There is little that a Corpsman can do to correct
internal soft-tissue injuries since they are almost
always surgical problems. The Hospital Corpsmans
goal must be to obtain the greatest benefit from the
victims remaining blood supply. The following steps
should be taken:
1. Treat for shock.
2. Keep the victim warm and at rest.
3. Replace lost fluids with a suitable blood volume
expander. DO NOT give the victim anything to
drink until the extent of the injury is known for
4. Give oxygen, if available.
5. Splint injured extremities.
6. Apply cold compresses to identifiable injured
7. Transport the victim to a medical treatment
facility as soon as possible.
SPECIAL CONSIDERATIONS IN
There are special considerations that should be
observed when treating wounds. The first of these is
immediate treatment to prevent shock. Next, infection
should be a concern: Look for inflammation and signs
of abscess. Hospital Corpsmen should be aware of
these conditions and have the knowledge to treat them.
Shock is likely to be severe in a person who has lost
a large amount of blood or suffered any serious wound.
The causes and treatment of shock are explained
earlier in this chapter.
Although infection may occur in any wound, it is a
particular danger in wounds that do not bleed freely, in
wounds in which torn tissue or skin falls back into
place and prevents the entrance of air, and in wounds
that involve the crushing of tissues. Incisions (in
which there is a free flow of blood and relatively little
crushing of tissues) are the least likely to become
Battle wounds are especially likely to become
infected. They present the problem of devitalized
(dead or dying) tissue; extravasated blood (blood that
has escaped its natural boundaries); foreign bodies
such as missile fragments, bits of cloth, dirt, dust; and a
variety of bacteria. The devitalized tissue proteins and
extravasated blood provide a nutritional medium for
the support of bacterial growth and thus are conducive
to the development of serious wound infection.
Puncture wounds are also likely to become infected by
the germs causing tetanus.
COMMON INFECTION-CAUSING BACTERIA.
There are two types of bacteria that commonly cause
infection in wounds: aerobic and anaerobic. Aerobic
bacteria live and multiply in the presence of air or free
oxygen, while anerobic bacteria live and multiply only
in the absence of air.
Aerobic Bacteria.The principal aerobic
bacteria that cause infection, inflammation, and
septicemia (blood poisoning) are streptococci and
staphylococci, some varieties of which are hemolytic
(destroy red blood cells).
The staphylococci and
streptococci may be introduced at the time of
infliction, or they may be introduced to the wound later
(at the time of first aid treatment or in the hospital if
nonsterile instruments or dressings are employed).
Anaerobic Bacteria.Anaerobic bacteria are
widespread in soil (especially manured soil). While
not invasive, anaerobic bacteria contribute to disease
by producing toxins and destructive enzymes, often
leading to necrosis and/or gangrene of the infected
M I N O R
W O U N D
C L E A N I N G
A N D
DRESSING.Wash minor wounds immediately with
soap and clean water; then dry and paint them with a
mild, nonirritating antiseptic. Apply a dressing if
necessary. In the first aid environment, do not attempt
to wash or clean a large wound, and do not apply an
antiseptic to it since it must be cleaned thoroughly at a
medical treatment facility. Simply protect it with a
large compress or dressing, and transport the victim to
a medical treatment facility. After an initial soap and
water cleanup, puncture wounds must also be directed
to a medical treatment facility for evaluation.
Inflammation is a local reaction to irritation. It
occurs in tissues that are injured, but not destroyed.
Symptoms include redness, pain, heat, swelling, and
sometimes loss of motion.