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OPORD LL First Aid Transport a Casualty University of gangrene by mikeholy

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									OPORD LL5 (First Aid, Transport a Casualty, 9-Line
MEDEVAC, Radio Procedures, BN FTX PCI)
Reference: FM 4-25.11, Fire BN TACSOP

Task Organization:
      Fire BN
              A co. trains at DPU
              B co. trains at UIC
              C co. train at IUN
          Enemy – N/A
          Friendly –
                 Fire BN CDTs
                 Fire BN Cadre
                 Civilians
The Fire Battalion will conduct training on 8 OCT 2009 consisting in First Aid tasks, 9-
Line MEDEVAC reports, transporting a casualty and radio procedures in order to prepare
cadets as future officers and leaders in the United States Army.

Commander’s Intent:

Concept of the Operation:
      The operation will be conducted in four phases: Phase One, planning and
      rehearsals; Phase Two, first formation; Phase Three, Execution of Training; Phase
      Four, Final Formation and Dismissal.

Scheme of Maneuver:
       Phase One: All instructor briefbacks are due NLT one week prior to the Lab,
       rehearsals and coordination between MS4s, MS3s and cadre will be done in this
       phase. On the day of the lab, all MS3s and 4s will arrive NLT one hour before
       first formation for final rehearsals and run-throughs.

       Phase Two: First formation will be held promptly, and training will begin ASAP.

       (2) Phase II consists of the PCI. It is held in the parking lot of the RRB.
       Both Companies will remain in formation in order to complete the PCI. The
       PCI begins with an in-ranks inspection conducted by each company’s
       respective 1SG. This is to inspect uniforms, and ensure properly equipped
       LCE and packing list for the Rucksack. (See Annex B for proper equipment
       on LCE). A list of deficiencies will be provided at the end of the PCI to the
       respective company XO and sent up the chain of command. Every item must
be seen by the squad leader before it can be packed. (See Annex B for the BN
FTX packing list).

Phase Three: Following first formation, each company will break down into four
groups. The first group will conduct training on First Aid tasks, the second group
will conduct training on Transporting a Casualty, the third group will conduct
training on 9-Line MEDEVAC and the fourth group will conduct training on
Radio Procedures. Each block of instruction will last twenty-six minutes with one
minute for movement attached to the end of the time allotted, and the main
instructors will be MSIII SLs, along with the full support of nursing students for
the First Aid Block (See Annexes for Instruction Block content). At the signal to
shift, the groups will move in a counter-clockwise manner. MSIVs will provide
oversight on each block of instruction. At the end of all blocks of instruction, each
squad will conduct a final review that will go over the main concepts discussed in
the previous four blocks.

Phase Four: Final formation will be held promptly, any announcements will be
made and all CDTs will be dismissed promptly.

Tasks to Cadets:
-Instructors will complete their instructor briefbacks, using all resources available,
including MS4s, and will brief lab OIC, MS4 oversight and CO, NLT one week
before Lab
-MS3 leadership to fix all uniform issues prior to the beginning of lab IAW the
uniform for lab
-MS3 leadership will confirm of receipt of the OPORD NLT one week prior to lab
-C/1SG will take accountability prior to the beginning of lab and report it to C/S-1
-All requests for supplies will go to C/S-4 NLT one week before lab
-C/S-1 will provide attendance roster to C/S-3
-C/S-3 will brief OPORD to staff NLT two weeks before lab, MS3 leadership
NLT two weeks before lab and provide BN S-3.

Coordinating Instructions:

Time                   Activity                             Location
1510           MSIII/MSIV First formation            All Training Locations
1545           All other cadets arrive                      All Training Locations
1600           First formation                       All Training Locations
1600-1626      First Block of Instruction            All Training Locations
1626-1652      Second Block of Instruction           All Training Locations
1652-1718      Third Block of Instruction            All Training Locations
1718-1744      Fourth Block of Instruction           All Training Locations
1730-1755      Orders Process                        All Training Locations
1745-1755      Review                                All Training Locations
1755-1800      Final Formation, Dismissal            All Training Locations

ACUs, LBE, pen/pencil, paper, TACSOP, OPORD
Service and Support:
Materials and Services:

Each company is to request the supplies needed NLT ten days before the Lab from the S-
4, and COs are responsible to ensure its arrival, use and return.


          CDTs will arrive at respective training locations either by POV, public
         transportation or by vans leaving from the respective schools at various times.

Medical evacuation and Hospitalization:

         All minor injuries will be treated on site by designated CLS. Life, limb, and
         vision threatening injuries will be evaluated and stabilized by CLS. Cadre will
         contact civilian emergency services (911) for evacuation.

Command and Signal:

         Succession of Command:
               C/BC White, C/XO Heagney, C/S-3 Barnes

         Primary: Voice
         Secondary: Cell Phone
         Emergency Cease Training: If training needs to cease for an emergency the first
         person to identify emergency will yell ―STOP TRAINING‖ 3 times. Cadre in
         vicinity will confirm emergency and then indicate next course of action



Annex A – BN FTX Packing List
ACUs complete
Patrol cap
Tan t-shirt
Black socks
Dog tags
Military ID card (other picture ID if not issued)
BN TACSOP (right cargo pocket, in Ziploc bag; available on-line on UIC ROTC
Protractor (if issued or have one)

Pistol belt
2 x canteen w/pouch
1 x canteen cup
2 x magazine pouches
1 x first aid kit w/pouch
1 x compass w/pouch (if issued)
1 x flashlight (civilian equivalent authorized if not issued)

Rucksack (IAW BN TACSOP)
Left Outside Pouch
2 pair socks in Zip-Lock bag
Gloves w/liners
Insect repellant
Foot Powder
Center Outside Pouch
Right Outside Pouch
MRE (Broken Down)
Rucksack (IAW BN TACSOP) (Continued)
Inside Top Flap
Terrain Model Kit (if issued or have one)
Field hygiene Kit
Inside Radio Pouch
FM 7-8 (in Ziploc bag)
Zip-Lock Bags
Camo Stick (if issued or have one)
Chapstick (optional)
Inside Main Compartment
Kevlar helmet
Water proof bag (with these items)
Cap, ACU (if issued extra)
Set of ACU
Socks (3)
Undershirt (1)
Underwear (1)
Wet Weather Jacket (civilian equivalent authorized if not issued)
Wet Weather Trousers (civilian equivalent authorized if not issued)
550 Cord (if issued or have)
MRE (Broken Down)
Poly Pro / Snivel Gear (civilian equivalent authorized if not issued)
Field jacket or Gortex jacket (civilian equivalent authorized if not issued)

Duffle Bag (or like bag if not issued)
Extra boots (civilian equivalent if not issued)
Hygiene kit consisting of: soap, shampoo, toothbrush, toothpaste, razor, shaving cream
Shower Shoes
Sleeping Bag (civilian equivalent if not issued)
PT Uniform (Fire Battalion t-shirt, black PT shorts, white socks, running shoes)
Shoe shine kit
$20 in cash
SH 21-76, Ranger Handbook (optional)
FM 22-5, Drill and Ceremonies (optional)
FM 21-20, Physical Fitness Training (optional)
Pillow (optional)
Watch cap (optional)
Sunscreen (optional)
Schoolwork (optional)
Pogey Bait (aka snacks, optional)
Bungee Cords (optional)
Camelbak (optional)

Important Note: USE visual aids and materials for this instruction block.

Important Terminology

Combat lifesaver. This is a US Army program governed by Army Regulation (AR) 350-
41. The combat lifesaver is a member of a nonmedical unit selected by the unit
commander for additional training beyond basic first aid procedures (referred to as
enhanced first aid). A minimum of one individual per squad, crew, team, or equivalent-
sized unit should be trained. The primary duty of this individual does not change. The
additional duty of combat lifesaver is to provide enhanced first aid for injuries based on
his training before the trauma specialist (military occupational specialty [MOS] 91W)
arrives. The combat lifesaver’s training is normally provided by medical personnel
assigned, attached, or in direct support (DS) of the unit. The senior medical person
designated by the commander manages the training program.

Trauma Specialist (US Army) or Hospital Corpsman (HM). A medical specialist trained
in emergency medical treatment (EMT) procedures and assigned or attached in support of
a combat or combat support unit or marine forces.

Casualty evacuation. Casualty evacuation (CASEVAC) is a term used by nonmedical
units to refer to the movement of casualties aboard nonmedical vehicles or aircraft.
Casualties transported in this manner do not receive en route medical care.

Medical evacuation. Medical evacuation is the timely, efficient movement of the
wounded, injured, or ill service members from the battlefield and other locations to
medical treatment facilities (MTFs). Medical personnel provide en route medical care
during the evacuation. Once the casualty has entered the medical stream (trauma
specialist, hospital corpsman, evacuation crew, or MTF), the role of first aid in the care of
the casualty ceases and the casualty becomes the responsibility of the health service
support (HSS) chain. Once he has entered the HSS chain he is referred to as a patient.

Tactical Combat Casualty Care (TCCC)
Tactical combat casualty care (TCCC) can be divided into three phases. The first is care
under fire; the second is tactical field care; the third is combat casualty evacuation care.
In the first, you are under hostile fire and are very limited as to the care you can provide.
In the second, you and the casualty are relatively safe and no longer under effective
hostile fire, and you are free to provide casualty care to the best of your ability. In the
third, the care is rendered during casualty evacuation (CASEVAC).
Warning: If a broken neck or back is suspected, do not move the casualty unless to save
his/her life.
1. Perform care under fire.
a. Return fire as directed or required before providing medical treatment.
b. Determine if the casualty is alive or dead.
Note: In combat, the most likely threat to the casualty's life is from bleeding. Attempts to
check for airway and breathing will expose the rescuer to enemy fire. Do not attempt to
provide first aid if your own life is in imminent danger.
Note: In a combat situation, if you find a casualty with no signs of life—no pulse, no
breathing—do NOT attempt to restore the airway. Do NOT continue first aid measures.
c. Provide tactical care to the live casualty.
Note: Reducing or eliminating enemy fire may be more important to the casualty's
survival than the treatment you can provide.
(1) Suppress enemy fire.
(2) Use cover or concealment (smoke).
(3) Direct the casualty to return fire, move to cover, and administer self-aid (stop
bleeding), if possible. If the casualty is unable to move and you are unable to move the
casualty to cover and the casualty is still under direct enemy fire, have the casualty ―play
(4) If the casualty is unresponsive, move the casualty, his/her weapon, and mission-
essential equipment to cover, as the tactical situation permits.
(5) Keep the casualty from sustaining additional wounds.
(6) Reassure the casualty.
d. Administer life-saving hemorrhage control.
(1) Determine the relative threat of the tactical situation versus the risk of the casualty’s
bleeding to death.
(2) If the casualty has severe bleeding from a limb or has suffered amputation of a limb,
administer life-saving hemorrhage control by applying a tourniquet before moving the
e. Transport the casualty, his/her weapon, and mission-essential equipment when the
tactical situation permits.
f. Recheck bleeding control measures as the tactical situation permits.
2. Perform tactical field care when no longer under direct enemy fire.
Note: Tactical field care is rendered by the individual when no longer under hostile fire.
Tactical field care also applies to situations in which an injury has occurred during the
mission but there has been no hostile fire. Available medical equipment is limited to that
carried into the field by the individual Soldier.
Warning: If there are any signs of nerve agent poisoning, stop the evaluation, take the
necessary NBC protective measures, and begin first aid.
Note: In the following situations communicate the medical situation to the unit leader
and ensure that the tactical situation allows for time to perform these steps before
initiating any medical procedure.
Note: When evaluating and/or treating a casualty, seek medical aid as soon as possible.
Do NOT stop treatment; but, if the situation allows, send another person to find medical
a. Form a general impression of the casualty as you approach (extent of injuries, chance
of survival).
Note: If a casualty is being burned, take steps to remove the casualty from the source of
the burns before continuing evaluation and treatment.
b. Check for responsiveness.
(1) Ask in a loud, but calm, voice: ―Are you okay?‖ Gently shake or tap the casualty on
the shoulder.
(2) Determine level of consciousness by using AVPU: A = Alert; V = responds to Voice; P
= responds to Pain; U = Unresponsive.
Note: To check a casualty’s response to pain, rub the breastbone briskly with a knuckle or
squeeze the first or second toe over the toenail.
(3) If the casualty is conscious, ask where his/her body feels different than usual, or
where it hurts. Go to step 2e. If the casualty is conscious but is choking and cannot talk,
stop the evaluation and begin treatment.
(4) If the casualty is unconscious, continue with step 2c.
c. Position the casualty and open the airway.
d. Assess for breathing and chest injuries.
(1) Look, listen, and feel for respiration.
Note: If the casualty is breathing, insert a nasopharyngeal airway and place the casualty
in the recovery position.
Note: On the battlefield the cost of attempting cardiopulmonary resuscitation (CPR) on
casualties with what are inevitably fatal injuries may result in additional lives lost as care
is diverted from casualties with less severe injuries. Only in the case of nontraumatic
disorders such as hypothermia, near drowning, or electrocution should CPR be
considered prior to the CASEVAC phase.
(2) Expose the chest and check for equal rise and fall and for any wounds.
(a) If the casualty has a penetrating chest wound, and is breathing or making an effort to
breathe, stop the evaluation to apply an occlusive dressing.
(b) Monitor for increasing respiratory distress. If this occurs, decompress the chest on the
same side as the injury.
(c) Position or transport with the affected side down, if possible.
e. Identify and control bleeding.
(1) Check for bleeding.
(a) Remove minimum of clothing required to expose and treat injuries. Protect casualty
from the environment (heat and cold).
(b) Look for blood-soaked clothes.
(c) Look for entry and exit wounds.
(d) Place your hands behind the casualty’s neck and pass them upward toward the top of
the head. Note whether there is blood or brain tissue on your hands from the casualty’s
(e) Place your hands behind the casualty’s shoulders and pass them downward behind the
back, the thighs, and the legs. Note whether there is blood on your hands from the
casualty’s wounds.
(2) If life-threatening bleeding is present, stop the evaluation and control the bleeding.
Apply a tourniquet, field dressing, or an emergency trauma dressing, as appropriate. Treat
for shock, as appropriate.
Note: If a tourniquet was previously applied, consider converting it to a pressure
dressing. By converting the tourniquet to a pressure dressing, it may be possible to save
the casualty’s limb if the tourniquet has not been in place for 6 hours.
(3) Dress all wounds, including exit wounds.
f. Check for fractures.
(1) Check for open fractures by looking for bleeding or bone sticking through the skin.
(2) Check for closed fractures by looking for swelling, discoloration, deformity, or
unusual body position.
(3) If a suspected fracture is present, stop the evaluation and apply a splint.
g. Check for burns.
(1) Look carefully for reddened, blistered, or charred skin. Also check for singed clothes.
(2) If burns are found, stop the evaluation and begin treatment.
h. Administer pain medications and antibiotics (the casualty’s combat pill pack) to any
Soldier wounded in combat.
Note: Each Soldier will be issued a combat pill pack prior to deployment on tactical
i. Transport the casualty to the site where evacuation is anticipated.
3. Monitor an unconscious casualty during casualty evacuation (CASEVAC).
Note: CASEVAC refers to the movement of casualties aboard nonmedical vehicles or
aircraft. Combat casualty evacuation care is rendered while the casualty is awaiting
pickup or is being transported. A Soldier accompanying an unconscious casualty should
monitor the casualty’s airway, breathing, and bleeding.
Heat Injuries
(1) Check the casualty for signs and symptoms of cramping.
• Signs and symptoms. Cramping is caused by an imbalance of chemicals (called
electrolytes) in the body as a result of excessive sweating. This condition causes the
casualty to exhibit: cramping in the extremities (arms and legs), abdominal (stomach)
cramps, excessive sweating.
NOTE: Thirst may or may not occur. Cramping can occur without the service member
being thirsty.
• First aid measures: Move the casualty to a cool, shady area or improvise shade if none
is available. Loosen his clothing (if not in a chemical environment).
NOTE: In a chemical environment, transport the heat casualty to a noncontaminated area
as soon as the mission permits.
• Have him slowly drink at least one canteen full of water. (The body absorbs cool water
faster than warm or cold water; therefore, cool water is preferred if it is available.) Seek
medical assistance should cramps continue.
(2) Check the casualty for signs and symptoms of heat exhaustion.
• Signs and symptoms. Heat exhaustion is caused by loss of body fluids (dehydration)
through sweating without adequate fluid replacement. It can occur in an otherwise fit
individual who is involved in physical exertion in any hot environment especially if the
service member is not acclimatized to that environment. These signs and symptoms are—
Excessive sweating with pale, moist, cool skin; headache; weakness; dizziness; loss of
appetite; cramping; nausea (with or without vomiting); urge to defecate; chills
(gooseflesh); rapid breathing; tingling of hands and/or feet; confusion.
• First aid measures: Move the casualty to a cool, shady area or improvise shade if none
is available. Loosen or remove his clothing and boots (unless in a chemical environment);
pour water on him and fan him. Have him slowly drink at least one canteen of water.
Elevate his legs. If possible, the casualty should not participate in strenuous activity for
the remainder of the day. Monitor the casualty until the symptoms are gone, or medical
assistance arrives.
(3) Check the casualty for signs and symptoms of heatstroke.
WARNING: Heatstroke is a medical emergency which may result in death if care is
• Signs and symptoms. A service member suffering from heatstroke has been exposed to
high temperatures (such as direct sunlight) or been dressed in protective overgarments,
which causes the body temperature to rise. Heatstroke occurs more rapidly in service
members who are engaged in work or other physical activity in a high heat environment.
Heatstroke is caused by a failure of the body’s cooling mechanism which includes a
decrease in the body’s ability to produce sweat. The casualty’s skin is red (flushed), hot,
and dry. He may experience weakness, dizziness, confusion, headaches, seizures, nausea,
stomach pains or cramps, and his respiration and pulse may be rapid and weak.
Unconsciousness and collapse may occur suddenly.
• First aid measures. Cool casualty immediately by—
• Moving him to a cool, shady area or improvising shade if none is available. Loosening
or removing his clothing (except in a chemical environment). Spraying or pouring water
on him; fanning him to permit the coolant effect of evaporation; massaging his
extremities and skin, which increases the blood flow to those body areas, thus aiding the
cooling process; elevating his legs; having him slowly drink at least one canteen full of
water if he is conscious.
NOTE: Start cooling casualty immediately. Continue cooling while awaiting
transportation and during transport to an MTF.
• Medical assistance. Seek medical assistance because the casualty should be transported
to an MTF as soon as possible. Do not interrupt the cooling process or lifesaving
measures to seek help; if someone else is present send them for help. The casualty should
be continually monitored for development of conditions that may require the performance
of necessary basic lifesaving measures.
Cold Injuries


• Signs and symptoms. Chilblain is caused by repeated prolonged exposure of bare skin at
temperatures from 60° Fahrenheit (F) to 32°F, or 20°F for acclimated, dry, unwashed
skin. The area may be acutely swollen, red, tender, and hot with itchy skin. There may be
no loss of skin tissue in untreated cases but continued exposure may lead to infected,
ulcerated, or bleeding lesions.
• First aid measures. Within minutes, the area usually responds to locally applied body
heat. Rewarm the affected part by applying firm steady pressure with your hands, or
placing the affected part under your arms or against the stomach of a buddy. DO NOT rub
or massage affected areas.

NOTE: Medical personnel should evaluate the injury, because signs and symptoms of
tissue damage may be slow to appear.

(2) Immersion syndrome (immersion foot and trench foot). Immersion foot and trench
foot are injuries that result from fairly long exposure of the feet to wet conditions at
temperatures from approximately 32°F to 50°F. Inactive feet in damp or wet socks and
boots, or tightly laced boots which impair circulation, are even more susceptible to injury.
This injury can be very serious; it can lead to loss of toes or parts of the feet. If exposure
of the feet has been prolonged and severe, the feet may swell so much that pressure
closes the blood vessels and cuts off circulation. Should
an immersion injury occur, dry the feet thoroughly and transport the casualty to an MTF
by the fastest means possible.
• Signs and symptoms. At first, the parts of the affected foot are cold and painless, the
pulse is weak, and numbness may be present. Second, the parts may feel hot, and burning
and shooting pains may begin. In later stages, the skin is pale with a bluish cast and the
pulse decreases. Other signs and symptoms that may follow are blistering, swelling,
redness, heat, hemorrhaging (bleeding), and gangrene.
• First aid measures. First aid measures are required for all stages of immersion syndrome
injury. Rewarm the injured part gradually by exposing it to warm air. Protect it from
trauma and secondary infections. Dry, loose clothing or several layers of warm coverings
are preferable to extreme heat. Under no circumstances should the injured part be
exposed to an open fire. Elevate the injured part to relieve the swelling. Transport the
casualty to an MTF as soon as possible. When the part is rewarmed, the casualty often
feels a burning sensation and pain. Symptoms
may persist for days or weeks even after rewarming.
NOTE: When providing first aid for immersion foot and trench foot—
DO NOT massage the injured part. DO NOT moisten the skin.
DO NOT apply heat or ice.

(3) Frostbite. Frostbite is the injury of tissue caused from exposure to cold, usually
below 32°F depending on the windchill factor, duration of exposure, and adequacy of
protection. Individuals with a history of cold injury are likely to suffer an additional cold
injury. The body parts most easily frostbitten are the cheeks, nose, ears, chin, forehead,
wrists, hands, and feet. Frostbite may involve only the skin (superficial), or it may extend
to a depth below the skin (deep). Deep frostbite is very serious and requires prompt first
aid to avoid or to minimize the loss of parts or all of the fingers, toes, hands, or feet.
• Signs and symptoms.
• Loss of sensation (numb feeling) in any part of the body.
• Sudden blanching (whitening) of the skin of the affected part, followed by a momentary
tingling sensation.
• Redness of skin in light-skinned service members; grayish coloring in dark-skinned
service members.
• Blisters.
• Swelling or tender areas.
• Loss of previous sensation of pain in affected area.
• Pale, yellowish, waxy-looking skin.
• Frozen tissue that feels solid (or wooden) to the touch.

CAUTION: Deep frostbite is a very serious injury and requires immediate first aid and
subsequent medical treatment to avoid or minimize loss of body parts.
• First aid measures:
• Face, ears, and nose. Cover the casualty’s affected area with his and/or your bare hands
until sensation and color return.
• Hands. Open the casualty’s field jacket and shirt. (In a chemical environment, do not
loosen or remove the clothing and protective overgarments.) Place the affected hands
under the casualty’s
armpits. Close the field jacket and shirt to prevent additional exposure.
• Feet. Remove the casualty’s boots and socks if he does not need to walk any further to
receive additional treatment. (Thawing the casualty’s feet and forcing him to walk on
them will cause
additional pain and injury.) Place the affected feet under clothing and against
the body of another service member.
WARNING: DO NOT attempt to thaw the casualty’s feet or other frozen areas if he will
be required to walk or travel to an MTF for additional medical treatment. The possibility
of additional injury from walking is less when the feet are frozen than when they are
thawed. (However, if possible avoid walking.) Thawing in the field increases the
possibilities of infection, gangrene, or other injury.

NOTE: Thawing may occur spontaneously during transportation to the MTF; this cannot
be avoided since the body in general must be kept warm. In all of the above areas, ensure
that the casualty is kept warm and that he is covered (to avoid further injury). Seek
medical treatment as soon as possible. Reassure the casualty, protect the affected area
from further injury by covering it lightly with a blanket or any dry clothing, and seek
shelter out of the wind. Remove or loosen constricting clothing (except in a contaminated
environment) and increase insulation. Ensure the casualty exercises as much as possible,
avoiding trauma to the injured part, and is prepared for pain when thawing occurs. Protect
the frostbitten part from additional injury. DO NOT—

• Rub the injured part with snow or apply cold water soaks.
• Warm the part by massage or exposure to open fire because the frozen part may be
burned due to the lack of feeling.
• Use ointments or other salves.
• Manipulate the part in any way to increase circulation.
• Use alcohol or tobacco because this reduces the body’s resistance to cold.

NOTE: Remember, when freezing extends to a depth below the skin, it is a much more
serious injury. Extra care is required to reduce or avoid the chances of losing all or part of
the toes or feet. This also applies to the fingers and hands.

(4) Snow blindness. Snow blindness is the effect that glare from an ice field or snowfield
has on the eyes. It is more likely to occur in hazy, cloudy weather than when the sun is
shining. Glare from the sun will cause an individual to instinctively protect his eyes.
However, in cloudy weather, he may be overconfident and expose his eyes longer than
when the threat is more obvious. He may also neglect precautions such as the use of
protective eyewear. Waiting until discomfort (pain) is felt before using protective eyewear
is dangerous because a deep burn of the eyes may already have occurred.
• Signs and symptoms. Symptoms of snow blindness are a sensation of grit in the eyes
with pain in and over the eyes, made worse by moving the eyeball. Other signs and
symptoms are watering, redness, headache, and increased pain on exposure to light.
• First aid measures. First aid measures consist of blindfolding or covering the eyes with
a dark cloth which stops painful eye movement. Complete rest is desirable. If further
exposure to light is not preventable, the eyes should be protected with dark bandages or
the darkest glasses available. Once unprotected exposure to sunlight stops, the condition
usually heals in a few days without permanent damage. The casualty should be evacuated
to the nearest MTF.
(5) Dehydration.
• Signs and symptoms. The symptoms of cold weather dehydration are similar to those
encountered in heat exhaustion. The mouth, tongue, and throat become parched and dry,
and swallowing becomes difficult. The casualty may have nausea (with or without
vomiting) along
with extreme dizziness and fainting. The casualty may also feel generally tired and weak
and may experience muscle cramps. Focusing the eyes may also become difficult.
• First aid measures. The casualty should be kept warm and his clothes should be
loosened (if not in a chemical environment) to allow proper circulation. Shelter from
wind and cold must be provided. Fluid replacement should begin immediately and the
service member transported to an MTF as soon as possible.
(6) Hypothermia (general cooling). When exposed to prolonged cold weather a service
member may become both mentally and physically numb, thus neglecting essential tasks
or requiring more time and effort to achieve them. Under some conditions (particularly
cold water
immersion), even a service member in excellent physical condition may die in a matter of
minutes. The destructive influence of cold on the body is called hypothermia. This means
bodies lose heat faster than they can produce it. Hypothermia can occur from exposure to
temperatures either above or below freezing, especially from immersion in cold water,
wet-cold conditions,
or from the effect of wind. Physical exhaustion and insufficient food intake may also
increase the risk of hypothermia. General cooling of the entire body to a temperature
below 95°F is caused by continued exposure to low or rapidly dropping temperatures,
cold moisture, snow, or ice. Fatigue, poor physical condition, dehydration, faulty blood
circulation, alcohol or other
drug use, trauma, and immersion can cause hypothermia. Remember, cold may affect the
body systems slowly and almost without notice. Service members exposed to low
temperatures for extended periods may suffer ill effects even if they are well protected by

• Signs and symptoms. As the body cools, there are several stages of progressive
discomfort and impairment. A sign that is noticed immediately is shivering. Shivering is
an attempt by the body to generate heat. The pulse is faint or very difficult to detect.
People with temperatures around 90°F may be drowsy and mentally slow. Their ability to
move may be hampered, stiff, and uncoordinated, but they may be able to function
minimally. Their speech may be slurred. As the body temperature drops further, shock
becomes evident as the person’s eyes assume a glassy
state, breathing becomes slow and shallow, and the pulse becomes weaker or absent. The
person becomes very stiff and uncoordinated. Unconsciousness may follow quickly. As
the body temperature drops even lower, the extremities freeze, and a deep (or core) body
temperature (below 85°F) increases the risk of irregular heart action. This irregular heart
action or heart standstill can result in sudden death.
• First aid measures. Except in cases of the most severe hypothermia (marked by coma or
unconsciousness and a weak pulse), first aid measures for hypothermia are directed
towards protecting the casualty from further loss of body heat. For the casualty who is
conscious, first aid
measures are directed at rewarming the body evenly and without delay. Provide heat by
using a hot water bottle or field expedient or another service member’s body heat.

CAUTION: DO NOT expose the casualty to an open fire, as he may become burned.

NOTE: When using a hot water bottle or field expedient (canteen filled with warm
water), the bottle or canteen must be wrapped in cloth prior to placing it next to the
casualty. This will reduce the chance of burning the casualty’s skin.

Always call or send for help as soon as possible and protect the casualty immediately
with dry clothing or a sleeping bag. Then, move him to a warm place. Evaluate other
injuries and provide first aid as required. First aid measures can be performed while the
casualty is waiting transportation or while he is en route. In the case of an accidental
breakthrough into ice water,
or other hypothermic accident, strip the casualty of wet clothing immediately and bundle
him into a sleeping bag. Rescue breathing should be started at once if the casualty’s
breathing has stopped or is irregular or shallow. Warm liquids (NOT HOT) may be given
gradually if the casualty is conscious. DO NOT force liquids on an unconscious or
semiconscious casualty because he may choke. The casualty should be transported on a
litter because the
exertion of walking may aggravate circulation problems. Medical personnel should
immediately treat any hypothermia casualty. Hypothermia is life threatening until normal
body temperature has been restored. The first aid measures for a casualty with severe
hypothermia are based upon the following principles: attempt to avoid further heat loss,
handle the casualty gently, and
transport the casualty as soon as possible to the nearest MTF. If at all possible, the
casualty should be evacuated by medical personnel.

WARNING: Rewarming a severely hypothermic casualty is extremely dangerous in the
field due to the possibility of such complications as rewarming, shock and disturbances in
the rhythm of the heartbeat. These conditions require treatment by medical personnel.

NOTE: Resuscitation of casualties with hypothermic complications is difficult if not
impossible to do outside of an MTF setting.

CAUTION: The casualty is unable to generate his own body heat. Therefore, merely
placing him in a blanket or sleeping bag is not sufficient.


Important Note: Physical demonstrations and overall group participation of
transportation techniques are highly recommended for this instruction block.

                                    Fireman’s Carry

                              Raising a Casualty to his feet

                                     Support Carry
                          Arms Carry

                       Saddleback Carry

                Performing the Pack Strap Carry

                Performing the Pistol Belt Carry

                  Two Man Fore and Aft Carry

Lifting a Casualty using the Modified Two Man Fore and Aft Carry

                    Two Man Support Carry

        Lifting a Casualty using the Two Arms Man Carry
                                            Neck Drag

                                      Two Hand Seat Carry



Important Note: Once explained and given a medevac scenario, each squad member
should be able to give a 9 line medevac request (See example).

    9-Line MEDEVAC Request   9-Line MEDEVAC Request             Smart Pack
1. Location of Pick-up-Site                                                        Call Signs/Frequency/Location (GPS)
                                 6. Number & Type of Wounds
2. Radio frequency/Call Sign     (Peacetime)

3. Number of PT’s by             7. Method of Marking Pick-up
precedence:                      Site:

           A-Urgent                         A-Panels
           B-Urgent Surgery                 B-Pyro
           C-Priority                       C-Smoke
           D-Routine                        D-None
           E-Convenience                    E-Other

4. Special Equipment             8. Patient Nationality & Status

           A-None                           A-US Military          Example:
           B-Hoist                          B-US Civilian
           C-Extraction                     C-Non-US Military      ―Goose, this is Maverick, over‖
           Equipment                        D-Non-US Civilian      ―Maverick, this is Goose, send over‖
           D-Ventilator                     E-EPW                  ―This is Maverick, request MEDEVAC, over‖
                                                                   ―Roger Maverick, send your request, over‖
5. # PT’s by Type:               9. NBC Contamination              ―Line One – LZ Jaybird 86750055 -Break‖
                                 (Tactical/Wartime)                ―Line Two-HF 231.45, UHF-114.1 Maverick -Break‖
           L-Litter                                                ―Line Three- 2A, 3C – Break‖
           A-Ambulatory                     N-Nuclear              ―Line Four-A – Break‖
                                            B-Bio                  ―Line Five-2L, 3A – Break‖
6. Security at Site (Tactical)              C-Chemical             ―Line Six-P – Break‖
                                                                   ―Line Seven-C – Break‖
           N-No enemy troops     9. Terrain Description            ―Line Eight- A – Break‖
           P-Possible enemy      (Peacetime)                       ―Line Nine- All Clear – Break‖
           E-Enemy troops                                          ―How Copy my last, Over‖
           (Caution)                        Hills                  ―Roger Maverick, solid copy, stand-by for inbound MEDEVAC plan –
           X-Enemy troops                   Power lines                 over‖
           (Armed Escort)                   Buildings              ―Maverick standing-by, over‖
                                            Grade of Land

Army Alphabet

Army Number Pronunciation Guide

Army prowords and associated meanings

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