P3-13 Dealing with casualties

Whenever a player goes down, anyone near them must make a hasty decision as to how to react to it. The immediate reaction is intended to do two things:

1. to suppress or kill the enemy that hit the downed player
2. to identify the status of the downed player so that a decision about how to deal with them can quickly be made.

Generally it is the responsibility of combat buddies in the buddy team system to respond to injuries or casulties belonging to their buddy team. Combat buddies should;

1. Smoke or secure the position
2. Drag or carry unresponsive casualties to a safer location for treatment or further assessment
3. Communicate any requirement for senior medical personnel as soon as it is safe to do so - quick action saves lives
4. Continue to provide first aid while awaiting medical staff, to provide the best chance of survival

When handling casualties, your priority is to take the wounded to a safer place, stop him from bleeding, and perform CPR if need be. Likewise, when you are wounded, first focus on moving to a safe position and then try to stop the bleeding, while waiting for a CLS to arrive.

Simplified 4-step process for non-medical personnel:

1. Apply tourniquets on limbs with multiple wounds.
2. Treat torso, head, and tourniquet-free limbs, and check pulse if patient is non-responsive.
3. Start CPR - CPR – check pulse routine if patient is non-responsive and no pulse is found.
4. Once pulse is back, treat wounds limb by limb and remove tourniquets after fully treating each limb. Monitor pulse in the meantime. If the patient goes into cardiac arrest again, go back to Step 3.

• While doing CPR try to follow “CPR – CPR – check pulse” routine. It will allow you to minimise the time spent on both checking pulse and needlessly resuscitating a patient with his heartbeat already back. This will allow you more time for other tasks.
• DO NOT give non-responsive patients morphine.
• DO NOT apply medicaments or IVs to limbs with a tourniquet on. Double check the limb you are working on if in doubt.
• DO use elastic bandage as your universal bandage.
• Remember, an unconscious patient will not wake up before his blood loss is less then 15% ("Lost some blood" or no loss of blood)

Dealing with Your Own Wounds

1. Do a hasty diagnosis. 
   Are you still combat effective? If yes, fight! Minor wounds can be treated once the immediate threat is dealt with (at which point you can continue on to the next step and beyond). If it's more serious and you cannot fight, proceed to the next step immediately.
    
2. Move to cover or concealment. 
   This will protect or conceal you from fire temporarily, though it will not get you off of the front line.
    
3. Do a full diagnosis. How bad is it?
   If you're bleeding, try to identify how severe the wound is and how urgently you'll need treatment. Heavy bleeding combined with frequent blackouts will require immediate medical assistance, whereas light bleeding may give you a bit more time to get yourself treated.
    
4. If you need a medic, call out that you are wounded over the radio or through directional speaking.
   Ensure that you state your name so that the medic knows who to look for. If necessary, mark your position on the map so that the medic can more easily find you. Speaking locationally gives the medic an additional aid, as he can "home in" on your calls and find you easier, especially in difficult terrain. Calling out also lets your buddy team member know that you're in trouble, and allows him to maneuver and fire to support you as you seek aid.
    
5. Coordinate with the medic as necessary. 
   He may need you to move in a specific direction or meet him halfway.
    
6. Use bandages or an tourniquet if the situation warrants. 
   If you are lightly bleeding and have bandages, ensure that you are in cover or concealment and attempt to use them to address your wound. They may or may not work, depending on the severity of it, and it may take a few tries to stop the bleeding. Once you have stopped the bleeding, you'll be stabilized, but the "aim waver" will persist until you can find an actual medic to heal at.
    
7. Once you are in good condition, move back to your fireteam and resume combat.
   Ensure that your team leader and buddy team member know that you have returned to combat.
    

Applying an tourniquet while taking cover behind a wall