Flashcards in Casualty Evaluation and Evacuation Deck (32):
The objectives for casualty care are the
Treatment of the casualty.
Prevention of additional casualties.
Completion of the mission.
All involved casualties must be assessed initially, stopping only to treat
The pulseless, non-breathing casualty.
The casualty with massive bleeding.
Those in coma or shock.
The Marine providing assistance needs to begin assessing the scene and asking himself/herself the following questions
1. Is the scene safe?
2. How many casualties do I have?
3. Do I have any help?
4. Determine consciousness.
5. Call for help.
6. Position the casualty.
7. Open the airway.
8. Check for signs of breathing.
9. If no breathing, immediately give two rescue breaths.
10. Check for signs of circulation
11. What is the mechanism of injury (MOI)?
12. What caused the injuries?
13. How bad are the injuries?
14. Does the casualty have a C-spine injury?
The four basic lifesaving steps are
1: (A) Open the airway.
2: (B) Check for breathing.
3: (C) Check for signs of circulation.
4: Treat for shock.
Goals of a secondary assessment are to:
Prepare the casualty or casualties for transport to the next level of care.
Reassess all life threatening injuries and treatments.
Manage problems associated with the airway and breathing.
Ensure pressure dressings, bandages, splinting, or tourniquets are secure enough to withstand rough, rugged transport
Consider the following in your secondary assessment:
Level of consciousness:
Airway: Is the airway still open?
Breathing: Reassess the chest, insuring rise and fall during respirations
Reassess previous treatments:
Head to Toe Assessment (DCAP-BTLS) is
Use the acronym DCAP-BTLS to guide the exam of the head, neck, chest, abdomen, pelvis, extremities and posterior body surface.
DCAP-BTLS stands for:
The usual pulse rate in adults is
60 to 100 beats per minute; in children, 80 to 100 beats per minute.
Usually respiration is between 12 and how many breaths per minute
20 breaths per minute
Deep, gasping, labored breathing may indicate
partial airway obstruction or pulmonary disease.
Normal body temperature is
98.6 degrees Fahrenheit (37.0 degrees Centigrade). The skin is largely responsible for regulating this temperature by radiation of heat from blood vessels near the skin and the evaporation of water as sweat.
In casualties with deeply pigmented skin, color changes may be apparent:
In the fingernail beds.
In the sclera (white portion of the eye).
Under the tongue.
In lightly pigmented casualties where changes may be seen more easily, colors of medical importance are
Skin color red indicates
High blood pressure.
Certain stages of carbon monoxide poisoning
White skin color indicates
insufficient circulation (there is literally not enough blood circulating in the skin) and is seen in casualties who are:
o In shock.
o Having an acute heart attack.
o In certain stages of fright.
Blue skin color indicates
A bluish color, cyanosis, results from poor oxygenation of the circulating blood. As a result, blood is very dark, and the overlying tissue appears blue. Cyanosis is caused by respiratory insufficiency due to airway obstruction or inadequate lung function. It is usually first seen in the fingertips and around the mouth
Constricted pupils are often present in
a drug addict or a casualty with a central nervous system disorder.
Dilated pupils indicate
a relaxed or unconscious state; such dilation usually occurs rapidly, within thirty seconds after cardiac arrest.
Failure of the pupils to constrict when a light shines into the eye occurs in:
AVPU stands for:
Alert and awake. If casualty is alert, determine what happened.
Responds to verbal stimuli.
Responds to painful stimuli.
Unresponsive. If the casualty is unresponsive, assessment and treatments will continue according to the casualty’s injuries.
The inability of a conscious casualty to move voluntarily is known as
Casualties with certain conditions or injuries have a priority for treatment and transportation over others. The three categories in which a casualty may be sorted into are:
Urgent injuries/problems include the following:
Airway and breathing difficulties.
Spinal or pelvic fractures.
Uncontrolled or suspected severe hidden bleeding.
Open chest or abdominal wounds.
Severe head injuries with evidence of brain damage, no matter how slight.
Several medical problems:
o Diabetes with complications.
o Cardiac disease with failure.
Priority injuries include
Burns without complications.
Major or multiple fractures.
Back injuries without spinal damage.
Heat/cold injuries—not counting heat stroke
Examples of routine injuries are
Injuries of a minor nature, i.e. sprains, small fractures, minor lacerations, etc.
Obviously mortal wounds where death appears reasonably certain.
A mass casualty event is declared when
the number and nature of casualties exceeds the skill level, resources, and personnel of those present
Casualties as a result of a chemical, biological, radiological or nuclear (CBRN) event are potentially contaminated and must be
segregated immediately as an initial step
The multitudes of factors that will affect the ability to evacuate a casualty via ground or air transportation are:
o Availability of aircraft or vehicles.
o Tactical situation.
o Status of the casualties.
Two methods of casualty reporting are:
9-line Casualty Evacuation / Medical Evacuation (CasEvac/MedEvac) Request
Casualty Report (CasRep)
9-line CasEvac/MedEvac Request
1. Grid coordinates of pick up site (8 digit grid).
2. Radio frequency/NET ID and call sign.
3. Number of casualties by precedence.
4. Special equipment requirement.
5. Number of casualties by type litter/ambulatory.
6. Security at pick up site.
7. Method of marking.
8. Patient nationality and status.
9. Additional information.