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081-831-1033 (SL1) - Perform First Aid for an Open Head Wound

Standards: Applied a dressing to the wound following the correct sequence without causing further injury to the casualty. The casualty was properly positioned and the dressing was secured without applying unnecessary pressure.

Conditions: You see a casualty who has an open head wound.  The casualty is breathing.  Necessary equipment and materials:  casualty's first aid packet and a canteen of water.

Standards: Applied a dressing to the wound following the correct sequence without causing further injury to the casualty.  The casualty was properly positioned and the dressing was secured without applying unnecessary pressure.

Performance Steps

1.   Check the casualty's level of consciousness.

a. Question the casualty.

(1)  "What is your name?"

(2)  "Where are you?"

(3)  "What is today's date (day, month, year)?"

b. Report incorrect answers, inability to answer, or changes in answers to medical personnel.

2.   Position the casualty.

WARNING

Do not move the casualty if he exhibits signs and/or symptoms, other than minor bleeding, of a neck, spine, or severe head injury

a. The casualty is conscious or has a minor scalp wound.

(1)  Have the casualty sit up unless other injuries prohibit sitting up.

(2)  Raise the head slightly if the casualty is lying down and is not accumulating fluids in his throat.

(3)  Turn his head to the side or position the casualty on his side (opposite the wound) if the wound is bleeding into the mouth or throat.

b. The casualty is unconscious or has a severe head injury.

(1)  Treat the casualty as having a potential neck or spinal injury.  Immobilize and do not move the casualty unless absolutely necessary.

(2)  Turn the casualty, if he is choking and/or vomiting or bleeding into the mouth.  Position the casualty on his side opposite the wound.

WARNING

If it is necessary to turn a casualty with a suspected neck or spinal injury, assistance will be required.  Roll the casualty gently onto his side keeping the head, neck, and body aligned while providing support for the head and neck

3.   Expose the wound by removing the casualty's helmet if necessary.

WARNING

In a chemical environment removing the mask or other protective clothing could be hazardous to the casualty

Note.  In a chemical environment-

-   If the casualty's mask and hood are not breached, do not apply a dressing.  If the all clear has not been given, do not remove the casualty's mask to treat the wound.

-   If the casualty's mask or hood has been breached, and the all clear has not been given, attempt to repair the breach with tape or wet cloth stuffing.  Do not apply a dressing.

-   If the casualty's mask or hood has been breached and the all clear has been given, remove the mask to apply a dressing.

4.   Apply the casualty's field dressing to the wound.

WARNING

To prevent further injury to the casualty-

             Do not try to clean the wound. 

             Do not put unnecessary pressure on the wound. 

             Do not try to push brain matter back into the head. 

             Do not give the casualty any food or drink. 

             Do not move the casualty if a broken neck or broken back is suspected

a. Forehead or back of the head.

(1)  Apply the dressing, white side down, directly over the wound with the tails extending toward the sides of the head.

(2)  Wrap the tails, one at a time, around the head in opposite directions making sure the tails cover the dressing but not the eyes and ears.

(3)  Tie the tails at the side of the head using a nonslip knot.

b. Top of the head.

(1)  Apply the dressing, white side down, directly over the wound.

(2)  Wrap one tail down under the chin and bring it up in front of the ear over the dressing to a point just above, and in front of, the opposite ear.

(3)  Wrap the other tail down under the chin in the opposite direction and up the side of the head to meet the first tail.

(4)  Cross the tails.

(5)  Wrap one tail across the forehead above the eyebrows to a point just above and in front of the opposite ear.

(6)  Wrap the other tail above the ear, low over the back of the head, and above the opposite ear to meet the other tail.

(7)  Tie the tails using a nonslip knot.

c. Side of the head or cheek.

(1)  Apply the dressing, white side down, directly over the wound with the tails extending up and down.

(2)  Wrap the top tail over the top of the head, down in front of the ear, under the chin, and up over the dressing to a point just above the ear.

(3)  Wrap the other tail in the opposite direction to meet the first tail.

(4)  Cross the tails and complete the procedure as follows:

(a)   Wrap one tail across the forehead above the eyebrows to a point just above, and in front of, the opposite ear.

(b)   Wrap the other tail above the ear, low over the back of the head, and above the opposite ear to meet the other tail.

(c)   Tie the tails using a nonslip knot.

5.   Monitor the casualty.

a. Check the casualty's level of consciousness every 15 minutes.

b. Awaken the casualty every 15 minutes if he falls asleep.

c. Note any changes from earlier checks.

6.   Watch the casualty for life-threatening conditions and check for other injuries, if necessary.

Evaluation Preparation: 

Setup:  Use the same field dressing repeatedly.  Have another soldier act as the casualty.  Use a moulage or otherwise simulate a wound to the forehead, back of the head, side of the head, cheek, or top of the head.  Brief the casualty on how to answer the soldier's questions during step 1.  You can have a canteen of water available and have the casualty say that he is thirsty to see if the soldier knows what to do.

Brief Soldier:  Tell the soldier to do, in order, all necessary first aid steps to treat the casualty's wound.  Tell the soldier that it is not in a chemical environment.  After the soldier completes step 4, ask him how often the casualty's level of consciousness should be checked and what should be done if the casualty falls asleep.  Score step 5 based on the soldier's responses.

Performance Measures

GO

NO GO

1.   Checked the casualty's level of consciousness.

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2.   Positioned the casualty.

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3.   Exposed the wound.

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4.   Applied the casualty's field dressing.

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5.   Monitored the casualty.

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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