FIRST AID AND RESCUE - Dcfpnavymil

FIRST AID AND RESCUE1. PURPOSE OF FIRST AID. To save life, prevent furtherinjury, and prevent infection.a. Definition: First aid is the emergency care givento sick and injured people until medical care can be given.b. The general rules of first aid (listed in priorityof importance):(1) Keep victim lying down until the extent ofinjuries have been determined.(2) Examine the victim for open airway,breathing, and circulation. This is known as a primarysurvey. Conduct a head-to-toe secondary survey, checkingfor bleeding, shock, broken bones, etc.(3) DO NOT give an unconscious victim anything bymouth.(4) Remove enough clothing to get a clear idea ofthe extent of injury. Do not allow victim to get chilled.(5) Keep victim reassured and comfortable, do notallow them to see their injuries.(6) Do not touch wounds and burns with hands orother unsterile objects unless proper dressings are notavailable.(7) When treating a wound: stop the bleeding,prevent infection, and prevent shock.(8) DO NOT move victim until the extent ofinjuries are determined and appropriate first aid measuresare taken, except when required due to flooding, fires, ortoxic gases.(9) After treatment of victim, always continue tomonitor the victim until relieved by medical personnel.(10) Keep the victim warm.

(11) Ensure a litter is carried feet forward,except when going up a ladder; then it is head first.

2.DRESSING WOUNDSa.Chest(1) Sucking chest wound. Use plastic covermaterial (e.g., ID card, package wrapper) and place overthe wound only taping three sides to the victim's chest(leaving one side untaped). When victim inhales, thematerial will seal the wound and when he/she exhales, itwill release excess pressure.(2) Examine for other entrance or exit wounds andtreat as noted above. Lay victim on affected side.b.Head(1) For any head injury, assume that the victimalso has a neck injury and immobilize.(2) Keep the victim lying flat, with the head atthe same level as the body. DO NOT RAISE THE FEET.(3) If victim is conscious, attempt to maintainsome level of consciousness (normally talking is enough).(4) If necessary, turn the victim on his/her sideto prevent choking on vomit, blood, etc. ALWAYS maintaincomplete stability of the neck while turning victim.c.Abdominal(1) These wounds usually cause intense pain,nausea, vomiting, muscle spasms, and severe shock.(2) Keep victim lying on his/her back and exposethe wound area.(3) Do not touch the intestines and do notattempt to push or manipulate them back into the abdominalcavity.(4) If bleeding is severe, try to stop withdirect pressure at the site of the bleeding only. Do notapply pressure over intestine or other abdominal organs.(5) If available, obtain a large battle dressingand moisten with sterile water or potable water if

intestine is exposed. If not exposed, keep dressing dry.When securing the dressing, be sure not to place the tieacross the abdomen and risk obstructing the intestines.

(6) Treat for shock and get the victim medicalhelp as soon as possible. Victim may be more comfortablewith knees drawn up.(7) DO NOT give victim anything to drink or eat;this will only cause increased peristalsis (movements) ofthe intestines. Moisten only the victim's mouth.d.Arm and Leg(1) Apply direct pressure or pressure thedressings to control bleeding. When using battledressings, ensure ties are tied over the wound to maintainpressure. DO NOT APPLY A TOURNIQUET EXCEPT AS A LASTRESORT.(2) If fractures are involved, splint theaffected limb as it lies. Do not attempt to reposition it.3.CONTROLLING BLEEDINGa. Arterial bleeding. Blood is bright red and iseasily identified by the pulsating spurts.b. Venous bleeding. Blood is dark red and has asteady flow.c.slowly.Capillary bleeding.NOTE:Blood is brick red and oozesDIRECT PRESSURE IS USUALLY THE MOSTEFFECTIVE METHOD OF CONTROLLING BLEEDING.(1) Use sterile dressing, if available, improviseas situation dictates.(2) If dressing has been applied and bleedingcontinues, place additional dressings over those dressingspreviously applied. DO NOT REMOVE OLD DRESSINGS.d.Pressure points(1) Applying pressure to the appropriate pressurepoint above the wound may often control arterial or venousbleeding.

(2) The following eleven major pressure pointsare on each side of the body and can be located by feelingfor the pulse (refer to Figure 2-1):(a) Temporal - In front of ear.(b) Facial - On lower jawbone.(c) Carotid - Next to windpipe (do not applypressure to both carotids at the same time).(d) Subclavian - Collarbone.(e) Brachial (upper) - Inside upper arm.(f) Brachial (lower) - Bend of arm.(g) Radical Ulnar - Inside wrist.(h) Iliac - Middle of groin.(i) Femoral - Upper inside thigh.(j) Popliteal - Behind knee.(k) Anterior/Posterior Tibial - Above ankle.e. Tourniquet. Constricting band used to cut off thesupply of blood to an injured limb (refer to Figure 2-2).(1) Place above and as close to the wound site aspossible.(2) A "T" should be marked on the victim'sforehead along with the time the tourniquet was applied.NOTE:TOURNIQUETS ARE THE LEAST PREFERRED METHODTO CONTROL HEMORRHAGE. A TOURNIQUET ISWARRANTED ONLY WHEN BLEEDING CANNOT BECONTROLLED BY DIRECT PRESSURE OR OTHER MEANSAND ONLY ON EXTREMITIES.(3) Once a tourniquet is applied, only a medicalofficer or corpsman can remove it.4.FRACTURES (refer to Figure 2-3)

a. Simple fractures are those in which the brokenbone does not break the skin.b.A comminuted fracture is one in which the bonehas been fractured into two or more fragments.c. A compound/open fracture is one in which the bonebreaks the skin and is exposed.d. Immobilizing a fracture. Use any solid materialat hand and wrap with an Ace bandage, belt, or tape toprevent movement.

PRESSURE POINTSFigure 2-1

APPLYING A TOURNIQUETFigure 2-2FRACTURESFigure 2-3

e. Splint/immobilize the fracture as it lies.TRY TO REDUCE OR MANIPULATE.DO NOTf. Check for a pulse below the fracture site.pulse is felt, obtain medical help immediately.If no5. SHOCK. Body state in which circulation of blood isseriously disturbed either by blood volume depletion,circulatory collapse, or sudden psychological overload(refer to Figure 2-4).a. Common causes. Crushing injuries, fractures,burns, poisoning, prolonged bleeding, asphyxiation and/orwitnessing a traumatic event.b.Symptoms(1) Weak or absent pulse.(2) Shallow or irregular breathing.(3) Pale, cold, or moist skin.(4) Eyes vacant, lackluster, and dilated.(5) Dizziness and nausea.c.Treatment(1) Every victim should be treated for shock assoon as possible.(2) Victim should be kept warm and comfortablewith feet higher than head (approximately 6-8 in.).6.TREATMENT FOR ELECTRICAL SHOCKa.Secure power.b.Remove victim from electrical source.NOTE:CONTACTDO NOT TOUCH VICTIM WHILE THEY ARE STILL INWITH ENERGIZED EQUIPMENT.

c. Begin breathing or mouth-to-mouth artificialresuscitation as needed (see procedure for resuscitationbelow).d.Treat wounds and burns as needed.

SYMPTOMS AND TREATMENT FOR SHOCKFigure 2-4

7. ASPHYXIATION (follow current American Heart AssociationStandards).a. Mouth to mouth artificial resuscitation (rescuebreathing).(1) Place victim on back. Immediately removeanything from victim's mouth and bring victim's tongueforward by using the head tilt-chin lift method.(2) Lift lower jaw forward.(3) Pinch nose shut (or seal mouth) to preventair leakage.(4) Take a deep breath and blow forcefully intomouth of victim watching for a rise and fall of the chest.(5) Remove your mouth from the victim and repeatstep 4 giving 1 breath every 5 seconds.(6) Continue rescue breathing until victim beginsto breath normally or when relieved by medical personnel.(7) If stomach becomes distended (swollen):(a) Place victim on their side (keeping headand neck supported).(b) Use the flat of your hand to exertmoderate pressure on the victim’s stomach between the naveland rib cage.(c) After the vomiting has ceased, quicklyclear the mouth and reposition the victim, and continuerescue breathing.8.HEAT CASUALTIES (refer to Figure 2-5)a. Heat stroke (MEDICAL EMERGENCY) occurs due to theinability of the body to regulate body temperature and thesweating mechanism.(1) Serious condition with a high death rate.(2) Characterized by extremely high bodytemperature (106-110 F).

(3) Skin usually will become hot, red, and dry,with little or no sweating.

(4) Victim is often unconscious or convulsionsare present.(5) Full and rapid pulse(6) Rapid deep breathing(7) High blood pressure(8) Treatment(a) Immediately cool victim's body ifpossible by removing clothing, immersing victim in coolwater, or sprinkling the body with water and fanning.(b) Raise the head and shoulders slightlyand massage limbs to release body heat.SYMPTOMS OF HEAT CASUALTIESFigure 2-5

b.Heat exhaustion(1) Victim rarely loses consciousness.(2) Considerable sweating, pallor of the skin(paleness, no color).(3) Rapid pulse (140-200 per min)(4) Treatment(a) Move victim to cool place to rest.victim plenty of water.Give(b) Elevate feet, massage arms, and legs.(c) Obtain medical help for furthertreatment.c.Heat cramps(1) Painful cramps to the voluntary muscles(arms, legs, etc.).(2) Results from excessive loss of electrolytes(salt) from the body.(3) Body temperature is usually normal.(4) Treatment.exhaustion.NOTE:9.First aid is same as for heatPERSONNEL MAY BEGIN WITH SYMPTOMS OF HEATCRAMPS AND PROGRESS THROUGH HEAT EXHAUSTIONTO HEAT STROKE.BURNS (refer to Figure 2-6)a.First degree (partial thickness)(1) Skin is red(2) Treatment(a) Immerse burn area in cold water

(b) Apply cold compress if immersion notfeasible.b.Second degree (partial thickness)(1) Skin is red with blisters.(2) Characterized by severe pain.(3) Treatment(a) Soak in cold water, if possible.(b) Do not break blister.(c) Apply a sterile dressing.c.Third degree (full thickness)(1) Destroys skin and may destroy muscle tissue.May destroy bones in severe cases.(2) Severe pain may be absent because nerveendings have been destroyed.(3) Color may vary from white to black(charring).(4) Treatment(a) Treat for shock(b) Use sterile sheets (if available) towrap victim.(c) Get immediate help.d. Use the Rule of Nines for determining percentageof total body area that is burned (refer to Figure 2-7).

BURNSFigure 2-6

RULE OF NINESFigure 2-710. STRETCHERSa.Reese Sleeves(1) There are five Reese Sleeves stretchers, madeof vinyl-coated nylon, on BAINBRIDGE (located in the RepairLockers).(2) Very effective for moving victim from enginerooms, trunks, and other compartments too confining topermit the use of a Stokes Stretcher.(3) Passageways inside the skin of the ship aretoo narrow to use Stokes Stretchers. Therefore, the Reese

Sleeves will be the only stretcher used when moving avictim up or down ladders or through hatches.b.Stokes (refer to Figure 2-8)

(1) Most common stretcher in the Navy.(a) Consists of a tubular metal frame, whichis constructed with a shallow wire basket where the victimcan be laid.(b) Securing straps can be used to hold thevictim in place.(2) There are 15 stokes stretchers on USSBAINBRIDGE.STOKES STRETCHERFigure 2-811. RESCUE OF A PERSON OVERCOME BY TOXIC FUMESa. Done under the supervision of the Duty FireMarshal/Gas Free Engineer due to the hazards of enteringthe space.b.Wear a SAR/SCBA.c. Once the space has been entered, use mostappropriate means available to remove the victim andadminister first aid.12. FIRST AID BOXESa. There are 49 first aid boxes (identified with alarge red cross) in various locations throughout the ship,which are used to provide first aid treatment to victim.

13. BATTLE DRESSING STATION (BDS) AND MEDICAL TREATMENTROOM LOCATIONSa. There is one Medical Treatment Room and two BDSfor treatment of casualties.