Operational Medicine 2001
Standard First Aid Course
NAVEDTRA 13119

An Introduction to First Aid

First aid is the emergency care and treatment of a sick or injured person before professional medical services are obtained. FIRST AID MEASURES ARE NOT MEANT TO REPLACE PROPER MEDICAL DIAGNOSIS AND TREATMENT, but will only consist of providing temporary support until professional medical assistance is available. The purposes of first aid are (1) to save life, (2) prevent further injury, and (3) to minimize or prevent infection.

Everyone in the Navy must know how and when to render first aid and be prepared to provide competent assistance to the sick and injured in all circumstances. The knowledge of first aid, when properly applied, can mean the difference between temporary or permanent injury, rapid recovery or long-term disability, and the difference between life and death.

While administering first aid, the three primary objectives are (1) to maintain an open airway, (2) maintain breathing, and (3) to maintain circulation. During this process you will also control bleeding, and reduce or prevent shock.

You must respond rapidly, stay calm, and think before you act. Do not waste time looking for ready-made materials, do the best you can with what is at hand. Request professional medical assistance as soon as possible.

Initial Assessment

When responding to a casualty, take a few seconds to quickly inspect the area. Remain calm as you take charge of the situation, and act quickly but efficiently. Decide as soon as possible what has to be done and which one of the injuries needs attention first. During your initial assessment, consider the following:

1. Safety - Determine if the area is safe. If the situation is such that you or the casualty is in danger, you must consider this threat against the possible damage caused by early movement. If you decide to move the casualty, do it quickly and gently to a safe area where proper first aid can be given. You cannot help the casualty if you become one yourself.

2. Mechanism of injury - Determine the extent of the illness or injury and how it happened. If the casualty is unconscious, look for clues. If the casualty is lying at the bottom of a ladder, suspect that he or she fell and may have internal injuries.

3. Medical information devices - Examine the casualty for a MEDIC ALERT (Fig. 1-1) necklace, bracelet, or identification card. This medical tag, provides medical conditions, medications being taken, and allergies about the casualty. The VIAL OF LIFE, a small, prescription-type bottle, also contains medical information concerning the casualty. This bottle is normally located in the refrigerator.

4. Number of casualties - Look beyond the first casualty, you may find others. One casualty may be alert, while another, more serious or unconscious, is unnoticed. In a situation with more than one casualty limit your assessment to looking for an open airway, breathing, bleeding, and circulation, the life-threatening conditions.

5. Bystanders - Ask bystanders to help you find out what happened. Though not trained in first aid, bystanders can help by calling for professional medical assistance, providing emotional support to the casualty, and keeping onlookers from getting in the way.

Figure 1-1-Medic Alert Symbol

6. Introduce yourself - Inform the casualty and bystanders who you are and that you know first aid. Prior to rendering first aid, obtain the casualties consent by asking is it "OK' to help them. Consent is implied if the casualty is unconscious or cannot reply.

General Rules

Every illness or injury presents with its own individual problems. Prior to learning first aid for a specific illness or injury, you must have a complete understanding of the following:

1. Keep the casualty lying down, head level with the body, until you determine the extent and seriousness of the illness or injury. You must immediately recognize if the casualty has one of the following conditions that represent an exception to the above.

a. Vomiting or bleeding around the mouth - If the casualty is vomiting or bleeding around the mouth, place them on their side, or back with head turned to the side. Special care must be taken for a casualty with a suspected neck or back injury.

b. Difficulty breathing - If the casualty has a chest injury or difficulty breathing place them in a sitting or semi-sitting position.

c. Shock - To reduce or prevent shock, place the casualty on his or her back, with their legs elevated 6 to 12 inches. If you suspect head or neck injuries or are unsure of the casualty's condition, keep them lying flat and wait for professional medical assistance.

2. During your examination, move the casualty no more than is necessary. Loosen restrictive clothing, at the neck, waist, and where it binds. Carefully remove only enough clothing to get a clear idea of the extent of the injuries. When necessary, cut clothing along its seams. Ensure the casualty does not become chilled, and keep them as comfortable as possible. Inform the casualty of what you are doing and why. Respect the casualty's modesty, but do not jeopardize quality care. Shoes may have to be cut off to avoid causing pain or further injury.

3. Reassure the casualty that his or her injuries are understood and that professional medical assistance will arrive as soon as possible. The casualty can tolerate pain and discomfort better if they are confident in your abilities.

4. Do not touch open wounds or burns with your fingers or un-sterile objects unless it is absolutely necessary. Place a barrier between you and the casualty's blood or body fluids, using plastic wrap, gloves, or a clean, folded cloth. Wash your hands with soap and warm water immediately after providing care, even if you wore gloves or used another barrier.

5. Do not give the casualty anything to eat or drink because it may cause vomiting, and because of the possible need for surgery. If the casualty complains of thirst, wet his or her lips with a wet towel.

6. Splint all suspected, broken or dislocated bones in the position in which they are found. Do not attempt to straighten broken or dislocated bones because of the high risk of causing further injury. Do not move the casualty if you do not have to.

7. When transporting, carry the casualty feet first. This enables the rear bearer to observe the casualty for any complications.

8. Keep the casualty comfortable and warm enough to maintain normal body temperature.

Infectious Diseases

You will probably render first aid to someone you know - a shipmate or family member. For this reason you will probably know your risk of contracting an infectious disease. Adopt practices that discourage the spread of blood-borne diseases (Hepatitis and HIV) and air-borne diseases such as influenza when performing first aid.

1. Wear gloves or use another barrier.
2. Wash your hands with soap and warm water immediately.
3. When possible, use a pocket mask or mouthpiece during rescue breathing.

The risk of contracting infections from a casualty is very remote. Do not withhold rendering first aid because of this rare possibility.

References

1. Karren, K. J. and Hafen, B. Q.: First Responder A Skills Approach, edition 3, Morton Publishing Company
2. American Red Cross Standard First Aid Workbook, edition 1991, American Red Cross
3. NAVEDTRA 10670-C, Hospital Corpsman 1 & C
4. NAVEDTRA 10669-C, Hospital Corpsman 3 & 2

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Operational Medicine 2001
Health Care in Military Settings

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