This is blood and guts of first response, the most important thing you will do is to SURVEY THE SITUATION. Whenever an accident or emergency occurs and you are the first person to arrive at the scene, there is one important technique to follow first : CHECK CALL CARE. Withnin the principles of CHECK CALL CARE , there are two more principle you must follow : SURVEY THE SCENE and CONDUCT A PRIMARY SURVEY. SURVEY THE SCENE ►you must first survey the scene to ensure your safety, you must determine if the scene is safe. If anything is dangerous is present such as live wire, a vicious animal, deep water, or fire you should not endanger your own life to endanger your own life to try to help the victim PRIMARY SURVEY ► you will check if the victim is conscious, has an open, unobstructed airway, is breathing, has a heartbeat, and is he/she not bleeding severely.   RESCUE DRAG AND CARRY TECHNIQUE the victim is too large, or further immobilization of the lower  extremities   is  necessary,  the  long  spineboardmay   be   slid   at   a   right   angle   behind   the   shortspineboard, and the victim maneuvered onto his sideand secured to the longboard.The   possible   uses   of   the   spineboard   in   anemergency   situation   are   limited   only   by   theimagination of the rescuers.Emergency Rescue Lines As  previously  mentioned,  the  steel-wire  lifelinecan  often  be  used  to  haul  a  person  to  safety. Anemergency  rescue  line  can  also  be  made  from  anystrong fiber line.  Both should be used only in extremeemergencies, when an injured person must be movedand no other means is available.  Figure 3–34 shows anemergency  rescue  line  that  could  be  used  to  hoist  aperson from a void or small compartment.  Notice that a  running  bowline  is  passed  around  the  body,  justbelow the hips, and a half hitch is placed just under thearms. Notice  also  that  a  guideline  is  tied  to  thecasualty’s ankles to prevent banging against bulkheadsand hatchways. Rescue Drag and Carry TechniquesThere will be times when you, as a Corpsman, willbe required to evacuate a sick or injured person from anemergency  scene  to  a  location  of  safety.     Casualtiescarried   by   manual   means   must   be   carefully   andcorrectly handled, otherwise their injuries may becomemore  serious  or  possibly  fatal.    Situation  permitting, evacuation   or   transport   of   a   casualty   should   beorganized  and   unhurried.  Each  movement  should  beperformed as deliberately and gently as possible.Manual  carries  are  tiring  for  the  bearer(s)  andinvolve   the   risk   of   increasing   the   severity   of   thecasualty’s injury.  In some instances, however, they areessential to save the casualty’s life.    Although manualcarries  are  accomplished  by  one  or  two  bearers,  thetwo-man  carries  are  used  whenever  possible.    Theyprovide more comfort to the casualty, are less likely toaggravate his injuries, and are also less tiring for thebearers, thus enabling them to carry him farther.   Thedistance  a  casualty  can  be  carried  depends  on  manyfactors, such as·   strength and endurance of the bearer(s), ·   weight of the casualty, ·   nature of the casualty’s injury, and ·   obstacles encountered during transport. You should choose the evacuation technique thatwill be the least harmful, both to you and the victim.When  necessary  and  appropriate,  use  a   one-rescuertechnique   (several   of   which   are   described   in   the following  section).    Two-rescuer  techniques  and  the circumstances   under   which   those   techniques   areappropriate are also listed below. ONE-RESCUER TECHNIQUES.—If  a  victim can stand or walk, assist him to a safe place. If there areno indications of injury to the spine or an extremity butthe  casualty  is  not  ambulatory,  he  can  be  carried  bymeans of any of the following:·  Fireman’s  Carry:  One  of  the  easiest  ways  to carry   an   unconscious   person   is   by   means   of   thefireman’s  carry.     Figure  3–35  shows  the  steps  of  thisprocedure.·  Pack-strap  Carry:   With  the  pack-strap  carry, shown   Itis  possible  to  carry  a  heavyperson for some distance. Use the following procedure:1.   Place the casualty in a supine position.2.   Lie   down   on    your   side   along   the   casualty’s uninjured  or  less  injured  side.     Your  shouldershould be next to the casualty’s armpit.3.   Pull   the    casualty’s   far   leg   over   your   own,holding it there if necessary.   4.   Grasp  the  casualty’s  far  arm  at  the  wrist  andbring it over your upper shoulder as you roll andpull the casualty onto your back.5.    Raise up your knees, holding your free arm forbalance and support.    Hold both the casualty’swrists close against your chest with your otherhand. 6.   Lean forward as you rise to your feet, and keepboth   of   your   shoulders   under   the   casualty’sarmpits.Do not attempt to carry a seriously injured personby  means  of  the  pack-strap  carry,  especially  if  thearms, spine, neck, or ribs are fractured. ·  Arm Carry: The technique for a one-person arm However, you shouldnever try to carry a person who is seriously injured withthis method.  Unless considerably smaller than you are,you will not be able to carry the casualty very far usingthis technique.·   -Blanket  Drag:   The   blanket   drag,   shown   in can be used to move a person who, due tothe severity of the injury, should not be lifted or carriedby one person alone.   Place the casualty in the supineposition on a blanket and pull the blanket along the flooror deck.   Always pull the casualty head first, with thehead and shoulders slightly raised so that the head willnot bump against the deck. A variant of the blanket drag is the  clothes drag,where the rescuer drags the victim by the clothing onthe victim’s upper body.·  Tied-hands   Crawl:    The   tied-hands   crawl shown   in   figure   3–39,   may   be   used   to   drag   anunconscious   person   for   a   short   distance. It   isparticularly useful when you must crawl underneath alow structure, but it is the least desirable because thevictim’s head is not supported.To be carried by this method, the casualty must bein the supine position.   Cross the wrists and tie themtogether.   Kneel astride the casualty and lift the armsover your head so that the wrists are at the back of yourneck.   When you crawl forward, raise your shouldershigh enough so that the casualty’s head will not bumpagainst the deck. TWO-RESCUER   TECHNIQUES.—If   the casualty  is  ambulatory,  you  and  your  partner  shouldassist him to safety.  However, if the victim has either aspinal   injury   or   a   fractured   extremity,   there   are   anumber of two-rescuer techniques that can be used tomove him to safety. ·  Chair Carry: The chair carry can often be used to move a sick or injured person away from a position ofdanger.   The casualty is seated on a chair, as shown infigure 3–40, and the chair is carried by two rescuers.This is a particularly good method to use when you mustcarry  a  person  up  or  down  stairs  or  through  narrow,winding passageways.This carry must NEVER beused  to  move  a  person  who  has  an  injured  neck,back, or pelvis. ·  Arm Carry: The two-person arm carry, shown in figures 3–41 and 3–42, can be used in some cases tomove an injured person.   However,  this carry shouldnot   be   used   to   carry   a   person    who   has   seriouswounds or broken bones.Another   two-person   carry    that   can   be   used   inemergencies is shown in figure 3–43.   Two rescuersposition themselves beside the casualty, on the sameside, one at the level of the chest and the other at thethighs. The rescuers interlock adjacent arms as shown,while  they  support  the  victim  at  the  shoulders  andknees.  In unison, they lift the victim and roll his fronttoward theirs.    This carry must not be used to moveseriously injured persons. TRANSPORTATION OF THEINJUREDLEARNING  OBJECTIVE:  Recognize  the different forms of emergency transportation,and   identify   essential   BLS   equipment   andsupplies on Navy ambulances.Thus far we have dealt with emergency methodsused to move an injured person out of danger and into aposition where first aid can be administered.    As we have  seen,  these  emergency  rescue  procedures  ofteninvolve substantial risk to the casualty and should beused only when clearly necessary.Once    you   have   rescued   the   casualty   from   theimmediate danger, SLOW DOWN! Casualties shouldnot be moved before the type and extent of injuries areevaluated   and   the   required   emergency   medicaltreatment is given.   (The exception to this occurs, ofcourse,   when   the   situation    dictates   immediatemovement for safety purposes.  For example, it may benecessary to remove a casualty from a burning vehicle.The  situation   dictates  that  the  urgency  of  casualtymovement   outweighs   the   need   to   administeremergency medical treatment.)From   this   point   on,    handle   and   transport   thecasualty  with  every  regard  for  the  injuries  that  havebeen sustained.   In the excitement and confusion thatalmost always accompany an accident, you are likelyto feel rushed, wanting to do everything rapidly.   To acertain extent, this is a reasonable feeling.     Speed isessential in treating many injuries and in getting thecasualty to a medical treatment facility.  However, it isnot reasonable to let yourself feel so hurried that you become careless and transport the victim in a way thatwill aggravate the injuries.Emergency VehiclesIn  most  peacetime  emergency  situations,  someform of ambulance will be available to transport thevictim   to   a    medical   treatment   facility. Navyambulances vary in size and shape from the old “grayghost”  to  modern  van  and  modular  units.   Althoughthere  are  many  differences  in  design  and  storagecapacity, most Navy ambulances are equipped to meetthe same basic emergency requirements.   They containequipment  and  supplies  for  emergency  airway  care,artificial   ventilation,   suction,   oxygenation,hemorrhage  control,  fracture  immobilization,  shockcontrol,  blood  pressure  monitoring,  and   poisoning.They will also contain litters, spineboards, and othersupplies and equipment as mandated in BUMEDINST6700.42.  (Table 3–1, at the beginning of this chapter,lists the currently required equipment for EMT-Basiclevel ambulances, and table 3–2 lists the contents of an emergency bag that a Hospital Corpsman might find inthat ambulance.) Deployed units at sea and in the field and certaincommands  near  air   stations  will  also  have  access  tohelicopter MEDEVAC support.    Helicopters are idealfor use in isolated areas but are of limited practical useat  night,  in  adverse  weather,  under  certain  tacticalconditions, or in developed areas where building andpower  lines  interfere. In  addition  to  taking  thesefactors into consideration, the Corpsman must decideif the victim’s condition is serious enough to justify acall for a helicopter. Some injuries require very smooth transportationor are affected by pressure changes that occur in flight.The   final   decision   will   be   made   by   the    unitcommander,  who  is  responsible  for  requesting  thehelicopter support. Preparing the Patient for TransportLEARNING    OBJECTIVE:R e c a l l p re p a r a t o r y,    e n    ro u t e ,    a n d    t u r n o v e rprocedures for patients being transported tomedical treatment facilities.Once emergency medical care has been completedon-scene, the patient must be transferred to the medicaltreatment  facility.     A  process  known  as   packaging provides the means of properly positioning, covering,and  securing  the   patient  to  avoid  any  unnecessaryaggravation to the patient’s condition. (Covering helpsmaintain   the   patient’s   body   temperature,   prevent sexposure to the elements, and provides privacy.)   Donot “package” a badly traumatized patient; it is moreimportant to transport the critical or unstable patient tothe   medical   treatment   facility   quickly. The   mostimportant    aspect   of   each   rescue   or   transfer   is   tocomplete it as safely and efficiently as possible.Care of Patient en RouteThe emergency care a Corpsman can offer patientsen route is limited only by the availability of supplies,the  level  of  external  noise  and  vibrations,  and  thedegree and ingenuity the Corpsman possesses. Care at the Medical TreatmentFacilityDo  not  turn  the  victim  over  to   anyone  withoutgiving a complete account of the situation, especially ifa tourniquet was used or medications administered.  Ifpossible, while en route, write down the circumstancesof the accident, the treatment given, and keep a log ofvital   signs. After   turning   the   patient   over   to    themedical   treatment   facility,   ensure   that   depletedambulance supplies are replaced so that the vehicle isin every way ready to handle another emergency.SUMMARYThis   chapter   covered   first   aid   equipment    andsupplies, and rescue and transportation of the injuredpatient. You   should  now  be  able  to  recognize  thevarious types of dressings and bandages, as well as howand when to apply them.   You should be familiar withprotective equipment, rescue operations, the stages ofextrication,  and  the  precautionary  steps  that  must  betaken  in  special  rescue   situations.    Additionally,  youshould be acquainted with the different patient-movingdevices and lifting techniques.   Further, you should beable to identify essential basic life support equipmentand supplies on Navy ambulances, and you should beable   to   recognize   different   forms    of   emergencytransportation. Finally, you should now be able to recall preparatory,   en   route,   and   turnover   procedures   forpatients   being   transported   to   medical   treatmentfacilities