How to evaluate a combat casualty
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How to Evaluate a Casualty During Combat

Being wounded in action is just about as bad as it gets for anyone and it is very important that all members of the military
know basic life saving techniques to give their fellow Soldiers a chance to get home alive. This page covers the basics of
how to evaluate a combat casualty in the proper sequence.

Getting to the Casualty
Once you know that a member of you team is wounded, the next step is to safely get to him and not get killed or wounded
in the process. You must take cover and scan the area for potential threats before you approach the casualty, if being
fired upon the you and your team must return heavy fire so that the enemy backs off or is unable to shoot at your position.
Approach the Casualty once you have suppressed enemy fire, this must be done at combat speed that is you better "haul
ass" to get the wounded Soldier out of the kill zone and to an area that provides maximum cover and concealment so that
you and your team can treat the wounds and start the MEDEVAC to get the Casualty to a hospital.

Check the Casualty for responsiveness
To check the casualty for responsiveness:
(1) Ask in a loud, but calm, voice: “Are you okay?” Gently shake or tap the casualty on the shoulder.
(2) Determine level of consciousness by using AVPU (A = Alert;V = responds to Voice; P = responds to Pain; U =
Unresponsive).
NOTE: If the casualty is alert or responds to voice, do not check the casualty's response to pain.
NOTE: To check a casualty’s response to pain, rub his breastbone briskly with a knuckle.
b. If the casualty is conscious, ask where it hurts or where his body feels different than usual. This helps to determine the
level of responsiveness and provides you with information that can be used when treating the casualty.
c. If the casualty is unconscious, position the casualty and open his airway. Opening his airway may result in the casualty's
level of consciousness being upgraded.

Position the casualty on his back if he is not already lying on his back. To turn a casualty onto his back, perform the
following steps.
a. Kneel beside the casualty with your knees near his shoulders, leaving space to roll the body.
b. Raise the casualty's arm that is nearest to you above the casualty's head.
c. Adjust the casualty’s legs so that they are together and straight or nearly straight.
d. Place one of your hands under the back of the casualty's head and neck for support.
e. With your free hand, reach across the casualty's back and grasp the casualty under the arm (far armpit area).
f. Pull steadily and evenly toward yourself, keeping the head and neck in line with the torso.
g. Once the casualty is rolled onto his back, place his arms at his sides.

NOTE: This method of rolling the casualty is used to minimize further injury to the
casualty's spine in case he has suffered an injury to the head, neck, or back.

CHECKING THE CASUALTY FOR BREATHING
Check the casualty for breathing.
NOTE: It is assumed that you and the casualty are in a protected area. If you are still exposed to enemy fire, apply a
tourniquet to control any severe bleeding and move the casualty and yourself to a safe location before checking for
breathing. If the casualty is conscious and talking, his breathing is satisfactory for now. However, continue to monitor the
casualty's breathing since swelling throat tissue, bleeding into the throat, or other injuries could require you to
establish an airway and perform rescue breathing.
a. Look, listen and feel for respirations. If the casualty is breathing, determine if the breathing rate is normal, rapid, or slow.
(1) Place your ear about one inch above the casualty's mouth and nose. Listen for breathing. Look at the casualty's chest
to see if it is rising and falling.
(2) Feel for breathing by placing your hand or cheek about one inch above the casualty's mouth and nose. Feel for air
being exhaled.
NOTE: If the casualty is not breathing, stop the evaluation to restore the airway.
NOTE: In a combat situation, if you find a casualty with no signs of life (no breathing and no pulse), do not attempt to
restore the airway. Do not attempt to perform cardiopulmonary resuscitation. Do not continue first aid measures.
(3) Count the casualty's respirations (one inhalation and one expiration together is one respiration) for 15 seconds. If the
casualty has less than two respirations during the 15 seconds,
a. nasopharyngeal airway may be required.
b. Expose the casualty’s chest to look for equal rise and fall of the chest and for wounds.
(1) If the casualty’s chest is not rising and falling evenly, make a mental note and proceed with the evaluation.
(2) If the casualty has a penetrating chest wound and is breathing or making an effort to breathe, stop the evaluation and
apply an occlusive dressing to seal the penetrating wound.
NOTE: Check for entrance and exit wounds to the chest. If an entrance wound and an exit wound are present, both must
be sealed.
(3) If the casualty has a penetrating chest wound, is not breathing, and is making no effort to breathe, do not attempt to
treat the injury.

Check the Casualty for Bleeding >>>
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