2-31. CONTINUE YOUR SURVEY AND TREATMENT
Continue your survey and treatment procedures, including treatment for
hypovolemic shock. Document treatment on a U.S. Field Medical Card and evacuate
the casualty as soon as possible. If the amputate was complete, evacuate the
amputated limb with the casualty. There is a possibility that the limb can be
Make sure the severed body part is kept out of the casualty's sight both
before and during evacuation.
Section V. TREATING INTERNAL BLEEDING IN AN EXTREMITY
2-32. IDENTIFY INTERNAL BLEEDING IN AN EXTREMITY
When an artery or vein in an extremity is damaged by a blow or a fractured
bone and there is no open wound that will allow the blood to escape, the blood from
the damaged blood vessel is trapped in the surrounding tissues. Since the marrow in
the center of bones like the femur produces blood cells, a fracture can result in
significant internal bleeding even if no major blood vessels are damaged.
a. Internal bleeding into the tissues of the arm or leg can result in hypovolemic
shock due to blood loss. Signs and symptoms of hypovolemic shock are given in
b. Other signs of internal bleeding in an extremity include discolored tissue
(bruises) and swelling of the injured limb. Swelling can be identified by comparing the
circumference of the injured limb to the circumference of the same area on the
2-33. TREAT INTERNAL BLEEDING IN AN EXTREMITY
Internal bleeding in a limb can be controlled somewhat by applying pressure
and a splint to the limb. Initiate an intravenous infusion if signs and symptoms of
shock are present and evacuate the casualty. If possible, administer oxygen (high
percentage) to the casualty during evacuation.
a. Pressure. Apply pressure to the injured limb (paragraphs 2-34 and 2-35).
The pressure should decrease internal bleeding, but should not stop
blood circulation. Check circulation in the limb after applying the
b. Immobilization. Keep the casualty as still as possible. Immobilize (splint)
the limb even if it does not appear to be fractured. A splint will apply pressure and
help protect the limb from further injury.