Surviving the world's extreme regions : desert, arctic, mountains, & jungle 9781422230817, 1422230813, 9781422230923, 1422230929

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Extreme Survival In the Military

SURVIVAL FIRST AID

Extreme Survival In the Military Learning Mental Endurance for Survival Ropes & Knots for Survival Survival at Sea Survival Equipment Survival First Aid Survival in the Wilderness Surviving by Trapping, Fishing, & Eating Plants Surviving Captivity Surviving Hostage Rescue Missions Surviving Natural Disasters Surviving the World’s Extreme Regions: Desert, Arctic, Mountains, & Jungle Surviving with Navigation & Signaling

Extreme Survival In the Military

SURVIVAL FIRST AID PATRICK WILSON

Introduction by Colonel John T. Carney. Jr., USAF-Ret. President, Special Operations Warrior Foundation

MASON CREST

Mason Crest 450 Parkway Drive, Suite D Broomall, PA 19008 www.masoncrest.com Copyright © 2015 by Mason Crest, an imprint of National Highlights, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, taping, or any information storage and retrieval system, without permission from the publisher. Printed and bound in the United States of America. 10 9 8 7 6 5 4 3 2 1 Series ISBN: 978-1-4222-3081-7 ISBN: 978-1-4222-3086-2 ebook ISBN: 978-1-4222-8778-1 Cataloging-in-Publication Data on file with the Library of Congress. Picture Credits Corbis: 12, 15, 21, 23, 33, 43, 52; TRH: 28, 44; US Dept. of Defense: 6, 8, 14, 26, 36, 54, 56 Illustrations courtesy of Amber Books and the following supplied by Patrick Mulrey: 17, 19, 24, 25, 30, 38, 39, 40, 46, 47, 48, 49.

ACKNOWLEDGMENT For authenticating this book, the Publishers would like to thank the Public Affairs Offices of the U.S. Special Operations Command, MacDill AFB, FL.; Army Special Operations Command, Fort Bragg, N.C.; Navy Special Warfare Command, Coronado, CA.; and the Air Force Special Operations Command, Hurlbert Field, FL. IMPORTANT NOTICE The survival techniques and information described in this publication are for educational use only. The publisher is not responsible for any direct, indirect, incidental or consequential damages as a result of the uses or misuses of the techniques and information within. DEDICATION This book is dedicated to those who perished in the terrorist attacks of September 11, 2001, and to the Special Forces soldiers who continually serve to defend freedom.

CONTENTS Introduction 7 Preparation and Equipment 9 Deciding on a Course of Action

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Breathing and Circulation 23 Wounds, Bleeding, and Burns 37 Bone, Joint, and Muscle Injuries

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Poisons and Bites 53 Series Glossary of Key Terms 60 Equipment Requirements 61 Useful Websites 62 Further Reading/About the Author

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Index 64

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INTRODUCTION Elite forces are the tip of Freedom’s spear. These small, special units are universally the first to engage, whether on reconnaissance missions into denied territory for larger, conventional forces or in direct action, surgical operations, preemptive strikes, retaliatory action, and hostage rescues. They lead the way in today’s war on terrorism, the war on drugs, the war on transnational unrest, and in humanitarian operations as well as nation building. When large scale warfare erupts, they offer theater commanders a wide variety of unique, unconventional options. Most such units are regionally oriented, acclimated to the culture and conversant in the languages of the areas where they operate. Since they deploy to those areas regularly, often for combined training exercises with indigenous forces, these elite units also serve as peacetime “global scouts” and “diplomacy multipliers,” a beacon of hope for the democratic aspirations of oppressed peoples all over the globe. Elite forces are truly “quiet professionals”: their actions speak louder than words. They are self-motivated, self-confident, versatile, seasoned, mature individuals who rely on teamwork more than daring-do. Unfortunately, theirs is dangerous work. Since “Desert One”—the 1980 attempt to rescue hostages from the U.S. embassy in Tehran, for instance—American special operations forces have suffered casualties in real world operations at close to fifteen times the rate of U.S. conventional forces. By the very nature of the challenges which face special operations forces, training for these elite units has proven even more hazardous. Thus it’s with special pride that I join you in saluting the brave men and women who volunteer to serve in and support these magnificent units and who face such difficult challenges ahead. Colonel John T. Carney, Jr., USAF-Ret. President, Special Operations Warrior Foundation U.S. Army soldiers attend to a “patient” during a simulated casualty exercise in 1998. All elite troops are trained in first-aid techniques.

Words to Understand Thermometer: Device used to measure the temperature of a person. Antiseptic: Cream/lotion that fights infection. Hypodermic: Injecting needle. Puritabs: Tablets that release chlorine to clean water and make it drinkable. Fracture: Chip, crack, or break. Artery: A major blood vessel that carries blood away from the heart.

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PREPARATION AND EQUIPMENT First aid is perhaps the most important part of elite soldiers’ training. It can help save their lives. Yet all good soldiers also know that prevention is better than cure. Their chances of survival are much greater if they have the right equipment and have done a lot of preparation. It is therefore worth taking a look at what goes into first-aid preparation before setting off on dangerous missions. Before launching themselves into remote or exposed places, troops need to make sure they are 100 percent fit. Even having a cold will make them think twice about taking part in an expedition. There are many other factors that need to be considered. For example, it is important for elite troops going to places with a cold climate to have their teeth checked. (If a tooth is in any way diseased, low temperatures intensify the pain.) They make sure their feet are in good condition and that their boots feel comfortable. Blisters can be a serious problem to elite troops who are expected to cover many miles on foot quickly. A blister can lead to serious infections. Here are a number of the typical questions they ask themselves before setting off on a mission: What is the weather like? Is there a threat from monsoons, ice melts, or tornadoes? What health issues are there? Do they need any vaccinations? (This is necessary to combat such illnesses as cholera, tuberculosis, tetanus, yellow fever, small pox, and hepatitis.) What sort of vegetation is there? Where are the A U.S. Army officer attends to a Royal Thai Marine during a mass casualty drill in Thailand.

10 survival first aid

Research Project Look at the list of basic first aid items a solder takes on page 11. Are there any that you don’t know anything about? Or are there any that interest you more than the others? Choose three of these items and write them down. Now go online and look up everything you can about each of the items. What are their main uses? Can they be used for more than just first aid?

clean water sources? What type of surfaces will we be crossing? What are the patterns of sunrise/sunset? What are the most extreme possibilities for daytime/nighttime temperatures?

First-aid kit Every member of the elite forces, whether they are in the British Special Air Service (SAS), the U.S. Special Forces, or U.S. Marine Corps carries a first-aid kit.

A survival first-aid kit showing some of the items that an elite soldier carries, including a scalpel, plasters, scissors, and bandages.

The following is a guide to some of the basic items they take. Their packs will vary depending on which region they are visiting, either tropical, desert, or arctic, but essentially they will contain:

Preparation and Equipment 11

Text-Dependent Questions 1. Why shouldn’t a soldier take part in an expedition if he is not feeling well? 2. List five of the questions that each soldier should ask himself before setting off on a mission. 3. Why wouldn’t a soldier be able to bring a heavy pack of first aid items?

thermometer; gauze dressing; scalpel blades (at least two); antiseptic swabs (at least five for cleaning smaller wounds and blisters); large safety pins; scissors; three green hypodermic needles (for removing splinters and draining blisters); fluid-replacement packet (helps replace fluids for conditions like diarrhea and burns; alternatively, mix eight teaspoons of salt with half a pint of water); puritabs (release chlorine to clean water; if the water is cloudy, troops will try and filter it first, then add an extra tablet; boiling water is also effective); painkillers; antacid tablets (for those suffering from indigestion); antidiarrhea tablets; bandages and wound dressings; sunblock; and lip balm. Often it is essential to travel fast. Packs must not be heavy and troops sometimes cannot take much medical equipment. A basic Navy SEALs medical kit is not heavy and takes up little space, but it still includes treatments for breathing and circulation difficulties, bleeding, breaks and fractures, burns, infections, and pain. It contains: blood volume expander, infusion fluid, dressings, artery forceps, suture kit, fracture straps, burns dressing, antibiotic tablets, antibiotic in injectible form, painkillers, anti-inflammatory cream, and creams for fungal infections.

Words to Understand Casualty: An injured person. Recovery position: A common position in which to place casualties, on their side. Resuscitation: Process of helping a person to breathe. Pulse: Beat of the heart, which sends blood around the body. Dislocations: Joints out of place.

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DECIDING ON A COURSE OF ACTION Troops are thoroughly trained in dealing with an emergency situation since it can be very shocking. Their first response should be to take deep breaths and then begin to assess the situation calmly, however traumatic it might appear. They then follow this step-by-step procedure. First, it is important to see if there are any new dangers present and establish who has been injured. In any accident situation, where there may be injured people, always check for dangers to yourself before approaching victims. Such dangers include electric cables, fires, gas pipes, falling debris, dangerous structures, or wreckage. If there are two or more persons present, one is put in charge to avoid confusion. They then follow the DATE system: • • • •

Diagnosis—working out quickly what the patient’s illness or injury is. Assessment—working out the best form of first-aid treatment. Treatment—giving treatment to the injured person. Evacuation—making sure that the patient is taken to a proper medical center or doctor if he or she is very ill or badly injured.

This soldier, taking part in a training exercise at Fort Polk, Louisiana, is taught to identify medical emergencies quickly. Once the problem is identified, he must then take appropriate action.

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Access to a helicopter plays a vital role in ensuring the patient gets to a medical center in time for life-saving treatment.

Throughout this time, troops like the U.S. Marine Corps are expected to keep the injured person as calm as possible. They will try to do this by talking quietly but confidently, to reassure the patient. Elite forces are trained to: • Shield the patient from distressing sights of other persons injured or killed. • Not reveal too much detail if the patient’s injuries are severe but to keep the focus on the positive things the patient can do to make the situation better. Even if injured soldiers are deeply unconscious, it is likely that they will still have some understanding of what is being said around them. It is therefore important to keep talking in the usual reassuring manner.

Deciding on a Course of Action 15

Rapid assessment The first thing that needs to be done on reaching the casualty is to find out what is wrong. This can sometimes be difficult, especially if the injuries are severe and gruesome, or if the patient is making a lot of noise due to the pain. If there are a number of wounded people, a member of the Special Forces, for example, does not just rush to the person who is shouting or screaming and ignore the casualty who is making no noise. This is because if a casualty is making a lot of noise, then at least his airway is open, and he is conscious and breathing. The casualty who is silent and unconscious may well be in a more life-threatening state. Note: if a victim has multiple injuries, a soldier’s first actions are to check breathing, heartbeat, and bleeding. Assessment is done by most of the Elite forces using the ABC method. ABC stands for Airway, Breathing, Circulation.

Airway

Rapid assessment and fast action is the key in an emergency situation. Note the teamwork here.

If a person is unconscious, the loss of muscular control in the tongue means that it can drop back and form a soft plug at the entrance of the airway. This may stop the person from breathing. Other objects such as food may also be lodged there. If this has happened, a soldier will open the casualty’s mouth and inspect for any blockages first. The mouth is

16 survival first aid

then cleared of any obvious blood or vomit. Once this is done, the tongue is eased forward to open the airway. To keep the airway open, the casualty’s head is moved. One hand is put on the casualty’s forehead, and two fingers from the other hand are placed under the point of the chin. The victim’s head is gently tilted backward, moving very slowly and carefully in case there are any spinal or neck injuries. This action will open the airway enough for the patient to breathe. The patient is placed in the recovery position to make it easier to breathe.

Breathing Once the airway has been cleared (this takes only a few seconds), the casualty’s breathing is checked. This is done by bending down and placing a cheek right next to the casualty’s mouth and nose. Eyes should be kept on the casualty’s chest. This will give you three opportunities to detect lack of breathing—you should feel the casualty’s breath on your cheek, hear it, and also see the rise

Make Connections: RAPID ASSESSMENT WITH THE SPECIAL FORCES A rapid assessment of any first-aid situation is vital. Knowing who to treat first can save lives. These are the priorities, as laid down by the Special Forces, for dealing with injuries in an emergency situation: restore and maintain breathing and heartbeat, stop bleeding, protect wounds and burns, deal with bone fractures, and treat shock.

Deciding on a Course of Action 17

and fall of the chest. If all these signs are absent for over 10 seconds, then it is necessary to begin giving resuscitation.

Circulation The basic principle here is to check for any major sources of blood or fluid loss, and to monitor the heartbeat. Checking for blood loss involves finding any source of heavy bleeding and stemming the flow using the most appropriate technique. In a cold climate, a soldier must check all areas of the body. Heavy, layered waterproof clothing can often hide areas of bleeding.

A first-aider checks this casualty’s breathing for signs of life by placing his hand in front of the nose and mouth.

Troops check for the pulse in one of two places. The first is the artery in the wrist. A soldier places three fingers (never the thumb: this has a pulse of its own, which may confuse matters) over the artery situated inside the wrist. The easiest place to find a pulse is the main artery in the neck. Soldiers find this by simply running their fingers down the patient’s jaw and onto the neck until their fingers drop into the groove along the side of the throat. Here, there should be a pulse. If the casualty is a man, the pulse can also be found by sliding the fingers from the Adam’s apple just to the side of the throat. A woman does not have an Adam’s apple. If there is no pulse for a period of 10 seconds, the soldier needs to judge whether the heart has stopped. If it has, then resuscitation should begin.

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Head-to-toe diagnosis Once patients’ most immediate needs have been attended to, it is necessary to carry out a full check of their condition. Look for the following injuries/disorders. • Head and mouth—it is important to check the casualty for signs of bleeding from the face or scalp. Blood or fluid leaking from the nose or ears can in certain situations indicate an injury to the skull or brain. The condition or shape of the jaw should be examined for any breakages or dislocations. The casualty’s mouth should also be checked for injuries such as lost teeth or heavy gum bleeding. • Eyes—look closely to see if the pupils are significantly different in size. (This can mean brain injury or a stroke.) It is important to test whether the casualty can move his eyes from side to side and up and down. (If not, this is another possible indication of brain damage.) The casualty should be asked about any problems with vision. • Skin—first check to see if the skin has a strange color or tint. If the person has

If a casualty is unconscious, you can check for their pulse in the wrist and in the neck.

Deciding on a Course of Action 19

dark skin, look at pale parts of the body such as the soles of feet, inside of lips or eyelids, or finger/toe nails. • Neck—elite soldiers will feel along the top part of the spine for anything unusual. They will then take a close look at the windpipe for any bruisings, swellings, and markings. • Chest—check that both sides of the chest move equally as the casualty is breathing. The soldier listens to the chest for any wheezings, cracklings, or

Make Connections: SKIN COLORATION The following skin colors give elite troops clues as to what is wrong with the casualty: A rapid assessment of any first-aid situation is vital. Knowing • Blue or blue/gray: especially if prominent in the lips and who to treat first can save lives. These are the priorities, as fingernails, may indicate that the patient is lacking oxygen. laid down by the Special Forces, for dealing with injuries in This may be caused by disrupted breathing, a heart attack, or an emergency situation: restore and maintain breathing and other cardiac problems. If the person is unconscious, it might heartbeat, stop bleeding, protect wounds and burns, deal with indicate malaria. bone fractures, and treat shock. • Darkened skin: can be a symptom of starvation. • Pale skin: if combined with cool, moist texture, suggests shock. Skin lightening can also occur with a lack of protein or hypothermia. • Red skin: may indicate poisoning; fever; heatstroke; sunburn.

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Research Project Choose one of the body parts that you are supposed to check when someone is injured. These include the head and mouth, eyes, skin, neck, chest, arms and hands, and legs and feet. This chapter gave you some of the things to look for when examining each of these body parts. Check online to see if there are any other observations you should be making while inspecting the body part you chose. Can dilated or enlarged pupils be an indicator of damage that is not mentioned in this chapter? What about if a person cannot feel the tips of their fingers? Write down a list of symptoms and what they could indicate.

whistlings, which may indicate the presence of fluid.

Food trapped in the human windpipe leading to the lungs can cause suffocation.

• Arms and hands—troops, like the Special Forces, are instructed to look for any breakages or swellings. They are taught to examine fingernails for any blueness. This tends to indicate circulation or breathing disorders. The casualty is asked if they feel any strange sensations, such as numbness

Deciding on a Course of Action 21

Text-Dependent Questions 1. What is the first thing a soldier should do if someone is injured? 2. How does an elite soldier act if the patient’s injuries are severe? 3. Why is it more important to rush to help a quiet or unconscious injured person than one who is shouting? 4. What are three things that you can do to tell if an unconscious victim is breathing? 5. What are some of the physical signs that can indicate a victim has suffered brain damage?

or pins and needles. This helps judge any nerve or spinal damage. One test is to ask the casualty to squeeze your two forefingers. If the strength of grip is not the same, this may indicate a stroke or physical damage to the limb. • Legs and feet—if the casualty is still able to walk, trained members of an elite force will ask the person to walk in a straight line so that they can check his balance. If the victims are conscious and lying down, they are told to pull and push their feet backward and forward against the resistance of a soldier’s hands. Any differences between the strength levels of the two limbs may indicate nerve or spinal damage. Elite troops check nerve responses by scratching the soles of the patient’s feet to test the tickle response.

Words to Understand Hypothermia: Serious condition caused by extreme cold. Respiration: Breathing. Compression: Pushing together. Cardiac: Having to do with the heart. Spasm: Sudden uncontrolled movement. Symptoms: Signs of disease or injury. Abdominal: Relating to the stomach area.

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BREATHING AND CIRCULATION Few first-aid situations are more serious than when casualties’ hearts stop pumping or when they are unable to breathe. If left untreated, brain death can occur within four minutes. Death can follow soon after, and there is nothing any member of the elite forces can do in such a situation. Stoppage of the heart can have a variety of causes. A heart attack, major blood loss, and hypothermia are among the major causes likely to be encountered by elite troops in a survival situation. Absence of pulse and the absence of breathing are the major signs that this has happened. Soldiers need to be cautious because, in cold conditions especially, an injured person’s pulse and circulation can become very difficult to detect. This is because the cold slows down the system. It is important to be very sure that the person’s heart really has stopped before taking emergency action.

Artificial respiration This is the practice of externally supplying casualties with enough air in order to make sure they have enough oxygen in the blood. The most common and wellknown artificial method is known as mouth-to-mouth respiration. This is where the first-aider breathes into the casualty’s mouth in order to get air into the lungs. The technique is as follows: Step 1: The casualty’s head is tilted back by placing one hand on the forehead and lifting under the point of the chin with the two forefingers of the other hand. The Vietnam War, 1962. A medic gives CPR (cardiopulmonary resuscitation) in an attempt to get this wounded soldier breathing again.

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head should not be moved if there are any spinal injuries. The head tilt lifts the tongue away from the entrance to the windpipe and ensures the free passage of air down to the lungs. Step 2: The casualty’s nostrils are then pinched, while the first-aider’s mouth is sealed around the casualty’s mouth. The first-aider then blows. This should make the patient’s chest rise. Once the first-aider’s mouth is removed, the chest muscles will force the air out of the lungs. The process is then repeated until the casualty begins to breathe alone again. The pattern should be one breath every five seconds, meaning that twelve breaths will be given every minute.

Cardiac massage

This is a technique used by elite troops, like the U.S. Marines and French Foreign Legion, to pump a casualty’s blood if there is no effective heartbeat. By pressing down on the breastbone, which is positioned directly above the heart, blood is

A

B

A step-by-step guide to mouth-to-mouth resuscitation. (A) Clear the airway of blockages. (B) Tilt the victim’s head backward, raise their chin, and pinch their nose.

Breathing and Circulation 25

squeezed out of the heart. Once the pressure is released, blood flows back in. The technique is as follows: Step 1: After kneeling next to the casualty, a finger should be run up one of the lowest ribs until it meets the breastbone. The heel of the first-aider’s hand should be placed about one finger’s width above this point, then he or she brings the other hand on top and interlocks the fingers. Step 2: Following this, the first-aider leans right over the casualty with the arms straight and presses the breastbone down by about one and a half to two inches (3-5 cm). The first-aider then releases the pressure but keeps the hands ready on the spot and follows with another compression. The compressions are maintained at a rate of about 100 pushes a minute. This is very tiring. A member of the elite forces will not give up with the cardiac massage procedure. They will continue for at least an hour if necessary. Because cardiac massage can be tiring, it is important to take turns if there is a group.

C

D

(C) Take a deep breath and blow air into their mouth. (D) Stop blowing when the victim’s chest expands.

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Cardiopulmonary resuscitation (CPR)

This is where both cardiac massage and mouth-to-mouth resuscitation are used. It is an important technique because when the patient’s heart stops, so does breathing. CPR can save a patient who would otherwise die. It is very important. These are the instructions given to U.S. Special Forces troops in training: • • • • • • • •

Check for consciousness. Establish an open airway. Look, listen, and feel for breathing. Give two rapid breaths. Check for pulse (while you look, listen, and feel for breaths). Locate the compression spot. Form proper hand position. Begin compressions: set of 30 compressions, then...

Soldiers from the Chilean Air Force assess a patient’s condition before giving CPR in the Atacama Desert.

Breathing and Circulation 27

• Two quick breaths after each set of 30 compressions. • After four complete sets of 30 compressions, two breaths, check for at least five seconds for pulse and breathing. • If there are no signs, continue for as long as is necessary.

Respiratory accidents Near-drowning

If water is nearby, drowning is a constant danger. It can happen very quickly. In cold water, it is possible for a person to lose consciousness in seconds. A further danger is that the throat goes into spasm and closes completely. Troops know that treatment needs to be quick and decisive. Once the person has been rescued, carry him from the water with the head lower than the rest of the body to help get the water from the stomach. On the bank, the casualty should be put on his back. It is important not to try to pump water out of his lungs. However, the casualty should have his breathing and pulse checked in the normal way. Bear in mind, however, that it is harder to find the pulse and to check breathing if a person has been in cold water. If the casualty is definitely not breathing and has no pulse, then CPR should be performed on him. Once breathing is restored, the person should be moved into the recovery position. This is not the end of the treatment. The person is wet and shocked and may be susceptible to hypothermia. The casualty is therefore given dry clothing and placed in a position sheltered from the wind.

Choking

People suffering from blocked airways are unable to breathe and, unless they are already unconscious, will be very distressed and red-faced. They will probably be

28 survival first aid

violently pointing to or clutching their throats. If they are found unconscious, they will have a gray blue complexion, the color that indicates a person is suffering from a lack of oxygen.

U.S. Navy SEALs are highly experienced swimmers. They undergo a strict training program, which makes it unlikely they would ever drown.

Breathing and Circulation 29

The “head back” position is recommended for victims of drowning because it makes it easier for water to flow back out of the lungs.

Note: If people are coughing, no matter how violently, then a soldier knows they are not choking. Their bodies are just naturally trying to get rid of the blockage. The most common form of blockage is food, but other causes of choking can be from the tongue or from a throat swelling caused by an allergic reaction. If it is a blockage and the person is conscious, he should be encouraged to cough. If this does not clear the blockage, they should be bent forward and given five sharp slaps between the shoulder blades. If the obstruction has still not come forward, the first-aider should perform the Heimlich maneuver.

Smoke and fumes inhalation

In outdoor survival situations, where there is plenty of fresh air, the dangers of breathing in smoke or fumes are small. However, there are exceptions such as:

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A

B

The Heimlich maneuver is used when a person is conscious (A), but if he is unconscious it is not used (B). Instead, CPR is supposed to be immediately administered.

• Carbon monoxide—the main sources of carbon monoxide are faulty gas or paraffin heaters, stoves used in tents, and fire smoke. Carbon monoxide deprives the body of oxygen. It is very dangerous and has no odor. Symptoms include fatigue, confusion, and even aggression. This leads to breathing failure and unconsciousness. Death can occur. • Smoke—any sort of smoke reduces the levels of oxygen in the air and can sometimes make breathing impossible. It is unlikely members of one of the elite forces would suffer this, unless they found themselves unexpectedly engulfed in a forest fire or in a burning building.

Breathing and Circulation 31

Make Connections: THE HEIMLICH MANEUVER This antichoking method, named after Henry J. Heimlich, the man who first invented it, is performed by elite troops around the world. It is the most reliable means of freeing a blockage in a patient’s throat during an emergency situation. • Stand behind the casualty and wrap your arms around her waist. • Make a fist and place it just beneath the casualty’s breastbone with thumb against the chest. Grip this fist with your other hand. • Pull your fist sharply in and up. Repeat three times, then check the mouth. This action forces air in the lungs up the windpipe. The air pushes the obstacle out like a cork from a bottle.

It is important that elite rescuers do not put themselves in danger from gas, fumes, or smoke. If they are not in immediate danger, rescue teams should pull the casualty out of the danger area and into fresh air. If there is little fresh air available, rescuers should cover their mouths with light material. They should then follow the standard procedure used to check breathing, consciousness, and circulation. Rescuers should note that mouth-to-mouth rescusitation might well be required.

Shock

This occurs when there is not enough blood circulating in the body of the patient. It can be caused by bleeding, breaking bones, and loss of fluids through sweating,

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vomiting, and diarrhea. Shock is a likely diagnosis if a person has pale, cold, and clammy skin, a fast and weak pulse, and fast and shallow breathing. To treat this, soldiers check to see the airway is open. Any bone breakages will be treated. The patient should be kept warm and still. Any rough handling of a casualty suffering from shock is very dangerous and therefore forbidden. Shock can be a killer. In the wild, you must recognize the symptoms and treat them. These are the guidelines the U.S. Army gives to troops: • If conscious, place the patient on a level surface, and slightly raise the legs. This will help to generate blood flow to the core organs and the head. • If unconscious, place the patient on the side with the head turned to one side to prevent choking. • Once the patient is in shock position, do not move.

A Special Air Service (SAS) soldier in a counterrevolutionary warfare outfit. He wears a gas mask at all times.

Breathing and Circulation 33

U.S. Marines take part in a decontamination training exercise in North Carolina. Even today, chemical warfare remains a reality of battle.

• Keep the patient warm. Heat loss and hypothermia will accelerate shock. You should also place something (a blanket, for instance) between the patient and the cold ground. • If the patient is wet, remove all wet clothing as quickly as possible and replace with dry items.

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Research Project This chapter explained the process of giving CPR and the Heimlich maneuver. Sometimes words cannot properly explain a process, though. Go online and look up instructional videos on how to perform each of these techniques. Then write down your own step-by-step explanation that you will be able to understand easily.

One of the best treatments for shock is to increase the blood supply to the patient’s vital organs. This can be done by raising the legs.

Breathing and Circulation 35

Text-Dependent Questions 1. What is the difference between mouth-to-mouth respiration and cardiopulmonary resuscitation? 2. Why should you carry a near-drowning victim with her head lower than the rest of her body? 3. What are the two steps that should be performed before beginning the Heimlich maneuver? 4. List three physical signs that a person is suffering from shock.

• Cover the patient with clothing, tree boughs, and shelter him or her from the weather. • Use hot liquids, food, or body heat to provide warmth. • Only give patients liquids or foods if they are conscious, and do not give them if the patients have abdominal wounds. • Let the patient rest for at least 24 hours.

Words to Understand Capillaries: Small blood vessels. Sterile: Germ-free. Tourniquets: Tight bandages to restrict the flow of blood. Toxins: Poisons. Amputated: To sever a limb, usually if it is seriously infected. Saline: Something that contains and/or tastes of salt. Ointment: Lotion.

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WOUNDS, BLEEDING, AND BURNS Wounds and blood loss are the most common forms of injury for elite troops because they spend much of their time in battle against enemy soldiers. There are three main types of bleeding, which vary in their degree of seriousness. Arterial bleeding is blood in the arteries that is under high pressure. If an artery is cut, the victim is in danger of a fatal loss of blood, and could die within minutes. Arterial blood can be recognized by its bright red color and by the blood’s spurting effect, which matches the rhythm of the pumping of the heart. Venous bleeding is more easily controlled than arterial blood, and is a darker shade of red. Capillary bleeding is the least serious. Capillaries are the blood vessels opened in minor cuts and grazes.

Severe bleeding

When a patient is bleeding heavily, soldiers will take immediate action to stop it. If the patient is bleeding from the veins or capillaries, then pressure is applied over the bleeding point. (Even minor arterial bleeding can be controlled with local pressure.) Troops will use anything to stop the blood flow, such as an item of clothing or a dressing. However, they are taught that it is important to try to make Blood loss is a serious matter. This soldier makes medical notes after dressing the head wound of a simulated casualty.

38 survival first aid

sure whatever they use is clean and sterile. Firm and continuous pressure is then maintained for around 5 to 10 minutes. Troops use a dressing to keep the wound clean.

Arterial bleeding

If the patient is bleeding from the veins or capillaries, pressure is applied over the bleeding point.

This is the most serious type of bleeding. Pressure on the major artery feeding an injured area will reduce or stop the flow of blood. The spots on the body where an artery can be easily compressed against a bone are called pressure points.

Pressure points in the human body are located in the: • Temple, forward of ear • Face, below eyes, side of jaw • Shoulder or upper arm (best area to control bleeding in the arm) • Elbow, underside of arm • Lower arm, crook of elbow • Hand, front of wrist

Wounds, Bleeding, and Burns 39

• Thigh, midway between the groin/top of knee (best area to control bleeding in the leg) • Lower leg, upper side of knee • Foot, front of ankle

Tourniquets Elite troops use these only when severe bleeding cannot be controlled by any other method. Tourniquets can be placed only on the upper arm (just below the armpit) and around the upper thigh. Elite soldiers use a cloth at least two inches wide. They wrap the cloth around the limb and tie a half-knot. A stick is then placed over the knot and a double knot is tied over this. The stick is then twisted to tighten the tourniquet until the bleeding stops. Warning—the loosening of a tourniquet can cause severe shock leading to death. (Toxins build up in the injured limb and then flood the heart when released.) If a tourniquet is applied, troops are aware that the limb may eventually be amputated.

Effects of blood loss • One pint (475 ml). A person who loses this amount of blood may feel a little faint (as long as their vital organs, such as lungs and liver, are not affected). Use tourniquets only in the case of • Two pints (1 liter). To lose this amount is more serious and the body starts to respond severe bleeding, tied around the upper arm or thigh. to a more serious challenge. The casualty’s

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blood pressure will begin to drop. This means that the body may not get enough oxygen. The person may become very faint, pale, and wobbly on the feet. • Four pints (1.9 liters). With this much blood loss, the casualty can collapse. They will have a rapid, weak pulse. The skin will become clammy and pale as blood is diverted to major organs. The casualty may feel very sick and thirsty. • Six pints (2.8 liters). With this much blood loss, the situation becomes lifethreatening. The casualty will probably be unconscious; cardiac arrest and respiratory failure can soon follow.

Internal bleeding This results after a violent blow, broken bones, or deep wounds. Internal bleeding is indicated by faintness, lightheadedness, pale skin that is cold and clammy to touch, red-colored urine, blood passed with feces, vomiting blood, and coughing blood. To treat, an elite soldier will lay the patient flat on the back with the legs elevated. The patient will then be kept warm while waiting for rescue.

Wounds The best means of controlling a nosebleed is to lean forward and pinch the nostrils.

Soldiers “irrigate” wounds with sterile saline solution or clean water. This means they wash it by pouring or squirting, not scrubbing. Butterfly bandages are used if the wound is not

Wounds, Bleeding, and Burns 41

too deep. This is where the soldier’s medical kit comes in useful, as the wound should be coated lightly with an antibiotic ointment before a sterile dressing and bandage is put on.

Nosebleeds A nosebleed is a simple and common cause of blood loss, which can be caused by even the mildest knock. The patient is seated with the head slightly forward, and told to pinch the nostrils while breathing through the mouth. Sniffing is discouraged because this can let blood be swallowed and induce vomiting. Once bleeding is stopped, the patient is told not to touch or rub the nose for several hours, since this may restart the bleeding. If the bleeding persists for more than 30 minutes, then further help is required.

Bleeding from the ear Bleeding from the ear should be taken very seriously. It can be a sign of brain damage. This will be indicated by a leakage of a thin, watery diluted blood. Other causes include a burst eardrum or something stuck inside the ear. In this case, blood will have a more regular texture and color. A soldier’s treatment of ear bleeding begins with placing the patient in the recovery position. The bleeding ear should be angled downward to encourage drainage. The ear should be covered with a light sterile dressing and bandage.

Bleeding from the mouth Bleeding from the mouth is usually caused by either a direct impact to the mouth, which bursts a lip, knocks out a tooth, or damages the gums, or by the teeth clamping onto the lip, gum, or tongue through an impact to the jaw. Either way, the bleeding can become serious.

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Research Project You learned in this chapter that there are three types of burns: first, second, and third degree. Choose one of these types and then look up and see the different things that could cause this type of burn. Can an electrical fire cause a second-degree burn? Can acid cause third-degree burns? Make a chart showing the different kinds of things that can cause each kind of burn.

If the injury is to the lip, an elite soldier pinches the wound between a pad and a finger. About 10 minutes of this pressure should stop the bleeding. No attempt is made to rinse the mouth out with water because this may restart the bleeding.

Burns Burns can be life-threatening in a survival situation. There are three types of burns: • First degree, which usually involve the first layer of skin. Not serious. • Second degree, which involves the second layer of skin. These burns are very red, produce blisters, and are intensely painful for up to 48 hours. There is fluid loss and a danger of infection. • Third degree, which destroys the first two layers of skin and damages deeper tissues. There is severe fluid loss and a danger of infection. The burned area is usually black, and the victim will suffer great pain.

Wounds, Bleeding, and Burns 43

Text-Dependent Questions 1. Why should a tourniquet only be used when severe bleeding can’t be controlled through any other method? 2. List five of the symptoms that someone is suffering from internal bleeding. 3. What are three injuries that bleeding from the ear can indicate? 4. Why shouldn’t someone whose mouth was bleeding rinse out their mouth with water?

Troops will make someone suffering from burns drink lots of water. The elite forces are also always prepared to treat burn victims for shock. Military units have to deal with explosives and munitions, which can cause horrific burns. Here is how Canada’s elite deal with them: • They wash the burn immediately with cool water. • They wash with peroxide followed by a light coating of iodine. Then they coat with an antibiotic ointment. • They cover with a sterile bandage but do not use an airtight dressing. • They remove the dressing every day and scrub the wound with a sterile gauze pad and peroxide. • All white and yellow dead tissue is removed every day. • They repeat the cleansing and dressing process.

Words to Understand Splinted: Held in place rigidly with a stick or other stiff object. Circulation: Blood flow. Traction: A continuous pull. Spinal: Connected with the backbone. Gangrene: Rotting of the flesh as a result of a wound or a lack of circulation.

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BONE, JOINT, AND MUSCLE INJURIES Since the work of the elite forces can involve much physical activity, they are particularly prone to bone breakages and muscle injuries. This chapter demonstrates the first-aid treatments they use to cope with this when out in the field.

Breaks and fractures A fracture is a chip, crack, or break of a bone. There are two types of fracture: open and closed. With an open fracture, the bone has come through the skin or something has penetrated the skin and then broken the bone. With a closed fracture, the bone is broken but there is no opening of the skin. A fractured limb is splinted in exactly the same position that it is found in to prevent it from being damaged further while the patient is being taken to a hospital. Padding is used to keep the limb in position. The Special Forces are experts in survival medicine. They use their training and identify the symptoms that can indicate a fractured limb. • • • •

Patient feels or hears the bone break. Partial or complete loss of motion. Grating sound when limbs are moved. If the bone looks out of place, for example, or if the arm is bending but not at the elbow.

For soldiers, bone fractures are commonplace. One of the most basic first-aid lessons they learn is how to put an arm in a sling.

46 survival first aid A splint--which can be made from sticks, branches, or boards—is used to prevent any further damage to a broken or fractured bone.

• Tenderness around the injury. • Muscle spasm.

Closed fracture If the casualty has a suspected closed fracture, then his or her pulse is checked at the wrist. If circulation is impeded (the hands feel cold or there is no pulse), it is important for the soldier to restore the flow of blood to the lower arm at once; otherwise the limb will have to be amputated. The casualty’s hand is pinched or poked to check and see if he or she feels anything. A member of the elite forces knows it is very serious if the patient has no feeling. Traction (a continuous pull) is then applied to try to restore some pulse and nerve response. It is not a major concern if the casualty has only a little feeling. In fact, it means that the casualty can wait to be back in civilization for complete restoration. Full nerve response can often be restored by surgical techniques, and a trained soldier will reassure the patient of this.

Bone, Joint, and Muscle Injuries 47

Simple fracture

Greenstick fracture

Closed fracture

Comminuted fracture

Open fracture

Diagrams showing differing types of fracture. The treatment given to a patient will vary depending on the seriousness of the break.

If the patient has some feeling, a splint is securely applied. The joint should be immobilized on either side of the fracture.

Open fracture

• First, it is important for the elite soldier to control the bleeding if it is severe. • The wound and the bone sticking out are then cleaned. The soldier then gives traction and tries to reset the fracture and close the wound. This is done slowly. • After traction, the wound is inspected to ensure the bone ends join properly. • The soldier then applies a splint, but in a way that leaves the wound free for treatment.

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Traction (a continuous pull) is required to reposition a bone in its normal position. It should also restore some pulse and nerve response.

Throughout this time, the patient’s pulse and nerve response will be checked. If any are missing, then the soldier needs to repeat the resetting and traction procedures.

Fractured ribs For fracture of the upper ribs, patients are told to hold their breath while two long adhesive strips are applied across the shoulder of the injured side. For fracture of the lower ribs, a piece of felt or foam rubber is applied over the fracture. Fractures take four to six weeks to heal. Fractured ribs can be painful; it is therefore important for the patient to get as much rest as possible.

Skull fracture Indications of a fractured skull can be straw-colored fluid seeping from the ear or nose. If this occurs, patients are placed in the recovery position, with the leaking side down. Fluid is then able to escape, and patients are told not to move but to make themselves comfortable.

Bone, Joint, and Muscle Injuries 49

Neck fracture Movement in a patient’s neck can be stopped using a cervical collar, or by placing a small rolled towel or sheet under the neck and then placing sandbags or boots filled with dirt or sand on either side of the head to stabilize it. The patient should not move until rescued.

Breaks In survival situations, it is usually toes and fingers that are broken. A soldier will reset the finger and then splint it with wood or something similar. Broken toes can be reset and taped to an unbroken toe next to it.

Spinal injuries Any injury to the spinal column can cause paralysis and is potentially fatal. Signs of spinal injury include: a pain in the back without movement; any spot along the spinal column tender to the touch; loss of bladder control. Spinal injuries are extremely dangerous. Always be careful when attempting to move a patient with a spinal injury.

A patient with a neck fracture must be stabilized as soon as possible.

• If the patient is face up, a folded blanket is placed under the small of the back to stop pieces of bone cutting or pressing into the spine.

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Research Project Dislocations can be very serious problems if they are not taken care of immediately. Go to your library and look up information on the proper procedure you should take if you or someone you know dislocates an arm, leg, or hip. Make yourself a guide on how to properly reset the dislocated body part. You could create this guide by writing it out step by step, or you could illustrate the steps you are supposed to take.

• If the patient is face down, a folded blanket is placed under the chest. • The back is always kept straight.

Strains and sprains All of these can be common in a survival situation. A strain is a overstretching of a muscle. A sprain is a wrenching or tearing connected with the joint. A dislocation is usually caused by a or sudden force applied to a joint. This forces the joint out

tearing or of tissues fall, blow, of place.

For strains, a soldier will rest the limb and apply cold packs to ease the pain. It is important to do this straight after injury, in order to reduce the swelling and pain. British Special Air Service (SAS) soldiers fight on foot most of the time, and can suffer sprained ankles. They therefore have to have effective treatments for sprains.

• Bathe sprain with cold water to reduce swelling.

Bone, Joint, and Muscle Injuries 51

Text-Dependent Questions 1. Why should a tourniquet only be used when severe bleeding can’t be controlled through any other method? 2. List five of the symptoms that someone is suffering from internal bleeding. 3. What are three injuries that bleeding from the ear can indicate? 4. Why shouldn’t someone whose mouth was bleeding rinse out their mouth with water?

• Support with a bandage; do not constrict circulation. • Raise affected limb and rest completely. If you sprain an ankle, keep your boot on if you have to keep walking: the boot will act as a splint. If you take it off, the swelling will prevent you from putting it back on again.

Dislocations When dislocations occur, swelling begins and the injury will be very sore. The joint must be reset before the swelling and muscle spasms begin; otherwise resetting will be difficult. The muscles near the joint will start to tighten up almost immediately. If this is not done, it may result in the casualty getting gangrene or other problems. The two most important things a member of the elite forces is trained to remember about resetting a joint is to do it properly and do it as soon as possible.

Words to Understand Venom: Snake or other animal poison. Exhaustion: Tiredness. Perspiration: Sweat.

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POISONS AND BITES Poisoning and bites by spiders, centipedes, scorpions, and ants can be very painful and can make a person sick and possibly even die, so troops always learn what creatures live in the area where they are operating. To treat a bite from a scorpion or spider, the wound is cleaned and the soldier elevates the body part that has been bitten. If soldiers have tobacco, they are trained to chew it and place it over the bite area. This will ease the pain. They treat the bite in the same way they would treat an open wound. Because its soldiers often have to fight in regions where there is a lot of insect life, the U.S. Army has created some very effective anti-insect measures. They do not underestimate the danger of insects. Here are some guidelines given to U.S. troops: • Inspect your body at least once a day to ensure there are no insects attached to you. • Cover any ticks with Vaseline, heavy oil, or tree sap to cut off their air supply. The tick will release its hold and you can remove it. (Grasp it where the mouth parts are attached to the skin.) Wash your hands afterward and clean the tick wound thoroughly each day. • Wash your skin well with soap and water if you have been in a mite-infested area. • If stung by a bee or wasp, immediately remove the stinger and venom sac by scraping with a fingernail or knife. Do not squeeze it. Wash the wound thoroughly with soap and water and apply an ice pack or compress. The South-East Asian Greenbush viper is one of the most venomous snakes in the world. If bitten, a soldier can die within 24 to 48 hours.

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Relieve itching caused by insect bites by applying cold compresses, a cooling paste of mud and ashes, dandelion sap, coconut meat, or crushed leaves of garlic.

Snake bites The chances of being bitten by a venomous snake in a survival situation are small. Nevertheless, it can happen and members of the elite forces must know how to treat snake bites.

During jungle survival training, a Thai soldier demonstrates to his class how to handle a cobra.

Snakes are split into a number of types:

• Crotalinae—pit vipers. • Elapidae—coral snakes, kraits, cobras, mambas, and asps.

• Hydrophine—sea snakes. • Colubridae—backfanged boomslang.

Symptoms of snake bite

With a crotalinae bite there will be swelling at the bite site, which will slowly spread to the surrounding area. Swelling begins within three minutes and may continue

Poisons and Bites 55

Poisonous bites must be washed thoroughly with clean water. An ice pack will slow the spread of poison.

for an hour. There is severe pain at the bite site and fang marks. Another symptom is blood in the urine. The venom will gradually destroy organs and blood cells. The victim will suffer severe headaches and thirst, a fall in blood pressure, a corresponding rise of pulse rate, and bleeding into surrounding tissues. There is a real danger of a loss of limbs, and death can occur within 24 to 48 hours if the bite is serious and left untreated. (Vipers account for the majority of snake bite fatalities throughout the world.)

Not all snakes are harmful. Snake bites that are venomous (bottom) and not venomous (top) can be identified by the pattern of the bite.

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Treatment is required immediately if the eyes come into contact with animal poison. If it is not received, the victim can easily be blinded.

The elapidae and colubridae type of bite cause irregular heartbeat, a drop in blood pressure, weakness and exhaustion, severe headaches, dizziness, blurred vision, confusion, loss of muscular control, breathing difficulties, tingling, excessive perspiration, numbness of the lips and soles of the feet, chills, nausea, diarrhea, and loss of consciousness. The hydrophine bite is usually painless. However, a bite should be suspected one to two hours after the onset of muscular aches, pains,

Poisons and Bites 57

and stiffness. The casualty will have reddish-brown urine within three hours. Death usually occurs within 12 to 24 hours without treatment. All snake-bite victims will need treatment for shock. If no antivenom is available, then a restricting bandage, not a tourniquet, should be placed above the bite. Cold water or ice is used to keep the bite area as cool as possible.

U.S. Special Forces’ tips—snake bite treatment The Special Forces use the following treatment for snake bites in the wild:

• Kill the snake if you are the one bitten: it will make snake identification easier. • Lie the patient down and make sure he or she does not move the injured part. • Keep the patient warm and quiet. • Begin specific treatment for snake types:

Make Connections: TREATMENT FOR POISONING—BRITISH SAS SAS soldiers have fought all over the world for over 70 years. They have well-tested rules for dealing with poisons. • In the case of suspected plant poisoning, elite troops make the person vomit. Alternatively, they make an antidote by mixing tea and charcoal with an equal part of milk of magnesia if available. The charcoal absorbs the poison and carries it from the body. • They then wash the poisoned skin with soap and water. With inhaled poisons, they move the patient into a place that has fresh air, loosen tight clothing, and give respiration.

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Research Project Not every snake is venomous, and often physical clues can tell you if a snake is venomous or not. Go online and look up how you can tell the difference between these two types of snakes. Can you tell by the shape of their eyes? How about by their color pattern? Create a chart that shows all of the physical differences between venomous and nonvenomous snakes.

Crotalinae • Make a clean cut about a quarter inch (5 mm) deep along, or in the direction of, the muscles through the puncture site. Do not make an X-cut and do not cut into joints. • Apply suction using a mechanical device. (Do not use your mouth; you risk spreading the poison and are also unlikely to be able to extract much poison from the bite.) Suction should not be used if antivenom can be given within one hour or if it is over one hour since the bite. • • • • •

Do not use a tourniquet, tight bandages, or cold packs. Do not let the patient eat food or drink alcohol. Give patient small amounts of water at frequent intervals. Inject antivenom. Use morphine or other suitable painkillers as necessary.

Poisons and Bites 59

Text-Dependent Questions 1. What does a soldier do if he finds a tick attached to his body? 2. What five things can you apply to insect bites to relieve itching? 3. List six of the symptoms that indicate you have been bitten by either the elapidae or colubridae snake. 4. What steps should you take if you are bitten by a crotalinae snake?

Elapidae and colubridae • Apply a tourniquet around the affected limb over a single bone (above the knee or below the elbow), which should be tight enough to stop arterial flow. It should be released for 30 seconds every 20 minutes to let fresh blood into the affected area. • Inject antivenom. Note: Do not administer morphine or other drugs that cause respiratory depression. Hydrophine Antivenom is the only treatment for hydrophine snake types. Incision and suction are of no value.

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Series GLOSSARY of Key Terms camouflage: Something that makes it hard to distinguish someone or something from the terrain or landscape around them. casualty: A person who is killed or injured in a war or accident. covert: Done in secret. dehydrated: When you don’t have enough water in your body for it to function properly. Alternatively, dehydrated food is food that has had all the water removed so that it won’t go bad. dislocation: When a joint is separated; when a bone comes out of its socket. edible: Able to be eaten. exposure: A health condition that results from bad weather around you. For example, when you get hypothermia or frostbite from cold weather, these are the results of exposure. flares: A device that burns brightly, and can be used to signal for help. They can only be used once. hygiene: The techniques and practices involved with keeping yourself clean and healthy. improvised: Used whatever was available to make or create something. When you don’t have professionally made equipment, you can make improvised equipment from the materials naturally found around you. insulation: Something that keeps you warm and protects you from the cold. kit: All of the clothing and equipment carried by a soldier. layering: A technique of dressing for the wilderness that involves wearing many layers of clothing. If you become too warm or too cold, it is easy to remove or add a layer. marine: Having to do with the ocean. morale: Confidence, enthusiasm, and discipline at any given time. When morale is high, you are emotionally prepared to do something difficult. When morale is low, you might be angry, scared, or anxious. purification: The process of making water clean and safe enough to drink. terrain: The physical features of a stretch of land. Hard or rough terrain might be mountains or thick forests, and easy terrain would be an open field. windbreak: Something that you use to block the wind from hitting you. If you camp somewhere exposed to the wind, it will be very difficult to stay warm.

Equipment Requirements 61

EQUIPMENT REQUIREMENTS Basic Medical Pack Thermometer—to check a patient’s temperature Guedel airway—to help maintain an open airway when someone is unconscious Gauze—disinfected material for dressing wounds Paraffin gauze dressing—see above Scalpel blades (at least two) Suture equipment—to stitch up wounds Large safety pins Scissors Antiseptic swabs—to prevent infection Green hypodermic needles—used for removing splinters and for draining blisters Fluid-replacement packets—used for people suffering from diarrhea and burns Puritabs—releases chlorine to clean water and make it drinkable Potassium permanganate—used as an antifungal/disinfectant Painkillers Antacid tablets—used for indigestion. Antidiarrhea tablets Antihistamine tablets—for bites and allergies Plasters and wound dressings Sunblock and lip balm Clothing and shelter Thermal underwear Thin layer of synthetic material Woolen or wool mixture shirt Woven fiber sweater or jacket (normally a fleece) Waterproof and windproof final layer Two pairs of socks (minimum) Compact, light, windproof pants with numerous pockets with zippers, to carry items securely Waterproof pants Gloves—leather or mittens Balaclava (a tight woolen garment covering the head and neck, except for parts of the face) Spare clothing—socks, underwear, shirts, etc. Soft, well-maintained leather boots H-frame backpack with side pockets Portable, lightweight, waterproof shelter

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Survival bag Pliers with wire cutter Dental floss (for sewing) Folding knife Ring saw Snow shovel Signal cloth Fishing hooks and flies Weights and line Multivitamins Protein tablets Large chocolate bar Dried eggs Dried milk

File Cutlery set Three space blankets Four candles Microlite flashlight Extra battery and bulb Fire starter Windproof and waterproof matches Butane lighter Insect repellent Snares Plastic cup Slingshot and ammunition Knife sharpener

USEFUL WEBSITES depts.washington.edu/learncpr/index.html www.medicinenet.com library.thinkquest.org/10624/index.html kidshealth.org/parent/firstaid_safe www.redcross.org emergency.cdc.gov/preparedness/kit/disasters

Further reading 63

FURTHER READING Auerbach, Paul S., M.D. Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies, Fifth Edition. Philadelphia, PA: Mosby Inc., 2009. Department of Defense. Special Operations Forces Medical Handbook. New York: Skyhorse Publishing, 2011. Jones, Shirley A. First Aid, Survival, and CPR: Home and Field Pocket Guide. Philadelphia, PA: F.A. Davis Company, 2011. McNab, Chris. First Aid Survival Manual. Edison, N.J.: Book Sales, 2001. Mears, Ray. The Outdoor Survival Handbook. London: Ebury Press, 2001. Wiseman, John. SAS Survival Handbook, Revised Edition: For Any Climate, in Any Situation. New York: William Morrow Paperbacks, 2009.

ABOUT THE AUTHOR Patrick Wilson was educated at Marlborough College, Wiltshire and studied history at Manchester University. He was a member of the Officer Training Corps, and for the past seven years he has been heavily involved in training young people in the art of survival on Combined Cadet Force (CCF) and Duke of Edinburgh Courses. He has taught history at St. Edward’s School, Oxford, Millfield School, and currently at Bradfield College in England. His main passion is military history. His first book was Dunkirk—From Disaster to Deliverance (Pen & Sword, 2000). Since then he has written The War Behind the Wire (Pen & Sword, 2000), which accompanied a television documentary on prisoners of war. He recently edited the diaries of an Australian teenager in the First World War.

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INDEX ABC method 15 airways, checking 27 arterial bleeding 37–38 artificial respiration 23, 57 assessing the situation 13, 15–16, 26

evacuation 13 eyes 16, 18, 20, 38, 56, 58 animal poison in 56 examining 20 exercise 13, 33

bites 53–59 bleeding 11, 15–19, 31, 37–43, 47, 51, 55 open fractures 45, 47 blisters 9, 11, 42 blocked airways 27 blood loss 17, 23, 37, 39–41 bone injuries 10, 16, 45–51 breathing, checking 11, 15–17, 19–21, 23, 26–27, 29–32, 41, 56 burns 10–11, 16, 19, 37, 42–43

feet 9, 19–21, 40, 56 toes 49 finger breaks 49 first-aid kits 10 fractured ribs 48 fractures, bone 10–11, 16, 19, 45, 48 French Foreign Legion 24 fume inhalation 29–31

capillary bleeding 37 carbon monoxide poisoning 30 cardiac massage 24–26 cardiopulmonary resuscitation 23, 26, 35 CPR 23, 26–27, 30, 34 casualty drills 9 chemical warfare 33 chest 16–17, 19–20, 24–25, 31, 50 Chilean Air Force 26 choking 27, 29, 32 circulation 11, 15, 17, 20, 23, 31, 46, 51 closed fractures 45–47 clothing 17, 27, 33, 35, 37, 57 crotalinae 54, 58–59 dangers in emergency situations 13 DATE system 13 decontamination 33 dental problems 9, 18, 41 diagnosis 13, 18, 32 dislocations 18, 50–51 drowning 27, 29, 35 ears, bleeding from 18 elapidae 54, 56, 59 emergency situations 13, 15–16, 19, 31

hands 16–17, 20–21, 23, 25–26, 31, 38, 46, 53 head 16, 18, 20, 23–24, 27, 29, 32, 35, 37, 41, 49 skull fracture 48 head-to-toe diagnosis 18 Heimlich Maneuver 29–31, 34–35 helicopters 14 hydrophine 54, 56, 59 hypothermia 19, 23, 27, 33 inhaled poisons 57 injections 11, 58–59 insects, dangerous 53 internal bleeding 40, 43, 51 joint injuries 45–47, 50–51 jungle survival training 54 legs 20–21, 32, 34, 39–40, 50 mouth 15–18, 20, 23–26, 31, 35, 41–43, 51, 53, 58 mouth-to-mouth respiration 23, 35 muscle injuries 45 near-drowning 27, 35 neck 16–20, 49 nosebleeds 40–41 open fractures 45, 47

plant poisoning 57 poisons 53, 55–58 preparation 9 pressure points 38 pulse 17–18, 23, 26–27, 32, 40, 46, 48, 55 rapid assessment 15–16, 19 recovery position 16, 27, 41, 48 ribs 25, 48 saline solutions 40 SAS (British) 10, 32, 50, 57 gas masks 32 sprained ankles 50 shelters 35 shock 10, 16, 19, 31–35, 39, 43, 57 skin 18–20, 32, 40, 42, 45, 53, 57 skull fractures 48 smoke inhalation 29–31 snake bites 54–55, 57 spinal injuries 24, 49 splinting fractures 45, 47, 49, 51 sprains 50–51 strains 50 teamwork 15 teeth 9, 18, 41 toes 18–19, 49 tourniquets 39, 43, 51, 57–59 traction 46–48 U.S. Army 9, 32, 53 anti-insect measures 53 U.S. Marine Corps 10, 14 U.S. Navy SEALs 28 U.S. Special Forces 10, 26, 57 vaccinations 9 venous bleeding 37 wounds 11, 16, 19, 35, 37–38, 40–43, 47, 53