BASIC LIFE SUPPORT
In any casualty situation, you will concentrate on
maintaining the ABCs (discussed in the Basic Life
Support section of chapter 9 in Dental Technician,
Volume 2, NAVEDTRA 12573) of the casualties.
TREATING OBVIOUS CONDITIONS
In your primary assessment, you will notice some
obvious conditions that require treatment (e.g.,
external hemorrhaging, shock, fractures, wounds,
etc.). After you triage the casualties, you will start
treatment of the obvious conditions.
Hemorrhage, or bleeding, occurs whenever there
is a break in the wall of a blood vessel. Blood circulates
throughout the body by means of three different kinds
of blood vessels: arteries, veins, and capillaries.
Arteries are large blood vessels that carry the
blood away from the heart. Veins are large blood
vessels that carry blood back to the heart. Capillaries
are smaller blood vessels that form a connecting
network between the arteries and veins.
Arterial bleeding is when bright red blood comes
from the wound. If the artery is near the surface of the
body, the blood will spurt out each time the casualtys
heart beats. If the artery is located deep within the
body, the blood will flow from the wound in a steady
Venous bleeding is when dark red blood comes
from the wound in a steady stream.
Capillary bleeding is when dark red blood comes
from the wound in a steady stream.
Slight wounds usually cause only capillary
bleeding. This bleeding can be controlled by lightly
fastening a sterile dressing over the wound. Deeper
wounds, however, may cause venous or arterial
bleeding. Because the veins and arteries are large
blood vessels, a casualty may lose a lot of blood.
You should regard venous or arterial bleeding as a
serious, life-threatening emergency.
The four methods for controlling hemorrhage are
direct pressure, elevation, applying pressure to the
pressure points, and the use of a tourniquet.
Apply a tourniquet only as a last resort.
DIRECT PRESSURE.In most cases, serious
external bleeding can be controlled by applying
pressure directly on the wound with your hand on a
sterile dressing as shown in figure 13-1.
A battle dressing is a combination dressing and
bandage in one unit. It is made of many layers of gauze
sewed to a muslin strip or strips. Emergency medical
kits are supplied with battle dressings (fig. 13-2), each
stored in a sterile package, ready for instant use. These
dressings come in different sizes; select a size to
completely cover the wound and extend at least 1 inch
in every direction beyond the border of the wound.
Make sure that the sterile side covering the wound does
not come into contact with your fingers, your clothes,
or other unsterile objects. Do not drag the dressing
across the casualtys skin, or allow it to slip out of place
once it has been positioned over the wound.
When the dressing is in place overthe wound,
apply pressure to the dressing with the palm of your
hand. Maintain pressure until the bleeding is
controlled. If blood soaks through the dressing, do not
replace it; add a second dressing on top of the first one
and maintain hand pressure.
When the bleeding is controlled, wrap the ends of
the dressing around the wound and secure them by
tying or pinning.
If you have no battle dressings, you may use the
cleanest cloth available (e.g., freshly laundered
handkerchief, towel, or shirt) and a roller bandage (fig.
13-3). But never use material that will stick to the
wound and be difficult to remove (e.g., absorbent
cotton and adhesive or friction tape). The roller
bandage is used to hold a compress in place, create
pressure, and immobilize joints. The purpose of the
bandage is to stop the bleeding, to prevent further
Figure 13-1.Direct pressure.