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47 Cards in this Set
- Front
- Back
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Nine general first aid rules
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Get organized
Do not move the patient unless they are in danger ABCs - brain damage occurs within 4-6 minutes Examine for fractures Expose by removing enough clothing to get an idea of the extent of injury Keep victim reassured and comfortable to ensure confidence in your ability Stay as sterile as possible Unless contraindicated place pt in recovery position Carry a litter patient feet first |
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Triage
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French word meaninf sort
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Sorting for Tactical Treatment
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Class I walking wounded
Class II injuries require immediate life sustaining measures. Initially require minimum amount of time. Class III Definative treatment can be dleayed without jeopardy to life or loss of limb Class IV Expectant |
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Sorting for Nontactical treatment
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Priority I life threatening injuries
Priority II serious but not life threatening injuries such as moderate blood loss, open or multiple fractures Priority III walking wounded Priority IV dead or fatally injured |
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Primary Survey
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Treat as you go. A rapid initial assessment to detect and treat life threatening conditions that require immediate care. Concerned with ABCDEs.
Airway Breathing Circulation Disability Expose As soon as ABCDE process is completed, you will need to make a status decision of the patient's condition. |
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What is a status condition?
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A judgement call about the severity of the patient's condition and wether the patient requires immediate transport to a medical facility without a secondary survey at the scene.
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Secondary Survey
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Head to toe exam. Complete and detailed exam consisting of a subjective interview and objective exam including vitals.
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Signs and symptoms of shock
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- Restlessness and apprehension are early symptoms, often followed by apathy.
- Eyes may be glassy and dull. Pupils may be dilated. (These are also the symptoms of morphine use.) - Breathing may be rapid or labored, often of the gasping, for air hunger, type. In the advanced stages of shock, breathing becomes shallow and irregular. - The face and skin may be very pale or ashen gray; in the dark complexioned, the mucous membranes may be pale. The lips are often cyanotic. - The skin feels cool and is covered with clammy sweat. The skins coolness is related to a decrease in the peripheral circulation. - The pulse tends to become rapid, weak, and thready. If the blood pressure is severely lowered, the peripheral pulse may be absent. The pulse rate in hemorrhagic shock may reach 140 or higher. In neurogenic shock, however, the pulse rate is slowed, often below 60. - The blood pressure is usually lowered in moderately severe shock; the systolic pressure drops below 100, while the pulse rises above 100. The body is compensating for circulatory fluid loss by peripheral vasoconstriction. This process tends to maintain the blood pressure at a nearly normal level despite a moderately severe loss of circulating blood volume. A point comes, however, when decompensation occurs, and a small amount of additional blood loss will produce a sudden, alarming fall in blood pressure. - There may be nausea, vomiting, and dryness of the mouth, lips, and tongue. - Surface veins may collapse. - There are frequent complaints of thirst. - The kidneys may shut down. Urine formation either ceases or greatly diminishes if the systolic blood pressure falls below 80 for long periods of time. - The person may faint from inadequate venous blood return to the heart. This may be the result of a temporary gravitational pooling of the blood associated with standing up too quickly. |
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How to control hemorrhage
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Pressure dressing - the best way to control external bleeding is by applying a compress and exerting pressure directly to the wound.
Pressure points - the spot where the main artery to an injured part lies near the skin surface and over a bone. There are 11 principle points on each side of the body, 22 total. It can seldom be maintained for more that 15 min. Tourniquets - used only as a last resort. Use any long flat material. do not use rope, wire, string or very narrow pieces of cloth because they cut into the flesh. Removed only by doctors. |
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Head wounds
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Never give any medications
Keep victum lying flat with head at level of the body. Do not raise the feet if face is flushed. If wound is in the back of head, turn patient on his side. Do not use direct pressure to control hemorrhage if the skull is depressed or obviously fractured. |
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Facial wounds
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Apply sterile compress and hold it in place with a firm bandage.
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Chest wounds
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Most serious injury that requires immediate attention is a sucking chest wound. Victims with open chest wounds gasp for breath, have difficulty breathing out and may have a bluish skin color to their face. Frothy-looking blood may bubble from the wound during breathing. Immediately seal the wound with any airtight material available. If patients condition suddenly deteriorates when you apply the seal, remove it immediately. Place patient in Fowler's or semi-Fowlers position. During combat, lay patient on stretcher o the affected side. Do not give anything to drink.
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Abdominal wound
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Do not attempt to push the intestines back in or to manipulate them in anyway. If bleeding is severe, try to stop it by applying direct pressure. If intestines are exposed, apply a sterile compress moistened with sterile water. Do not give anything to drink.
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Open fracture
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Open wound in the tissues and skin. Can be caused by the sharp end of a broken bone pushing through the flesh or by an object penetrating form the outside.
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Closed fracture
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Injury is internal, there is a break in the bone but not the skin
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Upper arm fracture
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Do not attempt to straighten or move it in any way. Spint in the position you find it in.
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Forearm fracture
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When the radius and ulna are both broke, the ar usually appears to be deformed. When only one bone is broke the other acts as a splint. Apply 2 well padded splints to the forearm, one on top and one on bottom. Put the forearm across the chest, palm turned in, with thumb pointing upward. Hand should be raised 4 inches above the elbow.
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Lower leg fracture
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Apply three splints, one on each side of the leg and one underneath.
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Thigh Fracture
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Femur fracture, limb is usually assumes an unnatural position, with the toes pointing outward. Fractured leg is shorted than the other. Apply 2 splints. One outside the injured leg from the armpit to the foot and one on the inside from the crotch to the foot. Fasten in 5 places, around ankle, over knee, just below hip, around pelvis and below armpit.
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Clavicle fracture
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When the patient stands, the injured shoulder is lower than the uninjured one. Figure of eight bandage may be used.
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Rib fracture
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Swathe arm on affected side to chest. Do not apply adhesive directly to skin for immobilization.
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Burns
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The seriousness of the injurt can be estimated by depth, extent, and location, the age and health of patient and other medical complications.
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First degree burns
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Involves epidermial layer that becomes irritated, reddened and tingling. Healing usually occurs naturally within a week.
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Second degree burns
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Epidermal blisters, mottled appearance, and a red base. Damage extends into but not through dermis. Recovery usually takes 2 to 3 weeks. Weeping fluid loss at surface.
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Third degree burns
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A full thickness injury penetrating into muscle and fatty connective tissues or even down to the bone. Tissue color will range from white (scalds) to black (charring).
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First aid for burns
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Maintain open airway
Remove constricting jewelry and articles of clothing Cover with clean sheets Do not remove clothing adhering to skin For all serious burns over 20 percent BSA and in the presence of shock start IV therapy eith LR in an unburned area Relieve mild pain with aspirn. Moderate pain with cool, wet compresses or ice water immersion (for burns less than 20% BSA) Severe pain may be relieved with morphine or demerol injections. |
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Aid station care of burns
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Give a booster dose of tetanus to all major burn patients.
Apply 1/16 inch thickness of Sulfamylon or Silvadene. |
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Heat cramps
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Excessive sweating may result in painful cramps in the muscle of the abdomen, legs, and arms. May also result from drinking ice water or other cold drinks either too quickly or in too large a quantity after exercise. Move the patient to a cool place. Caused by a loss of salt and water, give plenty of cool water, adding one teaspoon of salt to a liter or quart. Apply manual pressure to cramped muscle, or gently massage to relieve spasm.
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Heat exhaustion
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Most common condition caused by working or exercising in a hot environment. The vital signs usually are normal; however, the victim may have a weak pulse, together with rapid and shallow breathing. Body temperature may be below normal. Treat heat exhaustion as if the victim were in shock. Move the victim to a cool or air-conditioned area. Loosen the clothing, apply cool wet cloths to the head, axilla, groin, and ankles, and fan the victim. Do not allow the victim to become chilled. If the victim is conscious, give a solution of 1 teaspoon of salt dissolved in a liter of cool water. Intravenous fluid infusion may be necessary for effective fluid and electrolyte replacement to combat shock.
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Heat stroke
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Carries a 20% mortality rate. Most important feature is extremely high body temp 105 degrees F/41 degrees C or higher. Immerse in cold water bath. Do not give hot drinks or stimulants. Discontinue cooling when temp reaches 102 degrees F. Repeat cooling if temp reaches 103 degees F rectally.
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Hypothermia
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First sign is shivering.
Replace wet or frozen clothing and remove anything that constricts arems, legs, fingers or interfering with circulation. Immersion in tub of warm water 100 to 105 degree F. Buddy warming Give warm liquids, never give alcoholic beverages or allow pt to smoke. |
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Immersion foot
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Prolonged exposure to to wet cold at temp ranging from jusr above freezing to 5 degrees F. Swelling of the legs, feet, or hands, bluish discoloration of skin, painful blisters, Gangrene may occur.
Remove wet shoes, socks. and gloves to imorve circulation. Do not rupture blisters or apply salves and ointments. |
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Frostbite
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Exposure to temps of 32degrees or lower.
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Superficial Frostbite
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Surface of skin will feel hard, but the underlying tissue will be soft, allowing it to mive over bony ridges.
Rewarm habds by placing them under the armpits, against the abdomen or between the legs. |
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Deep Frostbite
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Freezing reaches into the deep tissue layers. Ice crystals in the entire thickness of extremity. Skin will not move over bony ridges ans will feel hard and solid.
Do not attempt to thaw area if there is a possibility of refreezing. Treat all pts with injuries to the feet and legs as litter pts. Rapidly rewarm by immersion in water at 100 to 105 degrees F. |
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Water purification under field conditions using iodine tablets
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Remove the cap from your canteen and fill the canteen with the cleanest water available.
- Put one tablet in clean water. - Put two tablets in the canteen of cloudy water. NOTE: Double the amount if you have a 2-quart canteen. - Replace the cap and wait 5 minutes. - Shake the canteen. - Loosen the cap and tip the canteen over to allow leakage around the canteen threads. - Tighten the cap and wait another 25 minutes before drinking or a total of 30 minutes. |
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Water purification under field conditions using calcium hypochlorite
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Fill the canteen with the cleanest water available. Leave airspace of 1 inch or more below the neck of the canteen
-Fill a canteen cup half full of water and add the calcium hypochlorite from one ampule. Stir with a clean stick until the powder is dissolved. -Fill the cap of a plastic canteen half full of the solution in the cup. -Add it to the water in the canteen. -Place the cap on the canteen. Shake it thoroughly. -Loosen the cap slightly and invert the canteen. Let the treated water leak onto the threads around the neck of canteen. -Tighten the cap on the canteen and wait at least 30 minutes before using the water for drinking or cooking. |
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Water purification under field conditions boiling water
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Hold at a rolling boil for at least 15 seconds to make it safe for drinking.
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Dig a cat hole
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1 foot wide by 1 foot deep
Used when on the march |
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Dig a straddle trench
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Approx 4 foot long, 2 1/2 feet deep and 1 foot wide
1 to 3 day bivouac sites |
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Fireman's carry
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Properly position the unconscious or disabled casualty.
Roll the casualty onto his or her abdomen. Kneel at the casualty’s uninjured side. Place the casualty’s arms above his or her head and cross the ankle farther from you over the one closer to you. Place one of your hands on the shoulder farther from you and your other hand in the area of the casualty’s hip or thigh, then gently roll the casualty toward you onto his or her abdomen. Raise the casualty from the ground. After rolling the casualty onto his or her abdomen, straddle him or her. Extend your hands under casualty’s chest and lock them together. Lift the casualty to his or her knees as you move backward Continue to move backward, thus straightening the casualty's legs and locking his or her knees. Walk forward, bringing the casualty to a standing position but tilted slightly backward to prevent his or her knees from buckling. Free your left arm, maintaining support of the casualty with your right arm. Quickly grasp his left wrist and raise his or her arm high. Instantly pass your head under the casualty’s raised arm, releasing his or her arm as you pass under it. Move swiftly to face the casualty and secure your arms around his or her waist Immediately place your right toe between the casualty’s feet, and spread his or her feet 6 to 8 inches apart. With your right hand, grasp the casualty's left wrist and raise his or her arm over your head. Bend at the waist and knees; then pull the casualty's arm over your left shoulder and down your back, thus bringing his or her body across your shoulders . At the same time, pass your left arm between his or her legs. Place the Marine's left wrist in your left hand, and place your right hand on your right knee for support in rising. Rise with the casualty in the correct position Free your right hand to use as needed. |
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One man support carry
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Raise the casualty from the ground as in the fireman's carry.
With your left or right hand, grasp the casualty's left or right wrist and draw his or her arm around your neck. Place your right or left right arm around his or her waist. (The casualty is now able to walk, using you as a crutch.) |
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One man arms carry
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Lift the casualty from the ground as you would in the fireman's carry.
Carry the casualty high to lessen fatigue. |
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Saddleback carry
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Raise the casualty to an upright position as in the fireman's carry.
Support the casualty by placing an arm around his or her waist, and move in front of him or her. Have the casualty circle his or her arms around your neck. Stoop, raise the casualty upon your back, and clasp your hands beneath his or her thighs. |
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Pack strap carry
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Lift the casualty from the ground as in the fireman's carry.
Supporting the casualty with your arm around him or her, grasp his or her wrist closest to you, and place his or her arm over your head and cross your shoulder. Move in front of the casualty while supporting his or her weight against your back. Grasp his or her other wrist, and place this arm over your shoulder Bend forward, and hoist the casualty as high on your back as possible so that all his or her weight is resting on your back |
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Pistol belt carry
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Link together two pistol belts to form a sling.
NOTE: If pistol belts are not available, use other items such as one rifle sling, two cravat bandages, two litter straps, or any suitable material that will not cut or bind the wounded Marine. Place the sling under the casualty's thighs and lower back so that a loop extends from each side. Lie between the casualty's outstretched legs Thrust your arms through the loops; grasp the casualty's hand and trouser leg on his or her injured side. Roll toward the casualty's uninjured side onto your abdomen, bringing the casualty onto your back. Adjust the sling as necessary. Rise to a kneeling position. The belt will hold the casualty in place Place one hand on your knee for support and rise to an upright position. NOTE: Your shoulders now support the casualty. Carry the casualty so that your hands will be free to fire your rifle, climb banks, or to surmount obstacles |
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Improvise a stretcher with a poncho and poles
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Open the poncho and lay the two poles (or limbs) lengthwise across the center. Reach in, pull the hood toward you and lay it flat on the poncho.
Fold the poncho over the first pole Fold the remaining free edge of the poncho over the second pole Improvise a stretcher with poles and jackets. Button two or three shirts or jackets and turn them inside out, leaving the sleeves inside. Pass the poles through the sleeves of the shirts or jackets. Cut holes in both shoulders of the shirts or jackets. Button or zip the two shirts or jackets. Push poles through the holes. Improvise litters made by inserting poles through sacks or by rolling a blanket |
