Figure 1-1. Soldier and rescuers wounded.
e. Medical personnel are limited and, if they are injured, no other medical
personnel will be available until the time of evacuation during the CASEVAC phase.
f. No immediate management of the airway is necessary at this time due to the
limited time available while under enemy fire and during the movement of the casualty
to cover. Airway problems typically play a minimal role in combat casualties. Wounding
data from Viet Nam indicates airway problems were present in only about one percent
of combat casualties, mostly from maxillofacial injuries.
g. The control of hemorrhage (major bleeding) is important since injury to a
major vessel can result in hypovolemic shock in a short time frame. Extremity
hemorrhage is the leading cause of preventable combat death.
Over 2,500 deaths occurred in Viet Nam secondary to hemorrhage from
extremity wounds; these casualties had no other injuries.
h. The use of temporary tourniquets to stop the bleeding is essential in these
types of casualties. If the casualty needs to be moved, as is usually the case, a
tourniquet is the most reasonable initial choice to stop major bleeding. Ischemic
damage to the limb is rare if the tourniquet is left in place for less than one hour
(tourniquets are often left in place for several hours during surgical procedures). In
addition, the use of a temporary tourniquet may allow the injured soldier to continue to
fight. Both the casualty and the soldier medic are in grave danger while applying the
tourniquet and non-life-threatening bleeding should be ignored until the tactical field