The tactical situation may not allow the time or safety for conventional methods of controlling the bleeding if you are under fire. The recommended means to control bleeding while underfire is a rapidly applied tourniquet. Tourniquets may be left in place for two hours without major complications. REMEMBER If you are unable to control bleeding except with a tourniquet, it is better to sacrifice a limb than to lose a life due to excessive bleeding. Both require a tourniquet.

Both involve bleeding from multiple arteries and are beyond control by the methods discussed in Section II. However, bleeding will start when the blood vessels relax or if the clot is knocked loose while moving the casualty. It is effective and can be applied quickly. Procedures for applying the CAT are given below. The Combat Application Tourniquet in figure is shown in its one-handed application configuration. The CAT is delivered in this configuration and is the recommended storage configuration. The Combat Application Tourniquet. The one-handed application is normally used when the CAT is applied to the upper extremity upper arm or forearm.

Applying the CAT using the one-handed application. IS 4 Pull the band tight and securely fasten the tourniquet band back on itself figure B. Do not adhere the tourniquet band past the rod-locking clip. Continue tightening until the bright red arterial bleeding has stopped and the distal pulse is eliminated. The darker bleeding from the veins may continue draining for a while. The CAT is now properly applied and the casualty is ready for transport. If the casualty is not to be transported at this time, check the tourniquet periodically.

The two-handed application is normally used for the lower extremity when greater pressure is needed to stop the bleeding. The two- handed application is always used when the tourniquet is applied to the casualty's thigh.

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The two-handed application is also used if the tourniquet band has become dirty since the friction buckle locks the band in place and help to prevent loosening during transportation. The CAT friction buckle is used with the two-handed application, but is not normally used with the one-handed application. The friction buckle will lock the tourniquet band in place. Applying CAT using two-handed configuration. IS 5 Pull the tourniquet band until it is very tight and securely fasten the tourniquet band back on itself figure C.

When the tourniquet band is pulled tight and secured, no more than three fingers will fit between the tourniquet band and the limb. The darker bleeding from the veins may continue for a while. Do not remove the first tourniquet. Storing the Combat Application Tourniquet. Follow the following procedures if you need to store an opened Combat Application Tourniquet. Placing the CAT in the one-handed configuration for storage. An improvised tourniquet is used with a rigid stick-like object to act as the windlass rod. To minimize skin damage, ensure that the improvised tourniquet is at least two inches wide.

Gather Materials for Making a Tourniquet. You need a band of strong, pliable material that is at least two inches wide when folded and will retain this width after being tightened. Page 1 of 1 Start over Page 1 of 1. How to Be an Imperfectionist: What do depression, procrastination, and low self-esteem have in common? Become an imperfectionist with 26 specialized mini habits.

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A nasopharyngeal air is inserted to maintain the casualty's airway as part of: Both care under fire and tactical field care. What is in the combat pill pack that you and other soldiers carry in combat? A casualty has a significant wound to his leg.

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The casualty is coherent and has a palpable radial pulse. The wound has been dressed and the bleeding is controlled. What should you do now? Nothing, unless the casualty looses consciousness. Initiate a saline lock. Initiate a saline lock and begin administering intravenous fluids. Why must a penetrating chest wound be sealed? To keep air from entering through the wound.

To keep air from escaping through the wound. You are going to administer a combat pill pack to a casualty. A pack from your aid bag. You are accompanying an unconscious casualty during evacuation. The casualty has an IV. Monitor the casualty's breathing.

Army Institute for Professional Development (AIPD) at the following: Address: Army Interschool Subcourse , Combat Lifesaver Course: Student Self- Study, contains equipment (if used) and evacuated the casualty using a drag, manual. Full text of "Combat Lifesaver Course: Student Self-Study Interschool Address: U.S. Army Medical Department Center and School Department of Combat . REFERENCES STP SMCT, Soldier's Manual of Common Tasks: Skill Level 1.

Monitor bleeding from the casualty's wounds. Monitor the casualty's IV. All of the above. Return fire para c 3 6. Tourniquet para d 2 7. Play dead para c 3 8. Pain medication and antibiotics para j FM , First Aid. WARNING If there are any signs of nerve agent poisoning, stop the evaluation, take the necessary nuclear, biological, and chemical NBC protective measures, and then resume appropriate first aid measures. Remember to protect yourself. Scan the area for potential danger.

Determine the best route of access to the casualty and the best route of egress. If you need to move the casualty to a safer area, be sure to select an area that provides optimum cover and concealment. Plan your evacuation route prior to exposing yourself to possible hostile fire. Request covering fire during movement to and from the casualty's location to reduce the risk to yourself and the casualty.

Anticipate the type of injuries the casualty may have received and what care will probably be needed. Did the casualty fall from a wall? If so, the casualty may have broken bones. Was there an explosion? If so, the casualty may have blast effects. Was there only small arms fire? If so, the casualty may have bleeding wounds. Anticipate how your actions movement, noise, light, and so forth may affect the enemy's fire. Decide what care you can administer to the casualty when you reach him and what care will have to wait until you have returned the casualty to a place of safety INITIAL ACTIONS Remember, if you and the casualty are still under effective hostile fire, return fire as directed or required.

Do not expose yourself to enemy fire in order to provide care. If possible, determine if casualty is alive or dead. Reducing enemy fire may be more important to the casualty's survival than the treatment you can provide. When the combat situation allows you to safely assist the casualty: To check the casualty for responsiveness: Gently shake or tap the casualty on the shoulder.

See paragraph c of Lesson 1 for additional information. If the casualty is alert or responds to voice, do not check the casualty's response to pain. To check a casualty s response to pain, rub his breastbone briskly with a knuckle or squeeze his first. If the casualty is conscious, ask where it hurts or where his body feels different than usual. This helps to determine the level of responsiveness and provides you with information that can be used when treating the casualty.

If the casualty is unconscious, position the casualty and open his airway Lesson 3. Opening his airway may result in the casualty's level of consciousness being upgraded. To turn a casualty onto his back, perform the following steps. Kneel beside the casualty with your knees near his shoulders, leaving space to roll the body. Raise the casualty's arm that is nearest to you above the casualty's head.

Adjust the casualty s legs so that they are together and straight or nearly straight. Place one of your hands under the back of the casualty's head and neck for support. With your free hand, reach across the casualty's back and grasp the casualty under the arm far armpit area. Pull steadily and evenly toward yourself, keeping the head and neck in line with the torso.

Once the casualty is rolled onto his back, place his arms at his sides. It is assumed that you and the casualty are in a protected area. If you are still exposed to enemy fire, apply a tourniquet to control any severe bleeding and move the casualty and yourself to a safe location before checking for breathing.

If the casualty is conscious and talking, his breathing is satisfactory for now. However, continue to monitor the casualty's breathing since swelling throat tissue, bleeding into the throat, or other injuries could require you to establish an airway and perform rescue breathing. Look, listen and feel for respirations. If the casualty is breathing, determine if the breathing rate is normal, rapid, or slow. Look at the casualty's chest to see if it is rising and falling. Feel for air being exhaled.

If the casualty is not breathing, stop the evaluation to restore the airway. In a combat situation, if you find a casualty with no signs of life no breathing and no pulse , do not attempt to restore the airway. Do not attempt to perform cardiopulmonary resuscitation. Do not continue first aid measures. If the casualty has less than two respirations during the 15 seconds, a nasopharyngeal airway may be required. Expose the casualty s chest to look for equal rise and fall of the chest and for wounds.

Check for entrance and exit wounds to the chest. If an entrance wound and an exit wound are present, both must be sealed. Look for blood-soaked clothes. Look for entry and exit wounds. Place your hands behind the casualty s neck and pass them upward toward the top of the head. Note whether there is blood or brain tissue on your hands from the casualty s wounds. Place your hands behind the casualty s shoulders and pass them downward behind the back, thighs, and legs. Note whether there is blood on your hands from the casualty s wounds.

If life-threatening bleeding from an extremity arm, forearm, thigh, or leg is present, stop the evaluation and control the bleeding using a tourniquet see Lesson 5.

After any needed immediate live-saving aid has been administered, move the casualty to an area where additional aid can be given. If possible, send a soldier to find a combat medic. Administer additional care until the combat medic arrives or until you are told to resume your combat duties. Now that you are in a safe area, you can render care that you could not administer while under fire. When the combat medic arrives, he may require your assistance, especially if several soldiers require treatment.

Show confidence in your actions.

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If you have administered the needed care and a combat medic has not arrived, initiate a Field Medical Card for the casualty see Lesson 7. As discussed in Lesson 1, the three primary preventable causes of death from injury on the battlefield are: Listed below are some situations in which you should avoid treating the casualty while under fire. Examples of such injuries are: You are going to the aid of an injured soldier. You are under fire. What should be your first action.

Scan the area for possible dangers. Check the soldier's pulse. Check the soldier for breathing. Check the soldier for bleeding. The casualty is lying on his back. You see a penetrating wound to the front of a casualty s chest. Which of the following is true? You only need to seal the visible chest wound. You need to check for both entrance and exit wounds to the chest and seal both. When should you plan how to move a wounded soldier out of enemy fire? Before you leave your place of safety to go to the wounded soldier.

As soon as you reach the wounded soldier. As soon as you have treated the life-threatening conditions. As soon as you have treated all of the casualty's injuries. You have reached a wounded casualty under fire. The casualty has a penetrating chest wound, is not breathing, and is making no effort to breathe. Which of the following is the proper procedure? Begin performing cardiopulmonary resuscitation. Seal the chest wound s. Move the casualty to a place of safety.

Do not try to treat the casualty. You are determining the casualty's level of responsiveness. The casualty tells you that he has been shot. Should you test the casualty's responsiveness to pain? Yes, a full testing is required. No, you already have sufficient information to make a determination that the casualty is alert. When evaluating a casualty, the casualty should be in what position? On his back supine.

On his chest prone. Lying on his injured side. Lying on his uninjured side.

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Which of the following should you treat first if exposed to enemy fire? Breathing difficulties with a penetrating chest wound. Which of the following should you treat first if you and the casualty are in a protected area? How does evaluation and treatment of a casualty in a secure situation differ from that in a combat under fire situation?

What are the three principal preventable causes of death on the battlefield? What are three situations in which you would not treat a casualty? Practice performing evaluations on a simulated casualty. In a secure environment, the enemy situation will not be a factor. This will allow you to focus more on the evaluation, treatment,and evacuation of the casualty para c Severe bleeding from an arm or leg wound.

Collapsed lung tension pneumothorax. Blockage of the nose and throat from an injury to the face. There are other casualties in the area who require treatment more urgently. The casualty does not have vital signs. The casualty s injury is not survivable. Your combat duties do not allow you to treat the casualty. You should have perform the steps in the following checklist in the sequence given. You have spotted a casualty simulated. Your area is under fire. The casualty is lying in a prone position.

Combat Lifesaver Medical Equipment Set. Forms an impression of the casualty's condition. Positions the casualty on his back. Checks the casualty for breathing. Checks the casualty for bleeding. Sends a soldier to get medical help. Describes situations where first aid would not be administered. Return to Table of Contents IS. Additional injuries to the casualty are prevented.

You must be in a situation in which you and the casualty are not under hostile fire before treating breathing problems. If you are under enemy fire, quickly move yourself and the casualty to a location where you can safely administer measures to restore breathing. See Lessons 1 and 2. Ask in a loud, but calm, voice: Also, gently shake or tap the casualty on the shoulder. Kneel beside the casualty. Place one of your hands under the casualty's head and neck.

Roll the casualty as a single unit. The head and neck should stay in line. This relaxation may cause the casualty's tongue to slip to the back of his mouth and block his airway. Removing the blockage and opening the airway may allow the casualty to resume breathing on his own. If you suspect that the casualty has suffered a neck or spinal injury, use the jaw thrust method. Even if the casualty is still breathing, positioning the airway will allow him to breathe easier.

If you see something in the casualty's mouth such as foreign material, loose teeth, dentures, facial bone, or vomitus that could block his airway, use your fingers to remove the material as quickly as possible. Do not use this method if a spinal or neck injury is suspected. The mouth should not be closed as this could interfere with breathing if the nasal passages are blocked or damaged.