5. Upon the direction of a medical officer,
start an intravenous line.
REMOVING FOREIGN OBJECTS
Many wounds contain foreign objects. Wood
or glass splinters, bullets, metal fragments, bits
of wire, fishhooks, nails, tacks, cinders, and small
particles from grinding wheels are examples of the
variety of objects or materials that are sometimes
found in wounds. In some cases, first aid treat-
ment for wounds includes the removal of such ob-
jects when they are near the surface and exposed.
However, first aid treatment does not include the
removal of deeply embedded objects, powdered
glass, or any widely scattered material of this
nature. You should never attempt to remove
bullets, but you should try to find out whether
the bullet remains in the victim; look for both en-
trance and exit wounds. The general rule to
remember is this: Remove foreign objects from
a wound when you can do so easily and without
causing further damage; but NEVER HUNT FOR
OR ATTEMPT TO REMOVE DEEPLY
BURIED OR WIDELY SCATTERED OB-
JECTS OR MATERIALS except in a definitive
The following procedure may be used to
remove a small object from the skin or tissues if
the object is near the surface and clearly visible:
Cleanse the skin around the object with
soap and water and paint with any
available skin antiseptic solution.
If necessary, pierce the skin with a sharp
instrument (a needle, razor, or sharp knife
that has been sterilized by passing it
through a flame several times).
Grasping the object at the end, remove it.
Tweezers, small pincers, or forceps maybe
used for this purpose. (Whatever instru-
ment you use should first be sterilized by
boiling if at all possible.)
If the wound is superficial, apply gentle
pressure to encourage bleeding.
Cover the wound with a dry, sterile
the foreign object is under a fingernail or
toenail, you may have to cut a V-shaped notch
in the nail so that the object can be grasped by
the forceps. Do not try to dig the object out from
under to nail with a knife of similar instrument.
A curved or barbed object such as a fishhook
may present special problems. Figure 4-49 shows
Figure 4-49.Removing a fishhook.
one method of removing a fishhook that has
become embedded in the flesh. As you can see
from figure 4-49A, the barb on the hook prevents
its direct removal. However, if you push the hook
forward through the skin, as shown in figure
4-49B, you can clip of the barb with a wire cutter
or similar tool, as shown in figure 4-49C. The re-
mainder of the fishhook can then be withdrawn
in the manner indicated in figure 4-49D.
The care of the wound is largely controlled by
the tactical situation, facilities available, and the
length of time before proper medical care maybe
available. Normally, the advice to the corpsman
regarding suturing of wounds would be DO NOT
ATTEMPT IT. However, if days are to elapse
before the patient can be seen by a surgeon, the
corpsman should know how to use the various
suture procedures and materials and how to select
the most appropriate of both.
Before discussing the methods of coaptation
(bringing together), some of the contraindications
to wound closing should be described:
1. If there is reddening and edema of the
wound margins, infection manifested by