PRIMARY SURVEY
CARE UNDER FIRE 1. Scene Assessment Return fire as directed or required Casualty should return fire if able Keep yourself from getting shot Prevent additional wounds to casualty Maintain situational awareness! 2. Quickly Identify and Control Severe Bleeding With a Tourniquet 3. Move the Casualty to Cover
TACTICAL FIELD CARE 1. Primary Survey A - A irway B - B reathing C - C irculation D - D isability E - E xpose/ E nvironment
TACTICAL FIELD CARE A - A irway Check for patent airway Open with manual methods as needed Insert simple airway adjunct if needed
TACTICAL FIELD CARE B - B reathing Check for breathing, respiratory rate/depth Check for tension pneumothorax and perform needle decompression if needed Inspect/palpate entire thorax and seal open chest wound (Asherman Chest Seal) if needed
TACTICAL FIELD CARE C - C irculation Check for pulse presence, quality, rate, and rhythm & skin capillary refill time, color, temperature, and moisture Check for and control remaining external hemorrhage using necessary means 1) Pressure Bandage (Kerlex/Trauma Dressing) 2) Tourniquet
TACTICAL FIELD CARE C - C irculation (Cont’d) Initiate fluid resuscitation as per: 1 - Controlled bleed/no shock=saline lock only 2 - Controlled bleed/shock=saline lock & IV fluids 3 - Uncontrolled bleed=saline lock
TACTICAL FIELD CARE D - Disability Check level of consciousness: A - Alert V - responds to Verbal stimulus P - responds to Painful stimulus U - Unresponsive
TACTICAL FIELD CARE E - Expose/Environment Expose only as needed for survey Protect from the environment and prevent hypothermia
TACTICAL FIELD CARE 2. Secondary Survey Head-to-toe evaluation “Where my hands go, my eyes follow” Reassess ABC’s “Look, listen, and feel” See, don’t just look! Hear, don’t just listen! Feel, don’t just touch!
CASEVAC 1. Package and prepare for casualty evacuation Non-ambulatory via SKEDCO litter or field expedient means Ambulatory 2. Aid and litter teams 3. Security teams
Questions?