- May 30, 2016
For all procedures, start with DR's ABC.
D) Danger, is the area around the patient (pt) dangerous? If yes, make the area as safe as possible to approach the pt then try and move them to a safe location.
R) Responce, is the patient responding too you? Do their eyes respond to light? If they do not talk, they are likely unconscious, and if they do not respond too light, then they almost certainly have a concussion.
A) Airway, open their mouth, is their airway clear? Can the patient breath?
B) Breathing, is the pt breathing? If the patient is not breathing, CPR may be necessary.
C) Is the patient circulating blood? Check their heartrate, if they are not, CPR may be necessary.
To perform CPR you must lay the pt flat and compress on their chest every second, every 30 bumps take a breath in and breathe into their mouth, if you can, have someone perform this with you, doing both at once.
Continue this until a medic is available.
The recovery position
If a pt is unresponsive, their breathing, circulation and airway are fine, then you will need to put them into the recovery position, to do this you must lay the pt on their back, bring their right (or left) hand to their left (or right) cheek, then with the side of the hand you brought over to their opposing cheek, use both the pivot points to pull the person over and onto their side.
If a soldier has a broken bone, take out a long splint and apply it to their leg, the splints should hopefully constrain the bones that have been broken and hold them together. Ensure you relieve pain from the pt if necessary, give a small amount of morphine to offset the pain, but not too much, or you will disorientate the pt. You may wish to attempt to push the bone back into place, however these splints should be able to do this automatically. DO NOT attempt to repair the fracture.
Missing limbs: Apply a tourniquet to cut off blood flow to the region, raise what is left of the region into the air, and bandage the end AFTER disinfecting the region. And ensure the pt is given morphine.
Alert a medic as soon as possible.
When applying a TQ you have to write down the exact time at which it was applied, preferably on the patient's arm/ the TQ itself
The pt will likely be in shock at the loss of their limb, this means they may not feel much pain and that their priority will be on re-attaching the limb, which is possible, if you can find the limb, keep it with the individual and a medic may be able to re-attach the limb if time is on their side and a medic is nearby.
Medics: Apply medigel to the wound, try to avoid using a clotting agent such as celox as that may enter their blood stream. After treating and destroyed or ruptured blood vessels that are exposed, you may wish to create a skin graft for the pt, do this by extending the skin and stitching it together over the wound.
GSW (Gun Shot Wound).
-Give the pt painkillers, and if possible, do not alert them as to the fact they have been shot, this will cause great shock and even more pain to the pt.
-Raise (if possible) the area the pt is wounded, for example, the leg or arms.
-Is the blood blackish red and oozing or bright red and squirting everywhere?
A) It is blackish, this means an artery has not been hit, and a tourniquet may not be necessary (although can be).
B) An artery has been hit, a tourniquet will need to be administered IMMEDIATELY to the area, the bleeding is the most important aspect of a GSW.
-DO NOT remove the bullet even medics should not attempt this.
-The exit wound is much bigger then the entry, so always treat the exit wound first if there is one, THEN the entry wound, if the bullet is still inside, leave it.
For this treatment, all you need to do is make an incision into the entry site, begin by locating the fragments, any bullet inside, and use metal clamps to hold the incision open. Once this is done, begin by using a bovie pen and a guaze pad (to wipe away the blood) and a tourniquet (to cut blood flow to the area) to repair any broken or damaged blood vessels, once this is done, begin removing fragments from the patient, as well as the bullet, once the bullet is removed, continue to repair the blood vessels, then stitching up the entry and/or exit wound and the incisions made.
For burns, all you need to know is, 1st degree is next to nothing, 2nd degree will hurt a lot, and requires anti-septics and burn cream, third degree will peal your skin off, this requires burn cream and antiseptics and bandages.
If you are set on fire, the best piece of advice I can give you is DO NOT BREATH the fire will not kill you! What kills you is breathing in air that is 200 degree's celcius and toxic, it will burn and poison you from the inside. Hit the floor, stop, drop and roll, if possible, try to douse yourself out with water or a fire extuinguisher. Don't take a breath in until you are completely extuinguished. If you have an oxygen tank on hand that is flame retardent and will not burst given the contact with the heat, use it immediately, however these can be incredibly dangerous near fires if the oxygen contacts with the fire.
Same treatment as on field, they should be fine unless the patient is in a severely critical condition, your first concern should be their lungs, give them a rebreather, if the lungs are damaged to the point that they can no longer intake oxygen, give them oxygenated water, essentially breathing water, which is not pleasant, at all.
Gas or Chemical agents:
The first thing to do in a gas or nerve agent attack is to put on your gas mask and full body suit and inject yourself with an ultramuscular injection of Atropine - if you are in a building - try to get to heigher ground immediately following the dispension of gas.
If no gas mask is available, urinate on a piece of cloth and cover your mouth and nose with the cloth. This will stop most crude gases, if the gas is highly developed, I apologise for your uncomfortable demise.
Use Atropine and Pralidoxime auto-injectors into the pt, this way they should survive the attack, if the lungs are damaged, give them a ventilator to assist their breathing while the lungs are repaired, surgery with a bovie pen may be needed to repair any damaged tissue within the pt's lungs.
Hope you enjoyed.
If I missed anything please do tell and I'll add it on.