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First Aid/ Self Aid/ Survival Medicine
The following are excerpts from notes on survival training that I used while
an instructor at the Special Forces School (1983-1985) where I was fortunate
enough to serve under LTC James N. (Nick) Rowe, and the US Army Ranger School
(1986-1988). They reflect my opinions and understandings of first aid and
survival medicine and in no way should they be accepted as "gospel." If you
have a need or interest in survival medicine, I suggest you research the
subject by reading any of the many excellent sources on the market to include:
FM 21-76: Survival, Outdoor Survival Skills by Larry Dean Olsen, Bushcraft by
Richard Graves, or Bernard Shanks' Wilderness Survival.
Carl J. Archer
MAJOR (USAR), Special Forces
First Aid/Self Aid/Survival Medicine
A. If you have an unconscious victim, you should not move them unless they
are in immediate danger from fire, etc.
B. You should first attempt to arouse an apparently unconscious victim..
C. If you have an accident, or a victim of an accident, you should
immediately perform a quick physical examination to determine the extent and
seriousness of all injuries. Start at the top and work down. Examine both
the front and back. Move the victim as little as possible. Check the pulse,
observe the breathing, check for bleeding, breaks, etc.
D. The life saving steps are those steps taken to stabilize a victim until
medical assistance can be obtained. They include:
(1) Clearing the airway.
(2) Restoring the breathing.
(3) Restoring the heartbeat
(4) Controlling the bleeding.
(5) Protecting the wound.
(6) Treat/prevent shock.
E. Burns are very painful and can cause scarring or death. Expose the burned
area without pulling clothing over the burn or removing clothing stuck to the
burn. Apply a loose, dry sterile dressing over the burn. Do not apply
ointment or grease. Do not break blisters. Treat for shock. Prevent
infection. Give small amounts of water if not nauseated and no neck or
abdominal wound is evident. Give aspirin to relieve the pain. For serious
burns, treat for shock and evacuate if possible.
F. Sprains and strains are common occurrences in the outdoors. Initially,
treat sprains and strains with cold to prevent swelling. Wrap affected area
tightly but do not cut off circulation. Give aspirin to relieve the pain and
reduce the swelling. Treat with heat to ease pain and promote healing.
G. The rule for breaks is to "splint them where they lie." Immobilize the
fracture without changing the position of the fracture and before moving the
victim. Immobilize the joint above and below the break. Pad the splints and
use nonslip knots. Treat the wounds caused by compound (open) fractures as
you would any open wound. Remove watches, rings, or any binding object from
the extremity to be splinted to prevent trauma caused by swelling. Give
aspirin to relieve the pain and reduce the swelling. Treat for shock and
evacuate if possible.
H. Snake bites are very serious and require immediate attention to prevent
possible death. Remain calm. Immobilize the affected part below the level of
the heart. Place a constricting band two to four inches above the wound,
between the wound and the heart. Remove any articles (watch, ring, etc.) that
may bind during swelling. Move the constricting band ahead of the swelling.
Cool the area to slow the venom and swelling if possible. Do not give
stimulants (coffee, tea, alcohol, tobacco, etc.) and do not cut the wound or
suck the venom. Give aspirin to relieve the pain and reduce the swelling.
Treat for shock and evacuate if possible.
I. Insect and animal bites should be cleaned to prevent infection, cooled to
prevent swelling, and covered. If swelling is present, remove binding
articles. Give aspirin to relieve the pain and reduce the swelling. Evacuate
if possible.
J. Heat injuries include heat cramps, heat exhaustion, and heat stroke.
(1) For heat cramps and exhaustion, move victim to shade, loosen clothing,
force victim to drink three to five quarts of water (salted if possible--one
quarter teaspoon per quart) slowly over an 8-12 hour period.
(2) For heat stroke, immerse the casualty in the coolest water available. If
limited amounts of water are available, strip the casualty, pour water on him,
and fan him continuously. If the casualty is conscious, give him cool water.
Evacuate immediately.
K. Cold Injuries include chilblain, hypothermia, immersion syndrome,
frostbite, snow blindness, and dehydration.
(1) The treatment for hypothermia is the slow, even rewarming of the body.
In a survival situation, strip and dry the casualty and place in a sleeping
bag or bundle in blankets. Another naked person may be placed in the bag to
add body heat. Warm liquids may be given slowly but should not be forced to
an unconscious person.
(2) Frostbite should be treated immediately by increasing circulation (do not
massage, rub with snow, manipulate, heat with open heat source, apply
ointment, etc.) and increasing insulation. Do not expose a frostbitten
location to the cold once it has thawed.
(3) Dehydration should be treated by warming the casualty and loosening the
clothes. Minerals and fluids should be replaced slowly and as soon as
possible (see heat injuries).
L. Prevention is the key to avoiding problems in a survival situation. If
you don't become injured or sick, you won't need to use these techniques. The
key to remaining healthy in a survival situation depends on four factors:
adequate food and water, good personal hygiene, sufficient rest, and shots and
immunizations being up to date. Prevention of infection is considered the
primary goal of staying healthy in a survival environment.
M. Survival medicine should be considered as a last resort when no other
medical option exists for the treatment of disease, wounds, or injuries. The
most common areas of survival medicine deal with the treatment or symptomatic
treatment of wounds, skin infection, diarrhea, intestinal parasites, and
burns.
(1) The treatment of open wounds in a survival environment is critical due to
the loss of blood and tissue as well as the possibility of infection. Open
wound therapy is the treatment of choice in a survival situation. Clean the
wound as soon as possible after it occurs. Remove clothing from the area of
the wound, clean the skin around the wound, and rinse (DO NOT SCRUB) the wound
with large quantities of the cleanest water available (sterile or boiled
water, sea water or a saline solution made of one teaspoon salt or 12 salt
tablets per liter of sterile water; fresh male urine ["straight from the
spigot"] will suffice if water is in short supply and donor has no diseases).
Leave the wound open to allow pus and infectious material to drain. Cover the
wound with a clean dressing and bandage. Change the dressing daily and check
the wound for infection. Pain, swelling, redness, increased temperature, and
pus are indications of infection. If infection is present, place a warm,
moist compress directly on the wound. Change the compress as it cools and
maintain the compresses for 30 minutes, three to four times daily. Open the
wound and drain the infected material. Use a sterile instrument (knife, piece
of glass, etc.) to assist in the removal of all pus and crusted matter.
Redress the wound, drink lots of fluid, and continue the treatment until all
signs of infection are gone. If the wound is severely infected and cannot be
controlled, consider the "Maggot Therapy" for treatment. This should only be
considered if antibiotics are unavailable and the infection is not responding
to other treatment. Expose the open wound to flies for one day, cover the
wound, and check for maggots daily. Once maggots appear, keep the wound
covered but check it daily. Remove all maggots and rinse the wound with large
quantities of sterile water once they reach healthy tissue (increased blood,
pain, and redness will result). Check the wound every four hours for several
days to insure the maggots are gone. Repeat steps as necessary should the
infection return or maggots reappear. Dress the wound and treat as any other
open wound once the treatment is over.
(2) Skin infections such as boils, funguses, and rashes seldom become major
problems but are annoying. Apply warm compresses to a boil and bring it to a
head. Open the boil with a sterile object and clean out the pus and matter.
Clean with soap and water and treat as a minor wound, check for infection
periodically. For fungal infections and rashes, keep the area as dry and
clean as possible. Expose fungus infections to as much sunlight as possible.
A cold compress will relieve the itching of some rashes.
(3) Intestinal parasites are always a possibility in a survival environment.
Proper hygiene and food preparation minimize the possibility of infestation.
Treatments are acts that change the environment of the intestinal tract and
allow the parasites to be passed. Mix four tablespoons of salt with a quart
of water and drink it. Do not repeat this treatment. Eat one to one and
one-half cigarettes. You may repeat this treatment in 48 hours. Drink two
tablespoons of kerosene. This treatment may be repeated in 48 hours. A
steady diet containing hot peppers is also effective.
(4) Diarrhea is a very serious, sometimes fatal, debilitating symptom of
several diseases. It generally kills through dehydration. It should be
treated promptly so as to minimize the effects. Limit your food and fluid
intake for 24 hours and drink one cup of strong tea every two hours until the
diarrhea slows or stops (tea contains tannic acid which is effective against
diarrhea). If tea is unavailable, boiling acorns or the inner bark of
hardwood trees will produce a solution that contains tannic acid. One handful
of ground chalk, charcoal, or bone, mixed in a cupful of water is also
effective. Add an equal portion of apple pomace (the pulpy material that
remains after the juice has been squeezed out), or chopped citrus fruit rinds
to the solution. Take two tablespoons of this primitive "kaopectate" every
two hours until the diarrhea slows or stops. Drink lots of purified water and
limit foods to bland, starchy dishes or clear broths once the diarrhea is
under control.
(5) Burns in a survival situation are critical because of the pain,
dehydration, and probability of infection that accompanies the destruction of
tissue. Never apply grease, fats, or ointments. Remove all clothing and
jewelry from the burned area that may cut off circulation during swelling.
Always cut clothing away--do not pull over injured area. Cool water, applied
immediately, will minimize tissue damage. Apply dressing or clean rags that
have been soaked for ten minutes in a boiling tannic acid (tea, acorns, or
inner bark of hardwood tree) solution and allowed to cool. Cover the burn
with loose clean dressings and give aspirin to relieve the pain. Administer
approximately 1 quart of water per 8 hour period to prevent dehydration. If
available, add 1/2 teaspoon of salt and 1/2 teaspoon sodium bicarbonate
(baking soda) per quart of water. Use salt alone if no sodium bicarbinate is
available.
(6) There are many primitive or herbal medicines in use worldwide. Wild
garlic and onion have low grade antibiotic qualities when eaten. "Jewel-weed"
will sooth the itch of poison ivy, etc. The inner bark of the willow tree
contains a salicylic acid (aspirin) like compound for the reduction of fever,
swelling, and pain. Pine needle tea is an excellent source of Vitamin A. The
local inhabitants of an area are excellent sources of this type of knowledge.
You should only use these herbal remedies when no other medical supplies are
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