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| Version | User | Scope of changes |
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| Aug 6 2008, 11:00 PM EDT | byates | |
| Aug 6 2008, 11:00 PM EDT | byates | 32 words added |
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This page is for the next step beyond first aid. A large part is from the field medical kit thread on the First Aid & Medicine page. A first aid kit is fine for what it is designed for, first treatment of injuries. In a crisis situation there might not be anyone outside your group for anywhere from a few days to never. This is an emergency supply, keep it all together, do not take anything out except to use and replace it when done. Last but not least, take a first aid course, basic and advanced if possible, and keep up to date.
Assuming that you do not have a kit or are unable to reach it in time to save someone you have to know how to give them the best chance of survivability without medicine it is reccomended for this reason that you take a wilderness survival first aid class to give yoour group their best chances to live.
This is not to be taken as medical advice and is only provided as entertainment, any damage that you do following the information on this page shows that you did not follow this advice.
Hemorrhage Control
1. External loss of blood, especially from wounds that damage the large vessels of the extremities are a common source of massive hemorrhage in combat.
2. Fortunately, hemorrhages of this nature are usually easy to control
3. Because these wounds may be fatal within 60-120 seconds, their treatment is the only time that deviation from securing an airway as the first priority of treatment should be considered.
a) Rationale – you can bleed to death in less than one minute from a massive wound to a main vessel. The body can go up to 4 minutes without oxygen before permanent damage occurs.
b) Once the hemorrhage is controlled, the establishment of the airway once again becomes the primary concern.
b. Loss of blood internally into the chest cavity, abdomen or pelvis.
1. Occurs frequently with blunt trauma or blast injuries.
2. Difficult to adequately treat in the field environment.
3. High rate of mortality associated with internal chest, abdominal, or pelvic bleeding.
b. If direct pressure does not work, point compression of the proximal artery should be attempted while better control of bleeding is obtained at the wound.
c. If this does not work and the wound is still bleeding, a tourniquet should then be applied.
1. Do not allow the casualty to lose a significant amount of blood before deciding to use a tourniquet.
2. In a combat environment, the use of a tourniquet to control massive bleeding may be your first option.
d. If a damaged vessel can be directly visualized, a hemostat may be utilized to clamp the vessel to prevent further bleeding.
1. If the vessel cannot be directly visualized, this procedure cannot be performed.
2. A wound should never be explored with a hemostat in an attempt to find the bleeding vessel. Exploration may cause further damage and promote additional bleeding.
3. Treatment of Internal Wounds:
TACTICAL TRIAGE
1. TRIAGE
a. Definition:
1. The categorization of casualties for the priority of treatment and evacuation.
2. Triage is one of the most important tasks in casualty care. It requires the most informed judgement, knowledge, and courage.
3. Triage is a continuing process and the individual assigned should be the most capable and experienced health care provider available.
2. PRINCIPLES OF TRIAGE:
a. Accomplish the greatest good for the greatest number of casualties
b. Employ the most efficient use of available resources
c. Return personnel to duty as soon as possible
3. TRIAGE FACTORS:
a. Number of casualties requiring treatment
b. Medical resources available to treat casualties (to include personnel and equipment)
c. Attention towards easily treated conditions
d. Rapid and accurate assessments
e. Continuous reassessment and re-triage of all casualties
A. THE FOUR CATAGORIES OF CASUALTY TRIAGE
1. The first formal triage establishes the patient’s category. These categories are color coded and are recognized as follows:
a. Category I – IMMEDIATE (RED TAG)
1. Includes all compromises to a patient’s ABC’s. If immediate medical attention is not provided, the patient will die. These medical procedures should not be time consuming and concern only those casualties with high chance of survival. Examples include:
a) Airway compromise – performing an emergency cricothyroidotomy for an obstructed airway
b) Breathing compromise – performing a needle thoracentesis to decompress a tension pneumothorax
c) Circulation compromise – applying a tourniquet to an arterial bleed
b. Category II – DELAYED (YELLOW TAG)
1. Includes any injuries that may be serious and potentially life threatening. They may require extensive and intensive treatment. However, they are not expected to significantly deteriorate over several hours and therefore can safely wait until the immediate category of patients has been stabilized. Examples include:
a) Compensated shock
b) Fractures, dislocations, or injuries causing circulatory compromise
c) Severe bleeding controlled with a tourniquet or other means
d) Open fractures and dislocations
e) Abdominal, thoracic, spinal, or head injuries
f) Uncomplicated major burns
c. Category III – MINIMAL (GREEN TAG)
1. Also called the “walking wounded.” These individuals have injuries that will still need treatment, however, are unlikely to deteriorate over the next few days. This includes those with relatively minor injuries who can effectively care for themselves or can be helped by untrained personnel. Examples include:
a) Minor lacerations
b) Abrasions
c) Fractures of small bones
d) Minor burns
e) Sprains and strains
d. Category IV – EXPECTANT (BLACK TAG)
1. This category is comprised of patients whose treatment would be time consuming and extremely complicated coupled with a low chance of survival. The extent of their treatment depends on available supplies and manpower. These patients should not be abandoned; however, every effort should devoted to their comfort. Once all immediate and delayed patients are treated, expectant patients will be re-triaged and treated based on remaining medical supplies and personnel. Examples include:
a) Cardiac arrest from any cause
b) Massive brain / head trauma
c) Second or third degree burns over 70% body surface area (BSA)
d) Massive exposure to radiation
B. THREE PRIORITIES OF TREATMENT
1. After the first and formal triage, Category I - IMMEDIATE (RED TAG) patients will be further triaged into treatment priorities. This allows the most severely injured IMMEDIATE patients to be treated first.
a. First Priority: These casualties suffer from any of the following:
1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Open/tension pneumothorax
4. Maxillofacial wounds
5. Shock due to major external hemorrhage
6. Major hemorrhage
7. Visceral (abdominal) injuries
8. Cardio/pericardial injuries
9. Massive muscle damage
10. Major fractures
11. Multiple wounds
12. Severe burns over 20% of body surface area
b. Second Priority: These casualties suffer from any of the following:
1. Visceral (abdominal) injuries with perforations of the intestinal tract, wounds of the genitourinary tract, or thoracic wounds without asphyxia
2. Vascular injuries needing repair
3. Closed cerebral injuries with increasing LOC
4. Burns under 20% of the body surface area involving face, hands, feet, and genitalia
c. Third Priority: These casualties suffer from any of the following:
1. Soft tissue wounds requiring debridement without major muscle damage
2. Lesser fractures and dislocations
3. Injuries of the eye
4. Maxillofacial injuries without asphyxia
5. Burns under 20% of body surface area"
Special Thanks To Our Sources:
Operational Medicine.Org
Medical Corps.Org
Red Cross.Org
US Federal Emergency Management Agency
US Center For Disease Control
For additional information on Old Fashioned remedies
Old-fashioned Home Remedies and Recipes
Wound Care: An Emergency Room Doctor's Perspective
Alpha Disaster Contingencies: Medical
Medic Kits - The Survivor's clinic in a bag
Assuming that you do not have a kit or are unable to reach it in time to save someone you have to know how to give them the best chance of survivability without medicine it is reccomended for this reason that you take a wilderness survival first aid class to give yoour group their best chances to live.
This is not to be taken as medical advice and is only provided as entertainment, any damage that you do following the information on this page shows that you did not follow this advice.
| "Medical Instruments and Equipment 1 EMT Shears, stainless steel 1 Splinter Forceps 1 Hemostat, curved 1 Tick Forceps 1 Fresnel Lens Magnifier, 1" x 4" 1 Thermometer, standard 1 Thermometer, hypothermia 3 Sutures, assorted 1 Sawyer "Extractor" Venom Pump Kit Medications 1 Triple Antibiotic Ointment, 1 oz. tube 1 "Martin's BurnAway Plus," 2 oz. bottle (burns, stings, bites, minor wounds) 1 Aloe Vera Gel, 1 oz. tube 24 "Tylenol" (acetaminophen 500 mg.) (analgesic) 24 Bufferred Aspirin Tablets, 350 mg. (analgesic) 24 Vicodin ES Tabs (7.5 mg hydrocodone bitartrate and 750 mg. acetaminophen) (analgesic) 24 Ibuprofen, 800 mg. (analgesic) 12 Zithromax, 250mg Caps (antibiotic) 12 "Malox Plus" Tabs (antiacid/antigas) 12 "Imodium-AD" (loperamide 2 mg) Caplets (antidiarrheal) 24 Pseudoephedrine, 60 mg. time release (decongestant) 24 Benadryl (diphenhydramine hydrochloride 25 mg.) (antihistamine) 24 Chlorpheniramine 12 mg. time release (antihistamine) 1 "Afrin" Nasal Spray, 1/3 oz. spray bottle (nasal decongestant) 1 "Sting-EZE" Insect Bite Treatment, 1/2 oz. plastic bottle (topical anesthetic) 2 Triamcenolone Cream .5%, 15 gm tube (topical treatment for contact dermatitis (poison ivy, etc), minor burns, skin irritations, etc.) 2 packages Oral Rehydration Salts (dehydration) Miscellaneous Items 3 Needles (sewing), assorted sizes 2 Single Edge Razor Blades 10 Safety Pins, assorted sizes 1 Tekna "Splash-Lite" Lithium Battery Flashlight 4 Paper Cups 1 Emergency Medical Guide - "A Comprehensive Guide to Wilderness & Travel Medicine" 1 Pouch, bag, etc. (container to hold all of the above) |
- Definition – the rapid loss of a large amount of blood from the body
- There are generally only two avenues for significant blood loss:
1. External loss of blood, especially from wounds that damage the large vessels of the extremities are a common source of massive hemorrhage in combat.
2. Fortunately, hemorrhages of this nature are usually easy to control
3. Because these wounds may be fatal within 60-120 seconds, their treatment is the only time that deviation from securing an airway as the first priority of treatment should be considered.
a) Rationale – you can bleed to death in less than one minute from a massive wound to a main vessel. The body can go up to 4 minutes without oxygen before permanent damage occurs.
b) Once the hemorrhage is controlled, the establishment of the airway once again becomes the primary concern.
b. Loss of blood internally into the chest cavity, abdomen or pelvis.
1. Occurs frequently with blunt trauma or blast injuries.
2. Difficult to adequately treat in the field environment.
3. High rate of mortality associated with internal chest, abdominal, or pelvic bleeding.
- Treatment of Extremity Wounds:
b. If direct pressure does not work, point compression of the proximal artery should be attempted while better control of bleeding is obtained at the wound.
c. If this does not work and the wound is still bleeding, a tourniquet should then be applied.
1. Do not allow the casualty to lose a significant amount of blood before deciding to use a tourniquet.
2. In a combat environment, the use of a tourniquet to control massive bleeding may be your first option.
d. If a damaged vessel can be directly visualized, a hemostat may be utilized to clamp the vessel to prevent further bleeding.
1. If the vessel cannot be directly visualized, this procedure cannot be performed.
2. A wound should never be explored with a hemostat in an attempt to find the bleeding vessel. Exploration may cause further damage and promote additional bleeding.
3. Treatment of Internal Wounds:
- Unlike bleeding from an extremity, blood loss into the major body cavities of the chest or abdomen cannot be controlled in the field.
- Internal bleeding requires surgery under general anesthesia at a hospital).
TACTICAL TRIAGE
1. TRIAGE
a. Definition:
1. The categorization of casualties for the priority of treatment and evacuation.
2. Triage is one of the most important tasks in casualty care. It requires the most informed judgement, knowledge, and courage.
3. Triage is a continuing process and the individual assigned should be the most capable and experienced health care provider available.
2. PRINCIPLES OF TRIAGE:
a. Accomplish the greatest good for the greatest number of casualties
b. Employ the most efficient use of available resources
c. Return personnel to duty as soon as possible
3. TRIAGE FACTORS:
a. Number of casualties requiring treatment
b. Medical resources available to treat casualties (to include personnel and equipment)
c. Attention towards easily treated conditions
d. Rapid and accurate assessments
e. Continuous reassessment and re-triage of all casualties
A. THE FOUR CATAGORIES OF CASUALTY TRIAGE
1. The first formal triage establishes the patient’s category. These categories are color coded and are recognized as follows:
a. Category I – IMMEDIATE (RED TAG)
1. Includes all compromises to a patient’s ABC’s. If immediate medical attention is not provided, the patient will die. These medical procedures should not be time consuming and concern only those casualties with high chance of survival. Examples include:
a) Airway compromise – performing an emergency cricothyroidotomy for an obstructed airway
b) Breathing compromise – performing a needle thoracentesis to decompress a tension pneumothorax
c) Circulation compromise – applying a tourniquet to an arterial bleed
b. Category II – DELAYED (YELLOW TAG)
1. Includes any injuries that may be serious and potentially life threatening. They may require extensive and intensive treatment. However, they are not expected to significantly deteriorate over several hours and therefore can safely wait until the immediate category of patients has been stabilized. Examples include:
a) Compensated shock
b) Fractures, dislocations, or injuries causing circulatory compromise
c) Severe bleeding controlled with a tourniquet or other means
d) Open fractures and dislocations
e) Abdominal, thoracic, spinal, or head injuries
f) Uncomplicated major burns
c. Category III – MINIMAL (GREEN TAG)
1. Also called the “walking wounded.” These individuals have injuries that will still need treatment, however, are unlikely to deteriorate over the next few days. This includes those with relatively minor injuries who can effectively care for themselves or can be helped by untrained personnel. Examples include:
a) Minor lacerations
b) Abrasions
c) Fractures of small bones
d) Minor burns
e) Sprains and strains
d. Category IV – EXPECTANT (BLACK TAG)
1. This category is comprised of patients whose treatment would be time consuming and extremely complicated coupled with a low chance of survival. The extent of their treatment depends on available supplies and manpower. These patients should not be abandoned; however, every effort should devoted to their comfort. Once all immediate and delayed patients are treated, expectant patients will be re-triaged and treated based on remaining medical supplies and personnel. Examples include:
a) Cardiac arrest from any cause
b) Massive brain / head trauma
c) Second or third degree burns over 70% body surface area (BSA)
d) Massive exposure to radiation
B. THREE PRIORITIES OF TREATMENT
1. After the first and formal triage, Category I - IMMEDIATE (RED TAG) patients will be further triaged into treatment priorities. This allows the most severely injured IMMEDIATE patients to be treated first.
a. First Priority: These casualties suffer from any of the following:
1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Open/tension pneumothorax
4. Maxillofacial wounds
5. Shock due to major external hemorrhage
6. Major hemorrhage
7. Visceral (abdominal) injuries
8. Cardio/pericardial injuries
9. Massive muscle damage
10. Major fractures
11. Multiple wounds
12. Severe burns over 20% of body surface area
b. Second Priority: These casualties suffer from any of the following:
1. Visceral (abdominal) injuries with perforations of the intestinal tract, wounds of the genitourinary tract, or thoracic wounds without asphyxia
2. Vascular injuries needing repair
3. Closed cerebral injuries with increasing LOC
4. Burns under 20% of the body surface area involving face, hands, feet, and genitalia
c. Third Priority: These casualties suffer from any of the following:
1. Soft tissue wounds requiring debridement without major muscle damage
2. Lesser fractures and dislocations
3. Injuries of the eye
4. Maxillofacial injuries without asphyxia
5. Burns under 20% of body surface area"
Special Thanks To Our Sources:
Operational Medicine.Org
Medical Corps.Org
Red Cross.Org
US Federal Emergency Management Agency
US Center For Disease Control
For additional information on Old Fashioned remedies
Old-fashioned Home Remedies and Recipes
Wound Care: An Emergency Room Doctor's Perspective
Alpha Disaster Contingencies: Medical
Medic Kits - The Survivor's clinic in a bag
