SABC NOTES
Courtesy of C/Bartlett and C/Maclean, posted with permission
Casualty Care in a CBRN Contaminated Environment
- perform SABC measures
- inject antidote if nerve agent symptoms are present **be sure to use casualty’s auto-injectors, not yours!
- Report casualty to UCC to not transmit personal information over unsecure net
- Decontaminate casualty and their equipment with M295 or M291 kits
- Transport casualty to CCP unit
Basic Lifesaving Steps
Airway – establish an open airway
Breathing – ensure
Circulation - stop bleeding to support circulation
Disability – prevent further
- immobilize neck injuries
- place dressings over open wounds
- splint obvious limb deformities
Exposure – minimize further to adverse weather
Types of Ailments
Shock
Symptoms
- confusion
- sweaty but cool skin
- breathing is shallow, labored, and rapid
- weak and rapid pulse
Treatment
- keep airway open
- if unconscious place on side in recovery position and monitor airway
- keep the person calm, warm, and comfortable
- elevate lower extremities
- do not give food or drink
Abdominal Wounds
Treatment
- if organs are outside body gently pick them up and place them on top of the abdomen – Do not replace or push organs into the body cavity
- cover exposed organs with a moist clean dressing
- secure with bandages
- if legs are not fractured, bend knees to relieve pressure
Bleeding
Symptom – obvious external bleeding
Convential Treatment
- apply direct pressure with hand, use dressing if available
- elevate the extremity if no fractures are suspected
- use pressure points iwht elevation to control bleeding
- tourniquet as a last result to stop bleeding. – use to save life at possible loss of limb
- consider using QuikClot if available
Care Under Fire
- return fire as directed or required before providing medical treatment
- if the casualty can function, direct to return fire, move to cover, and administer self aid
- if casualty is unable to function and you cannot assist, tell casualty to play dead until enemy fire is suppressed
- if the casualty has life threatening bleeding from a limb, tourniquet first to the limb or amputation – if bleeding is in a location where a tourniquet cannot be applied (armpit or groin) consider QuikClot in conjunction with direct pressure
- Place one inch wide constricting band around arm or leg to stop severe bleeding
- DO NOT USE WIRE OR SHOE STRING
- Place band two to four inches above injury if possible
- Tighten band enough to stop bleeding and no more
- Once in place, do not loosen or remove
- Leave Tourniquet area exposed for quick visual reference
- Mark time and letter “T” on casualties forehead in ink or blood
- DO NOT REMOVE Tourniquet ONCE APPLIED
Eye Injury
Symptom – obvious pain or injury
Treatment
- do not remove any impaled objects
- dress around the object to secure it
- apply bandage lightly to both eyes
- DO NOT LEAVE CASUALTY UNATTENDED
COMMON INJURIES
Sucking Chest Wound
Symptoms
- sucking noise from chest
- frothy red blood
- difficulty breathing
Treatment
- look for an entry and exit wound
- cover holes with airtight seal (plastic, tin foil, id card)
- tape down all four side of seal
- allow casualty to assume position of easiest breathing, preferably on affected side
Fractures
Symptoms
- deformity, bruising
- tenderness over specific part of body
- swelling or discoloration
Treatment
- DO NOT STRAIGHTEN LIMB
- if in doubt, splint injury where they lie if possible
- splint joints above and below injury
- remove clothing from injured area
- remove rings from fingers if possible
- check pulse below injury away from heart to determine if blood flow is restricted by splint
Spinal/Neck/Head Injury
Symptoms - lack of feeling or control anywhere below neck, drainage of fluid or blood from ear, nose, or mouth
Treatment
- if conscious caution casualty not to move
- continuously monitor and check airway without turning head
- immobilize the head and neck
If casualty must be moved…
- use hard surface for stretcher (door, cut lumber, other)
- use as many people as needed to place casualty on stretcher
- one person must immobilize the head and neck
- be sure casualties limbs are secure at the chest and thigh regions
- turn whole body together as a unit
Combating Heat Illness and Cold Injury
Dehydration | Heat Exhaustion | Heat Stroke | |
Key Indicators | |||
Mental State | Conscious may be dizzy | Conscious may be dizzy | Sudden Collapse Unusual behavior Altered state of mind |
Body Temperature | Normal | Normal | Hot Elevated |
Action | Sit down in shade/cool area Provide water Observe | Sit down in shade/cool area Provide water Observe | Call 911 immediately SABC Cool victim |
Other Symptoms | Headache Dry mouth Loss of skin Turgor (remains elevated when pinched) | Weakness Headache Dry mouth Nausea Muscle cramps/spasms | Red Face/Skin Strong rapid pulse Wet or dry skin Most likely sweating in younger individuals |
Dehydration
Symptoms
- Dizzy
- Headache
- Dry mouth
- Loss of skin Turgor (remains elevated when pinched)
Treatment – provide water
Heat Exhaustion
Early Symptoms
- dizziness/weakness
- headache
- dry mouth
- nausea
- muscle cramps/spasms
- profuse sweating
- loss of salt in the body
- normal body temperature
Treatment
- remove from work or training
- allow casualty to rest in shade or cool area
- provide sips of water
- if symptoms to do not improve in 15 to 30 minutes, transfer to a medical facility
- if signs or symptoms worsen, call ambulance
Late Signs or Symptoms
- weak and or rapid pulse
- confusion, unresponsive, or coma
- loss of bowel or bladder control
- convulsions
- cramps in abdomen or limbs
- pale face
- dizziness/faintness/weakness
- nausea or vomiting
- profuse sweating or moist cool skin
- normal body temperature
Treatment
- treat for shock
- lay person down in cool area
- loosen/open clothing
- cool body by sprinkling with cool water or fanning (not to the point of shivering)
- give victim cool water to drink if conscious
- seek medical attention
Heat Stroke
Symptoms
- headache
- dizziness
- red face/skin
- strong, rapid pulse
- confusion and disorientation
- hot dry skin or sweating
- high body temperature (hot to touch)
Immediate Actions
- call 911/local emergency number or radio for ambulance immediately for transport to the medical treatment area
- during combat, transport victim to CCP via unit assets
- lay person down in shade or cool area with feet elevated until help arrives
- give sips of water if casualty is conscious
- if skin is hot and ry to touch, remove clothing – pour water over person and fan
- if casualty begins to shiver, stop fanning, if shivering stops, resume fanning
Treatment
- lay person in cool area
- loosen/open clothing
- cool body by sprinkling with cool water or fanning
- give cool water to drink if conscious, add two teaspoons of salt to one canteen if available
- seek immediate medical attention
- treat for shock
Burns
- burns may be from heat (thermal), electrical, chemical, or radiation. Treatment is based on depth, size, and severity (termed degree) of burn
- ALWAYS TREAT FOR SHOCK AND SEEK MEDICAL ADVICE
Thermal / Partial Thickness (First and Second Degree)
Symptoms – skin reddens (sun burn like), painful, blisters
Treatment
- stop the burning process
- apply cool water to affected area
- do not break blisters
- apply clean dressing to affected area
Thermal/Full Thickness (Third Degree)
Symptoms
- charred or whitish looking skin
- may burn clear to the bone
- burn area not painful, but area around burn very painful
Treatment
- stop the burning process
- do not remove clothing adhered to burn area
- cover with or apply clean dressing to affected area
Electrical Burns
- ensure power is off
- look for entry and exit wound
- treat burned area
Chemical Burns
- flush with large amount of water
- flush eyes for at least 20 minutes
- brush off visible contaminants
- keep phosphorous burns covered with a wet dressing to keep air from activating phosphorous
- fingers have a tendency to swell, ensure that rings and jewelry are remove immediately
COLD INJURIES
Hypothermia
Symptoms
- body is cold under clothing
- may appear confused
- may appear dead
Treatment
- move to a warm place
- remove wet clothing
- put on warm clothes or wrap with dry towel
- do not rub body parts
- do not give or consume alcohol
Frostbite
Symptoms
- skin has a white or waxy appearance
- skin feels hard to touch
Treatment
- move to warm place
- re-warm affected area with warm water (104 to 108 degrees fareinheit) for fifteen to thirty minutes (not hot water)
- cover with several layers of clothing
- do not rub affected area
- seek medical attention immediately