m. Key points.
Return fire as directed or required.
The casualty should also return fire if able.
Direct the casualty to cover and apply self-aid, if able.
Try to keep the casualty from sustaining any additional wounds.
Airway management is generally best deferred until the tactical field care
(6) Stop any life-threatening hemorrhage with a tourniquet or a HemConTM
Bandage, if applicable.
TACTICAL FIELD CARE
The "tactical field care" phase is distinguished from the "care under fire" phase by
having more time available to provide care and a reduced level of hazard from hostile
a. The time available to render care may be quite variable. In some cases,
tactical field care may consist of rapid treatment of wounds with the expectation of a re-
engagement of hostile fire at any moment. In some circumstances, there may be ample
time to render whatever care is available in the field. The time to evacuation may be
quite variable from minutes to several hours.
b. If a victim of a blast or penetrating injury is found without a pulse, respirations,
or other signs of life, do not attempt cardiopulmonary resuscitation (CPR). Attempts to
resuscitate trauma casualties in arrest have found to be futile even in the urban setting
where the victim is in close proximity to a trauma center. On the battlefield, the cost of
attempting CPR on casualties with what are inevitably fatal injuries will be measured in
additional lives lost as care is withheld from casualties with less severe injuries and as
soldier medics are exposed to additional hazard from hostile fire because of their
attempts. Only in the case of non-traumatic disorders, such as hypothermia, near
drowning, or electrocution, should CPR be considered. Casualties with an altered level
of consciousness should be disarmed immediately. Remove both weapons and
grenades. This provides a safety measure for the care providers. When the casualty
becomes more awake and alert he could mistake the good guys for the enemy he was
c. Initial assessment consists of airway, breathing, and circulation.