and shock control
You find your patient who has a wound in this case to his forearm. Usually
they will not be as clean or have as little blood so make sure you wear
gloves. Expose the wound but do not remove embedded clothing or objects
penetrating the wound. If there is a penetrating injury, secure the object
in place so it doesn't move and wrap the dressings around it.
Take one of the patient’s battle dressings and place it on the wound and
apply direct pressure with your hand. If you use one of your battle
dressings the patient will be evacuated to the rear with his first aid
supplies and you will be without one when you get injured.
Elevate the wound to a level above the heart.
Wrap the bandage around the dressing and put the knot over the wound. If
the dressing becomes soaked with blood you may remove the first bandage
and apply another. If a blood soaked dressing is bleeding through it is
not clotting and doesn’t absorb blood. Repositioning the bandage may also
aid in slowing bleeding the second time. If the second dressing bleeds
through apply another to the top and do not remove it.
If the wound continues to bleed apply pressure to the correct artery.
If after this the bleeding does not stop you might consider a tourniquet.
90% of bleeding can be controlled with direct pressure, elevation,
bandages and arterial pressure. Many combat injuries involving massive
trauma such as a shattered limb or when a blood vessel is torn along its
length may require a tourniquet. If one is used only tighten enough to
stop the bleeding and mark the patient’s forehead with a “T” along with
the date and time the device was put on.
If the patient begins to go into shock, have them lay down on their back,
elevate their feet above their heart, apply oxygen if available, keep them
warm and consider ALS interventions if so trained. Transport to advanced
medical care as soon as possible.
If you do not have battle dressings you can use 4X4 dressings.
Again, if it bleeds through you can remove the top layers of 4X4 and add
more to the top. You can use roller gauze or cervix rolls to secure the
dressing to the arm.
Sometimes a person will have an injury in a place that is hard to wrap
such as the neck. To secure the bandage, wrap the gauze or ties under the
person's arm and not around their neck or it will strangle them.
If the patient starts to go into shock, immediately have them lie down,
raise their legs above heart level, apply oxygen if possible, keep them
warm and transport. If you are able begin ALS procedures.