combat lifesaver re-certification course welcome ssg scaliatine sgt mcnamara

Combat Lifesaver Re-certification Course

Welcome

SSG Scaliatine

SGT McNamara


Task: Re-certify Combat Lifesaver skills IAWISO826 (CLS Instructors Booklet)

Conditions: Given performance check list on four tasks (I.V., Measure/Monitor Pulse, Restore Breathing, Stop bleeding on a limb)

Standards: Receive a go on all tasks


Watch your head, LOW CEILING

Use the hand rail when on stairs

Don’t lean back on chairs

No “horseplay”

Combat Lifesaver Re-certification Course Perform First Aid to Clear an Object stuck in the

throat of a Conscious Casualty

This slide show presentation was built with the help of FM21-11 (First Aid for Soldiers).

Page 2-1, of your Buddy-Aid book, has the Task Conditions & Standards for this Lesson

Follow along in your book. The wording may not be exact, the skills and information are.


Evaluate the CasualtySteps in a Primary Survey

1. Mask and Treat a Chemical Agent Casualty2. Check the Casualty for Responsiveness3. Check the Casualty’s Airway4. Check the Casualty’s Breathing5. Check the Casualty’s Circulation6. Check the Casualty for Bleeding7. Treat for Chemical Agent Poisoning (if appropriate)8. Check the Casualty for Shock


Evaluate the CasualtySteps in a Secondary Survey

1. Check the Casualty for Fractures2. Check the Casualty for Burns3. Check the Casualty for Closed Head Injury (concussion)4. Check the Casualty for Environmental Injuries5. Check the Casualty for Other Wounds/ Fractures6. Check the Casualty for Combat Stress Reaction


Airway Obstructions

In order for oxygen from the air to flow to and from the lungs, the upper airway must be unobstructed.

a. Upper airway obstructions often occur because—

(1) The casualty’s tongue falls back into his throat while he is unconscious as a result of injury, cardiopulmonary arrest, and so forth. (The tongue falls back and obstructs, it is not swallowed.)

(2) Foreign bodies become lodged in the throat. These obstructions usually occur while eating (meat most commonly causes obstructions). Choking on food is associated with— Attempting to swallow large pieces of poorly

chewed food.

Drinking alcohol.

Slipping dentures.


(3) The contents of the stomach are regurgitated and may

block the airway.

(4) Blood clots may form as a result of head and facial injuries.


Upper airway obstructions may be prevented by taking the

following precautions:

(1) Cut food into small pieces and take care to chew slowly

and thoroughly.

(2) Avoid laughing and talking when chewing and swallowing.

(3) Restrict alcohol while eating meals.

(4) Keep food and foreign objects from children while they

walk, run, or play.

(5) Consider the correct positioning/maintenance of the

open airway for the injured or unconscious casualty.


Upper airway obstruction may cause either

partial or complete airway blockage.

• Partial airway obstruction. The casualty may still have an air exchange. A good air exchange means that the casualty can cough forcefully, though he may be wheezing between coughs. You, the rescuer, should not interfere, and should encourage the casualty to cough up the object on his own. A poor air exchange may be indicated by weak coughing with a high pitched noise between coughs. Additionally, the casualty may show signs of shock (for example, paleness of the skin, bluish or grayish tint around the lips or fingernail beds) indicating a need for oxygen. You should assist the casualty and treat him as though he had a complete obstruction

Combat Lifesaver Re-certification Course Complete airway obstruction.

A complete obstruction (no air exchange) is indicated if the casualty cannot speak, breathe, or cough at all. He may be clutching his neck and moving erratically. In an unconscious casualty a complete obstruction is also indicated if after opening his airway you cannot ventilate him.


Types of airway Blockages

• Partial Blockage with Good Air Exchange• Partial Blockage with Poor Air Exchange• Complete Blockage


Treatment of airway Blockages• Partial Blockage with Good Air Exchange

o Encourage coughing

• Partial Blockage with Poor Air Exchangeo Get help, administer Abdominal Thrusts

• Complete Blockageo Get help, administer Abdominal Thrusts


Clearing a conscious casualty’s airway obstruction can be performed with the casualty either standing or sitting, and by following a relatively simple procedure.

WARNING

Once an obstructed airway occurs, the brain will develop an oxygen deficiency resulting in/unconsciousness. Death will follow rapidly if prompt action is not taken.


NOTE

The manual thrust with the hands centered between the waist, and the rib cage is called an abdominal thrust (or Heimlich maneuver). The chest thrust (the hands are centered in the middle of the breastbone) is used only for an individual in the advanced stages of pregnancy, in the markedly obese casualty, or if there is a significant abdominal wound.


Look at Practical Exercise on Page 2-6

DO NOT write in BOOK


Find a Partner, Practice this skill

Use Checklist found on page 2-9 in your Buddy-Aid Book

DO NOT write in BOOK


Perform Mouth-to-Mouth Resuscitation

Task Conditions & Standards are listed on Page 3-1

Buddy-Aid Book

Combat Lifesaver Re-certification CourseEvaluate the Casualty

Steps in a Primary Survey



Steps in a Secondary Survey



What is Mouth-to-Mouth Resuscitation ????



1. Check for Responsiveness2. Position the Casualty for Mouth-to-Mouth Resuscitation3. Open the Casualty’s Airway4. Check for Breathing, while maintaining an Open airway5. Initiate Mouth-to-Mouth Resuscitation6. Perform a Finger Sweep7. Administer Modified Abdominal Thrusts8. Administer Modified Chest Thrusts9. Feel for Pulse10.Continue Mouth-to-Mouth Resuscitation11.Monitor the Casualty



1. Check for Responsiveness

• Ask Casualty “Are you OK?”

• Call for help

HELP !



2. Position the Casualty for Mouth-to-Mouth Resuscitation

• On his back (Supine)• Roll if needed, protect head and spine• Avoid Injury



3. Open the Casualty’s Airway

• Head Tilt / Chin Lift• Jaw Thrust



4. Check for Breathing, while maintaining an Open airway

• Look Rise & Fall of the Chest / Abdomen

• Listen For sounds of breathing

• Feel For breath on the side of your face



5. Initiate Mouth-to-Mouth Resuscitation

• Maintain an Open Airway• Close Casualty’s Nose• Administer Two Full Breaths• Evaluate Effectiveness of the Ventilation



If Breaths do NOT go in:

Re-tilt the Airway and try again

If Breaths still do NOT go in:

ASSUME THERE IS AN AIRWAY BLOCKAGEPerform Finger Sweeps and Manual Thrusts as needed



6. Perform a Finger Sweep, if needed

Use only if you see a foreign body in the mouth

Look at Page 3-8



7. Administer Modified Abdominal Thrusts

• Artificial Cough• Find the correct position• Press inward and upward

After thrust do a Finger Sweep (if needed)

Repeat Thrust, Finger Sweeps, and Ventilations until AIR GOES IN

(Don’t focus on the object, the goal is to get the Air in)



8. Administer Modified Chest Thrusts

• Used w/ Casualty who has a serious abdominal wound, a Casualty who is noticeably pregnant, or a Casualty who is extremely Overweight

Page 3-10 & 3-11 has pictures



9. Feel for Pulse

• Carotid is best place• Middle & Index fingers• 5 to 10 Seconds• DO NOT USE YOUR THUMB• NO PULSE ? , CPR is NOT a CLS Skill

Did you know ?Medics, on the Battle Field, will only do CPR for one minute before leaving the Casualty to treat other wounded soldiers.



10.Continue Mouth-to-Mouth Resuscitation

• Stop: When breathing is restored Medical personnel take over You must go get help (no pulse) You must continue the Battle You are too exhausted to Continue

11. Monitor the Casualty



Practical Exercise is on Page 3-15

Remember: DO NOT WRITE IN BOOKS



Practice on the Manikins

Use Checklist on Pages 3-20, 3-21 & 3-22



Questions ????


Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity

Page 4-1 in Buddy-Aid book


Evaluate the CasualtySteps in a Primary Survey



Evaluate the CasualtySteps in a Secondary Survey

1. Check the Casualty for Fractures2. Check the Casualty for Burns3. Check the Casualty for Closed Head Injury (concussion)4. Check the Casualty for

Environmental Injuries5. Check the Casualty for

Other Wounds/ Fractures6. Check the Casualty for

Combat Stress Reaction


Task: Apply a Field Dressing, elevation and manual pressure, a pressure dressing, and a Tourniquet, as needed, to a wound on a Casualty’s limb

Conditions: Given a simulated Casualtywith bleeding from a limb and needed Supplies

Standards: Score a GO on the Performance Checklist



All Bleeding stops eventually

Stop it before it runs out



Dressing: Material placed directly over a wound

Bandage: Material used to Hold Dressing

Field Dressing: Carried by all Soldiers



Step # 1:

Expose the Wound

Use Caution with Burns or if in a Chemical Environment



Step # 2:

Apply & Secure a Field Dressing

Expose the WoundPrepare DressingOpen DressingApply to woundSecure dressingTie tails in Non-Slip Knot

Pictures onpage 4-3 show it all



Step # 3:

Apply Manual PressureDirect Pressure for 5 to 10 Minutes

Step # 4:

Elevate the Injured Limb Do this at the same time as Applying PressureDO NOT elevate a suspected Fracture



Hold And Wrap


Step # 5:

Apply a Pressure DressingOnly on a wound of the Arm or LegPlaced on top of the field dressingPictures on Page 4-6



Need a hand ???

How about a Tourniquet ?


Step # 6:

Determine if a Tourniquet is NeededOnly when all else Fails

Not on wounds to the Head, Neck, Chest

Not used on amputation of part of Hand or Foot

Is used on amputation of Upper Arm, Forearm, Thigh or Lower leg



Step # 7:

Gather Materials for Making a Tourniquet

Tourniquet Bands

Rigid Object

Securing Materials

Padding



Step # 8:

Select Tourniquet SiteUpper Arm

Thigh

Above the Joint, as Close to Joint as Possible

Not over a Fracture



Step # 9:

Apply a Tourniquet ONLY USED AS LAST RESORT

Fold it as seen on Page 4-9

Apply it to a Limb as seen on Page 4-11An Arm Amputation as seen on Page 4-10A Leg Amputation as seen on Page 4-12



Application Of Tourniquet(Tying of Half-Knot)


Application of Tourniquet(Positioning Stick)


Application Of Tourniquet(Full-Knot on Stick)


Secure Stick


Step # 10:

Dress an Amputation

Read Paragraph 4-11 on Page 4-12



Step # 11:

Mark the Casualty

•“T” and time of Tourniquet application• Do not cover tourniquet• Monitor Casualty and Treat for Shock



Test your Knowledge

Do the Practical Exercise on Page 4-13

DO NOT WRITE IN BOOKS



Find your Partner

Use the Performance Checklist on Page 4-20 & 4-21



QUESTIONS ??



Following are some photos If you have a weak stomach or do not like the sight of blood do not look at these pictures!


Measure and Monitor a Casualty’s Pulse


Steps in a Primary Survey



Steps in a Secondary Survey



Task, Conditions & Standards found on page 18-1 in Medical Tasks book

Measure & Monitor a Casualty’s Pulse


Step #1Locate the pulse site

CarotidRadial

NOTE: DO not palpate both of the Casualty’s Carotid Arteries at the same time

Other sites: Posterior Tibial, Temporal, Brachial, Femoral, Popiteal, Dorsalis Pedis & Apical.

Look at the picture on page 18-3 for locations.



Step #2Palpate the pulse site

Use Middle and Ring fingersDo not use your thumbCount the beats felt in one minute

Do not cheat, IE: 30 seconds x 2 Normal: 60-80 Beats per Minute (BPM)Tachycardia: Over 100 BPMBradycardia: Less then 50 BPM



Step #2 (cont)Classify the Strength of the Pulse

Regular: Easy to feel, Even Beats, Normal Force

Bounding: Easily detected due to large amount of blood pumping

Weak: Difficult to detect due to loss of blood

Absent: You guessed it; NO PULSE FOUND



Step #3

Monitor the Casualty’s Pulse

Count as needed Periodically

Report Abnormal readings or changes



Try the Practical Exercise on Page 18-6


DO NOT WRITE IN BOOKS


Initiate an Intravenous Infusion

Read the Task, Conditions, Standards on

Page 17-1 of Medical Book


Turn to Page 17-1 in Medical Book.

Read to page 17-13


Take the practical examination (Written) on page 17-14

DO NOT WRITE IN BOOK


Watch this demonstration then pair off do the Skill, using the checklist from page 17-19(medical book)


Questions ???

See you next year !!!

combat lifesaver re-certification course welcome ssg scaliatine sgt mcnamara

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