SELF-AID/BUDDY-AIDSubcourse Number IS0877EDITION AUNITED STATES ARMY MEDICAL DEPARTMENT CENTER AND SCHOOLFORT SAM HOUSTON, TEXAS 78234-610020 Credit HoursINTRODUCTIONOVERVIEWInterschool Subcourse 0877, Self-Aid/Buddy-Aid, contains instructions for performingself-aid/buddy-aid (first aid) tasks that all soldiers are required to know. All of the taskswithin this subcourse contain important, lifesaving information.GENERALThis subcourse reflects the current thought of the U.S. Army Medical DepartmentCenter and School and conforms to printed Department of the Army doctrine as closelyas possible. Development and progress render such doctrine continuously subject tochange.When used in this publication, words such as "he," "him," "his," and "men" are intendedto include both the masculine and feminine genders, unless specifically stated otherwiseor when obvious in context.The initial letters of the names of some products are capitalized in this subcourse. Suchnames are proprietary names, that is, brand names or trademarks. Proprietary nameshave been used in this subcourse only to make it a more effective learning aid. The useof any name, proprietary or otherwise, should not be interpreted as endorsement,deprecation, or criticism of a product; nor should such use be considered to interpret thevalidity of proprietary rights in a name, whether it is registered or not.IS0877i

CREDIT HOURSSuccessful completion of the subcourse will result in the awarding of 20 credit hours toenrolled students. You must score a minimum of 70 percent on the subcourseexamination in order to satisfactorily complete this subcourse.IS0877ii

TERMINAL OBJECTIVESTASK: Identify conditions requiring treatment.CONDITIONS: Given a casualty on the battlefield.STANDARDS: Soldier identifies airway obstructions, respiratory problems, circulationproblems, open chest wounds, tension pneumothorax, bleeding, fractures, nerve agentpoisoning, heat injuries, and cold injuries in accordance with the instructions presentedin this subcourse.TASK: Treat a casualty.CONDITIONS: Given a casualty on the battlefield.STANDARDS: Soldier treats airway obstructions, respiratory problems, circulationproblems, open chest wounds, tension pneumothorax, bleeding, fractures, nerve agentpoisoning, heat injuries, and cold injuries in accordance with the instructions presentedin this subcourse.TASK: Apply preventive medicine measures (self-aid).CONDITIONS: Soldier deployed to a unit in the field.STANDARDS: Preventive medicine measures are applied to protect against cold, heat,arthropod-borne diseases, water-borne diseases, food-borne diseases, nerve agents,hearing loss, skin infections, sexually-transmitted diseases (STD), Humanimmunodeficiency virus (HIV), foot problems, oral hygiene problems, and tobacco use inaccordance with the instructions presented in this subcourse.TASK: Transport a casualty.CONDITIONS: Given a casualty in need of transportation and appropriate supplies.STANDARDS: Casualty transported using an appropriate manual carry, SKED litter, orimprovised litter in accordance with the instructions presented in this subcourse.ADMINISTRATIVE INSTRUCTIONSThere are no supervisory requirements for completion of this subcourse.No supplementary references are required for this subcourse.IS0877iii

SUGGESTED STUDY PROCEDURESAfter reading a lesson, work the lesson exercises at the end of the lesson. Write yourresponses on a sheet of paper or on a printout of the lesson exercises. Refer to thelesson text as needed.When you have completed the lesson exercises, compare your answers with thesolution sheet following the lesson exercises. For each exercise answered incorrectly,reread the material referenced for that exercise.Complete each lesson before proceeding to the next.After you have completed all of the lessons and lesson exercises, complete theexamination. Refer to the lessons as needed. Double check your responses.CONTACTSFor issues involving subcourse enrollment, grades, and student records, please contactthe Army Institute for Professional Development, U.S. Army Training Support Center,Fort Eustis, Virginia, at:DSN: 826-2127/3322Commercial: (757) 878-3322-2127E-mail: [email protected] mail: Section AArmy Institute for Professional DevelopmentUS Army Training Support CenterNewport News, VA 23628-0001If you wish to ask a question or make a comment related to the subject matter of thesubcourse, please contact the Department of Combat Medic Training, United StatesArmy Medical Department Center and School, Fort Sam Houston, Texas, at:DSN: 471-4574Commercial: (210) 221-4574E-mail: [email protected] mail:Department of Combat Medic TrainingAMEDDC&S3151 W. W. White Road, Bldg. 1374Fort Sam Houston, TX 78234-6100Be sure to include your name, rank, and return address on any mail sent to DCMT. Besure to include the subcourse number, title, and edition in your correspondence.Reference the lesson, paragraph number, and/or lesson exercise number, ifappropriate. For a question/comment on an examination item, include thequestion/stem since the item number may change if the examination is taken on line.IS0877iv

TABLE OF CONTENTSLessonParagraphsINTRODUCTION1PERFORMING TACTICAL COMBAT CASUALTY CARE.1-1 -- 1-5Lesson Exercises2EVALUATING A CASUALTY.2-1 -- 2-9Lesson Exercises3OPENING AND MANAGING A CASUALTY'S AIRWAYSection I.On The Battlefield.3-1 -- 3-9Section II.Removing an Obstruction from a Person'sAirway.3-10 -- 3-16Section III. Performing Cardiopulmonary Resuscitation.3-17 -- 3-19Lesson Exercises4TREATING PENETRATING CHEST TRAUMA ANDDECOMPRESSING TENSION PNEUMOTHORAXSection I.Treating an Open Chest Wound.4-1 -- 4-6Section II.Treating Tension Pneumothorax.4-7 -- 4-9Lesson Exercises5CONTROLLING BLEEDINGSection I.General.5-1 -- 5-2Section II.Procedures for Controlling Bleeding.5-3 -- 5-13Section III. Other Procedures.Lesson ExercisesIS0877v5-14 -- 5-17

6.SPLINTING FRACTURES.6-1 -- 6-12Lesson Exercises7EVACUATING A CASUALTYSection I.Manual Carries.7-1 -- 7-4Section II.SKED and Improvised Litters.7-5 -- 7-12Lesson Exercises8TREATING A NERVE AGENT CASUALTYSection I.Self-Aid.8-1 -- 8-9Section II.Buddy-Aid.8-10 -- 8-12Lesson Exercises9PREVENTING/TREATING ENVIRONMENTAL INJURIESSection I.Heat Injuries.9-1 -- 9-4Section II.Cold Injuries.9-5 -- 9-8Section III. Other Preventive Medicine Measures.Lesson ExercisesAppendix:Improved First Aid KitIS0877vi9-9 -- 9-19

LESSON ASSIGNMENTLESSON 1Performing Tactical Combat Casualty Care.LESSON ASSIGNMENTParagraphs 1-1 through 1-5.LESSON OBJECTIVESAfter completing this lesson, you should be able to:1-1.Identify procedures for tactically managing acasualty under combat conditions.1-2.Identify the major causes of battlefield deaths.1-3.Identify the three phases of tactical combatcasualty care.1-4,Identify care provided in each phase of tacticalcombat casualty care.REFERENCESSTP 21-1-SMCT, Soldier's Manual of Common Tasks:Skill Level 1.FM 4-25.11, First Aid.Training Support Package 071-D-2321 / First Aid 6(Perform Tactical Combat Casualty Care).SUGGESTIONAfter completing the assignment, complete theexercises at the end of this lesson. These exerciseswill help you to achieve the lesson objectives.IS08771-1

LESSON 1PERFORMING TACTICAL COMBAT CASUALTY CARE1-1.BATTLEFIELD DEATHSa. Most combat deaths occur on the battlefield before the casualties reach aMTF. Most of these deaths are inevitable (massive trauma, massive head injuries, andso forth). However, some conditions such as bleeding from a wound on an extremity(arm or leg), tension pneumothorax, and airway problems can be treated on thebattlefield. This treatment can be the difference between a combat death on thebattlefield and a recovering soldier in a MTF. It has been estimated that proper use ofself-aid and buddy-aid skills can reduce battlefield deaths by up to 15 percent (mostlyfrom methods to control bleeding from the extremities). Table 1-1 gives an estimatedbreakdown of battlefield deaths.b. In combat, the combat medic may not be able to reach the casualty in time tosave the casualty's life, especially if the casualty is losing a great deal of blood quickly.The combat medic may even become a casualty and require aid himself. In such asituation, quick self-aid (the injured soldier treating himself) or buddy-aid (the injuredsoldier being treated by a fellow soldier) is needed. For example, over 2500 soldiersdied in Viet Nam caused by hemorrhage from extremity wounds even though thesoldiers had no other serious injuries. Proper application of pressure dressings andtourniquets by fellow soldiers could have saved most of these casualties.DEATHS CAUSED BY GROUND COMBAT31%--Penetrating head trauma25%--Surgically uncorrectable torso trauma10%--Potentially correctable surgical trauma9%--Exsanguination (bleeding) from extremity wounds7%--Mutilating blast trauma5%--Tension pneumothorax1%--Airway problems12%--Died of Wounds after being evacuated to amedical treatmentfacility (usually from infections and complicationsof shock)Table 1-1. Estimated breakdown of battlefield deaths.IS08771-2

1-2.TACTICAL COMBAT CASUALTY CARETactical combat casualty care (TCCC) can be divided into three phases. Thefirst is care under fire; the second is tactical field care; the third is combat casualtyevacuation care.a. Care Under Fire. In a situation in which the casualty and you are underhostile fire, you are very limited as to the care you can provide. Paragraph 1-3discusses this situation.b. Tactical Field Care. In tactical field care, you and the casualty are in aprotected or safe environment. In this situation, you are free to provide casualty care tothe best of your ability. Paragraph 1-4 discusses this situation.c. Combat Casualty Evacuation Care. In the third situation, care is beinggiven to the casualty during casualty evacuation (CASEVAC). Casualty evacuationrefers to the care given to the casualty while the casualty is awaiting pickup or is beingtransported by a nonmedical vehicle, such as a vehicle used to transport troops orsupplies. Paragraph 1-5 discusses this situation.NOTE: Casualty evacuation is different from medical evacuation (MEDEVAC). InMEDEVAC, a designated medical vehicle (ground ambulance or airambulance) is used.1-3.PERFORMING CARE UNDER FIRECare under fire is rendered at the scene of the injury while you and the casualtyare still under effective hostile fire. In such a situation, you should perform the followingactions.a. Return fire as directed or required before providing medical treatment.b. Determine if casualty is alive or dead.c. Provide tactical care to the live casualty. Reducing or eliminating enemy firemay be more important to the casualty's survival than the treatment you can provide.(1)Suppress enemy fire.(2)Use cover or concealment (smoke) to conceal the casualty, if possible.(3) If the casualty is able, direct him to return fire, move to cover, andadminister self-aid (control bleeding). If the casualty is unable to move and you areunable to move the casualty to cover, have casualty “play dead.”IS08771-3

(4)Keep the casualty from sustaining additional wounds.(5)Reassure the casualty.d. If you can safely move the casualty to safety, do so. Administer only lifesaving hemorrhage control while still under enemy fire.NOTE: Hemorrhage refers to serious bleeding.(1) If the casualty has severe bleeding from a limb or has sufferedamputation of a limb, quickly apply a tourniquet before moving the casualty to safety.Do not take time to check the casualty for breathing or airway obstruction.(2) Move the casualty, his weapon, and any mission-essential equipment tocover as the tactical situation permits. Do not take the time to move equipment that isnot mission essential.NOTE:You must determine the relative threat of the tactical situation versus the riskto the casualty. Can you remove the casualty to a place of relative safetywithout becoming a casualty yourself? Is the casualty safer where he is?If possible, seek guidance and assistance from your leader.e. Recheck the bleeding control measures as the tactical situation permits.1-4.PERFORMING TACTICAL FIELD CAREPerform tactical field care when you and the casualty are no longer under directenemy fire.NOTE:Tactical field care also applies to situations in which an injury has occurred ona mission when there is no hostile fire. Available medical supplies arelimited to those carried into the field by individual soldiers.a. Communication. Communicate the medical situation to the unit leader.Ensure that the tactical situation allows time to treat the casualty before initiatingtreatment procedures. Inform the unit leader if:(1)The casualty will not be able to continue his mission.(2)There is any significant change in casualty's status.b. General Impression. Form a general impression of the casualty as youapproach (extent of injuries, chance of survival, and so forth). Continue to evaluate thetactical situation for possible danger to yourself and the casualty.IS08771-4

NOTE:If the casualty has suffered from a blast or penetrating trauma and has nosigns of life (no pulse, no respirations), do not perform cardiopulmonaryresuscitation (CPR). These casualties will probably not survive and you mayexpose yourself to enemy fire.c. Level of Consciousness. When possible, determine the casualty's level ofconsciousness using the AVPU system. Ask questions that require more than a "yes"or "no" answer, such as, "What is your name? What is the date? Where are we?"Recheck the casualty's level of consciousness about every 15 minutes to determine ifthe casualty's condition has changed. Report your findings to the combat medic orcombat lifesaver when he comes.(1)A--The casualty is alert, knows who he is, the date, where he is, etc.(2)V--The casualty is not alert, but does responds to verbal commands.(3)P--The casualty responds to pain, but not verbal commands.(4)U--The casualty is unresponsive.NOTE:Maintaining a check on the casualty's level of consciousness is especiallyimportant when the casualty has suffered a head injury.NOTE:If the casualty is alert or responds to voice, do not check the casualty'sresponse to pain.NOTE:To check a casualty’s response to pain, rub his breastbone briskly with aknuckle or squeeze his first.d. Airway. Assess and secure the casualty's airway.(1) If the casualty is conscious, able to speak, and is not in respiratorydistress, no airway intervention is needed.(2)If the casualty is unconscious, perform the following.(a) Use a head-tilt/chin-lift or jaw thrust to open the airway. The headtilt/chin-lift is the normal method of opening the casualty's airway. The jaw thrust isused if you suspect the casualty has suffered injury to the head, jaw, or spine (back).NOTE:IS0877The muscles of an unconscious casualty's tongue may have relaxed, causinghis tongue to slide to the back of his mouth and cover the opening to histrachea (windpipe). Using the head-tilt/chin-lift or jaw thrust removes theblockage by moving the tongue away from the trachea. Moving the tongueaway from the opening to the trachea may result in the casualty breathing onhis own again without the need for rescue breathing techniques.1-5

(b) Check the casualty for breathing. Place your ear over thecasualty's mouth and nose with your face toward the casualty's chest while maintainingthe casualty's airway (head-tilt/chin-lift or jaw-thrust). Look for the rise and fall of thecasualty's chest and abdomen. Listen for sounds of breathing. Feel for his breath onthe side of your face.1 If the casualty is not breathing, begin rescue breathing.2 If the casualty is breathing on his own, insert a nasopharyngealairway (NPA) to maintain the airway.NOTE:Procedures for opening the airway, performing rescue breathing, andinserting a nasopharyngeal airway are described in Lesson 3 of thissubcourse.e. Chest. Assess and treat the casualty for chest injuries (Lesson 4).(1) Expose the chest and check for equal rise and fall. Remove theminimum of clothing required to expose and treat injuries. Protect the casualty from theenvironment (heat and cold) as much as possible.(2) Examine the chest for wounds. Check for both entrance and exitwounds (sucking chest wounds).(3) Immediately seal any penetrating injuries to the chest with an occlusivedressing. Sealing the wound keeps air from entering the wound. If air can freely enterthrough the wound, the casualty's affected lung will collapse.(4) Monitor the casualty for progressive severe respiratory distress(breathing becomes more labored and faster). If respiration becomes progressivelyworse, consider this a tension pneumothorax and decompress the affected chest sidewith a 14-gauge needle inserted at second intercostal space (ICS) at midclavicular line(MCL). Secure the catheter in place.CAUTION:Only perform needle chest decompression on a casualty with apenetrating (sucking) chest wound.f. Bleeding. Identify and control major bleeding (see Lesson 5).(1)Apply a tourniquet to a major amputation of the extremity.(2)Apply an emergency bandage and direct pressure to a severely bleedingwound.IS08771-6

(a) If conventional methods of controlling severe bleeding (emergencybandage, direct pressure, pressure dressing, hemostatic dressing, and so forth) do notcontrol the bleeding on an extremity, apply a tourniquet.(b) If a tourniquet was previously applied, consider changing thetourniquet to an emergency bandage or pressure dressing to control bleeding. Leavethe tourniquet in place while doing this. Loosen it, but do not remove it. If conventionalmethods are not able to control hemorrhage, retighten the tourniquet until bleedingstops.NOTE:By converting the tourniquet to a pressure dressing or controlling the bleedingby other methods, you may be able to save the limb of the casualty if thetourniquet has not been in place for 6 hours. If tourniquet has been in placefor more than 6 hours do not remove the tourniquet.g. Other Wounds. Identify and treat other wounds. Dress all wounds, includingexit wounds. Remember to remove only the minimum of clothing required to exposeand treat injuries. Protect the casualty against the environment (hot and coldtemperatures, and so forth).h. Fractures. Splint any obvious long bone fractures (see Lesson 6).i. Combat Pill Pack. Administer pain medications and antibiotics (combat pillpack) to any soldier wounded in combat. Do not administer your own pack since youmay need them yourself and you have no extra combat pill packs in your aid bag.NOTE:Each soldier will be issued a combat pill pack prior to deployment on tacticalmissions.j. Positioning the Casualty.(1) Usually, you will roll the casualty onto his side and position the casualty'sarms and legs to stabilize him in the recovery position (figure 1-1). This position allowsaccumulated blood and mucus to drain from the casualty's mouth instead of choking thecasualty. This is especially important if the casualty is unconscious and you cannot staywith him.IS08771-7

Figure 1-1. Unconscious casualty placed in the recovery position.(a) If the casualty has an open chest wound without a needle chestdecompression, position the casualty with the injured side toward the ground. The bodypressure acts to "splint" the affected side.(b) If a needle chest decompression has been performed, position thecasualty with the uninjured side toward the ground.(2) For some injuries, the recovery position is not used. For example, asoldier with an abdominal wound is positioned on his back with his knees flexed (kneesraised with the bottoms of his feet on the ground). If the casualty is being treated forshock (severe blood loss, and so forth), the casualty is placed on his back with his feetelevated (placed on a log, pack, or other stable object).1-5. PERFORMING COMBAT CASUALTY EVACUATION CAREPrepare the casualty for evacuation, if needed.a. When possible, the casualty is transported by medical ambulance (helicopteror ground ambulance) to a medical treatment facility (MTF). If a medical ambulance isused to transport a casualty, it is called medical evacuation (MEDEVAC).b. If a ground or air ambulance is not available, the casualty may be transportedby nonmedical means. For example, a truck used to haul troops or supplies may beused to transport casualties to a medical treatment facility. When nonmedical vehiclesare used to transport a casualty, it is called casualty evacuation (CASEVAC).c. Sometimes a casualty must be moved to another area where he can beplaced on a vehicle, either MEDEVAC or CASEVAC. If the casualty needs to becarried, he should be moved on a litter. Lesson 7 describes how to prepare and use theSKED litter and how to make improvised litters.IS08771-8

LESSON EXERCISES: LESSON 1INSTRUCTIONS: Answer the following exercises by marking the letter of the responsethat best answers the question or best completes the sentence or by writing the answerin the space provided.After you have answered all of the exercises, check your answers against the"Solutions to Lesson Exercises" at the end of the exercises. For each exerciseanswered incorrectly, reread the lesson material referenced.1.Of the deaths that occur during ground combat, about what percent die beforereaching a medical treatment facility?a. 10 percent.b. 20 percent.c.50 percent.d. 90 percent.2.Your unit is in ground combat. You see a soldier fall as though he has been shot.Your primary duty is to:a. Continue firing at the enemy.b. Stop firing and go to the fallen soldier.3.Of the following types of deaths occurring during ground combat and beforereaching a medical treatment facility, select the type of preventable death fromwhich more soldiers died.a. Tension pneumothorax.b. Blocked airway.c.Bleeding from wounds to the extremities.d. Heart attack.IS08771-9

4.What is the only aid rendered while under fire?a. Perform cardiopulmonary resuscitation.b. Control bleeding with a tourniquet.c.Relieve tension pneumothorax.d. Control pain and infection.5.You and a casualty are under fire. The casualty is conscious and able to fire hisweapon. What should you tell him to do?6.You and a casualty are under fire. The casualty has a severe wound to the arm.You can administer treatment without endangering the mission. What treatmentshould you administer?7.You have been wounded and are still under enemy fire. You are unable to returnfire and there is no safe cover nearby. What should you do?8.You can move a casualty out of enemy fire. Should you try to retrieve his weaponalso?a. Yes, if the tactical situation permits.b. Yes, under all circumstances.c.IS0877No.1-10

9.A nasopharyngeal air is inserted to maintain the casualty's airway as part of:a. Care under fire.b. Tactical field care.c.10.Both care under fire and tactical field care.What is in the combat pill pack that you and other soldiers carry in combat?11.Why must a penetrating chest wound be sealed?a. To keep air from entering through the wound.b. To keep air from escaping through the wound.c. To control bleeding.12.You are going to administer a combat pill pack to a casualty. You shouldadminister:a. The casualty's pack.b. Your personal pack.13.Classify the following casualties according to the AVPU system.Casualty number one moves his arm when you tell him forcefully to do soand responds to pain when you moved him , but does not respond otherwise.Casualty number two does not appear to have any injuries other than abruise on the side of his head; however, he does not respond to anything you do.Casualty number three has been shot in the leg and is yelling at you to"Hurry and do something." Casualty number four groans when you try tomove his injured leg, but does not respond when you ask him how he feels or tellhim to move his uninjured arm.IS08771-11

14.What is the most likely cause of a blocked airway in an unconscious casualty?15.When opening an unconscious casualty's airway, you should normally use themethod. However, if you suspect a head or spinalinjury, the method is preferred.16.You find a casualty that appears to be unconscious. You are not in danger fromenemy fire and have time to perform care. In which order should you perform thefollowing tasks? Write "1" in the space before the first task you would perform, "2"in the space before the next task you would perform, and so forth.Apply a pressure dressing to a serious wound on the casualty's arm.Check the casualty for breathing using Look, Listen, and Feel.Open the casualty's airway using the head-tilt/chin-lift.Splint the casualty's fractured leg.17.Apply a seal to an open chest wound.You must leave an unconscious casualty to perform other duties. How should younormally position the casualty before you leave?a. On his back.b. On his side.c.On his chest.d. In whatever position you originally found him.18.Why did you position the casualty in exercise 17 in the manner you chose?IS08771-12

19.A casualty is to be evacuated to a military medical treatment facility. If thecasualty is transported using a medical ground or air ambulance, it is called a. If a truck normallyused to carry supplies to troops in the field is used to transport the casualty, it iscalled a .IS08771-13

SOLUTIONS TO LESSON EXERCISES: LESSON 11.d(para 1-1a,Table 1-1)2.a(para 1-3)3.c(Table 1-1)4.b(paras 1-3d, d(1))5.Return fire (para 1-3c(3))6.Tourniquet (para 1-3d(1))7.Play dead (para 1-3c(3))8.a(para 1-3d(2))9.b(para 1-4d(2)(b)2)10.Pain medication and antibiotics (para 1-4i)11.a(para 1-4e(3))12.a(para 1-4i)13.Casualty number one: VCasualty number two. UCasualty number three. ACasualty number four P (para 1-4c)14.Casualty's tongue relaxes, slides to the back of the mouth and covers the openingto the trachea (para 1-4d(2) NOTE).15Head-tilt/chin-liftJaw thrust (para 1-4d(2)(a)16.4 Apply a pressure dressing to a serious wound on the casualty's arm.2 Check the casualty for breathing using Look, Listen, and Feel.1 Open the casualty's airway using the head-tile/chin-lift.5 Splint the casualty's fractured leg.3 Apply a seal to an open chest wound.(paras 1-4d, e, f, h)IS08771-14

17.b18.This position allows accumulated blood and mucus to drain from the casualty'smouth (para 1-4j(1))19.Medical evacuation (MEDEVAC) (para 1-5a)Casualty evacuation (CASEVAC) (para 1-5b)IS0877(para 1-4j(1), fig 1-1).1-15

LESSON ASSIGNMENTLESSON 2Evaluating a Casualty.LESSON ASSIGNMENTParagraphs 2-1 through 2-9.LESSON OBJECTIVESAfter completing this lesson, you should be able to:2-1.Identify procedures for evaluating a casualtyunder combat conditions.2-2.Identify the proper sequence of actions used inevaluating a casualty.2-3.Identify the procedures for turning a casualtyonto his back.2-4.Identify the procedures for checking a casualtyfor breathing.2-5,Identify the procedures for checking a casualtyfor bleeding.REFERENCESSTP 21-1-SMCT, Soldier's Manual of Common Tasks:Skill Level 1.FM 4-25.11, First Aid.FM 100-14, Risk Management.Training Support Package 071-D-2316 / First Aid 1Evaluate a Casualty for Life-ThreateningConditions).SUGGESTIONAfter completing the assignment, complete theexercises at the end of this lesson. These exerciseswill help you to achieve the lesson objectives.IS08772-1

LESSON 2EVALUATING A CASUALTY2-1.INTRODUCTIONThis lesson assumes that you are in a combat situation, there is a woundedsoldier in need of help, and you can provide care without endangering your combatmission.WARNINGIf there are any signs of nerve agent poisoning, stop theevaluation, take the necessary NBC protective measures, andthen resume appropriate first aid measures (Lesson 8).2-2.ACTIONS BEFORE APPROACHING THE CASUALTYTake the following actions before approaching the casualty on the battlefield.Remember to protect yourself.a. Scan the area for potential danger.(1)Survey the area for small arms fire.(2)Detect area for fire or explosive devices.(3)Determine threat for chemical or biological agents.(4)Survey buildings, if any, for structural stability.b. Determine the best route of access to the casualty and the best route ofegress. If you need to move the casualty to a safer area, be sure to select an area thatprovides optimum cover and concealment. Plan your evacuation route prior to exposingyourself to possible hostile fire.c. Request covering fire to reduce the risk to yourself and the casualty duringmovement to and from the casualty's location.d. Anticipate the type of injuries the casualty may have received and what carewill probably be needed. Did the casualty fall from a wall (broken bones)? Was therean explosion (blast effects)? Was there only small arms fire (bleeding wounds)?IS08772-2

e. Anticipate how your actions (movement, noise, light, etc.) may affect theenemy's fire.f. Decide what care you can administer to the casualty when you reach him andwhat care will have to wait until you have returned the casualty to a place of safety.2-3.INITIAL ACTIONSRemember, if you and the casualty are still under effective hostile fire, return fireas directed or required. Do not expose yourself to enemy fire in order to provide care.a. If possible, determine if casualty is alive or dead.b. Provide tactical care to the live casualty.(1) Suppre

SELF-AID/BUDDY-AID Subcourse Number IS0877 EDITION A UNITED STATES ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL FORT SAM HOUSTON, TEXAS 78234-6100 20 Credit Hours INTRODUCTION OVERVIEW Interschool Subcourse 0877, Self-Aid/Buddy-Aid, contains instructions for performing self-aid/buddy-aid (first aid) tasks that all soldiers are required to know.