Perform tactical combat casualty care
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Perform tactical combat casualty care

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cls 68w

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Perform tactical combat casualty care Perform tactical combat casualty care Presentation Transcript

  • In the Vietnam conflict, over 2500 soldiers died due to hemorrhage from wounds to the arms and legs even though the soldiers had no other serious injuries.
    • What Happened
    • This individual was wounded by an IED (improvised explosive device). He sustained a penetrating shrapnel injury to the neck with laceration of his right common carotid artery from which he bled to death.
    • What Might Have Saved Him
    • Sustained direct pressure
    • over the bleeding site
    • HemCon dressing
    • Faster evacuation
  • Combat Lifesaver
    • Functioning as a Combat Lifesaver is your secondary mission.
    • Your primary mission is still your combat duties.
    • You should render care only when such care does not endanger your primary mission.
  •  
  • Why CLS?
    • About 15 percent of the casualties that die before reaching a medical treatment facility can be saved if proper measures are taken.
      • Stop severe bleeding (hemorrhaging)
      • Relieve tension pneumothorax
      • Restore the airway
    • The three goals of CLS
      • 1. Save preventable deaths
      • 2. Prevent additional casualties
      • 3. Complete the mission
  • EQUIPMENT
  • Care Under Fire
    • Care rendered by the medic or first responder at the scene of the injury while still under effective hostile fire
    • Very limited as to the care you can provide
  • Tactical Field Care
    • Care rendered once you are no longer under effective hostile fire
    • You and the casualty are safe and you are free to provide casualty care (primary mission is complete)
  • Combat Casualty Evacuation Care
    • Care rendered during casualty evacuation
    • Call Medivac and set up LZ
    • Additional medical personnel and equipment may have been pre-staged and available at this stage of casualty management
  • Care Under Fire
  • Care Under Fire
    • If the casualty can function, direct him to return fire, move to cover, and administer self-aid
    • If unable to return fire or move to safety and you cannot assist, tell the casualty to “play dead”
    • If a victim of a blast or penetrating injury is found without a pulse, respirations, or other signs of life, DO NOT attempt CPR
    • About 90 percent of combat deaths occur on the battlefield before the casualties reach a medical treatment facility (MTF). Most of these deaths cannot be prevented by you or the medic. Examples: Massive head injury, massive trauma to the body.
  • Care Under Fire
    • move casualty to cover quickly
    • If the casualty has severe bleeding from a limb or has an amputation, apply a tourniquet
    Improved First Aid Kit
  • Care Under Fire
    • Hemorrhage from extremities is the 1 st leading cause of preventable combat deaths
    • Prompt use of tourniquets to stop the bleeding may be life-saving in this phase
  • Combat Application Tourniquet (CAT) WINDLASS OMNI TAPE BAND WINDLASS STRAP
  • Tourniquets
  • Tactical Field Care
  • Tactical Field Care
    • Perform tactical field care when you and the casualty are not under direct enemy fire.
    • Recheck bleeding control measures if they were applied while under fire.
  • Tactical Field Care
    • Casualties with confused mental status should be disarmed immediately of both weapons and grenades.
  • Tactical Field Care
    • Initial assessment is the ABCs
      • Airway
      • Breathing
      • Circulation
  • Tactical Field Care: Airway
    • Open the airway with a chin-lift or jaw-thrust maneuver
    • If unconscious and spontaneously breathing, insert a nasopharyngeal airway
    • Place the casualty in the recovery position
  • Nasopharyngeal Airway
  • A survivable airway problem
  • Tactical Field Care: Breathing
    • tension pneumothorax
      • cover the wound with occlusive dressing
      • Perform a needle chest decompression
  •  
  • Needle Chest Decompression
  • Tactical Field Care: Circulation
    • Any bleeding site not previously controlled should now be addressed
    • Only the absolute minimum of clothing should be removed, although a thorough search for additional injuries must be performed
  • Tactical Field Care: Circulation
    • Apply a tourniquet to a major amputation of the extremity
    • Apply an emergency trauma bandage and direct pressure to a severely bleeding wound
    • If a tourniquet was previously applied, consider changing to a pressure dressing and/or using hemostatic dressings (HemCon) or hemostatic powder (QuikClot) to control any additional hemorrhage
  • Hemostatic Dressing
  • Tactical Field Care: Additional injuries
    • Splint fractures as circumstances allow while verifying pulse and prepare for evacuation
    • Administer the Soldier’s Combat Pill Pack
  • Combat Pill Pack
  • Combat Casualty Evacuation Care
  • Casevac Care
    • If the casualty requires evacuation, prepare the casualty
    • Use a blanket to keep the casualty warm
    • If the casualty is to be evacuated by medical transport, you may need to prepare and transmit a MEDEVAC request
  • Preservation of Amputation Parts
    • Rinse amputated part free of debris
    • Wrap loosely in saline-moistened sterile gauze
    • Seal amputated part in a plastic bag or cravat
    • Place in a cool container, do not freeze
    • Never place amputated part in water
    • Never place amputated part directly on ice
    • Never use dry ice to cool an amputated part
  •  
  • Conclusion
    • “ If during the next war you could do only two things, (1) place a tourniquet and (2) treat a tension pneumothorax, then you can probably save between 70 and 90 percent of all the preventable deaths on the battlefield.”
    • - COL Ron Bellamy
  • QUESTIONS?
  • United States Army Medical Material Agency (USAMMA) http://www.usamma.army.mil/