How to provide first aid to a wounded person “under fire”: instructions
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The Security Service of Ukraine published a series of educational lectures on tactical medicine – pre-hospital first aid. This knowledge in the conditions of war can help save a person’s life at the front. Currently, 7 short lectures are available on the SBU YouTube channel. Lecture 1. Helping a wounded person under enemy fire In this video, special forces of the Special Operations Center “A” of the Security Service explain how to help a wounded person under fire contact conditions and show how to prevent additional losses during combat missions. There are two types of assistance to a wounded person under fire – self-aid and mutual aid. For mutual aid, the wounded must act as follows: continue to return fire, find a safe shelter. Then it is necessary to assess the severity of the wound and the condition of the victim, after which give him instructions, depending on the situation: continue to return fire, find the nearest safe shelter and move to it, provide self-aid if the soldier is able to do it on his own. Also, the fighter must inform the commander about the wounded. If the injured cannot move or is unconscious, it is necessary to develop a plan to reach him. The only thing that can be done at the stage of assistance “under fire”, if the tactical situation allows, is to stop the massive bleeding by applying a tourniquet. You can learn more about the signs of massive bleeding, self-help, the rules for applying a tourniquet at the “under fire” stage, ensuring the patency of the respiratory tract, moving a wounded person from the battlefield to a shelter in the first SBU lecture. Read also: How to properly apply a tourniquet and stop bleeding: 5 myths about first aid Lecture 2. Helping a wounded person in tactical conditions and inspecting the first aid kit After the wounded person has been moved from the area under fire to a safer place, it is necessary to proceed to help in tactical conditions. The Security Service of Ukraine told what should be in the first-aid kit of each soldier and how to act to the rescuer of a wounded person before starting to provide aid according to the MARCH algorithm. The MARCH algorithm determines the priorities and order of actions in providing assistance to the injured. It is used when fighters are no longer under fire and can concentrate on saving their comrades. What should be in a fighter’s first aid kit: paramedic scissors, medical gloves, a tourniquet, tamponades – gauze with and without hemostatic, a bandage to stop bleeding, a nasopharyngeal airway for the respiratory tract, an occlusive sticker for closing wounds, a thermal blanket, an eye patch, a pill set Pill- pack, which contains an antibiotic and anti-inflammatory drugs, a tissue patch, a “wounded card” and a permanent marker. In the video, you can also learn more about: organization and control of the security perimeter, disarming the wounded, conditions for delaying the evacuation, placing the first-aid kit and the turnstile on the equipment. designation of the composition of the first-aid kit. Read also: How to assemble a first aid kit? Advice from a doctor Lecture 3. MARCH algorithm. M – Massive Bleeding In this video, the SBU explains how to control massive bleeding in a wounded person, because a person can die in a matter of minutes from rapid blood loss. The SBU explained what the actions of a soldier should be when rescuing a comrade. In particular: how to correctly perform a visual and tactile examination of the wounded, how and when to apply a tourniquet, in which cases to apply tamponade, when a bandage is applied, how to diagnose shock. Lecture 4. The MARCH algorithm. A – Patency of the respiratory tract After stopping the massive bleeding, the next stage of care is to check the consciousness, reaction to the voice, reaction to pain in the injured person. If he does not respond to any of the stimuli, it is necessary to check whether the injured person is breathing. To do this, you need to unfasten the helmet strap and examine the oral cavity for the presence of foreign objects. If there are any, they must be pulled out by turning the injured person’s head to the side, as shown in the video on the mannequin. More details about the subsequent actions of the rescuer – opening the airways, placing a nasopharyngeal airway and transferring the wounded to a stable position – in the SBU lecture. Lecture 5: The MARCH algorithm. R – Breathing Having ensured the patency of the injured person’s airways, it is necessary to proceed to checking the indicators of breathing and assistance in case of chest injuries. First, the rescuer must assess the breathing of the wounded: determine the frequency of breathing in 10 seconds (the norm for the wounded is 10-30 breaths per minute), determine the depth of breathing by placing a hand on the lower part of the chest, determine the symmetry of breathing by placing both palms on the lower parts of the chest on both sides. After that, the fighter should examine the chest and back of the wounded. How to do it correctly, as well as when to use an occlusive sticker, what help to provide during a pneumothorax (accumulation of gas (most often, air) in the pleural cavity with a simultaneous increase in pressure in it) and how to act to prevent hypothermia (lowering of body temperature) – in the SBU lecture. Lecture 6: The MARCH algorithm. C – Blood circulation At this stage, it is necessary to carry out a traumatic exposure and check for the presence of non-critical bleeding in the wounded and stop them. It is also necessary to check the effectiveness of the previous means for controlling massive bleeding used in the stage “M – Massive bleeding” of the MARCH algorithm. Another important element of this stage is the examination of the pelvis for the presence of fractures and its fixation. The SBU explained how to check for signs of shock in a victim as a result of injuries, help in the case of a pelvic fracture, and properly apply bandages to wounds. Lecture 7. MARCH algorithm: H – Head injury, hypothermia and preparation of the wounded for evacuation The last stage of helping the wounded according to the MARCH algorithm is checking for the presence of a craniocerebral injury and the first actions in case of its detection. After that, we have to prepare the injured person for evacuation and activate the PAWS algorithm. To detect signs of a craniocerebral injury, it is necessary to check: the head for bruises, bruises and fractures, bruises around the eyes – if they are without signs of a nose injury, this indicates a severe TBI, symmetry of the pupils (asymmetry is a sign of TBI), reaction of the pupils to light, closing and opening the injured person’s eyes with his hands – his pupils should narrow if there is no TBI. If there is no lighting, you can use a flashlight, but do not shine it directly into the injured person’s eyes – switch the beam to another nearby object. The SBU also talked about: completion of assistance to prevent hypothermia, filling out the injured person’s card, the PAWS algorithm: pain relief, antibiotics, wounds and fracture splints. Read also: The Ministry of Health reminded the basic rules of pre-medical care in case of stroke and seizures
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