STP 21-1-SMCT - APPLY A DRESSING TO AN OPEN CHEST WOUND


081-831-1026



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CONDITIONS


Given a casualty who has an open chest wound. The casualty is breathing. The casualty's first aid packet is available.


STANDARDS


Apply a dressing to the wound, following the correct sequence without causing further injury to the casualty. Make sure that the wound is properly sealed and that the dressing is firmly secured without interfering with breathing.


TRAINING AND EVALUATION



Evaluation Preparation


Setup:
Use the same field dressing repeatedly. Prepare the field dressing outer wrapper or provide a piece of airtight material (plastic, cellophane, foil). Have another soldier act as the casualty. Use a moulage or otherwise simulate the chest wound.

Brief Soldier:
Tell the soldier to do, in order, all necessary first aid steps to treat the casualty's wound. Tell the soldier that there is no exit 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. Do not evaluate step 7 in the simulated mode.


Evaluation Guide





















Performance Measure
Results


NOTE: If there are two wounds, the same procedure should be followed for both wounds starting with the one which is most serious (heaviest bleeding, largest).




1. Uncover the wound unless clothing is stuck to the wound or a chemical environment exists.


WARNING
DO NOT ATTEMPT TO CLEAN THE WOUND.
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F

2. Apply airtight material over the wound without touching the inner surface, if possible.


    a. Use the fully opened outer wrapper of the casualty's field dressing or other airtight material.

    b. Apply the inner surface of the airtight material directly over the wound after the casualty breathes out completely.

    c. Hold the material in place.


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F

3. Apply the casualty's field dressing.


    a. Apply the dressing, white side down, directly over the airtight material.

    b. Have the casualty breathe normally.

    c. Maintain pressure on the dressing while wrapping the tails, in opposite directions, around the body and back to the starting point.

    d. Tie the tails into a nonslip knot over the center of the dressing after the casualty has breathed out completely.

    e. Check to make sure that the dressing tails are tied firmly enough to secure the dressing without interfering with breathing.


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F

4. Apply direct manual pressure over the dressing for 5 to 10 minutes, when practical.

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F

5. Position the casualty on the injured side or in a sitting position, whichever makes breathing easier.


WARNING
IF THE CASUALTY'S CONDITION (DIFFICULTY IN BREATHING, SHORTNESS OF BREATH, RESTLESSNESS, OR GRAYNESS/BLUENESS OF SKIN) WORSENS AFTER PLACING THE DRESSING, QUICKLY LIFT OR REMOVE AND THEN REPLACE THE AIRTIGHT DRESSING.
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F

6. Perform steps 1 through 5 in the correct sequence.

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7. Watch the casualty closely for life-threatening conditions and check for other injuries, if necessary. (See the task Evaluate A Casualty, task number 081-831-1000.)

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F


REFERENCE



FM 4-25.11 First Aid

IS0821 SELF-AID BUDDY AID

IS0831 TREATING WOUNDS AND FRACTURES