a. Determine responsiveness as follows:
(1) If unconscious, arouse by shaking gently and shouting.
(2) If no response—
[a] - Keep head and neck aligned with body.
[b] - Roll victims onto their backs.
[c] - Open the airway by lifting the chin (Figure V-1).
[d] - Look, listen, and feel for air exchange.
Figure V-1. Chin Lift
(3) If victim is not breathing—
[a] - Check for a clear airway; remove any blockage.
[b] - Cover victim's mouth with your own.
[c] - Pinch victim’s nostrils closed.
[d] - Fill victim’s lungs with 2 slow breaths.
[e] - If breaths are blocked, reposition airway; try again.
[f] - If breaths still blocked, give 5 abdominal thrusts: Straddle the victim, Place a fist between breastbone and belly button, Thrust upward to expel air from stomach.
[g] - Sweep with finger to clear mouth.
[h] - Try 2 slow breaths again.
[i] - If the airway is still blocked, continue (c) through (f) until successful or exhausted.
[j] - With open airway, start mouth to mouth breathing: Give 1 breath every 5 seconds, Check for chest rise each time.
(4) If victim is unconscious, but breathing—
[a] - Keep head and neck aligned with body.
[b] - Roll victim on side (drains the mouth and prevents the tongue from blocking airway).
(5) If breathing difficulty is caused by chest trauma, refer to page V-7, paragraph 1d, Treat Chest Injuries.
b. Control bleeding as follows:
(1) Apply a pressure dressing (Figure V-2).
(2) If STILL bleeding—
[a] - Use direct pressure over the wound.
[b] - Elevate the wounded area above the heart.
Figure V-2. Application of a Pressure Dressing
(3) If STILL bleeding—
[a] - Use a pressure point between the injury and the heart (Figure V-3).
[b] - Maintain pressure for 6 to 10 minutes before checking to see if bleeding has stopped.
Figure V-3. Pressure Points
(4) If a limb wound is STILL bleeding—
[Caution] - Use of a tourniquet is a LAST RESORT measure. Use ONLY when severe, uncontrolled bleeding will cause loss of life. Recognize that long-term use of a tourniquet may cause loss of limb.
[a] - Apply tourniquet (TK) band just above bleeding site on limb. A band at least 3 inches (7.5 cm) or wider is best.
[b] - Follow steps illustrated in Figure V-4.
[c] - Use a stick at least 6 inches (15 cm) long.
[d] - Tighten only enough to stop arterial bleeding.
[e] - Mark a TK on the forehead with the time applied.
[f] - DO NOT cover the tourniquet.
[g] - If rescue or medical aid is not available for over 2 hours, an attempt to SLOWLY loosen the tourniquet may be made 20 minutes after application.
Figure V-4. Application of a Tourniquet
c. Treat shock. (Shock is difficult to identify or treat under field conditions. It may be present with or without visible injury.)
(1) Identify by one or more of the following:
[a] - Pale, cool, and sweaty skin.
[b] - Fast breathing and a weak, fast pulse.
[c] - Anxiety or mental confusion.
[d] - Decreased urine output.
(2) Maintain circulation.
(3) Treat underlying injury.
(4) Maintain normal body temperature.
[a] - Remove wet clothing.
[b] - Give warm fluids. DO NOT give fluids to an unconscious victim. DO NOT give fluids if they cause victim to gag.
[c] - Insulate from ground.
[d] - Shelter from the elements.
(5) Place conscious victim on back.
(6) Place very weak or unconscious victim on side, this will—
[a] - Allow mouth to drain.
[b] - Prevent tongue from blocking airway.
d. Treat chest injuries.
(1) Sucking chest wound. This occurs when chest wall is penetrated; may cause victim to gasp for breath; may cause sucking sound; may create bloody froth as air escapes the chest.
[a] - mmediately seal wound with hand or airtight material.
[b] - Tape airtight material over wound on 3 sides only (Figure V-5) to allow air to escape from the wound but not to enter.
[c] - Monitor breathing and check dressing.
[d] - Lift untapped side of dressing as victim exhales to allow trapped air to escape, as necessary.
(2) Flail chest. Results from blunt trauma when 3 or more ribs are broken in 2 or more places. The flail segment is the broken area that moves in a direction opposite to the rest of chest during breathing.
Figure V-5. Sucking Chest Wound Dressing
[a] - Stabilize the flail segment as follows: Place rolled-up clothing or bulky pad over site, Tape pad to site, DO NOT wrap tape around chest.
[b] - Have victim keep segment still with hand pressure.
[c] - Roll victim onto side of flail segment injury (as other injuries allow).
(3) Fractured ribs.
[a] - Encourage deep breathing (painful, but necessary to prevent the possible development of pneumonia).
[b] - DO NOT constrict breathing by taping ribs.
e. Treat fractures, sprains, and dislocations.
(1) Control bleeding.
(2) Remove watches, jewelry, and constrictive clothing.
(3) If fracture penetrates the skin—
[a] - Clean wound by gentle irrigation with water.
[b] - Apply dressing over wound.
(4) Position limb as normally as possible.
(5) Splint in position found (if unable to straighten limb).
(6) Improvise a splint with available materials:
[a] - Sticks or straight, stiff materials from equipment.
[b] - Body parts (for example, opposite leg, arm-to-chest).
(7) Attach with strips of cloth, parachute cord, etc.
(8) Keep the fractured bones from moving by immobilizing the joints on both sides of the fracture. If fracture is in a joint,immobilize the bones on both sides of the joint.
(9) Use RICES treatment for 72 hours.
[a] - Rest
[b] - Ice
[c] - Compression
[d] - Elevate
[e] - Stabalization
(10) Apply cold to acute injuries.
(11) Use 15 to 20 minute periods of cold application.
[a] - DO NOT use continuous cold therapy.
[b] - Repeat 3 to 4 times per day.
[c] - Avoid cooling that can cause frostbite or
(12) Wrap with a compression bandage after cold therapy.
(13) Elevate injured area above heart level to reduce swelling.
(14) Check periodically for a pulse beyond the injury site.
(15) Loosen bandage or reapply splint if no pulse is felt or if swelling occurs because bandage is too tight.
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