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081-831-1026 (SL1) - Perform First Aid for an Open Chest Wound

Standards: Applied a dressing to the wound following the correct sequence, without causing further injury to the casualty. The wound was properly sealed and the dressing was firmly secured without interfering with breathing.

Conditions: You see a casualty who has an open chest wound.  The casualty is breathing.  Necessary equipment and materials:  casualty's first aid packet and material to improvise a dressing (clothing or blankets).

Standards: Applied a dressing to the wound following the correct sequence, without causing further injury to the casualty.  The wound was properly sealed and the dressing was firmly secured without interfering with breathing.

 

Performance Steps

Note.  If there are two wounds, the same procedure should be followed for both.  Start with the one that is more serious; (the one that has the heavier bleeding or is larger).

1.   Uncover the wound unless clothing is stuck to the wound or in a chemical environment.

CAUTION

Uncovering the wound in a chemical environement or removing stuck clothing could cause additional harm

WARNING

Do not attempt to clean the wound

2.   Apply airtight material over the wound.

a. Use the fully opened outer wrapper of the casualty's field dressing or other airtight material.

b. Apply the inner surface of the airtight material directly over the wound after the casualty exhales completely.

Note.  When applying the airtight material try not to touch the inner surface.

c. Hold the material in place.

3.   Apply the casualty's field dressing.

a. Apply the dressing, white side down, directly over the airtight material.

b. Have the casualty breathe normally.

c. Maintain pressure on the dressing while you wrap the tails around the body back to the starting point.

d. Tie the tails into a nonslip knot over the center of the dressing after the casualty has exhaled completely.

e. Check to make sure the knot is tied firmly enough to secure the dressing without interfering with breathing.

Note.  When practical, apply direct manual pressure over the dressing for 5 to 10 minutes to help control the bleeding.

4.   Position the casualty on the injured side or in a sitting position, whichever makes breathing easier.

WARNING

 If the casualty's condition (difficulty in breathing, shortness of breath, restlessness, or blueness of skin) worsens after placing the dressing, quickly lift or remove and then replace the airtight dressing

Note.  Watch the casualty for life-threatening conditions, check for other injuries, and seek medical aid

Evaluation Preparation: 

Setup:  Use the same field dressing repeatedly.  Prepare the field dressing outer wrapper or provide a piece of airtight material (plastic, cellophane, foil).  Have another soldier act as the casualty.  Use a moulage or otherwise simulate the chest wound.

Brief Soldier:  Tell the soldier to do, in order, all necessary first aid steps to treat the casualty's wound.  When testing step 1, you can vary the test by telling the soldier that clothing is stuck to the wound or that a chemical environment exists.

Performance Measures

GO

NO GO

1.   Uncovered the wound unless clothing is stuck to the wound or a chemical environment exists.

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2.   Applied airtight material over the wound without touching the inner surface.

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a. Used the fully opened outer wrapper of the casualty's field dressing or other airtight material.

 

 

b. Applied the inner surface of the airtight material directly over the wound after the casualty exhaled completely.

 

 

c. Held the material in place.

 

 

3.   Applied the casualty's field dressing.

--

--

a. Applied the dressing, white side down, directly over the airtight material.

 

 

b. Had the casualty breathe normally.

 

 

c. Maintained pressure on the dressing while wrapping the tails around the body back to the starting point.

 

 

d. Tied the tails into a nonslip knot over the center of the dressing, after the casualty exhaled completely.

 

 

e. Checked to make sure the knot is tied firmly enough to secure the dressing without interfering with breathing.

 

 

4.   When practical, applied direct manual pressure over the dressing for 5 to 10 minutes to help control the bleeding.

--

--

5.   Positioned the casualty on the injured side or in a sitting position, whichever made breathing easier.

--

--

6.   Performed steps 1 through 5 in the correct sequence.

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Evaluation Guidance:  Score the soldier GO if all performance measures are passed.  Score the soldier NO GO if any performance measure is failed.  If the soldier scores NO GO, show what was done wrong and how to do it correctly.

 

References

 

Required

Related

 

 

FM 4-25.11