SSG Scaliatine

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Welcome SSG Scaliatine SGT McNamara
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Task Re-certify Combat Lifesaver skills
IAW ISO826 (CLS Instructors Booklet) Conditions
Given performance check list on four tasks
(I.V., Measure/Monitor Pulse, Restore Breathing,
Stop bleeding on a limb) Standards Receive a go
on all tasks
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• Watch your head, LOW CEILING
• Use the hand rail when on stairs
• Dont lean back on chairs
• No horseplay

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Perform First Aid to Clear an Object
stuck in the throat of a Conscious
Casualty This slide show presentation was
built with the help of FM21-11 (First Aid for
Soldiers). Page 2-1, of your Buddy-Aid book,
has the Task Conditions Standards for this
Lesson Follow along in your book. The wording
may not be exact, the skills and information
are.
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Evaluate the Casualty

• Steps in a Primary Survey
• Mask and Treat a Chemical Agent Casualty
• Check the Casualty for Responsiveness
• Check the Casualtys Airway
• Check the Casualtys Breathing
• Check the Casualtys Circulation
• Check the Casualty for Bleeding
• Treat for Chemical Agent Poisoning (if
  appropriate)
• Check the Casualty for Shock

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Evaluate the Casualty

• Steps in a Secondary Survey
• Check the Casualty for Fractures
• Check the Casualty for Burns
• Check the Casualty for Closed Head Injury
• (concussion)
• Check the Casualty for Environmental Injuries
• Check the Casualty for Other Wounds/ Fractures
• Check the Casualty for Combat Stress Reaction

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Airway Obstructions In order for oxygen from the
air to flow to and from the lungs, the upper
airway must be unobstructed. a. Upper airway
obstructions often occur because (1) The
casualtys tongue falls back into his throat
while he is unconscious as a result of injury,
cardiopulmonary arrest, and so forth.
(The tongue falls back and obstructs, it is
not swallowed.) (2) Foreign bodies become
lodged in the throat. These obstructions usually
occur while eating (meat most commonly causes
obstructions). Choking on food is associated
with Attempting to swallow large pieces of
poorly chewed food. Drinking
alcohol. Slipping dentures.
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(3) The contents of the stomach are regurgitated
and may block the airway. (4) Blood clots may
form as a result of head and facial injuries.
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Upper airway obstructions may be prevented by
taking the following precautions (1) Cut food
into small pieces and take care to chew
slowly and thoroughly. (2) Avoid laughing and
talking when chewing and swallowing. (3) Restrict
alcohol while eating meals. (4) Keep food and
foreign objects from children while they walk,
run, or play. (5) Consider the correct
positioning/maintenance of the open airway for
the injured or unconscious casualty.
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• Upper airway obstruction may cause either
• partial or complete airway blockage.
• Partial airway obstruction. The casualty may
  still have an air exchange. A good air exchange
  means that the casualty can cough forcefully,
  though he may be wheezing between coughs. You,
  the rescuer, should not interfere, and should
  encourage the casualty to cough up the object on
  his own. A poor air exchange may be indicated by
  weak coughing with a high pitched noise between
  coughs. Additionally, the casualty may show signs
  of shock (for example, paleness of the skin,
  bluish or grayish tint around the lips or
  fingernail beds) indicating a need for oxygen.
  You should assist the casualty and treat him as
  though he had a complete obstruction

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Complete airway obstruction. A complete
obstruction (no air exchange) is indicated if the
casualty cannot speak, breathe, or cough at all.
He may be clutching his neck and moving
erratically. In an unconscious casualty a
complete obstruction is also indicated if after
opening his airway you cannot ventilate him.
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Types of airway Blockages

• Partial Blockage with Good Air Exchange
• Partial Blockage with Poor Air Exchange
• Complete Blockage

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Treatment of airway Blockages

• Partial Blockage with Good Air Exchange
• Encourage coughing
• Partial Blockage with Poor Air Exchange
• Get help, administer Abdominal Thrusts
• Complete Blockage
• Get help, administer Abdominal Thrusts

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Clearing a conscious
casualtys airway obstruction can be performed
with the casualty either standing or sitting, and
by following a relatively simple
procedure. WARNING Once an obstructed airway
occurs, the brain will develop an oxygen
deficiency resulting in/unconsciousness. Death
will follow rapidly if prompt action is not
taken.
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NOTE The manual thrust with the hands centered
between the waist, and the rib cage is called an
abdominal thrust (or Heimlich maneuver). The
chest thrust (the hands are centered in the
middle of the breastbone) is used only for an
individual in the advanced stages of pregnancy,
in the markedly obese casualty, or if there is a
significant abdominal wound.
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Look at Practical Exercise on Page 2-6
DO NOT write in BOOK
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Find a Partner, Practice this skill Use
Checklist found on page 2-9 in your Buddy-Aid Book
DO NOT write in BOOK
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Perform Mouth-to-Mouth Resuscitation

• Buddy-Aid Book

Task Conditions Standards are listed on Page 3-1
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Evaluate the Casualty

• Steps in a Primary Survey
• Mask and Treat a Chemical Agent Casualty
• Check the Casualty for Responsiveness
• Check the Casualtys Airway
• Check the Casualtys Breathing
• Check the Casualtys Circulation
• Check the Casualty for Bleeding
• Treat for Chemical Agent Poisoning (if
  appropriate)
• Check the Casualty for Shock

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Evaluate the Casualty

• Steps in a Secondary Survey
• Check the Casualty for Fractures
• Check the Casualty for Burns
• Check the Casualty for Closed Head Injury
• (concussion)
• Check the Casualty for Environmental Injuries
• Check the Casualty for Other Wounds/ Fractures
• Check the Casualty for Combat Stress Reaction

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Perform Mouth-to-Mouth Resuscitation
What is Mouth-to-Mouth Resuscitation ????
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Perform Mouth-to-Mouth Resuscitation

• Check for Responsiveness
• Position the Casualty for Mouth-to-Mouth
  Resuscitation
• Open the Casualtys Airway
• Check for Breathing, while maintaining an Open
  airway
• Initiate Mouth-to-Mouth Resuscitation
• Perform a Finger Sweep
• Administer Modified Abdominal Thrusts
• Administer Modified Chest Thrusts
• Feel for Pulse
• Continue Mouth-to-Mouth Resuscitation
• Monitor the Casualty

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Perform Mouth-to-Mouth Resuscitation

• Check for Responsiveness
• Ask Casualty Are you OK?
• Call for help

HELP !
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Perform Mouth-to-Mouth Resuscitation

• Position the Casualty for Mouth-to-Mouth
  Resuscitation
• On his back (Supine)
• Roll if needed, protect head and spine
• Avoid Injury

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Perform Mouth-to-Mouth Resuscitation

• Open the Casualtys Airway
• Head Tilt / Chin Lift
• Jaw Thrust

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Perform Mouth-to-Mouth Resuscitation

• Check for Breathing, while maintaining an Open
  airway
• Look
• Rise Fall of the Chest / Abdomen
• Listen
• For sounds of breathing
• Feel
• For breath on the side of your face

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Perform Mouth-to-Mouth Resuscitation

• Initiate Mouth-to-Mouth Resuscitation
• Maintain an Open Airway
• Close Casualtys Nose
• Administer Two Full Breaths
• Evaluate Effectiveness of the Ventilation

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Perform Mouth-to-Mouth Resuscitation

• If Breaths do NOT go in
• Re-tilt the Airway and try again
• If Breaths still do NOT go in
• ASSUME THERE IS AN AIRWAY BLOCKAGE
• Perform Finger Sweeps and Manual Thrusts as
  needed

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Perform Mouth-to-Mouth Resuscitation

• Perform a Finger Sweep, if needed
• Use only if you see a foreign body in the mouth
• Look at Page 3-8

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Perform Mouth-to-Mouth Resuscitation

• Administer Modified Abdominal Thrusts
• Artificial Cough
• Find the correct position
• Press inward and upward
• After thrust do a Finger Sweep (if needed)
• Repeat Thrust, Finger Sweeps, and Ventilations
  until AIR GOES IN
• (Dont focus on the object, the goal is to get
  the Air in)

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Perform Mouth-to-Mouth Resuscitation

• Administer Modified Chest Thrusts
• Used w/ Casualty who has a serious abdominal
  wound, a Casualty who is noticeably pregnant,
• or a Casualty who is extremely Overweight
• Page 3-10 3-11 has pictures

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Perform Mouth-to-Mouth Resuscitation

• Feel for Pulse
• Carotid is best place
• Middle Index fingers
• 5 to 10 Seconds
• DO NOT USE YOUR THUMB
• NO PULSE ? , CPR is NOT a CLS Skill

Did you know ? Medics, on the Battle Field, will
only do CPR for one minute before leaving the
Casualty to treat other wounded soldiers.
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Perform Mouth-to-Mouth Resuscitation

• Continue Mouth-to-Mouth Resuscitation
• Stop
• When breathing is restored
• Medical personnel take over
• You must go get help (no pulse)
• You must continue the Battle
• You are too exhausted to Continue
• Monitor the Casualty

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Perform Mouth-to-Mouth Resuscitation
Practical Exercise is on Page 3-15
Remember DO NOT WRITE IN BOOKS
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Perform Mouth-to-Mouth Resuscitation
Practice on the Manikins Use Checklist on Pages
3-20, 3-21 3-22
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Questions ????
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Perform First aid for Bleeding of an Extremity
Page 4-1 in Buddy-Aid book
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Evaluate the Casualty

• Steps in a Primary Survey
• Mask and Treat a Chemical Agent Casualty
• Check the Casualty for Responsiveness
• Check the Casualtys Airway
• Check the Casualtys Breathing
• Check the Casualtys Circulation
• Check the Casualty for Bleeding
• Treat for Chemical Agent Poisoning (if
  appropriate)
• Check the Casualty for Shock

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Evaluate the Casualty

• Steps in a Secondary Survey
• Check the Casualty for Fractures
• Check the Casualty for Burns
• Check the Casualty for Closed Head Injury
• (concussion)
• Check the Casualty for
• Environmental Injuries
• Check the Casualty for
• Other Wounds/ Fractures
• Check the Casualty for
• Combat Stress Reaction

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Perform First aid for Bleeding of an Extremity
Task Apply a Field Dressing, elevation and
manual pressure, a pressure dressing, and a
Tourniquet, as needed, to a wound on a
Casualtys limb Conditions Given a simulated
Casualty with bleeding from a limb and needed
Supplies Standards Score a GO on the
Performance Checklist
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Perform First aid for Bleeding of an Extremity
All Bleeding stops eventually
Stop it before it runs out
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Perform First aid for Bleeding of an Extremity
Dressing Material placed directly over a
wound Bandage Material used to Hold
Dressing Field Dressing Carried by all Soldiers
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Perform First aid for Bleeding of an Extremity
Step 1 Expose the Wound Use Caution with
Burns or if in a Chemical Environment
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Perform First aid for Bleeding of an Extremity
Step 2 Apply Secure a Field
Dressing Expose the Wound Prepare
Dressing Open Dressing Apply to wound Secure
dressing Tie tails in Non-Slip Knot
Pictures on page 4-3 show it all
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Perform First aid for Bleeding of an Extremity
Step 3 Apply Manual Pressure Direct Pressure
for 5 to 10 Minutes
Step 4 Elevate the Injured Limb Do this at
the same time as Applying Pressure DO NOT elevate
a suspected Fracture
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Hold And Wrap
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Perform First aid for Bleeding of an Extremity
Step 5 Apply a Pressure Dressing Only on a
wound of the Arm or Leg Placed on top of the
field dressing Pictures on Page 4-6
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Need a hand ???
How about a Tourniquet ?
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Perform First aid for Bleeding of an Extremity
Step 6 Determine if a Tourniquet is
Needed Only when all else Fails Not on wounds
to the Head, Neck, Chest Not used on amputation
of part of Hand or Foot Is used on amputation of
Upper Arm, Forearm, Thigh or Lower leg
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Perform First aid for Bleeding of an Extremity
Step 7 Gather Materials for Making a
Tourniquet Tourniquet Bands Rigid
Object Securing Materials Padding
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Perform First aid for Bleeding of an Extremity
Step 8 Select Tourniquet Site Upper
Arm Thigh Above the Joint, as Close to Joint as
Possible Not over a Fracture
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Perform First aid for Bleeding of an Extremity
Step 9 Apply a Tourniquet ONLY USED AS LAST
RESORT Fold it as seen on Page 4-9 Apply it to
a Limb as seen on Page 4-11 An Arm Amputation as
seen on Page 4-10 A Leg Amputation as seen on
Page 4-12
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Application Of Tourniquet(Tying of Half-Knot)
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Application of Tourniquet(Positioning Stick)
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Application Of Tourniquet(Full-Knot on Stick)
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Secure Stick
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Perform First aid for Bleeding of an Extremity
Step 10 Dress an Amputation
Read Paragraph 4-11 on Page 4-12
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Perform First aid for Bleeding of an Extremity

• Step 11
• Mark the Casualty
• T and time of Tourniquet application
• Do not cover tourniquet
• Monitor Casualty and Treat for Shock

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Perform First aid for Bleeding of an Extremity
Test your Knowledge Do the Practical Exercise on
Page 4-13 DO NOT WRITE
IN BOOKS
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Perform First aid for Bleeding of an Extremity
Find your Partner Use the Performance Checklist
on Page 4-20 4-21
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Perform First aid for Bleeding of an Extremity
QUESTIONS ??
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Following are some photos If you have a weak
stomach or do not like the sight of blood do not
look at these pictures!
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• Measure and Monitor a Casualtys Pulse

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Evaluate the Casualty

• Steps in a Primary Survey
• Mask and Treat a Chemical Agent Casualty
• Check the Casualty for Responsiveness
• Check the Casualtys Airway
• Check the Casualtys Breathing
• Check the Casualtys Circulation
• Check the Casualty for Bleeding
• Treat for Chemical Agent Poisoning (if
  appropriate)
• Check the Casualty for Shock

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Evaluate the Casualty

• Steps in a Secondary Survey
• Check the Casualty for Fractures
• Check the Casualty for Burns
• Check the Casualty for Closed Head Injury
• (concussion)
• Check the Casualty for Environmental Injuries
• Check the Casualty for Other Wounds/ Fractures
• Check the Casualty for Combat Stress Reaction

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Measure Monitor a Casualtys Pulse

• Task, Conditions Standards found on page 18-1
  in Medical Tasks book

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Measure Monitor a Casualtys Pulse

• Step 1
• Locate the pulse site
• Carotid
• Radial
• NOTE DO not palpate both of the Casualtys
  Carotid Arteries at the same time
• Other sites Posterior Tibial, Temporal,
  Brachial, Femoral, Popiteal, Dorsalis
  Pedis Apical.
• Look at the picture on page 18-3 for locations.

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Measure Monitor a Casualtys Pulse

• Step 2
• Palpate the pulse site
• Use Middle and Ring fingers
• Do not use your thumb
• Count the beats felt in one minute
• Do not cheat, IE 30 seconds x 2
• Normal 60-80 Beats per Minute (BPM)
• Tachycardia Over 100 BPM
• Bradycardia Less then 50 BPM

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Measure Monitor a Casualtys Pulse

• Step 2 (cont)
• Classify the Strength of the Pulse
• Regular Easy to feel, Even Beats, Normal Force
• Bounding Easily detected due to large amount of
  blood pumping
• Weak Difficult to detect due to loss of blood
• Absent You guessed it NO PULSE FOUND

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Measure Monitor a Casualtys Pulse

• Step 3
• Monitor the Casualtys Pulse
• Count as needed Periodically
• Report Abnormal readings or changes

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Measure Monitor a Casualtys Pulse

• Try the Practical Exercise on Page 18-6

DO NOT WRITE IN BOOKS
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Initiate an Intravenous Infusion Read the Task,
Conditions, Standards on Page 17-1 of Medical
Book
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Turn to Page 17-1 in Medical Book. Read to page
17-13
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Take the practical examination (Written) on page
17-14
DO NOT WRITE IN BOOK
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Watch this demonstration then pair off do the
Skill, using the checklist from page
17-19 (medical book)
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Questions ???
See you next year !!!