Title: Lesson 24 MANAGE A CASUALTY WITH COMBAT STRESS REACTION (BATTLE FATIGUE)
1Combat Life Saver
Lesson 24MANAGE A CASUALTY WITHCOMBAT STRESS
REACTION (BATTLE FATIGUE)
Compiled and edited by, 2LT John C. Miller, PA-C
2Lesson 24MANAGE A CASUALTY WITHCOMBAT STRESS
REACTION (BATTLE FATIGUE)
- INTRODUCTION
- Not all casualties have bleeding wounds, broken
bones, or chemical agent poisoning. Some
casualties suffer psychological injuries,
commonly referred to as combat stress reaction,
but since World War II it has also been called
battle fatigue. Most combat stress casualties can
be treated without evacuating them out of the
combat zone. Sometimes the treatment is simply
making sure the soldier gets a good night's rest,
warm food, and a change of clothing.
3MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)
- INTRODUCTION (cont)
- Combat stress can be mild to severe. Mild cases
do not seriously interfere with the soldier's
effectiveness. If the combat stress is moderate
to severe, the soldier is ineffective and usually
requires evacuation. Moderate and severe combat
stress reactions are sometimes referred to as
"more serious" combat stress.
4MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)
- TASK
- Identify characteristics of combat stress
reaction and its treatment. - CONDITIONS
- Given written items pertaining to the
identification and treatment of combat stress
reaction. - STANDARD
- Score 70 or more points on the 100-point written
examination.
5IDENTIFY THE CAUSES OF COMBAT STRESS
- Some of the problems which contribute to the
development of combat stress are - Physical exhaustion.
- Constant alertness.
- Loss of sleep.
- Trauma of seeing fellow soldiers wounded or
killed. - Fear of being killed or maimed.
- Fear of killing other people.
- Fear of failure or disgrace.
- Worry about family problems back home.
6IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION
- Physical Signs and Symptoms
- Tenseness, jumpy, startled at sudden sounds or
movement. - Headache, backache, pain in old wounds.
- Fidgeting, fine trembling of the hands, fumbling.
- Cold sweat, dry mouth, pale skin.
- Blurred vision.
7IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION
- Pounding heart, feeling dizzy or light-headed.
- Feeling "out of breath," breathing too rapidly.
- Tingling, cramps, or numbness in fingers and
toes. - Upset stomach, "dry heaves," or actual vomiting.
- Uncontrollable emptying of bowels and bladder
when danger suddenly appears. - Fatigue, feeling drained of energy.
- Blank, haunted, "1000-yard" stare.
8IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION
- Mental and Emotional Signs and Symptoms
- Anxiety, worrying, bothered by little things.
- Irritability, complaining.
- Difficulty in paying attention or remembering
details. - Difficulty in thinking, speaking, and
communicating. - Sleeping difficulties, such as being awakened by
bad dreams. - Grieving, tearfulness, crying for a dead or
wounded buddy.
9IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION
- Feeling guilty about mistakes made or at things
that had to be done. - Anger, resentment.
- Feeling let down others, loss of confidence in
self and/or others.
10TREAT A CASUALTY WITH MILD COMBAT STRESS REACTION
- Be calm.
- Keep the soldier focused on the unit's immediate
mission. - Encourage the soldier to eat, bathe, and sleep as
the tactical mission and safety permit. - Keep the soldier busy when he is not resting.
- Get the soldier to perform simple, well-learned
tasks. - Have the soldier use relaxation techniques (take
a deep breath and let it out slowly, etc.).
11TREAT A CASUALTY WITH MILD COMBAT STRESS REACTION
- Allow and encourage the soldier to ventilate his
feelings. - Remind the soldier that some degree of combat
stress reaction is normal and to be expected.
12IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION
- Physical Signs and Symptoms
- Cannot keep still, constantly moving around.
- Arms or whole body shake.
- Cowering in terror.
- Flinching or ducking at almost any sudden sound
or movement. - Sudden paralysis (hand, arm, leg) with no injury.
- Sudden blindness or deafness (partial or
complete) with no injury.
13IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION
- Total immobility (freezing) under fire.
- Total physical exhaustion (just stands or sits).
- Staggering or swaying when standing.
14IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION
- Mental and Emotional Signs and Symptoms
- Rapid talking, constantly making suggestions.
- Starting fights, recklessness, "vicious" behavior
within own group, uncontrollable anger. - Social withdrawal (silence, sulking, prolonged
sadness). - Inattentiveness to self-care and hygiene, no
interest in eating. - Apathetic and indifferent to danger.
15IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION
- Cannot remember orders, how to perform duties, or
where he is. - Inability to concentrate or make decisions.
- Severe speech problems, including stuttering and
inability to talk. - Fear of sleeping, even in a relatively safe area.
- Sees things which are not there (usually after
severe sleep loss). - Rapid emotional swings, hysteria, strange
behavior. - Panic running under fire.
16TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION
- A soldier suffering from moderate or severe
combat stress reaction usually requires routine
evacuation. Combat stress reaction patients
should be managed separately from other patients.
Combat stress reaction casualties usually recover
completely after resting in a safe area, being
able to clean up, and receiving hot, nutritious
meals. About 70 to 85 percent of evacuated combat
stress reaction casualties are capable (with good
management) of returning to their combat units
within three days.
17TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION
- Early on, these patients need to talk, ventilate
to any medical person. All combat stress reaction
patients should be treated with the expectation
of their going back to duty. Most of the
remainder will return to their own unit or to
another unit within two weeks. - Appear to be calm and in control of the
situation. - Calmly try to talk the casualty into cooperating
if he is responsive.
18TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION
- If the soldier appears to be dangerous, take his
weapon away from him. - Physically restrain the casualty if the soldier
is a - danger to himself or others.
- Get medical assistance if possible.
- Evacuate the casualty if he does not improve or
if he is dangerous. Restrain the casualty if
needed.
19TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION
- Question
- What are some of the things done to help mild and
more serious combat stress casualties recover? - Response
- Normal activities such as sleeping, eating, and
getting cleaned up which the soldier has been
denied due to combat conditions. - Question
- About how many combat stress casualties that are
evacuated return to the unit within three days? - Response
- 70 to 85 percent.
20MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)
- CLOSING
- Procedures used to treat mild combat stress
reaction casualties can also be used to prevent
combat stress from developing. When a combat
stress reaction casualty returns to the unit,
welcome him back. Be willing to talk about what
happened and express your confidence in him. Make
him feel part of the unit again. Remember, no one
is immune to combat stress reaction. - This lesson is tested in the written
multiple-choice examination.
21Questions