First Aid and Combat Lifesaver Skills
First Aid and Combat Lifesaver Skills tests immediate trauma care under fire and in tactical field care: controlling massive bleeding, opening the airway, treating chest and breathing problems, preventing shock and hypothermia, and documenting care.
Core rules
- In care under fire, return fire, take cover, and move the casualty to safety before detailed treatment when the situation demands. Control life-threatening bleeding first.
- Use MARCH as a treatment priority guide: Massive hemorrhage, Airway, Respiration, Circulation, Head injury and hypothermia.
- Apply a tourniquet high and tight on a limb for severe bleeding that pressure cannot control; tighten until bleeding stops, and record the time. Do not loosen or remove it in the field unless directed by medical authority.
- Pack junctional wounds, apply pressure dressings, and seal open chest wounds as trained. Treat tension pneumothorax only with authorized training and equipment.
- Keep the casualty warm, monitor breathing and responsiveness, and pass a clear report, including tourniquet time and treatment given.
Worked example
A casualty has bright red blood spurting from a thigh. You take cover, expose the wound, apply a tourniquet high and tight above the injury, tighten until the spurting stops, and mark the time. Reasoning: spurting arterial bleeding can kill within minutes, so massive hemorrhage outranks airway checks in a casualty who is still breathing.
Traps that cost marks
Checking the airway before controlling obvious massive bleeding; applying a tourniquet loosely and leaving it as a pressure dressing; covering a tourniquet with clothing so it cannot be monitored; forgetting to record the time; and removing a tourniquet because the casualty complains of pain. Also do not delay movement under fire to perform nonurgent care.