survival preschool:evaluate a casualty

To this day. Almost 20 years after basic training. I can still remember the chant some E7 taught us to help us remember the steps in how to evaluate a casualty. Over and over again he had us chant: RESPONSIVENESS, BREATHING, BLEEDING, SHOCK, FRACTURES, BURNS, CONCUSSION, RESPONSIVENESS, BREATHING, BLEEDING, SHOCK, FRACTURES, BURNS, CONCUSSION, RESPONSIVENESS, BREATHING, BLEEDING, SHOCK, FRACTURES, BURNS, CONCUSSION…..
(X about 100)

Ahhh the Army. They sure have a way of hammering stuff into the brain cells.

Now. First Aid is a very important skill to have. This is not to be construed as professional advice and it is not thorough information in the least, this is simply the framework of steps needed to perform a basic first aid evaluation. For HOW to do what is required to deal with these steps, get some training from a qualified instructor. In a nutshell:

First off, always evaluate the scene for hazards. You will do nobody any good if you wind up down next to the person you were trying to assist.

RESPONSIVENESS: Calmly, and in a loud voice ask “ARE YOU ALRIGHT? HEY! ARE YOU OK?”. Gently tap or shake the person to see if he/she is conscious. If the person is conscious ask them questions about what happened, where they are injured etc. This info will help but you will still need to do the remaining steps. Conscious or not..have someone (i.e. point at someone and TELL them) call 911.

BREATHING: For this purpose, “breathing” will cover respiration and pulse. Determine if the person is breathing. If not open the airway, check for pulse and start CPR if necessary.

BLEEDING: Check for bleeding and treat with direct pressure, pressure points and/or tourniquet as necessary.

SHOCK: The rule of thumb I was taught was “if the face is red raise the head, if the face is pale raise the tail.” In general, the commonly taught shock treatment is to place the casualty on his back upon a blanket or something to insulate him from the ground. Loosen the casualties clothing and elevate the feet so that they are above the level of the heart. Depending upon the persons injuries there are alternate positions but you will have to research those yourself…I’m just giving the nut n’ bolts as I recall them here. Keep the casualty from getting too hot or cold by shading or covering him.

FRACTURES: Stabilize the head and spine. DON’T MOVE the person if you suspect a spinal injury (unless this is a crashed on a desert island scenario).  Look for fractures.  Open (bone sticking out) fractures may have to be treated as “BLEEDING”. The basic treatment is to splint in place.

BURNS: Remove the person from what is burning them without getting burned yourself. Put out any flames. Remove any clothing around the burn BUT don’t peel away stuck fabric…cut around it…then loosely bandage.

CONCUSSION: Look for cerebrospinal fluid that may be leaking from the ears and/or nose. Look for unequal pupils. If the person is displaying any of those sit them down or lay them on their side and watch them till help arrives. If they loose consciousness go back to step one and start over. Maintain an airway and support the  head and neck.

As I said earlier. This is just a framework. You may come across someone on fire. Obviously you will have to skip right to the BURN part. If after the person is extinguished he/she is yelling in pain, then obviously the RESPONSIVENESS, BREATHING steps can most likely be skipped. However, if at some point the person looses consciousness you may very well have to go back to the top and start over. Be sure that when help arrives you tell the medicos what happened and what you did to help.

For more information visit THIS SITE.



2 thoughts on “survival preschool:evaluate a casualty”

  1. The mnemonic device we were given in the Army was “Really Bad Boys Should Find Better Habits”, which stood for “R_esponse, B_reathing, B_leeding, S_hock, F_ractures, B_urns, H_ead injuries”.

  2. I trained as an EMT, granted that is a little different than military medical training but to give some additional points …

    1. we were told to never call it a tourniquet because people misunderstand what that is. Instead we were told to call it a constrictor band. The reason is you do not want to totally cut off blood flow, doing so will kill whatever tissue is on the other side of the band from the heart. This can result in amputation, necrotic tissue (which will spread through the body), and other issues. If you do cut off the blood flow you need to loosen it every 15 or so minutes to prevent such maladies.

    2. We used SAMPLE as an acronym for the “intake” paperwork. While not really intake it does give you a lot of information about what happened and what might be the problem. This obviously does not work well with an unconscious victim unless a friend/family member is present to help you get this info.

    Past medical history
    Last intake (food/water)
    Events leading to the situation you are there for

    We were also told ABC as that sets an order of precedence. Airway, Breathing, Circulation. Going with circulation however you have to check to ensure they will not bleed out, which may require a full body check (which should be taught in person and not explained on a webpage because you can do more harm than good if you dont do it right).

    Often people will arrive on scene and see blood and seek to stop the blood not noticing that the person is not breathing. You can go a bit longer with an open wound than you can without oxygen. The average human can go about 3 minutes without air from the time they stopped breathing.

    And of course dont forget situational awareness in all of this. You do not want to rush in to save someone passed out on the floor only to realize, too late, that they were electrocuted and you are standing in a puddle of water that is still charged.

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