taskchp4

Task

Apply a field dressing, elevation, manual pressure, a pressure dressing, and a tourniquet, as needed, to a wound on a casualty's limb. For bleeding that can not be stopped using a field or pressure dressing apply a tourniquet to stop bright red bleeding.

Conditions

Given a casualty who has a bleeding wound of the arm or leg. The casualty is breathing. The casualty’s first aid packet and materials to improvise a pressure dressing and to elevate the extremity are available. For bleeding that cannot be stopped using a field or pressure dressing a stick or similar object and strips of cloth are available to apply a tourniquet.

Standard

Take appropriate action to control bleeding of a wound, following the correct sequence. Apply the field dressing over the wound, ensuring that the sides of the dressing are sealed and that the dressing does not slip. Make sure that application of field and pressure dressings does not have a tourniquet-like effect.

Site Preparation

Use the same field dressing repeatedly. Have materials available for a pressure dressing (wadding and cravat or a strip of cloth). Have one soldier play the part of the casualty and another apply the field and pressure dressing. Use a moulage or mark a place on the casualty’s are or leg to simulate a wound. When bleeding can not be controlled by field or pressure dressings apply a tourniquet which stops bright red bleeding. The tourniquet stick does not unwind. Score a GO on the performance checklist. To evaluate a tourniquet you must use a mannequin or a simulated arm or leg (padded length of 2x4 inch wood with a glove or boot on one end). Under not circumstances will you evaluate it using a live simulated casualty. Place a real or simulated field dressing on the arm or leg. Place the tourniquet materials ( stick and one or two pieces of cloth) nearby.

Student Equipment

Field dressing (s) (or suitable material)

Pressure dressing material

Cravat (s) (Other materials, such as a handkerchief, sock, or strip of cloth torn from a shirt)

Rigid object (usually a stick)

Scenario

Tell the soldier to do, in order, the first aid steps required to put a field dressing and, if necessary, a pressure dressing on 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. After step 2 and step 3, tell the soldier that the bleeding has not stopped. After step 4, tell the soldier that the bleeding has stopped and ask what should have been done if bleeding had continued. Do not evaluate step 6 in the simulated mode. To simulate the tourniquet tell the soldier that field and pressure dressings have failed to stop the bleeding from the wound and that they must put on a tourniquet. For steps 19 through 27 use a mannequin or a simulated arm or leg.

Performance Measures	Results
1. Uncovers the wound unless clothing is stuck to the wound or a chemical environment exists.	Go	No-go
2. Removes the casualty’s field dressing from plastic and paper wrappers without contaminating the white side of the dressing.	Go	No-go
3. Grasps the tails of the field dressing with both hands, holds the dressing directly over the wound with the white side down, pulls the dressing open and places the dressing pad directly over the wound.	Go	No-go
4. Holds (or has casualty hold) the dressing in place and wraps one tail around the injured limb, covering one exposed edge of the dressing.	Go	No-go
5. Wraps other tail in opposite direction so the other edge of the dressing pad is covered.	Go	No-go
6. Ties the tails into a non-slip knot over outer edge of the dressing (not over the wound). Should be able to insert two fingers under the knot.	Go	No-go
7. Checks the casualty's circulation below the injury.	Go	No-go
8. Loosens and reties tails if the bandage is too tight.	Go	No-go
9. Applies direct hand pressure over the dressing or has the casualty apply pressure if he is able.	Go	No-go
10. Checks limb for fracture.	Go	No-go
11. Elevates the wound above the level of the heart if limb is not fractured.	Go	No-go
12. Applies a pressure dressing if bleeding continues.	Go	No-go
13. Folds material as necessary to form pressure dressing wad (pad).	Go	No-go
14. Places wad on top of the field dressing pad directly over the wound.	Go	No-go
15. Wraps a strip of cloth (cravat) tightly around the wad and limb.	Go	No-go
16. Ties a non-slip knot directly over the wound to secure the wad. Should be able to insert only one fingertip under pressure dressing bandage.	Go	No-go
17. Checks circulation below the injury.	Go	No-go
18. Loosens and reties the bandage if needed.	Go	No-go
19. Applies a tourniquet if bleeding continues.	Go	No-go
20. Makes a band (cravat) at least two inches wide.	Go	No-go
21. Wraps the tourniquet around the upper arm or thigh.	Go	No-go
22. Has padding (shirt sleeve, etc.) between tourniquet band and skin.	Go	No-go
23. Ties a half-knot.	Go	No-go
24. Places the rigid object (stick) on top of the half-knot.	Go	No-go
25. Ties a full knot over the rigid object.	Go	No-go
26. Twists the stick to tighten the tourniquet. [Simulate if practicing on a person.]	Go	No-go
27. Secures rigid object to prevent tourniquet from untwisting using the ends of the tourniquet band or a strip of cloth (cravat) wrapped around the limb (below the tourniquet) and ties the tails in a non-slip knot.	Go	No-go
28. Marks the casualty's forehead with a "T" and the time of application.	Go	No-go
28. OVERALL EVALUATION	Go	No-go

Score the student GO if all performance measures are go. Score the student NO GO if any performance measure is no-go. If the student scores a NO GO, show the student what was done wrong and how to do it correctly.