Individual First Aid Kit (IFAK) Training

Individual First Aid Kit (IFAK) Training

Individual First Aid Kit (IFAK) Product Description The IFAK is issued to every Soldier. Weighing one pound, the IFAK consists of the following six (6) expendable medical items packaged inside of a modified MOLLE 100 round SAW ammo pouch. NSN NOMENCLATURE UNIT PACK QTY 6515-01-521-7976 Tourniquet, Combat Application 1 6510-01-492-2275 Bandage Kit, Elastic 1 6510-01-503-2117 Bandage GA4-1/2 100 s 1 6510-00-926-8883 Adhesive Tape Surg 2 6 s 1 6515-01-180-0467 Airway, Nasopharyngeal, 28Fr, 12s 1 6515-01-519-9161 Glove, Patient Exam 100 s 4 MOLLE Pouch NSN: 6545-01-584-1582 IFAK Insert NSN: 6545-01-583-2483 Benefit Against the Threat The IFAK increases individual Soldier capabilities to provide Self-Aid/Buddy-Aid and provides interventions for two leading causes of death on the battlefield, severe hemorrhage and inadequate airway. These capabilities increase Soldier survivability during dispersed operations and the expandable pouch allows for METT-C specific add-ins. 2

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Tactical Combat Casualty Care There needs to be a shift in our thinking, the days of not providing self aid and laying there and yelling Medic are over We must have the ability to assess our own wounds, provide self or buddy aid, and continue the mission if able The bottom line is to ensure each soldier is trained and equipped at the point of wounding. To decrease the chance of a preventable battlefield death This strategy will increase the unit s combat effectiveness and survivability. If we could make some minor changes in the soldiers medical skills training, we can improve the survival rate of 20% of all battlefield deaths 4

Tactical Combat Casualty Care Primary causes of preventable death Hemorrhage (Bleeding) from extremity wounds Tension pneumothorax Airway problems 5

Number of US Military Warriors with Injuries by Body Region FOR OFFICIAL USE ONLY Data Source: Joint Theater Trauma Registry (JTTR) 2002-OCT 2008 Head & Neck Overall = 37.6% BI = 43.6% NBI = 22.1% Extremities Overall = 65.1% BI = 74.0% NBI = 49.3% Spine & Back Overall = 8.1% BI = 7.8% NBI = 8.6% Upper Extremities Overall =43.8% BI = 50.3% NBI = 32.1% Torso Overall = 26.4% BI = 33.8% NBI = 13.0% Lower Extremities Overall =40.4% BI = 50.7% NBI = 22.0% Burns: 9.3% 11.6% 5.3% All Warriors with Injuries = 16499; Warriors with Battle Injuries (BI) = 10560; Warriors with Non-Battle Injuries (NBI) = 5939 # of Warriors with Injuries: Black- Overall %; Blue BI %; White- NBI % 6

Tactical Combat Casualty Care (TC3) Objectives Treat the casualty Prevent additional casualties Complete the mission 7

Tactical Combat Casualty Care Phases of Care Care Under Fire Tactical Field Care Tactical Evacuation (TAC-EVAC) 8

CARE UNDER FIRE 9

CARE UNDER FIRE Care Under Fire - is the care rendered by the soldier at the scene of the injury while still under effective hostile fire Self aid / Buddy aid Direct Casualty to return fire and take cover Direct or expect the Casualty to remain engaged as a combatant, if appropriate Direct the casualty to apply Self-Aid Move the casualty to cover, safer location Try to keep the casualty from sustaining additional wounds STOP LIFE THREATING Hemorrhage control with a Tourniquet 10

CARE UNDER FIRE Try to keep yourself from being wounded Suppression of hostile fire may minimize the risk of injury to personnel No immediate Airway management. Airway management is best deferred to Tactical Field Care Reassure the casualty Do not attempt to salvage a casualty s rucksack, unless it contains items critical to the mission Take the patients weapon and ammunition (if possible) to prevent harm to you and potential future use by the enemy. 11

Hemorrhage Control Bleeding can usually be controlled by: Tourniquet ETD - Emergency Trauma Dressing Manual pressure, Elevation and Field Dressing 12

Tourniquet The tactical situation may limit the time you have to treat your casualty. If the tactical situation requires; place the tourniquet high on the limb over the uniform and quickly move yourself and the casualty to cover. With training this can be done quickly in a dangerous situation. 13

Hemorrhage Control In some situations, such as an amputation of an arm or leg, a tourniquet is always applied first since the other methods will not be adequate to control the bleeding. 14

Tourniquet DO NOT REMOVE A TOURNIQUET The need for immediate access to a tourniquet in such situations, makes it clear that all soldiers on combat missions should have a suitable tourniquet readily available. In a standard location on their battle gear and be trained to use it (Example IFAK) As the tactical situation permits and more time is available, consider loosening the tourniquet with Medical direction 15

Combat Application Tourniquet Tourniquet of choice Lightweight Easy to use Application NEVER Cover it Secure it in place with Tape T" on casualty's forehead or somewhere (Sharpie pen) 16

TACTICAL FIELD CARE Tactical Field Care is the care rendered by the combat lifesaver when no longer under effective fire It also applies to situations in which an injury has occurred on a mission, but there is no hostile fire The Tactical Field Care phase is distinguished from the Care Under Fire phase by having more time to provide care and a reduced level of hazard from hostile fire 17

AIRWAY MANAGEMENT Airway Compromise is the third leading cause of preventable battlefield deaths Airway management is delayed until you are no longer under effective hostile fire AIRWAY MANAGEMENT IN CARE UNDER FIRE SITUATIONS IS A NO GO!!!! 18

Open the Casualty s Airway The tongue is the most common cause of an airway obstruction When a casualty is unconscious, muscles relax. This relaxation may cause the tongue to slip to the back of the mouth and block the airway 19

Airway Management: Conscious Patient If the casualty is talking or yelling he has an open airway No attempt at airway intervention if the patient is conscious and breathing normal on his own 20

Airway Adjunct Naso-pharyngeal Airway (NPA) Identify when to use Determine the size Insertion of the airway Monitor the casualty 21

Nasopharyngeal Airway When to use: Conscious, Semi-Conscious, Unconscious Respiration rate is not normal less than two in 15 seconds greater than six in 15 seconds Snoring and gurgling sounds Airway of choice in tactical environment 22

Nasopharyngeal Airway Do not use the NPA - if there is significant facial trauma Do not use the NPA -if the roof of the casualty s mouth is fractured 23

How to size: Nasopharyngeal Airway Tip of the Nose to the earlobe 24

Nasopharyngeal Airway 25

Nasopharyngeal Airway 26

Nasopharyngeal Airway 27

Nasopharyngeal Airway DO NOT continue if resistance is met Stop, remove adjunct, re-lubricate and try other nostril If resistance is still met, check proper size If unable to insert NPA, Remove and continue Rescue Breathing and seek immediate medical attention NPA Removal, pull out with steady motion along curvature of nasal cavity 28

Open Chest Wound When an object penetrates the chest wall, the injury is called an open chest wound. The penetration can be caused by a bullet, knife blade, shrapnel, or other object. Anytime there is an open chest wound, there is danger of the lung collapsing. 29

Signs and Symptoms of an Open Chest Wound Sucking or hissing sounds coming from chest wound. (When a casualty with an open chest wound breathes, air goes in and out of the wound, creating a "sucking" sound. Because of this distinct sound, an open chest wound is often called a "sucking chest wound.") 30

Sucking Chest Wound 31

Signs and Symptoms of an Open Chest Wound In order for a wound to become a sucking chest wound it must be at lease 2/3rd the diameter of the trachea. So unless it is relatively large it may not be a sucking chest wound. Casualty coughing up blood. Frothy blood coming from the chest wound. (The air going in and out of an open chest wound causes bubbles in the blood coming from the wound.) 32

Signs and Symptoms of an Open Chest Wound If you are not sure if the wound has penetrated the chest wall completely, treat the wound as though it were an open chest wound. 33

Expose the Wound Expose the wound by removing, cutting, or tearing the clothing covering the wound Use scissors from aid bag, a knife, or a bayonet Do not remove clothing stuck to the wound Do not clean the wound or remove objects stuck in the wound 34

Preparing Sealing Material Since air can pass through most dressings and bandages, you must place airtight material over the chest wound before you dress and bandage the wound. Plastic from a field dressing or other bandage pack is one source of airtight material. Specific chest seals like the Asherman, Hyfin, or Bolin chest seal may be used 35

Seal an Open Chest Wound Using an Improvised Seal Expose the wound Tell casualty to exhale and hold his breath Place the occlusive material or chest seal directly over the hole in the chest to seal the wound Tape it on all four sides as needed 36

Seal an Open Chest Wound Using an Improvised Seal Check the sealing material to ensure that it extends at least two inches beyond the wound edges in all directions. Tell the casualty to resume normal breathing. Dress and bandage the wound to protect the airtight material from damage and protect the wound 37

Improvised Seal 38

Positioning a Casualty Place casualty in a recovery position with injured side to the ground, or sitting up to make breathing easier. 39

Emergency Trauma Dressing (ETD) Field/pressure dressing to stop mild to severe bleeding May be used on any part of the body Not recommended for use as a tourniquet for severe arterial bleeding, although the same procedure can be used to increase pressure on the wound 40

Emergency Trauma Dressing (ETD) Also called Israeli bandage / Israeli pressure dressing Used on any bleeding wound Replaces the field first aid dressing Applies continuous pressure to wound Use the casualty's emergency bandage first in order to conserve your supply. 41

Emergency Trauma Dressing (ETD) 42

Functions of TAC-EVAC Transporting a Casualty Carries / Litters (Tallon II / Sked / Improvised) Casualty Documentation (TC3 Card DA Form 7656) Medevac Request (9 Line Radio format) Movement of Casualties (Vehicle and Air Assets) 43

Medical Evacuation Transportation of casualties from the battlefield are accomplished by an evacuation of the injured personnel (Def Joint Pub 4-02) Movement of casualties by medical ground/air ambulances to a medical treatment facility The term MEDEVAC is used when military medical vehicles are used for transport. Medical personnel aboard The term CASEVAC is used when non-medical vehicles are used to evacuate casualties 44

Evacuation Being able to evacuate a casualty in a quick and efficient manner can result in saving his life You may need to move the casualty to a company aid post or other location where the casualty can receive needed medical care Sometimes, the casualty can walk, but at other times he must be carried on a litter 45

Talon II Litter Washable Mesh Material Carrying case Stable evacuation platform 46

Sked Litter Compact Lightweight Strong 47

Improvised Litters Litters can be improvised from materials at hand Must be well-constructed Off the Shelf products Ex. Poleless litter 48

Tactical Combat Casualty Card TC 3 Card - DA Form 7656 49

MEDEVAC Request Special 9-line format Rather than stating type of information, a line number is given Brevity codes used Transmitted in line order sequence 50

9 LINE MEDEVAC LINE 1 (8) Digit Grid: LINE 2 LINE 3 Your Call sign / Frequency: Category of Patient: A: urgent B: urgent-surgical C: priority D: routine E: convenience LINE 4 Special Equipment: A none B hoist C extraction equipment LINE 5 Patient By type: L-litter A-ambulatory Security of Pickup Site: N none P possible enemy E- enemy troops (proceed with caution) X enemy troops (armed escort required) LINE 6 LINE 7 Method of Marking Pick up Site: A: panels B: pyrotechnic signal C: smoke signal D: none E: other LINE 8 Patient Nationality and Status: A. US MILITARY B. US CILIVIAN C. NON US MILITARY D. NON US CIVILIAN E. EPW DUSTOFF LINE 9 NBC Contamination: N nuclear; B biological; C chemical 51

Lines 1 through 5 Must be transmitted before the evacuation mission begins Remaining lines should be transmitted at the same time (if possible), but can be transmitted to the ground or air transport en route 52

Ground Ambulance Type M997 armored ambulance Four litter casualties M996 armored ambulance Two litter casualties 53

Heavy Armored Ground Ambulance (HAGA) 54

Ground Ambulance Type M-1133 or M.E.V. (Medical Evacuation Vehicle) Four litter casualties Six ambulatory casualties Top speed is 60 miles per hour. 55

Air Evac Unit - Blackhawk 56

Questions 57