CHAPTER 13 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 GUIDELINES

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 explained.

ASSESSMENT

You must make a quick and accurate assessment of the site and of the immediate condition of the casualties.

Site Assessment

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?

Casualty Assessment

During the initial or preliminary casualty assessment, you will perform a primary examination of the casualty to determine if injuries are life- threatening.

Basic rules for casualty assessment are as follows:

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 different positions:

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.