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SURVIVAL EXAM REVIEW JS1401 (Dinwiddie) MEDICAL Chapter 5 Objective 1: Identify the ABCs of emergency care. Airway, Breathing, and Circulation. Objective 2: Select the four methods of controlling bleeding in a survival episode. 1. Apply a pressure dressing (Figure V-2). 2. If STILL bleeding: a. Use direct pressure over the wound. b. Elevate the wounded area above the heart. 3. If STILL bleeding: a. Use a pressure point between the injury and the heart (Fig V-3). b. Maintain pressure for 6 to 10 minutes before checking to see if bleeding has stopped. 4. If a limb wound is STILL bleeding: CAUTION: Use of a tourniquet is a LAST RESORT measure. Use ONLY when severe, uncontrolled bleeding will cause loss of life. Recognize that long-term use of a tourniquet may cause loss of limb. a. Apply tourniquet (TK) band just above bleeding site on limb. A band at least 3 inches (7.5cm) or wider is best. b. Follow step illustrated in Fig V-4. c. Use a stick at least 6 inches (15cm) long. d. Tighten only enough to stop arterial bleeding. e. Mark a TK on the forehead with the time applied. f. DO NOT cover the tourniquet. CAUTION: The following directions apply ONLY in survival situations where rescue is UNLIKELY and NO medical aid is available. g. If rescue or medical aid is not available for over 2 hours, an attempt to SLOWLY loosen the tourniquet may be made 20 minutes after application. Before loosening— *Ensure pressure dressing is in place. *Ensure bleeding has stopped *Loosen tourniquet SLOWLY to restore circulation. *Leave loosened tourniquet in position in case bleeding resumes. (Owen) Objective 3: Identify the correct treatment for shock. 1. Identify by one or more of the following: a. Pale, cool and sweaty skin b. Fast breathing and a weak, fast pulse c. Anxiety or mental confusion d. Decreased urine output 2. Maintain circulation 3. Treat underlying injury 4. Maintain normal body temp a. Remove wet clothing b. Give warm fluids i. DO NOT give fluids to unconscious victim c. Insulate from ground d. Shelter from the elements 5. Place conscious victim on back 6. Place very weak or unconscious victim on side, this will- a. Allow mouth to drain b. Prevent tongue from blocking airway Objective 4: Identify and explain the three types of chest injuries. 1. Sucking Chest Wound: This occurs when the chest wall is penetrated; may cause victim to gasp for breath; may cause sucking sound; may create bloody froth as air escapes the chest 2. Flail Chest: Results from blunt trauma when three or more ribs are broken in two or more places. The flail segment is the broken area that moves in a direction opposite to the rest of chest during breathing. 3. Fractured Ribs: Encourage deep breathing (painful, but necessary to prevent the possible development of pneumonia.) (Peñuela) Objective 5: Select the correct steps to treat fractures, dislocations and sprains. 1. Control bleeding 2. Remove watches, jewelry, and constrictive clothing. 3. If fracture penetrates the skin a. Clean wound by gentle irrigation with water b. Apply dressing over wound 4. Position limb as normally as possible 5. Splint in position found if unable to straighten 6. Improvise a splint with available materials: a. Sticks or straight, stiff materials from equipment b. Body parts ( Opposite leg, arm to chest) 7. Attach with strips of cloth, parachute cord, etc. 8. Keep the fractured bones from moving by immobilizing the joints on both sides of the fracture. If fracture is in a joint, immobilize the bones on both sides of the joint Note: Splint fingers in a slight flexed position. 9. Use RICES treatment for 72 hours a. Rest b. Ice c. Compression d. Elevation e. Stabilization 10. Apply cold to acute injuries 11. Use 15 to 20 minute periods of cold application a. DO NOT use continuous cold therapy b. Repeat 3 to 4 times per day c. Avoid cooling that can cause frostbite or hypothermia 12. Wrap with a compression bandage after cold therapy. 13. Elevate inured area above heart level to reduce swelling. 14. Check periodically for a pulse beyond the injury site 15. Loosen bandages or reapply splint if no pulse is felt or if swelling occurs because bandage is too tight. 16. Objective 6: Select the correct treatment for burns. 1. Cool the burned area with water. a. Use immersion or cool compresses b. Avoid aggressive cooling with ice or frigid water. 2. Remove watches, jewelry, constrictive clothing. 3. DO NOT remove embedded , charred material that will cause burned areas to bleed. 4. Cover with sterile dressings. 5. DO NOT use lotion or grease 6. Avoid moving or rubbing the burned part. 7. Drink extra water to compensate for increased fluid loss from burns. (If possible with ¼ teaspoon of salt) 8. Change dressings when soaked or dirty. (Schmidt) OBJECTIVE 7: Select the correct treatment for eye injuries. - Sun/Snow Blindness (gritty, burning sensation & possible vision reduction) -- Prevent with goggles or improvised goggles -- Treatment --- Patch affected eye(s) --- Check after 12 hours --- Replace patch for another 12 hrs if not healed --- Use cool compress to reduce pain. - Foreign Body in Eye -- Irrigate with clean water from the inside to the outside corner of the eye -- If foreign body isn‘t removed by irrigation, improvise a small swab. Moisten and wipe gently over affected area. -- If foreign body is still not removed, patch eye for 24 hours and reattempt removal using above steps. OBJECTIVE 8: Identify the three major types of heat disorders and their treatment. - Heat Cramps (cramps in legs or abdomen) -- Rest -- Drink water - Heat Exhaustion (pale, sweating, moist, cool skin) -- Rest in shade -- Drink water -- Protect from further heat exposure - Heat Stroke (victim disoriented or unconscious, skin is hot and flushed, [sweating may or may not occur], fast pulse) -- Cool as rapidly as possible --- saturate clothing and fan the victim --- remember to cool the groin and armpit areas --- avoid overcooling -- Maintain airway, breathing, and circulation CAUTION: Handle heat stroke victim gently. Shock, seizures, and cardiac arrest can occur. (Mulder) 9. Identify the two major types of cold injuries and their treatment. (V-11) 1. Frostnip and frostbite – progressive injuries. Ears, noseand toes are affected 1st. Areas will feel cold and may tingle leading to numbness that progresses to waxy appearances with stiff skin that cannot glide over freely over a joint. a. Frostnip treatment – affected areas rewarm with body heat. If body heat WILL NOT rewarm area in 15 to 20 minutes, , then frostbite is present. b. Frostbite – deeply frozen areas that require medical treatment. Caution – repeated freezing and thawing causes severe pain and increases damage to the tissue. DO NOT rub frozen tissue. DO NOT thaw frozen tissue. 2. Hypothermia – progressive injury. Intense shivering, impaired ability to perform complex tasks, leads to Violent shivering, difficulty speaking, sluggish thinking, leads to Muscular rigidity with blue, puffy skin, leads to Coma, respiratory and cardiac failure. a. Protect victim from environment: -remove wet clothing -put on dry clothing -prevent further heat loss (cover top of head) -warm with blankets, sleeping bags, or shelter -warm central areas before extremities -place heat packs in groin, ,armpits, and around neck -avoid causing burns to skin Caution – Handle victim gently. Avoid overly rapid rewarming, may cause cardiac arrest. Skin to skin contact inside sleeping bag is survival technique, but may lower internal temperatures of both. 10. Select the five plants with medicinal properties. (V-15) a. Tannin b. Salicin/salicylic acid c. Common plantain d. Papain e. Common Cattail JS1402 (Thweatt) Objective 1: Identify the possible signaling devices for rescue. 1. Pyrotechnic signals 2. Signal mirror (can be made from any shiny metal or glass) 3. Strobe/IR lights (produces one residual flash when turned off) 4. Pattern signals 5. Sea dye marker 6. Non-combat extras a. Fire at night b. Smoke in the day c. Sweep the horizon with the mirror d. Use audio signals (voice, whistle, weapons fire) 7. Although radios (voice) and locators (data) aren‘t specifically mentioned under signaling, I think might be useful signals (see next section). Objective 2: Identify the correct survivor rescue responsibilities for communications and recovery. 1. Radio and data communications a. Conserve the batter b. Face the recovery asset c. Point the antenna perpendicular to the intended receiver d. Avoid grounding the antenna e. Transmit and receive according to standard plans/orders or as directed by the rescuers f. In combat i. Shut off the locator ii. Limit transmissions to 3-5 seconds iii. Move to a new concealed site after every transmission 2. Recovery responsibilities a. Establish radio contact with recovery force b. Maintain communication with rescuers until recovered c. Be prepared to authenticate according to plans/orders d. Follow recovery force instructions, be prepared to report enemy activity, recovery site characteristics, number in party, medical situation, signal devices available. e. In no radio, a ground-to-air signal may be your only means to effect recovery f. Although not specifically listed under ‗responsibilities,‘ the text implies you are also responsible for recovery site selection and preparation as well as for knowing the recovery procedures (e.g., how to use the rescue strap or penetrator, or when/how to approach rescuers). JS1404 (Pasquino) Food and Water Objective 1. Identify water requirements. -Drink extra water. Minimum 2 quarts per day to maintain fluid level. Exertion, heat, injury, or an illness increases water loss. NOTE: Pale yellow urine indicates adequate hydration. (Bolen) Objective 2. Identify water sources, procurement, and purification. Water procurement: A. DO NOT Drink: 1. Urine 2. Fish juices 3. Blood 4. Sea water 5. Alcohol 6. Melted water from new sea ice B. Water sources: 1. Surface Water (streams, lakes, and springs) 2. Precipitation (rain, snow, dew, sleet) 3. Subsurface (wells and cisterns) 4. Ground Water (when no surface water is available) a. Abundance of lush green vegetation b. Drainages and low-lying areas c. ―V‖ intersecting game trails often lead to water d. Presence of swarming insects indicates water is near e. Bird flight in the early morning or late afternoon might indicate direction to water. 5. Snow or ice a. DO NOT eat ice or snow 1) Lowers body temperature 2) Induces dehydration 3) Causes minor cold injury to the lips and mouth b. Melt with fire 1) Stir frequently to prevent damaging container 2) Speed the process by adding hot rocks or water c. Melt with body heat 1) Use water proof container 2) Place between layers of clothing 3) DO NOT place next to the skin d. Use a water generator 6. Open Seas a. Water available in survival kits b. Precipitation - Drink as much as possible - Catch rain in spray shields and life raft covers - Collect dew off raft c. Old sea ice or icebergs 7. Tropical areas a. All open sources previously mentioned above b. Vegetation 1) Plants with hollow sections can collect moisture 2) Leaning Tree. Cloth can absorb rain running down tree 3) Banana plants 4) Water trees (avoid milky sap) a) Tap before dark. Let sap stop running and harden during the daytime. b) Produce most water at night c) For evasion situations, bore into the roots and collect water 5) Vines a) Cut bark (DO NOT use milky sap) b) If juice is clear and water like, cut as large a piece of vine as possible (cut the top first) c) Pour into hand to check smell, color, and taste to determine if drinkable. d) DO NOT touch vine to lips e) When water flow stops, cut off 6 inches of opposite end, water will flow again. 6) Old bamboo a) Shake and listen for water b) Bore hold at bottom of section to obtain water. c) Cut out entire section to carry with you. d) Filter and purify 7) Green bamboo--See diagram page VII-5B (Bend bamboo over into collection device.) 8. Dry areas a. Solar still b. Vegetation bag c. Transpiration bag 1) Water bag must be clear 2) Water will taste like the plant smells 3) Seepage basin C. Water Purification 1. Water from live plants requires no further treatment 2. Purify all other water. a. Boil at least one minute b. Pour from one container to another to improve taste to aerate c. Water purification tablets. Follow instructions on package (Hoeg/Bolen) Objective 3. Identify food sources and procurement methods. A. Food Procurement 1. Sources and locations a. Mammals can be found where: 1) Trails lead to watering, feeding, and bedding areas 2) Droppings or tracks look fresh. b. Birds can be found by: 1) Observing the direction of flight in the early morning areas and late afternoon (leads to feeding, watering, and roosting areas). 2) Listening for bird noises (indication of nesting areas) c. Fish and other marine life locations d. Reptiles and amphibians are found almost worldwide e. Insects are found: 1) In dead logs and stumps 2) At ant and termite mounds 3) On ponds, lakes, and slow moving streams B. Procurement techniques 1. Snares a. Work while unattended b. Location: 1) Trails leading to water, feeding, and bedding areas 2) Mouth of dens c. Construction of simple loop snare 1) Use materials that will not break under the strain of holding an animal. 2) Use a figure 8 (locking loop) if wire is used. a) once tightened, the wire locks in place, preventing reopening, and the animals escape. 3) To construct a squirrel pole, use simple loop snares. 4) Make noose opening slightly larger than the animal‘s head (3 finger width for squirrels, fist-sized for rabbits). d. Placement of snares (set as many as possible) 1) Avoid disturbing the area 2) Use funneling (natural or improvised) 2. Noose stick (easier and safer to use than the hands) 3. Twist stick a. Insert forked stick into a den until something soft is met b. Twist the stick, binding the animal‘s hide in the fork. c. Remove the animal from the den. d. Be ready to kill the animal; it may be dangerous. 4. Hunting and fishing devices. a. Club or rock b. Spear c. Slingshot d. Pole, line, and hook e. Net f. Trap -Avoid poisonous food (see VIII-5 to VIII-8) -Use your evasion chart to identify edible plants! (Harris) Objective 4. Identify cooking methods. Cooking Methods: -Boiling -Baking -Leaching -Roasting Boiling is the most nutritious (the stuff that gets cooked out is trapped in the water you boiled it into, save that water to drink later on). In order to boil things, you can make metal containers out of your food ration cans. You can drop heated rocks into other containers to boil or cook that food as well. To bake, you can wrap it in leaves, or pack it in mud. Burying the food in dirt under coals of fire works as well. Leaching: Some nuts (acorns, for example) need to be leached to remove the tannin from them. There are two methods of doing this: -First Method -Soak the nuts and then pour the water off is one variation of this method. You can also crush the nuts and pour the water through the crushed nuts. Cold water should be tried first, but boiling water sometimes works better. Make sure that you discard this water afterwards, it is not safe to drink. -Second Method -Boil, pour off water, and then taste it. If it's still bitter, repeat this process until it's not. Roasting: This method usually tastes the best (from experience). If you want to roast nuts, place them in a container with hot coals. For meat, roast thinly sliced meat and insects over a candle. JS 1405 (Williams) Objective 1. Identify proper clothing principles to maintain personal protection. A. Never discard clothing. B. Wear loose and layered clothing to create dead air space and maintain blood flow. C. Keep the entire body covered to prevent sunburn & dehydration in hot climates. D. Avoid overheating by removing layers, using a hat E. Dampen clothing when in the ocean with salt water, in hot weather and dry before dark. F. Keep clothing dry to maintain insulation qualities. If you fall into the water in winter, build a fire, remove clothes and dry by the fire. If no fire is available, remove clothes, get into sleeping bag, allow clothes to freeze and then break out the ice. G. Dirt reduces insulation qualities so keep clothes clean. Avoid sitting or lying on the ground. Wash and repair clothes when possible. Improvised footwear can be created using a section of secured cloth. (Bulthaus) Objective 2 - Identify shelter considerations used to select the location and type of shelter. Site selection 1. Near signal and recovery site. 2. Availability of food and water. 3. Avoid natural hazards. A. Dead standing trees B. Drainage and dry river beds except in combat areas C. Avalanche areas 4. Location large enough and level enough to lie down in. Shelter type 1. Immediate (fig. VI-4) – Shelter needing minimal improvement. 2. General – Temperate climates require shelter that gives protection from wind and rain. 3. Thermal A Frame, Snow Trench, Snow Cave (fig. VI-5-7) – Cold climates require enclosed, insulated shelter. A. Snow is the most abundant insulating material. B. Air vent is required to prevent CO poisoning when using an open flame in enclosed shelters. 4. Shade Shelter (fig. VI-8) – Hot climates require a shelter to protect from UV rays. A. To reduce surface temperatures, shelter floor should be elevated or dug down (approx. 18‖) B. For thermal protection, a minimum of 2 layers of material suspended 12-18‖ above the head is required (light colored outer layer, dark inner layer) 5. Elevated Platform (fig. VI-9) – Tropical/Wet climates require enclosed, elevated shelter for protection from dampness and insects. Objective 3 – Select correct construction and types of fires. 1. Tepee (fig. VI-12) – Used to produce a concentrated heat source for cooking, lighting or signaling. 2. Log Cabin (fig. VI-13) – Used to produce large amounts of light and heat, to dry out wet wood, and provide coals for cooking etc. 3. Sod Fire and Reflector (fig. VI-14) – Use reflectors to get the most warmth from a fire. Build against rocks or logs. 4. Dakota Fire Hole (fig. VI-15) – Used for high wind/evasion situations. 5. Improvised Stoves (fig. VI-16) – Used for efficiency.
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