CASUALTY CARE AND CBR WARFARE
As a dental assistant, your training in basic life
support and emergency medical treatment makes you a
vital resource in mass casualty situations. In such
situations, you will be expected to assume the role of a
medical aid person, to provide basic life support and
emergency medical treatment, to sustain life, and to
prevent further injuries. You can be called to these
duties during either peace or wartime situations. This
chapter explains your roles in (1) mass casualty
situations and (2) chemical, biological, and
radiological (CBR) casualty situations.
To meet these needs, we will explain procedures
for providing emergency medical (first aid) treatment
in a mass casualty and CBR situation.
GENERAL MASS CASUALTY
The general guidelines for dealing with mass
casualty situations are as follows:
Assess the site.
Assess the condition of casualties.
Perform basic life support.
Treat the obvious conditions.
1. Control external hemorrhage.
2. Treat for shock.
3. Immobilize fractures.
4. Dress wounds.
Perform a secondary examination.
Prepare casualties for transport.
Transport casualties to a safe area.
In the following sections, the guidelines are
You must make a quick and accurate assessment of
the site and of the immediate condition of the
Before you attempt to rescue or to administer
emergency treatment, it is essential that you assess the
conditions at the casualty site to ensure that it is safe for
both you and the casualty.
Consider all aspects of the casualty site and the
environment to determine the probability of success if
a rescue is attempted. This assessment should include:
Accessibility of the casualty site. Can the site be
reached with available equipment? Once reached, can
emergency treatment be rendered on site? Can the
casualty be removed from the site if immobile?
Safety of the casualty site. Is the site stable? Can
you move safely at the site? Is the site exposed to hostile
fire? In case of an unforeseen emergency, can you and
the casualty be rescued from the site?
Environmental conditions at the site. Is there
adequate, breathable air at the site to sustain both the
rescuer and the casualty? Are there poisonous or
dangerous substances in the area? Will weather
conditions hamper an attempted rescue?
During the initial or preliminary casualty
assessment, you will perform a primary examination
of the casualty to determine if injuries are life-
Basic rules for casualty assessment are as
1. Keep the casualty lying down, with the head
level with the body, until you have found out what kind
of injury the person has and how serious it is. The
following problems require that you place a casualty in
a. Vomiting, bleeding about the mouth, or
semiconscious. If the casualty is in danger of sucking in
blood, vomited matter, or water, place the patient on the
side, or back, with the head turned to one side, lower
than the feet.