two rubber tubes; the main line is identified by the openings at the tip and at the wide
base on the opposite end. The second tube is connected and sealed along the side of
the main tube; the end of the tube is fixed in a manner that allows it to be inflated with
air or sterile liquid, causing the formation of an inflated balloon around the main tube.
The balloon prevents the catheter from slipping out of the urinary tract. Refer to
Subcourse MD0579, The Genitourinary System I for complete information on inserting a
Foley cather in a patient, male or female.
f. Insert a Nasogastric (NG) Tube. Insert this tube unless you suspect a
fractured cribriform plate. Confirm a cribriform plate fracture by X-ray. If there is a
cribriform plate fracture, insert an orogastric tube. See lesson 5 of this subcourse for
information on nasogastric intubation. Orogastric intubation is much like nasogastric
intubation with the exception that the tube is passed through the casualty's mouth rather
than his nose.
DO NOT have inexperienced personnel perform nasogastric intubation.
DO NOT give morphine to the casualty unless there is a long wait before
the casualty can be evacuated and a medical doctor has ordered
g. Position the Casualty. Place the casualty in a semi-Fowler's position. The
semi-Fowler's position involves raising the casualty's head 45 degrees and raising his
knees 15 degrees. Raising the casualty's knees makes him more comfortable because
this reduces strain on his abdominal and leg muscles. If the casualty is not comfortable
in the semi-Fowler position, place him in any other position. Be sure the position you
have placed the casualty in does not cause further medical complications.
h. Evacuate the Casualty. Evacuate the casualty immediately at low altitude.
General considerations for air transport of casualties with intra-abdominal (within the
abdomen) injuries include the following:
Gas in the bowel and stomach expands as the altitude increases.
(2) Vomiting can lead to fatal aspiration into the tracheo-bronchial tree.
Therefore, place a nasogastric tube in the casualty before take-off. The tube should be
left open so that drainage can occur freely.
(3) If a casualty has possible intra-abdominal hemorrhaging, the straining
and retching associated with vomiting can cause additional hemorrhaging.
The patients with abdominal injuries will usually require definite surgical
treatment. You can optimally prepare these patients for their surgical treatment.