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Combat Lifesaver Re-certification Course
Welcome
SSG Scaliatine
SGT McNamara
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
(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.
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
Types of airway Blockages
• Partial Blockage with Good Air Exchange• Partial Blockage with Poor Air Exchange• Complete Blockage
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
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.
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Look at Practical Exercise on Page 2-6
DO NOT write in BOOK
Combat Lifesaver Re-certification Course
Find a Partner, Practice this skill
Use Checklist found on page 2-9 in your Buddy-Aid Book
DO NOT write in BOOK
Combat Lifesaver Re-certification Course
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
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
Combat Lifesaver Re-certification CourseEvaluate the Casualty
Steps 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
Combat Lifesaver Re-certification Course
What is Mouth-to-Mouth Resuscitation ????
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
1. Check for Responsiveness
• Ask Casualty “Are you OK?”
• Call for help
HELP !
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
2. Position the Casualty for Mouth-to-Mouth Resuscitation
• On his back (Supine)• Roll if needed, protect head and spine• Avoid Injury
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
3. Open the Casualty’s Airway
• Head Tilt / Chin Lift• Jaw Thrust
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
5. Initiate Mouth-to-Mouth Resuscitation
• Maintain an Open Airway• Close Casualty’s Nose• Administer Two Full Breaths• Evaluate Effectiveness of the Ventilation
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
6. Perform a Finger Sweep, if needed
Use only if you see a foreign body in the mouth
Look at Page 3-8
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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)
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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.
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
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
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
Practical Exercise is on Page 3-15
Remember: DO NOT WRITE IN BOOKS
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
Practice on the Manikins
Use Checklist on Pages 3-20, 3-21 & 3-22
Perform Mouth-to-Mouth Resuscitation
Combat Lifesaver Re-certification Course
Questions ????
Combat Lifesaver Re-certification Course
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Page 4-1 in Buddy-Aid book
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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
Combat Lifesaver Re-certification Course
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
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
All Bleeding stops eventually
Stop it before it runs out
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Dressing: Material placed directly over a wound
Bandage: Material used to Hold Dressing
Field Dressing: Carried by all Soldiers
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Step # 1:
Expose the Wound
Use Caution with Burns or if in a Chemical Environment
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
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
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
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
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Hold And Wrap
Combat Lifesaver Re-certification Course
Step # 5:
Apply a Pressure DressingOnly on a wound of the Arm or LegPlaced on top of the field dressingPictures on Page 4-6
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Need a hand ???
How about a Tourniquet ?
Combat Lifesaver Re-certification Course
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
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Step # 7:
Gather Materials for Making a Tourniquet
Tourniquet Bands
Rigid Object
Securing Materials
Padding
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Step # 8:
Select Tourniquet SiteUpper Arm
Thigh
Above the Joint, as Close to Joint as Possible
Not over a Fracture
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
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
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Application Of Tourniquet(Tying of Half-Knot)
Combat Lifesaver Re-certification Course
Application of Tourniquet(Positioning Stick)
Combat Lifesaver Re-certification Course
Application Of Tourniquet(Full-Knot on Stick)
Combat Lifesaver Re-certification Course
Secure Stick
Combat Lifesaver Re-certification Course
Step # 10:
Dress an Amputation
Read Paragraph 4-11 on Page 4-12
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Step # 11:
Mark the Casualty
•“T” and time of Tourniquet application• Do not cover tourniquet• Monitor Casualty and Treat for Shock
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Test your Knowledge
Do the Practical Exercise on Page 4-13
DO NOT WRITE IN BOOKS
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Find your Partner
Use the Performance Checklist on Page 4-20 & 4-21
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
QUESTIONS ??
Perform First aid for Bleeding Perform First aid for Bleeding of an Extremityof an Extremity
Combat Lifesaver Re-certification Course
Following are some photos If you have a weak stomach or do not like the sight of blood do not look at these pictures!
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Measure and Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification CourseEvaluate the Casualty
Steps 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
Combat Lifesaver Re-certification CourseEvaluate the Casualty
Steps 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
Combat Lifesaver Re-certification Course
Task, Conditions & Standards found on page 18-1 in Medical Tasks book
Measure & Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification Course
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.
Measure & Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification Course
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
Measure & Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification Course
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
Measure & Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification Course
Step #3
Monitor the Casualty’s Pulse
Count as needed Periodically
Report Abnormal readings or changes
Measure & Monitor a Casualty’s Pulse
Combat Lifesaver Re-certification Course
Try the Practical Exercise on Page 18-6
Measure & Monitor a Casualty’s Pulse
DO NOT WRITE IN BOOKS
Combat Lifesaver Re-certification Course
Initiate an Intravenous Infusion
Read the Task, Conditions, Standards on
Page 17-1 of Medical Book
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Combat Lifesaver Re-certification Course
Turn to Page 17-1 in Medical Book.
Read to page 17-13
Combat Lifesaver Re-certification Course
Take the practical examination (Written) on page 17-14
DO NOT WRITE IN BOOK
Combat Lifesaver Re-certification Course
Watch this demonstration then pair off do the Skill, using the checklist from page 17-19(medical book)
Combat Lifesaver Re-certification Course
Questions ???
See you next year !!!