War Wounds

By: HM1 (SW) Shane R. Walker

Afloat Training Group 30May00

What are the 8 “War Wounds”?

• Compound Fracture of the Jaw• Electrical Shock• Smoke Inhalation• Burns• Compound Fracture of the Leg • Abdominal Wound with protruding intestines• Sucking Chest Wound• Amputation

First Aid Supplies Needed

• Battle dressings (large & small)

• Splints (wire or SAMS)

• Ace wraps• Tourniquet• Skin Marker

Compound Fracture of the Jaw

• A compound fracture implies the bone is exposed.

• Never touch exposed bone!

• Pinch the wound edges together rather than apply direct pressure.

Compound Fracture of the Jaw

• Place casualty on his back

• Pinch wound edges together

• Look, Listen and Feel for breaths & remove any possible airway obstructions

Compound Fracture of the Jaw

• Fold a MEDIUM battle dressing in half (sterile side out)

• Place over the wound with the open edge down

Compound Fracture of the Jaw

• Bring the top ties around the neck and tie them on top of the wound in order to apply direct pressure

• Bring the bottom ties up and tie on top of head

• ENSURE DRESSING DOES NOT OBSTRUCT THE MOUTH

Compound Fracture of the Jaw

• Check the patient for other injuries both front and back

• Position the casualty face-down and rest the wound on his hands

• Keep casualty warm and await instructions

Electrical Shock• SECURE POWER!!• Remove casualty

from circuit• Check for

unresponsive and conduct A B C’s

Electrical Shock• If no breathing or pulse

call away “Medical Emergency”

• Establish airway by Performing head/jaw lift

• Deliver 2 full breaths. Make sure the chest rises and falls with each breath

Electrical Shock• Check carotid artery

for pulse• If there IS a pulse

begin rescue breathing, 1 breath every 5 seconds

• If NO pulse, begin CPR

Electrical Shock• Maintain proper

compression to breath ratio, 15:2.

• Re-check ABC’s every 1 minute (or 4 cycles)

• Continue until relieved by Medical or casualty has a pulse and is breathing

• Check for other injuries & Treat for shock (feet higher than head)

Smoke Inhalation• Check casualties ABC’s and react as

needed• Conduct a thorough check for other injuries

before moving casualty (if possible)• Properly remove casualty from smoke filled

environment to fresh air• Maintain airway and recheck patient

periodically, DON’T LEAVE CASUALTY

Burns• Check ABC’s• Call for help as

needed• check for other

injuries• All three degrees of

burns are treated the same

Burns• Treat the burn:• Expose burn, do NOT

break or open blisters• Secure a sterile battle

dressing over the burn• Elevate injury and allow

for drainage• Treat for shock• Re-check ABC’s as

needed

Compound Fracture of the Leg

• Always support the limb above and below the fracture

• Avoid touching the exposed bone

• Reassure patient

Compound Fracture of the Leg

• Place casualty on his back

• Control bleeding by pinching the wound edges together

• Wrap a LARGE battle dressing around the leg

• Criss-cross the bottom ties up and the top ties down

Compound Fracture of the Leg

• Using the ball of the GOOD foot as a starting point mold two splints.

• A wire splint or a SAMS splint may be used

• Ensure the splint extends past the knee

Compound Fracture of the Leg

• Wrap the molded splint with three ace wraps from the foot to the knee

• Check for other injuries (front & back)

• Place casualty in shock position, support leg above & below the fracture sight

Abdominal Wound with Protruding Intestines

• Don’t touch the intestines

• Don’t try and put intestines back

• Don’t tie anything on top of the wound

• Application of a dry dressing should be avoided.

Abdominal Wound with Protruding Intestines

• Place casualty on his back, expose the wound bend patients knees

• Saturate 2 LARGE battle dressings before application to the wound

Abdominal Wound with Protruding Intestines

• Lay the first battle dressing sterile side up and slip under the protruding intestines, forming a pouch

• Take both ties over to the other side and tie to the patients side. DO NOT TIE OVER WOUND.

Abdominal Wound with Protruding Intestines

• Take the second dressing and lie sterile side down over the wound

• Tie in same manor as the other battle dressing

• Check for other injuries (front & back)

• Treat for shock and keep casualty warm

Sucking Chest Wound• Sit patient up while

treating wound• Always check for an

exit wound

Sucking Chest Wound• Place the casualty in a

sitting position and spread legs, preferably in a corner and expose the injury

• Immediately attempt to plug the wound with the palm of your hand or pinch the wound edges together

Sucking Chest Wound• Cover the wound with

the plastic covering from a battle dressing folding into quarters

• Wipe of the excess blood and apply tape to three edges of the plastic, leaving the bottom open

Sucking Chest Wound• Check for exit wound

and treat as before• Cover the plastic with

a large battle dressing criss-crossing the ties in the back

• Check for other injuries & keep casualty warm

Amputation• Never remove a

saturated battle dressing. Apply additional dressings as needed over the old dressing

• Mark the tourniquet time applied to forehead with a skin marker

• Never use the buckle to tighten the tourniquet

Amputation• Place casualty on

his or her back and elevate arm

• Control bleeding by use of a pressure point

Amputation• Have another person

apply a tourniquet 2-4 inches below the amputation

• Secure with a square not, do NOT use the buckle

• Mark a “T” and time the tourniquet was applied on the forehead with a skin marker

Amputation• Cover the

amputation with a LARGE battle dressing

• Use one tie to secure the four corners by wrapping it around the limb

Amputation• Use the remaining

ties by criss-crossing them over the top of the wound

• Tuck in the ends of the ties

• Treat for shock & Keep the casualty warm

Summary• Be aggressive in treating these casualties…

time counts!• Always check for addition injuries• Treat for shock• Position casualty properly while awaiting

transport• Keep casualties warm & re-assure them