Over 2500 soldiers died in the Vietnam conflict due to blood loss from wounds to the arms and legs despite having no other serious injuries. As a combat lifesaver, one's primary mission is combat duties, but rendering medical care is secondary when it does not jeopardize the primary mission. For care under fire, if a casualty can return fire or move to safety, direct them to do so or tell them to play dead if unable; do not attempt CPR for casualties without signs of life. Prompt use of tourniquets in this phase may save lives since hemorrhaging from extremities is a leading cause of preventable combat death.

1. 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.

2. Combat Lifesaver Functioning as a Combat Lifesaver is your secondary mission.

3. Your primary mission is still your combat duties.

4. You should render care only when such care does not endanger your primary mission.

5. Combat Casualty Evacuation Care Care rendered during casualty evacuation

6. Call Medivac and set up LZ

7. Additional medical personnel and equipment may have been pre-staged and available at this stage of casualty management

8. Care Under Fire

9. Care Under Fire If the casualty can function, direct him to return fire, move to cover, and administer self-aid

10. 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

11. Care Under Fire move casualty to cover quickly

12. If the casualty has severe bleeding from a limb or has an amputation, apply a tourniquet Improved First Aid Kit

13. 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

14. Combat Application Tourniquet (CAT) WINDLASS OMNI TAPE BAND WINDLASS STRAP

15. Tourniquets

16. Tactical Field Care

17. Tactical Field Care Casualties with confused mental status should be disarmed immediately of both weapons and grenades.

18. Tactical Field Care Initial assessment is the ABCs Airway

19. Breathing

20. Circulation

21. Nasopharyngeal Airway

22. Tactical Field Care: Breathing tension pneumothorax cover the wound with occlusive dressing

23. Perform a needle chest decompression

25. Needle Chest Decompression

26. Tactical Field Care: Circulation Any bleeding site not previously controlled should now be addressed

27. Only the absolute minimum of clothing should be removed, although a thorough search for additional injuries must be performed

28. Tactical Field Care: Circulation Apply a tourniquet to a major amputation of the extremity

29. Apply an emergency trauma bandage and direct pressure to a severely bleeding wound

30. 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

31. Hemostatic Dressing

32. Tactical Field Care: Additional injuries Splint fractures as circumstances allow while verifying pulse and prepare for evacuation

33. Administer the Soldier’s Combat Pill Pack

34. Combat Casualty Evacuation Care

35. Casevac Care If the casualty requires evacuation, prepare the casualty

36. Use a blanket to keep the casualty warm

37. If the casualty is to be evacuated by medical transport, you may need to prepare and transmit a MEDEVAC request

39. QUESTIONS?

40. United States Army Medical Material Agency (USAMMA) http://www.usamma.army.mil/