081-831-1001 - Evaluate a Casualty (Tactical Combat Casualty Care) Evaluate the casualty following the correct sequence. Identify all life-threatening conditions and other serious wounds Conditions: You have a casualty who has signs/symptoms of an injury. Your unit may be under fire. Standards: Evaluate the casualty following the correct sequence. Identify all life-threatening conditions and other serious wounds. Performance Steps:
Note: Tactical combat casualty care (TCCC) can be divided into three phases. The first is care under fire; the second is tactical field care; the third is combat casualty evacuation care. In the first, you are under hostile fire and are very limited as to the care you can provide. In the second, you and the casualty are relatively safe and no longer under effective hostile fire, and you are free to provide casualty care to the best of your ability. In the third, the care is rendered during casualty evacuation (CASEVAC). Warning: If a broken neck or back is suspected, do not move the casualty unless to save his/her life. 1. Perform care under fire.
a. Return fire as directed or required before providing medical treatment. b. Determine if the casualty is alive or dead.
Note: In combat, the most likely threat to the casualty's life is from bleeding. Attempts to check for airway and breathing will expose the rescuer to enemy fire. Do not attempt to provide first aid if your own life is in imminent danger. Note: In a combat situation, if you find a casualty with no signs of life-no pulse, no breathing-do NOT attempt to restore the airway. Do NOT continue first aid measures. c. Provide tactical care to the live casualty.
Note: Reducing or eliminating enemy fire may be more important to the casualty's survival than the treatment you can provide. (1) Suppress enemy fire.
(2) Use cover or concealment (smoke).
(3) Direct the casualty to return fire, move to cover, and administer self-aid (stop bleeding), if possible. If the casualty is unable to move and you are unable to move the casualty to cover and the casualty is still under direct enemy fire, have the casualty "play dead." (4) If the casualty is unresponsive, move the casualty, his/her weapon, and mission-essential equipment to cover, as the tactical situation permits. (5) Keep the casualty from sustaining additional wounds.
(6) Reassure the casualty.
d. Administer life-saving hemorrhage control.
(1) Determine the relative threat of the tactical situation versus the risk of the casualty's bleeding to death. (2) If the casualty has severe bleeding from a limb or has suffered amputation of a limb, administer life-saving hemorrhage control by applying a tourniquet before moving the casualty. (See task 081 -831-1032.) e. Transport the casualty, his/her weapon, and mission-essential equipment when the tactical situation permits. f. Recheck bleeding control measures as the tactical situation permits. 2. Perform tactical field care when no longer under direct enemy fire. Note: Tactical field care is rendered by the individual when no longer under hostile fire. Tactical field care also applies to situations in which an injury has occurred during the mission but there has been no hostile fire. Available medical equipment is limited to that carried into the field by the individual Soldier. Warning: If there are any signs of nerve agent poisoning, stop the evaluation, take the necessary NBC protective measures, and begin first aid. (See task 081-831-1 044. ) Note: In the following situations communicate the medical situation to the unit leader and ensure that the tactical situation allows for time to perform these steps before initiating any medical procedure. Note: When evaluating and/or treating a casualty, seek medical aid as soon as possible. Do NOT stop treatment; but, if the situation allows, send another person to find medical aid. a. Form a general impression of the casualty as you approach (extent of injuries, chance...
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