Charred timbers lay smoldering on the ground and the tang of cordite pricks your nose. You’ve been on the move ever since things got bad, though this is different. These people were different. You have to help, otherwise, you be just as bad. Despite everything screaming no, you head up to check the bodies. Maybe, just maybe, there will be a survivor.
Disaster scenarios often bring out the worst sort of people because they believe that without a government there are no rules. While you are not going to explore the moral quandary of this mindset, there is no debate that giving medical assistance to those in need is an admirable activity. Without access to hospital and other healthcare facilities, many people will succumb to even minor injuries due to infection. With 7 simple steps, you can assess a casualty and then have a much better idea how to treat whatever has befallen to others. It should be noted that while this is intended to assess others, it is possible to use these steps to assess yourself in order to mitigate shock in the event that you are injured.
A mnemonic device used to help remember the process is the saying, “Really Big Books Should Fit Both Hands.” Each capital letter corresponds to one element of the process. When you first approach a patient you need to use the R from Really.
Verbally ask them if they are okay. If they answer then it shows that they a conscious and will likely direct you whatever injury that they feel. This saves a large amount of time and can be the difference of being just in time and being too late. Just because they do not answer, does not mean that they are unresponsive. Watch their eyes to see if they can focus on you as you talk, and if all else fails firmly adjust their wrist in order to see if they respond to pain. Do not use the sternum rub method as it can cause damage in the case that they have some sort of chest injury.
If they are completely unresponsive the most important element to check for is if they are breathing. Even if you see blood on their person, it is more important to treat respiratory problem because it can kill someone faster.
Watch for the rise and fall of the chest and press your cheek against their mouth to feel the heat of their breath. If you notice that only one side of their chest is rising, they may have a collapsed lung from hemo/tension pneumothorax. If this is the case immediately treat it before moving to the next step.
Starting from their head, cup your hands under their body and remove to see if there is any blood that you cannot see. As you find a lacerated area apply a pressure dressing or tourniquet dependent on the injury itself. In all situations, use a tourniquet as a last resort because it may result in the person losing the limb.
For those who are unconscious, this is not as big of a problem. For those who are awake, it is imperative to keep the patient calm. Shock can cause heart failure, even if the injury would not have been lethal otherwise. Signs of shock a cold, clammy skinny, dilated pupils, and incoherent sentences. Try to reassure the patient and limit visibility to whatever wound they have sustained. Loosen their clothing at the collar, belt line, and shoes in order to help make them comfortable. While this sounds like it is all in the head, shock can be lethal.
Fractured bones are not likely to cause immediate death, though they will likely incapacitate whoever had sustained them. Compound breaks are easy to spot as the bone will jut from an odd angle, but simple fractures can be much harder to detect. Look for areas with extreme swelling or major discoloration. Treat fracture by resetting bones then immobilizing the affected limb with the use of a splint.
Burns are likely one of the easiest to detect due to the smell of burnt flesh. If a patient has sustained this injury, do not remove any clothing around the wound. This will cause additional tissue damage and increase the possibility of infection. Sterilize the wound and then wrap it in a pressure dressing until you are in a sterile environment.
While head injuries are incredibly serious, there is little you can do from a first responder standpoint. Check to see if the patient has unevenly dilated pupils, fluid leaking from their ears, or in the case of men, if they have an erection. If so immobilize the head in order to minimize any additional damage to the brain.