Forums / Strategies, Tactics & Training / Treating wounds, pt 3 Evaluating a casualty (Steps 1 and 2)

8 years 4 weeks ago, 12:27 PM


runawaygun762's picture

Vice President
Join Date:
Nov 2008
Richland, MO, United States

Medicine is always advancing, and that includes field medicine. The steps I'm going to discuss are basic steps, something anybody can do. I could go through and research the stats of how many soldiers die on the battlefield of injuries that could be treated by first responders (Something very close to 90 percent), but I'll spend more time actually discussing what to do. These steps are based on the army's 8 steps of evaluating a casualty. They are very basic, and very fast, but that's the name of the game. Fast, but thorough. The phrase I like to use is the same one as when talking about shooting while moving. As fast as you can, as slow as you have to. A careful hurry.

When evaluating and treating, remember to treat it as you find it. The steps are listed in order of importance. Splinting a fracture does no good if the casualty isn't breathing.

1- Check for responsiveness. There are a few levels of responsiveness. These are good ways of determing whether a casualty is stabilizing or is getting worse. It is also good information to give to the 911 dispatcher or ER triage nurse. The basic levels are as follows:

Alert- You approach the casualty and he/she acknowledges your presence and is able to have a conversation.

Voice- If a casualty doesn't respond to you as you approach, gently shake them and say "Are you okay?" If this gets a response from the casualty, whether verbal or just a shake of the head, the casualty responds to voice.

Pain- If a casualty still doesn't respond to the above, cause a small bit of pain or discomfort. A pinch to a sensitive area will usually be enough if they are responsive at all. One method is the sternum rub, in which you rake your second joint up and down their sternum. Like giving a noogie to their breastbone. This is a potentially dangerous technique, as you don't know what kind of injuries the casualty has sustained.

Unresponsive- If all of the above has failed, the casualty is unresponsive. Move to the next step.

Responsiveness is something to keep checking. If the casualty is talking to you and is coherent one minute, but begins to seemingly ignore you or require more effort to get his/her attention, this will let you know he/she may be going into shock.

2- Check for breathing. This is a fairly easy check, you use the "Look, listen, feel" method. Position the casualty so his airway is open. The head tilt/chin lift method is the easiest and best for the airway, but you have to be very careful not to aggravate a spinal injury. I will give some tips from the field on all of these in another post and video later. The look, listen, feel works like this; You position your ear right in front of the casualty's mouth, your head turned to look toward the casualty's feet.

Look- For the rise and fall of the chest
Listen- For the sound of the casualty breathing
Feel- The casualty's breath on your cheek.

We could add a Smell step in case ebear is a casualty, I suppose.

Smell- Tamales and stale cum. Hah hah hah

"I have always been a soldier. I have known no other life. The calling of arms, I have followed from boyhood. I have never sought another." From The Virtues of War, by Steven Pressfield.

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