First Aid

The Company Aid Man is going to be skilled in delivering most of the following and will carry the necessary supplies to do so on his person. Additionally, first aid will be administered at an Aid Station of battalion or regimental level. 


Quoted: FM 21-11

"First aid means those medical measures which a soldier can carry out for himself or a companion and does not apply to the emergency medical treatment which is given by a medical officer or a Medical Department soldier.

IMPORTANT FIRST-AID RULES
a. Do not get excited; act quickly but calmly.
b. Do not try to do too much.
c. Handle an injured person gently.
d. Keep an injured person warm.
e. Whenever possible, give an injured person first aid before he is moved.
f. Do not pour liquids into the mouth of an unconscious person: to do this may choke him.
g. Do not try to bring an unconscious injured person to consciousness. Let him lie quietly, face down, with his head turned to one side.
h. Remember that drugs are dangerous if too much is given; follow directions when using drugs in first-aid kits and packets.
i. Anyone who has been given first aid f/or a serious condition should be seen as soon as possible by a medical officer.

First Aid in Combat
Successful accomplishment of the assigned mission is the aim of battle. The combat soldier will administer first aid only when he can do so without interfering with his combat duties. When administration of first aid in actual combat is possible, usually only those measures will be taken which are immediately necessary to save life. The wounded person should be placed where he is protected from enemy fire and the elements, marking the spot where he lies so that he can be easily found by Medical Department personnel.


Wounds
First aid for wounds includes measures to stop bleeding, overcome shock, relieve pain, and prevent infection.

Exposure of Wound
To give proper first aid, the entire wound must be well exposed in order to ascertain exactly where it is, how large it is, and how much it- is bleeding. When a wound has been caused by a bullet, a shell fragment, or other object which could have gone all the way through a part of the body, look for a wound where the object may have come out, because the wound where it comes out is usually larger than the wound where it goes in. In order to see all wounds which may be present, cut, tear, or remove the clothing as much as necessary. Do not drag clothes over a wound; carefully lift them off.

Bleeding
All open wounds bleed more or less. Bleeding from an artery is known as arterial bleeding, and bleeding from a vein is known as venous bleeding. Bleeding from the arteries is more dangerous because the blood flows fast and will soon cause a person to bleed to death unless the flow of blood is stopped. In most severe wounds there is bleeding from both arteries and veins. Bleeding of any type must be stopped as soon 'as possible. The first-aid methods to stop bleeding are to press directly over the wound, to elevate the wounded part, or to use a tourniquet.

Use of Tourniquet
(1) Do not use a tourniquet unless bleeding cannot be stopped by other means. Bleeding from a wound canrl usually be sto;ped by applying a sterile dressing, pressing directly over the wound, and, if possible, raising the wounded part. If a regular issue tourniquet is used, the buckle should be on the inside of the upper arm or thigh and the strap should be pulled. If bleeding cannot be stopped by simply pulling the tourniquet tight, loosen it enough to slip a bayonet or other object under it so that it can be made tight enough by twisting.
(2) For bleeding from the arm and hand, put on the tourniquet about a hand's breadth below the armpit. For the thigh and leg, put it on about a hand's breadth below the crotch.
(3) If a regular tourniquet is not available, a triangular bandage, a tie, a belt, or a handkerchief will do instead. Figure 5 shows how a tourniquet is tightened by twisting it with a bayonet or a stick.
(4) Tighten a tourniquet only as much as is necessary to stop bleeding.
(5) A properly applied tourniquet stops all the blood going to the injured part, and gangrene may develop if a tourniquet is left on too long. It should be loosened every 20 or 30 minutes, and then tightened again after 10 or 15 seconds.
(6) Do not cover a tourniquet with a bandage or a splint because, if covered, it may be forgotten and left on too long. If you put a tourniquet on a wounded person who is conscious and then leave him, tell him to be sure to get someone to loosen it for at least 10 or 15 seconds every 20 or 30 minutes.

Shock
Shock is a condition of weakness which usually follows wounds, burns, or other injuries. When severe shock has developed, the injured person is pale, and his skin is cold and wet with sweat. Remember, however, that these are signs of severe and fully developed shock. A person who is suffering from a mild degree of shock may not show these signs. First-aid measures for shock should, whenever possible, be started before the injured person has developed definite signs of shock. Shock is especially likely to occur if a person is bleeding. Shock can also be caused or increased by exposure to cold, fatigue, or hunger. A certain amount of shock follows all injuries and burns; it may be slight and last only for a few minutes, or it may be severe and last for a long time, and may even cause death. As a rule, the more severe an injury or burn, the greater will be the amount of shock. Shock often does not appear until many minutes or even several hours after a wound, burn, or other injury. Even before shock can be noticed, take measures to prevent it.

1. Handle the injured person gently, avoid unnecessary moving of the injured part or of the injured person, and in all other ways make him as comfortable as possible.
2. To prevent or overcome shock, put the injured person on his back with his head ang shoulders lower than his legs and hips. If he is unconscious, keep him face down, with his head turned to one side, and with his head and shoulders lower than his legs and hips.
3. Stop any bleeding as soon as possible.
4. Remove the individual's pack and loosen tight clothing or straps.
5. Keep an injured person warm, but be sure not to overheat him because overheating can increase shock instead of preventing or overcoming it.
6. Warm drinks are helpful in shock. If a person has a wound of the abdomen or throat, never give him more than a few small sips of water to wet his lips. Unless very thirsty, a person with a wound of the abdomen or throat should be given nothing to drink, and should never be given anything to eat.

Pain
Some pain occurs sooner or later following all wounds.' Pain is often so slight that it does not bother the injured person enough to require any particular attention but, if pain is severe, it must be relieved as much as possible. Pain can often be prevented or relieved by simple measures such as keeping an injured person quiet and warm, carefully changing his position to make him comfortable, splinting an injured arm or leg, and gentle handling during transportation. Only when pain is severe, or when a badly injured person must be moved quickly, as from a wrecked vehicle or aircraft, is it wise to give him morphine. If pain is severe, however, a dose of morphine will not only relieve the pain but will also lessen shock.

Caution: The full effects of, morphine are not felt for 20 to 30 minutes after injection. A second injection of morphine for continued severe pain should not be given sooner than 2 hours after the first one. Never give a second dose of morphine to a person who is breathing 12 or less times a minute. Never give morphine to an unconscious person.


Infection
Whenever the skin is torn or cut, infection may occur. Infection is very likely to take place if a wound touches the ground, or if anything else dirty touches or gets into it. A wound which becomes infected is much more serious than one which is kept clean, so the prevention of infection is a very important first-aid measure. At the same time that bleeding is being stopped and a dressing applied, as well as after these first-aid measures have been carried out, care must be taken to keep a wound clean, so as to prevent infection. 

Do not touch a wound with dirty hands or dirty clothing..Do not allow a wound to touch the ground. Do not wash a wound.

If there is only a small amount of bleeding from a wound when first seen, or if bleeding has been easily stopped, sprinkle sulfanilamide, which is in the first-aid packet (figs. 6 and 7), into the wound as shown in figure 8, and then apply the sterile dressing, which is also in the first-aid packet. When bleeding has been hard to stop, do not lift up or take off the dressing to sprinkle sulfanilamide into the wound; removing the dressing may start bleeding again.

The proper application of a sterile dressing is an important means of preventing infection as well as of stopping bleeding. To use the dressing in the first-aid packet, carefully remove the wrapper. Open the compress by pulling on the two folded bandages attached to the compress, being careful not to touch the inside of the compress with the fingers or anything else. Still holding one folded bandage in each hand, apply the compress to the wound; then wrap the bandage around the injured part of the body and tie the ends together or fasten them with safety pins. 

When wounded other than in the abdomen or throat, take by mouth, along with a large amount of water, the eight sulfadiazine tablets (or the twelve sulfanilamide tablets found in some packets instead of sulfadiazine tablets) which are in the sealed packet carried in the first-aid pouch attached to the cartridge sbweelat.t ingI f has been great or if large amounts of water cannot be taken both with the drug and for 24 hours afterward, no sulfadiazine or sulfanilamide tablets are to be taken.


WOUNDS REQUIRING SPECIAL ATTENTION
Wounds extending into the chest
If there is a wound of the chest through which air is sucking in and blowing out, the life of the person may depend upon quickly applying a dressing which is large enough to cover the wound and which completely stops the flow of air through the wound. If this does not stop the back and forth movement of air, apply more dressing. A large piece of raincoat, overcoat, blouse or shirt applied tightly over the dressing may be useful in making the dressing airtight.

Wounds entering the abdomen
If a bullet or other object has gone into or through the abdomen, the injured person should be given nothing to eat or drink. Under no circumstances give anything more than a few small sips of water to wet his lips. If the abdominal organs have come through the wound do not try to put them back. Sprinkle sulfanilamide over the wound and organs, and put on a large sterile dressing.

Wounds of the jaws, mouth, and face
If there is a wound of these parts, the face of the wounded person should be kept pointed toward the ground in order to prevent blood from getting into the back of the throat where it may cause choking. Until bleeding stops, keep the person in a sitting position with his head bent forward. If it is necessary for him to lie down, or if he must be carried on a litter, keep his face pointed to the ground.


Other:
FAINTING
When a person who has fainted falls, it is usually best to let him lie quietly; loosen any tight clothing. If a person is about to faint or has actually fainted while sitting up, lower his head between his knees.

Unconsciousness 
It is frequently impossible to find out the cause of unconsciousness; always think of the possibility of bleeding, sunstroke, or injury to the head.

Keep the person lying face down with his head turned to one side. If his skin is very warm and he might have heatstroke, give him first aid as described for that of heatstroke (sunstroke). If he is cold, keep him warm. Do not move the person unless absolutely necessary and then do so very carefully. Do not pour liquids into the mouth of an unconsdcious person; to do this may choke him.

HEATSTROKE, HEAT EXHAUSTION, AND HEAT CRAMPS
All. these conditions are caused by heat, but differ in their symptoms and in the first-aid measures needed for them. The general body effects of heat can usually be prevented by avoiding unnecessary exposure to extreme heat; by keeping living and working quarters as cool as possible; by keeping the head and body covered when in the sun; by wearing light, loose fitting outer clothes; by taking plenty of salt with food, and by drinking enough water to which salt tablets have been added. The bad effects of overheating and sweating are less likely to happen if short rest periods are taken during the heat of the day. It is better to drink small amounts of water frequently instead of large amounts all at once. Alcoholic and iced drinks, including ice water, should be avoided. Do not eat large, heavy meals. Eat sparingly during the heat of the day. Fruits and vegetables, preferably cooked, and fruit juices are good types of food in a hot climate. Avoid unnecessary physical exercise. Keeping the skin clean and free from dust and grease helps in the control of body heat.

Heatstroke (also known as sunstroke)
Heatstroke is often caused by direct rays of the sun, but it can also happen even when a person has been under cover. The symptoms are headache, dizziness, irritability, seeing objects red or purple, and sometimes vomiting; the skin is hot and dry; the face is flushed and there is high fever. The pupils of the eyes are usually very small. Unconsciousness usually occurs, and the body becomes limp; sometimes there may be convulsions.

First-Aid Measures: Remove the person to a shady, cool place if possible, and remove all clothing except light underwear. Lay him on his back X ith shoulders raised. Cool by sprinkling large amounts of cool water evenly over the body, and fanning continuously to cause rapid evaporation. Apply cool wet cloths to the head, changing them frequently. Briskly rub the arms, legs, thighs, and trunk. Do not overdo these things; stop every few minutes to note their effects. When the person is conscious give cool water containing two salt tablets to a canteenful of water. If the skin gets hot again, repeat the measures.

Heat Exhaustion
The first signs of heat exhaustion are an "all in" feeling, dizziness, nausea, and unsteady walking. The face Is pale, the skin is cold, and there is severe sweating. Fainting may occur. The pupils of the eyes are usually very large.

First-Aid Measures: Remove the person to a cool or shady place, lay him on his back and have him drink three to five canteenfuls of cool salt water (1/4 teaspoonful of table salt or two salt tablets to a canteenful of water) In a 12-hour period.

Heat Cramps
Heat cramps usually occur after a person has been sweating a great deal, especially if extra amounts of salt have not been taken. In this condition
there are muscle cramps, especially of the legs and arms; the skin is cool, moist, and pale; breathing is shallow; frequently there is vomiting. There may also be severe weakness and dizziness.

First-Aid Measures: Heat cramps can usually be prevented by taking extra amounts of salt on days when sweating a great deal. If cramps have already developed, rest in a cool place and take three to five canteenfuls of cool salt water (V. teaspoonful of table salt or two salt tablets to a canteenful of water) in a 12-hour period.


Transportation of the Sick or Injured
Correct transportation of a seriously injured person is one of the most important parts of first aid. Careless or rough handling can increase the seriousness of an injury and may even cause death. Whenever possible, give whatever first aid is needed before moving an injured person. If there is no absolute need for moving him at once, it is usually best to let him stay where he is until he can be moved by litter, ambulance, or some other means. Unless he is already overheated, an injured person should be keptwarm both while waiting to be moved and during transportation.

Without Litters
Sometimes situations require transportation without litters or other equipment. If this should be necessary it can be done by one or another of several ways.

Movement by one bearer
Movement of an injured person by a single bearer may be done by the fireman's carry, supporting carry, arms carry, saddle-back carry, pack-strap carry, or fireman's drag.

Author's description:
Fireman's Carry: Carrying them sideways on your back, with one of their legs and arms over each of your arms. See: Photo
Supporting Carry: One of the wounded's arms over your shoulder, helping them walk along
Arms Carry: Carrying them like you would a baby
Saddle-Back Carry: PIGGY BACK RIDE! PIGGY BACK RIDE!
Pack-Strap Carry: Wounded's arms are pulled over your shoulders and the wounded is carried on your back
Fireman's Drag: Grabbing them from under the armpits and dragging them backwards

Movement by two bearers
Movement of an injured person by two bearers may be done by the supporting carry, arms carry, saddle-back carry, or pack-saddle carry.

Author's description:
Supporting Carry: Similar to that done by one person, but now by two
Arms Carry: As if your arms were loaded with firewood, two people carry the body
Saddle-Back Carry: "You get his legs, I'll get his arms" One grabs him at the knees and the other under the pits and they walk him along.
Pack-Saddle Carry: The two bearers face one another, forming an interlocking 'seat' with their arms. The wounded sits on their arms and uses his arms to hold onto their necks. 

With Improvised Litters
Many objects and materials may be used to make improvised litters in an emergency.

The usual way to make a litter is with a blanket or shelter tent, and poles about 7 feet long.
(1) The blanket is spread on the ground.
(2) One pole is laid across the center of the blanket which is then folded over it.
(3) The second pole is placed across the center of the new fold.
(4) The blanket is folded over the second pole as over the first.
(5) The free end of the blanket is fixed.

A litter can be prepared by turning two or three blouses inside out and buttoning them up, sleeves in, then passing poles through the sleeves, the backs of the blouses forming the bed.

Camp cots, window shutters, doors, benches, ladders, boards, or poles, tied together and preferably padded, serve well as litters.

Litters can be made by ripping the bottoms or cutting off the corners of sacks, bags, or bedticks, then passing two poles through them and tying crosspieces to the poles to keep them apart. 

A shelter half, a blanket, a piece of matting, or a piece of carpet can be fastened to poles by tacks or twine to make a litter.

Rope or wire can be woven between poles and this network covered with a blanket.

If no poles can be had, a blanket, rolled from two sides and supported, can be used as a litter.

In snow country, sleds will serve as a litter; if a regular sled is not available, skis can be fastened together to serve the same purpose."
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