105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
105.1 State the sequence to examine an injured person.
Check for breathing: lack of oxygen intake can lead to
brain damage or death in a very few minutes
Check for bleeding: life cannot continue without an
adequate volume of blood to carry oxygen to tissues
Check for shock: unless shock is prevented or
treated, death may result even though the injury
would not otherwise be fatal
Examination warnings:
If there are any signs of chemical or biological agent
poisoning, you should immediately mask the casualty.
If it is nerve agent poisoning, administer the antidote, using
the casualty’s injector/ampules
In a chemically contaminated area, do not expose the wounds
Leg fractures must be splinted before elevating the legs as a treatment for shock
.2 State the reason for not moving an injured person unless absolutely necessary.
As a general rule, make your preliminary examination in the position and place you find the victim. Moving the victim before this check could gravely endanger life, especially if there are fractures, skull or spine injuries.
If the situation is such that you or the victim is in danger, you must weigh this threat against the potential damage caused by premature transportation. If you decide to move the victim, do it quickly and gently to a safe location where proper first aid can be administered
.3 Describe the signs, symptoms, and treatment of shock.
Shock is a condition in which the circulation of the blood is seriously disturbed. This can cause lack of oxygen to body systems.
Shock creates a vicious cycle; the worse it is, the worse it will become. A person going into shock may display quite a few signs and symptoms
Signs/symptoms
The signs of shock do not always appear at the onset of the injury. The following is a list of some of those signs:
Sweaty but cool skin (clammy skin)
Paleness of skin Restlessness or nervousness
Thirst
Pulse is weak and rapid
Enlarged pupils
Breathing is shallow and irregular
Blotchy or bluish skin, especially around the mouth
Nausea and/or vomiting
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
Treatment
–Keep the victim calm Try to prevent the victim from seeing the injury
If victim is conscience and not internal injuries are evident, you should give the victim small amounts of warm water.
If it is possible, place the injured person on the back on a bed, cot, or stretcher, and raise the
lower end of the support about 12 inches so that the victim's feet will be higher than the head
.4 Explain why you should not give an unconscious person anything by mouth.
Giving an unconscious person any food or drink by mouth can cause vomiting.
If the victim vomits, the vomited material may enter the lungs.
Victim could choke to death
.5 Describe the three types of bleeding.
Capillary bleeding. Bleeding is slow, the blood "oozes" from the (wound) cut
Venous bleeding. The blood is dark red or maroon, and flows in a steady stream
Arterial bleeding. The blood bright red and “spurts” from the wound.
Arterial bleeding is life threatening and difficult to control
.6 Explain the four methods for controlling bleeding.
Direct pressure:
First method to use when controlling bleeding. In almost every case bleeding can be
stopped by direct pressure on the wound
Use a sterile dressing when available and tie a
knot directly over the wound. Do not tie the knot too tight and cut off circulation
Elevation:
Raising an injured limb above the level of the heart helps to control the bleeding.
Elevation should be used together with direct pressure
Caution!
•Do not elevate a limb when you suspect a fracture
Indirect pressure:
In instances of severe bleeding where direct pressure and elevation are not controlling the
bleeding, indirect pressure may be used. Bleeding from a cut artery or vein can often be
controlled by applying pressure to the appropriate pressure point The object of the
pressure is to compress the artery against the bone, thus shutting off the flow of blood
from the heart to the wound
Tourniquet:
Should only be used as a last resort for severe, life threatening bleeding that cannot be
controlled by any other method. When using this method, be thoroughly familiar with the
dangers and limitations of it’s use
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.7 Discuss the major pressure points of the body.
Facial artery
Apply pressure on this point when bleeding is on the face below the level of the eyes
Subclavian artery
Used for bleeding in the shoulder or in the upper part of the arm.
Apply pressure with the fingers behind the clavicle
Brachial artery
Used to control bleeding between the middle of the upper arm and the elbow
Radial and ulnar arteries
Used to control bleeding from the hand.
If possible hold the arm up in the air
Iliac artery
Used to control bleeding from the thigh.
Pressure with your fingers should be sufficient to stop the bleeding
Anterior and posterior tibial arteries
Used to control bleeding from the foot.
As with the hand, elevation is helpful in controlling the bleeding
Superficial temporal
Used to control bleeding from the region of the temple or scalp
Common Carotid
Used to control bleeding of the neck and head
Femoral artery
Controls bleeding in the upper thigh.
A great deal of pressure must be exerted to compress the artery against the bone
Popliteal artery
Controls bleeding between the knee and the foot
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
105.8 Describe the first aid treatment for a sucking chest wound.
Requires immediate first aid treatment
A penetrating injury to the chest that produces a hole in the chest cavity, causing the lung to collapse, which prevents normal breathing functions
It is imperative the wound be sealed with an airtight dressing to prevent air from entering the chest cavity through the wound. Any material that will form an airtight barrier, can be used if they are large enough to cover the wound
If the victim’s condition suddenly deteriorates when you apply the seal, IMMEDIATELY remove it
After the wound is sealed and dressed, the victim should be placed on the wounded side unless there are back injuries
Watch the victim closely for shock and treat accordingly
Do not give victim anything to drink. Transport to treatment facility IMMEDIATELY.
.9 Describe the first aid treatment for a person with a suspected spinal injury.
Do not move the victim unless it is absolutely essential
Do not bend or twist the victim’s body, do not move the head forward, backward, or sideways and do not under any circumstances allow the victim to sit up
First aid procedures
Minimize shock
Prevent further injury to the spinal cord
Keep the victim comfortably warm
.10 Describe the three degrees of burns.
First Degree Burns
Characterized by redness, mild swelling, and pain
Usually the result of spending too much time in the sun, short contact with chemicals, or minor scalding with hot water or steam
Second Degree Burns
Are much deeper than first-degree burns
Appearance: very red with blisters
Usually results from deep sunburns or flash burns from gasoline fires
Most painful type of burns because the nerve endings are still intact even though the skin is severely damaged
Third Degree Burns
The most serious burn because the burn is so deep, it requires a long time to heal and scars will form over the burn area
Skin may look white or charred black
Extends through all layers of the skin and into the flesh below the skin
.11 Describe the first aid treatment for the following injuries:
a. White phosphorous burn on back
A special category of burn is that caused by contact with white phosphorus
First aid for this type of burn is complicated by the fact that white phosphorus particles ignite upon contact with air
Treatment:
Partially embedded particles must be continuously flushed with water while the first aid provider removes them with whatever tools are available
Deeply embedded particles that cannot be removed must be covered with a saline soaked dressing
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
b. Chemical burn on arm
Flush the area immediately with a lot of cool running water for 5 to 10 minutes to wash away any chemicals.
Remove clothing and jewelry from the victim on which chemicals have spilled
Flush again with water and gently pat it dry with a sterile gauze. Do not rub the area.
Transport the victim to a medical facility
Warning!
Do not attempt to neutralize any chemical unless it is known exactly what it is and what substance will effectively neutralize it
Alkali burns caused by dry lime:
Mixing water and lime creates a very corrosive substance. Dry lime should be removed by brushing the material from the skin and clothing unless massive amounts of water are available for rapid and complete flushing
Acid burns caused by carbolic acid
Wash the affected area with alcohol because carbolic acid is not water soluble. Then wash the area with large quantities of water
If alcohol is not available, flushing with water is better than no treatment at all
c. Flash burn to eyes
Burns caused by a nuclear explosion are divided into two classes: direct and indirect burns
Direct burns, usually called flash burns, are the result of thermal, infrared radiation emitted by a nuclear explosion
Indirect burns are the result of fires caused by the explosion
Symptoms:
Blindness may persist for 20 to 30 minutes
Eyes are irritated, like having sand in the eyes
Treatment:
Apply cold compresses to the affected area. Transport victim to the nearest medical treatment facility
d. Chemical burn to eyes
The one and only emergency treatment for a chemical burn to the eyes is to flush the eye(s) immediately with large amounts of water or sterile saline solution
Acid burns to the eyes should be irrigated for at least 5 to 10 minutes with at least 200 milliliters of water
Alkali burns should be irrigated for at least 20 minutes
Do not allow water to fall directly on the eye. Hold the victim’s head in a position that allows water to flow from inside the corner of the eye toward the outside
Caution!
Never use any chemical antidotes such as baking soda or alcohol when treating burns of the eye.
Do not try to neutralize chemical agents
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.12 Describe the symptoms and treatment of:
Heat stroke:
Sunstroke is more accurately called heat stroke since it is not necessary to be exposed to the sun for this condition to develop.
Heat stroke is less common but far more serious than heat exhaustion.
The most important factor of heat stroke is the extremely high body temperature, 105 F or higher, that accompanies it 20% mortality rate
Symptoms:
Dry hot skin
Pupils constricted
Very high body temperature
Treatment
–Heat stroke is a true life or death emergency
The longer the victim remains overheated, the more likely the victim is to suffer irreversible body and brain damage or death
The main objective is to get the body temperature down as quickly as possible
Get victim to a medical treatment facility as soon as possible
Cooling measures must be continued during transport
b. Heat exhaustion
The most common heat related condition resulting from prolonged exposure to hot conditions
Heat exhaustion involves a serious disturbance of blood flow to the brain, heart, and lungs
Symptoms:
Victim may appear ashen gray; skin will be cold, moist, clammy, normal or subnormal temperature
Pupils may be enlarged
Victim may experience symptoms such as weakness, fatigue, headache, loss of appetite, and nausea
Treatment:
Loosen clothing and apply cool wet cloths to the head, armpits, groin,, and ankles.
Do not chill the victim
If the victim is conscious, a solution of one-teaspoon of salt dissolved in a quart of cool water should be given.
Transport the victim to a medical facility as soon as possible
Care for the victim as if in shock.
Move the victim to an air conditioned space if possible.
c. Heat cramps
Heat cramps usually affect people who work in hot environments or who engage in strenuous exercise without acclimating themselves to the conditions
May result from drinking ice water or other cold drinks too quickly or in too large a quantity after exercise
Symptoms
–Excessive sweating which can result in painful cramps in the muscles of the abdomen, legs, and arms
Muscle spasms caused by heat cramps usually last only a few minutes
Treatment
Move to a cool place
Give plenty of water to drink
Gently massage muscles to relieve the spasms
If symptoms do not improve treat for heat exhaustion and transport to a medical facility
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.13 Explain how heat casualties in the field may be prevented.
Command responsibility
Prevention centers on water and salt replacement
Do not consume alcoholic beverages
.14 Describe frostbite and immersion foot.
Frostbite occurs when ice crystals form in the skin or deeper tissues after sustained exposure to a temperature of 32 degrees F or lower
Depending upon the temperature, altitude, and wind speed, the exposure time necessary to produce frostbite varies from a few minutes to several hours.
The areas most commonly affected are the face and extremities
Frostbite occurs when ice crystals form in the skin or deeper tissues after sustained exposure to a temperature of 32 degrees F or lower
Depending upon the temperature, altitude, and wind speed, the exposure time necessary to produce frostbite varies from a few minutes to several hours.
The areas most commonly affected are the face and extremities
As ice crystals form, the frozen extremity appears white, yellow-white, or blotchy blue and white
The surface of the skin feels hard, but the underlying tissue is soft
Warning!
•
•Never rub a frostbitten area!
Never heat a frostbitten area with open fire
Superficial frostbite
The skin and region just below the skin are affected
Surface feels hard, but the underlying tissue is soft, allowing it to move over body ridges
Treatment:
Thaw with body heat or warm water
Hands: Place hands under the armpit, against the
abdomen, or between the thighs
Feet: Feet can be warmed by using the armpit or
abdomen of a buddy
Other areas. Warm with warm water immersion,
skin to skin contact, or warm-water bottles
Deep frostbite
Freezing reaches into the deep tissue layers, the skin does not move over the bony ridges and feels hard and solid
Protect from further injury
Thaw the area rapidly by immersion in warm water
Immersion foot, which may also occur in the hands, is a cold injury resulting from prolonged exposure to wet, cold temperatures just above freezing
It is often associated with limited motion of the extremities and water-soaked clothing
The temperature does not need to be below 32 degrees F to cause injury
Symptoms
Early stages, the feet and toes turn pale and feel cold, numb, and stiff
Walking becomes difficult
The feet will swell and become painful
If not treated the flesh dies and amputation of the extremity may be necessary
•Treatment:
Do not rub or massage the injured part
Remove wet clothing
Do not rupture blisters or apply salves or ointments
Clean with soap and water, dry thoroughly, elevate and keep extremity exposed to dry air
Evacuate by litter
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
105.15 Describe the signs and symptoms when general loss of body heat occurs to a person exposed to extreme cold (hypothermia).
Hypothermia is cooling of the entire body. It can be caused by continued exposure to low or rapidly dropping temperatures, cold moisture, snow, and/or ice
Symptoms:
Several stages of progressive shivering
Feelings of sluggishness, drowsiness and confusion
Victim may become unconscious
Victim may go into shock
The lower extremities may freeze
Treatment:
Victim must be warmed quickly
Move victim to warmth
In the field, place nude victim in a sleeping bag with two volunteers stripped to their underwear to provide body-to-body heat transfer. This WILL SAVE LIVES in the field
Hypothermia is a medical emergency!
The victim needs heat!
.16 Explain how cold injuries can be prevented.
Cold weather injuries can be prevented by becoming accustomed to a cold climate, by wearing warm layered clothing, and by maintaining good discipline and training
Wearing dry gloves, stocking cap, well insulated boots, and keeping the body well hydrated will help the body maintain its normal temperature
.17 Describe the symptoms and first aid treatment for a joint dislocation.
Description
A bone that has been forcibly displaced from its joint is dislocated
Dislocations are usually caused by falls or blows but are occasionally caused by muscle exertion. The joints that are most frequently dislocated are the shoulder, hip, finger, and jaw
Symptoms
Rapid swelling and discoloration
Loss of ability to use the joint
Severe pain and muscle spasms
Possible numbness
Possible loss of pulse below the joint
Shock
Treatment
Loosen the clothing around the injured part
Place the victim in the most comfortable position possible
Support the injured part by means of a sling, pillow, bandages, splints, or any other device that will make the victim comfortable
Treat the victim for shock
Get medical help as soon as possible
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.18 Explain when and why a cold pack or heat pad would be used on a sprain.
Treat all sprains as fractures until ruled out by x-rays
Apply cold packs for the first 24 to 48 hours to reduce swelling and to control internal hemorrhage
Apply a snug, smooth, figure eight bandage to control swelling and to provide immobilization
After the swelling stops moist heat can be applied for short periods (15 to 30 minutes) to promote healing and reduce swelling
.19 Describe the procedure for removing ticks.
The best method for removing ticks is to coat them with petroleum jelly, baking powder paste, or clear nail polish
The tick should be pulled off with a pair of tweezers or one’s fingers.
Care should be taken not to crush the tick or break off the head or embedded mouth parts while still in the skin
.20 Describe the first aid treatment for snake bites.
The most important first aid treatment for venomous snakebites is reducing the circulation of blood through the bite area
This will delay absorption of the venom, prevent aggravation of the local wound, and maintain the victim’s vital signs
Wrap a constricting band 2 to 3 inches above the fang marks, or above the nearest joint, but away from the swelling
A second constricting band should be placed 2 to 3 inches below the wound.
Feel the victim’s pulse below the constricting bands to keep ahead of the swelling
If the victim can not reach a medical facility within 30 minutes, and if there are definite signs of poisoning, use a sterile knife blade to make an incision about 1/2 inch long and 1/4 inch deep lengthwise over each fang mark.
Apply suction cups to help remove injected venom.
Suction by mouth is recommended only as a last resort.
The human mouth contains so many bacteria that the bite could become infected.
Incision and suction more than 30 minutes after the bite is not recommended.
Treat for shock
Use a splint to immobilize the victim’s affected extremity, keeping the involved area at or below the level of the heart
Cover the wound to prevent further contamination.
Telephone the nearest medical facility so proper anti-venom can be made available.
Transport the victim (and the dead snake) to a medical facility as soon as possible
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.21 Describe the first aid treatment for fractures.
If there is any possibility that a fracture has been sustained, treat the injury as a fracture until an x-ray can be made
Rough handling of the victim may convert a closed fracture into an open fracture, increase the severity of shock, or cause extensive damage to the blood vessels, nerves, muscles, and other tissues around the broken bone
Do not move the victim until the injured part has been splinted
Treat for shock
When a long bone in the arm or leg is fractured, the limb should be carefully straightened so that splints can be applied unless it appears that further damage will be caused.
Never apply force or traction
Apply splints. If the victim is to be transported a short distance, or treatment by a medical officer will not be delayed, it is best to leave the clothing on and place emergency splinting over it
If the fracture is an open fracture you must take care of the wound before you can deal with the fracture
.22 Describe how to reinforce a battle dressing.
Battle dressings may be reinforced by applying additional sterile dressings over the battle dressing and covering the entire dressing with an elastic bandage
105.23 Explain the following methods for carrying a casualty:
a. Fireman’s carry
b. One and two man supporting carry
c. One and two man arms carry
d. One and two man saddle back carry
e. Pack-strap carry
f. Back lift and carry
g. Pistol-belt carry
h. Neck drag
i. Four-hand (packsaddle) carry
j. Four-hand arms carry
105 BASIC FIRST AID AND PERSONAL HYGIENE FUNDAMENTALS
.24 Explain the importance of personal hygiene and cite examples.
Because of close living accommodations in the field, personal hygiene is extremely important
Disease and sickness can spread rapidly and affect an entire battalion in a short period
Good practices
Daily bath or shower prevents body odor and is absolutely necessary for maintaining cleanliness and preventing common skin diseases
Using medicated powders and deodorants helps keep the skin dry
Socks and underwear should be changed daily
The importance of washing your hands at appropriate times can not be over emphasized
.25 Explain three methods of purifying water in the field.
Boiling
Boiling is used when disinfecting compounds are not available. To purify a canteen of water by boiling, follow the steps listed below:
Boil the water at a rolling boil for at least 15-20 seconds
Let the water cool before drinking it. Once the water has cooled, it must be consumed
Iodine tablets
Iodine Tablets
Check tablets for physical change. If the tablets are stuck together, crumbled, or have a color other than steel gray, do not use them.
Fill canteen with the cleanest, clearest water available
Add one iodine per 1 quart canteen of clear water, 2 tablets if the water is cloudy
Place cap loosely and wait 5 minutes
Shake canteen, allowing leakage to rinse the threads around the neck of the canteen
Tighten the cap and wait an additional 20 minutes before using the water for any purpose
Calcium hypochlorite ampules
Fill the canteen with the clearest, cleanest water available, leaving an air space of at least 1 inch below the neck of the canteen
Add one ampule of calcium hypochlorite to a canteen cup half full of water; stir with a clean stick until the powder has dissolved
Fill the canteen cap half full of the solution in the cup, and add it to the water in the canteen, place the cap on the canteen and shake it thoroughly
Loosen the cap slightly; invert the canteen to allow the treated water to leak onto the threads around the canteen neck
Tighten the cap and wait at least 30 minutes before using the water