Unresponsive Victim

Actions

• Check responsiveness: verbal, sternum rub, ear pinch
• Call 911, retrieve AED
• If possible opioid overdose:
  • Open airway: Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose
  • 2 breaths
  • Give Narcan: insert into nostril until finger touches base of nose. Press plunger.
  • Give rescue breaths for 3 minutes
• Check breathing
• If breathing: maintain airway
• If not breathing:
  • 30 compressions (2 hands for adult, 1 for child, 2 fingers for baby)
  • Open airway: Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose
  • 2 breaths
• Utilize AED as soon as available
• Recovey Position
  • Kneel beside victim
  • Place victim's closest arm above the head, and furthest arm across the chest
  • Bend the victim's nearest leg at the knee
  • Place your hand under the hollow of the victim's neck to stablize the head
  • Roll the patient towards you so the head rests on the extended arm and the face is facing slightly downward
  • Bend both legs at the knees to stabilize victim

Heart Attack

Symptoms

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes – or it may go away and then return. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath. This can occur with or without chest discomfort.
• Other signs. Other possible signs include breaking out in a cold sweat, nausea or lightheadedness.

Actions

• Call 911
• If safe: chew (1) 325mg Asprin tablet

Stroke

Symptoms

• Face: Smile and see if one side of the face droops.
• Arms: Raise both arms. Does one arm drop down?
• Speech: Say a short phrase and check for slurred or strange speech.
• Time: If the answer to any of these is yes, call 911 right away and write down the time when symptoms started.
• Sudden weakness or numbness of the face, arm, or leg, usually on one side of the body
• Sudden dimness or loss of vision, particularly in one eye
• Loss of speech, or trouble talking or understanding speech
• Sudden severe headache with no apparent cause
• Sudden episodes of difficulty walking or unexplained dizziness or unsteadiness; especially in combination with any of the previously noted symptoms

Poisoning

Actions

• Call Poison Control: (800) 222-1222

Choking

Actions

• Abdominal Thrusts:
  • Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.
  • Make a fist with one hand. Position it slightly above the person's navel.
  • Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
  • Perform between six and 10 abdominal thrusts until the blockage is dislodged.
• Infants: 5 back blows, 5 abdominal thrusts. Repeat.

Bleeding

Actions

• Unctrolled bleeding: apply tourniquet 2 inches above wound. If wound is not obvious, apply TQ has high on the limb as possible. DO NOT REMOVE TQ once applied.
• Large wounds: tightly pack with gauze or fabric, then apply pressure dressing.
• Chest wound: if foamy, bloody bubbles, or hear sucking; cover wound with airtight material and tape on 3 sides.

Lightning Safety

General Advice

• Immediately get off elevated areas such as hills, mountain ridges or peaks
• Never lie flat on the ground
• Never shelter under an isolated tree
• Never use a cliff or rocky overhang for shelter
• Immediately get out and away from ponds, lakes and other bodies of water
• Stay away from objects that conduct electricity (barbed wire fences, power lines, windmills, etc.)

Last Resort

• Look for a dry, low-lying area such as a valley and become the smallest target possible.
• Crouch down with your heels touching, head between the knees, and ears covered. Minimize your contact with the ground and do not lie down flat.
• Stand on a foam pad, backpack or other non-conductive item to separate you from the ground

Dental Emergency

Actions

• Store patients tooth in: whole milk (ideal), patient's saliva, low fat milk, contact lens solution, gatorade

Power Lines

General Advice

• Every downed cable should be considered electrically charged
• Keep at least 35 feet away from downed power lines
• If you vehicle comes in contact with an electrical cable, remain in the vehicle, call 911

Last Resort

• If needed, you can touch the outside of your vehicle. But you MUST not make contact between the outside of your vehicle and the ground.
• If you must leave your vehicle, do so by jumping from it and landing with both feet together.
• Use small, shuffling steps to move 35 feet from your vehicle.

Poison Ivy

Plant Identification

• Leaves: clusters of 3 leaflets with pointed tips on short stalks
• Flowers: Inconspicuous greenish flowers with five petals, about 3 mm in diameter
• Fruit: Berry-like fruits containing a single seed (drupes) are hard and whitish

Rash Identification

• Rash forms between 4 hours and 24 hours of exposure
• Rash shows up as red, itchy bumps on the skin.
• Rash is not contagious
• Rash may initially look like large a bug bite

Field Treatment

• Wear long pants/sleeves clothes to avoid contact
• Wash off area with water as quickly as possible
• Cortisone cream and Benadryl help with itch

Home Treatment

• Use hydrogen peroxide to see if rash has broke through the skin. If the peroxide bubbles, then it has and there's an infection risk.
• Cover open rash areas with bacitracin
• Cover closed rash areas with calamine lotion
• If rash continues to grow and oozes yellow, see urgent care for possible steroid / antibiotic treatment.

References

• Tips to Identify Poison Ivy
• Myths and Facts of Poison Ivy
• Poison ivy pictures

Mass Casualty

Priorities

1. Mitigate Threat: Run/Hide/Fight
2. Prepare: Move to self/injured to safe position, confirm 911 has been called
3. Bleeding: Apply pressure, tourniquets as needed
4. Airway: unconcious people: open / clear airway; put in recovery position
5. Breathing: if wounds in torso, apply chest seal. Monitor. Burp as needed.
6. Hypothermia: move to warm area; replace wet garments; apply extra insulation
7. Burns: stop the burning process, cover with dry, clean dressings, prevent hypothermia
8. Pain Control: ice, elevation, immobilization, Tylenol.

Special Considerations

• CPR in a mass casualty event is low priority. Treat the above first as they have high risk, high survivability conditions.
• Avoid Ibruprofen and Asprin for pain relief as they can interfere with platlet function and may worsen bleeding.

References

• Optimizing the use of Limb Tourniquets in Tactical Combat Casualty Care: TCCC
• Aspirin for heart attack: Chew or swallow?
• Stretch and Wrap Style Tourniquet Effectiveness With Minimal Training
• Wound Packing Essentials for EMTs and Paramedics
• TECC Guidelines for Active Bystanders
• This Might Shock You: Downed Power Line