directly from the battlefield to a medical facility, which allows you to save the lives of fighters with severe injuries.
If already from the first seconds the wounded person is provided with the necessary minimum assistance that will allow him to survive until admission to a medical institution, then we can count on a significant reduction in losses during anti-terrorist operations in the community.
Recommendations for the use of the teaching aid “Atlas of first aid in the context of anti-terrorist operations” in the medical training of personnel of special units of the Ministry of Internal Affairs.
This training manual Atlas of First Aid in the context of anti-terrorist operations is intended to teach a group of 8-12 people. In the Atlas, the questions of providing first aid in each of the six, most often situations of injuries to military personnel, leading to irreparable losses, are discussed in detail. Particular attention is paid to the problems of providing assistance in the shelling sector and in temporary shelter.
First aid in the shelling sector.
In the shortest possible time, it is only necessary to provide the minimum amount of assistance that will allow the wounded person to survive until the end of the battle or ensure vitality during transportation.
It is in this situation that the training of personnel requires a strict implementation of the algorithm of first aid skills in compliance with their own safety and the strict implementation of the time standard of up to one second. As the experience of training shows, at least 15-20 attempts to perform each manipulation are required to bring the skills of its execution to the level of professional automatism, when a fighter, without wasting time understanding the technique of performing this or that manipulation, solves the question of the most rational actions taking into account the assigned combat mission.
The Atlas pays great attention to issues of assessing the condition of a wounded person at a distance and preliminary selection of tactics of rational actions in first aid, the standards for which in the shelling sector should not exceed 20 seconds.
First aid in shelter.
In a temporary shelter, the standard of first aid for preparing the wounded for transportation to the next stage of evacuation should not exceed 4 minutes. The fulfillment of the established standard is possible only if the actions of the fighters are coordinated during the examination of the wounded, a complex of cardiopulmonary resuscitation, bandages on wounds and intravenous administration of solutions.
Practical exercises using the Atlas should be carried out in conditions as close as possible to military operations under the control of a stopwatch and certification cards. In the assessment of the credit, not only the time taken to complete the task, but also the amount of the penalty minutes accrued for the errors made, according to the technological certification cards, is taken into account.
To successfully pass the certification test by a group of 8-12 people, divided into teams of 4 fighters, at least 16 training hours are required. Each set-off successfully passed in this way allows counting on the preservation of the life of another commando.
Analysis of typical situations that result in permanent loss due to inaction or illiteracy of personnel.
First situation. Wounded with a traumatic brain injury in a coma, lying on his back, dies from asphyxiation and aspiration within 5-6 minutes.
Actions: make a “civil turn” on the stomach through the axis of an outstretched arm to fix the cervical spine. Execution time, taking into account the assessment of the condition of the wounded: no more than 10-15 seconds. Options: lying or kneeling. Type of help: mutual assistance only.
The second situation. Soft tissue head injury with signs of heavy bleeding.
The wounded may die within a few seconds from an air embolism of the brain vessels or one hour from irreparable blood loss. Actions: swab the wound with a piece of cloth or a roll of bandage. Fix the swab with a hat, tape or bandage. Execution time: no more than 5 seconds. Options: lying or sitting. Type of help: self-help or mutual assistance.
The third situation. Excessive bleeding from limb wounds.
If bleeding from the femoral artery is not stopped within 2-3 minutes, then the wounded do not survive in 100% of cases. Actions: squeeze the damaged vessel above the wound with a fist, followed by the application of an atraumatic hemostatic tourniquet according to all the rules for applying a tourniquet in case of arterial bleeding.
In cases of traumatic amputation of a limb fragment, squeeze the stump 3-4 cm above its end with further application of a tourniquet. In cases of traumatic separation of the limb – produce a tight tamponade of the wound. Execution time: no more than 15-20 seconds. Options: lying or sitting. Type of assistance: mutual assistance, self-help is possible.
The fourth situation. Neck gunshot wound.
Death in the first seconds occurs from an air embolism in case of injury to the jugular veins, or within a few minutes in cases of injury to the carotid artery. Actions: to make a tamponade of the wound with pressing the vessels with the thumb through the collar of clothing, followed by tamponade with a bandage and pressing the tampon with a tourniquet. Execution time: no more than 5 seconds. Options: while lying or sitting. Type of assistance: mutual assistance, self-help is possible. Solution: to train each soldier in practical skills of tamponade of a neck wound and tourniquet in case of a neck wound.
Fifth situation. Reflex cardiac arrest in cases of: shock wave, chest blow, emotional shock.
The effective use of precardial shock does not exceed 3-4 minutes. Actions: punch the middle third of the sternum. Execution time: no more than 3 seconds. Options: while lying or sitting. Type of help: mutual assistance only.
Sixth situation. Penetrating chest wound.
Death of the wounded in cases of removal from the wound of a foreign object within a few seconds. Death from complications of pneumothorax, pleurogenic shock can occur within an hour. Actions: squeeze the inlet and outlet with your hands, followed by the application of IPP or sealing dressings. Execution time: no more than 20 seconds. Options: lying or sitting. Type of assistance: mutual assistance, self-help is possible.