Most people react to misfortune or disasters (military or civilian,
threatened or actual) after the situation has passed. All people feel some
fear. This fear may be greater than they have experienced at any other
time, or they may be more aware of their fear. In such a situation, they
should not be surprised if they feel shaky, become sweaty, nauseated or
confused. These reactions are normal and are not a cause for concern.
8-5
FM 21-11
However, some reactions, either short or long term, will cause problems if
left unchecked. The following are consequences of too much stress:
a. Emotional Reactions.
(1) The most common stress reactions are simply inefficient
performances, such as:
Slow thinking (or reaction time).
Difficulty sorting out the important from all the
noise and seeing what needs to be done.
Difficulty getting started.
Indecisiveness, trouble focusing attention.
A tendency to do familiar tasks and be preoccupied
with familiar details. This can reach the point where the person is very
passive, such as just sitting or wandering about not knowing what to do.
(2) Much less common reactions to a disaster or accident
may be uncontrolled emotional outbursts, such as crying, screaming, or
laughing. Some soldiers will react in the opposite way. They will be very
withdrawn and silent and try to isolate themselves from everyone. These
soldiers should be encouraged to remain with their assigned unit.
Uncontrolled reactions may appear by themselves or in any combination
(the person may be crying uncontrollably one minute and then laughing
the next or he may lie down and babble like a child). In this state, the
person is restless and cannot keep still. He may run about, apparently
without purpose. Inside, he feels great rage or fear and his physical acts
may show this. In his anger he may indiscriminately strike out at others.
b. Loss of Adaptability.
(1) In a desperate attempt to get away from the danger
which has overwhelmed him, a person may panic and become confused.
In the midst of a mortar attack, he may suddenly lose the ability to hear
or see. His mental ability may be so impaired he cannot think clearly or
even follow simple commands. He may stand up in the midst of enemy
fire or rush into a burning building because his judgment is clouded and
he cannot understand the likely consequences of his behavior. He may
lose his ability to move (freezes) and may seem paralyzed. He may faint.
(2) In other cases, overwhelming stress may produce
symptoms which are often associated with head injuries. For example,
the person may appear dazed or be found wandering around aimlessly.
8-6
•
•
•
•
•
FM 21-11
He may appear confused and disoriented and may seem to have a
complete or partial loss of memory. In such cases, especially when no eye
witnesses can provide evidence that the person has NOT suffered a head
injury, it is necessary for medical personnel to provide rapid evaluation
for that possibility. DO NOT ALLOW THE SOLDIER TO EXPOSE
HIMSELF TO FURTHER PERSONAL DANGER UNTIL THE
CAUSE OF THE PROBLEM HAS BEEN DETERMINED.
c. Sleep Disturbance and Repetitions. A person who has been
overwhelmed by disaster or some other stress often has difficulty
sleeping. The soldier may experience nightmares related to the disaster,
such as dreaming that his wife, father, or other important person in his
life was killed in the disaster. Remember that nightmares, in themselves,
are not considered abnormal when they occur soon after a period of
intensive combat or disaster. As time passes, the nightmares usually
become less frequent and less intense. In extreme cases, a soldier, even
when awake, may think repeatedly of the disaster, feel as though it is
happening again, and act out parts of his stress over and over again. For
some persons, this repetitious reexperiencing of the stressful event may
be necessary for eventual recovery; therefore, it should not be
discouraged or viewed as abnormal. For the person reexperiencing the
event, such reaction may be disruptive and disturbing regardless of the
reassurance given him that it is perfectly normal. In such a situation, a
short cut that is often possible involves getting the person to talk
extensively, even repetitiously, about the experience or his feelings. This
should not be forced; rather, the person should be given repeated
opportunities and supportive encouragement to talk in private,
preferably to one person. This process is known as ventilation.
d. Other Factors. In studies of sudden civilian disasters, a rule
of thumb is that 70 to 80 percent of people will fall into the first category
( a above). Ten to 15 percent will show the more severe disturbances (b and
c above). Another 10 to 15 percent will work effectively and coolly. The
latter usually have had prior experience in disasters or have jobs that can
be applied effectively in the disaster situation. Military training, like the
training of police, fire, and emergency medical specialists in civilian jobs,
is designed to shift that so that 99 to 100 percent of the unit works
effectively. But sudden, unexpected horrors, combined with physical
fatigue, exhaustion, and distracting worries about the home front can
sometimes throw even well-trained individuals for a temporary loss.
e. Psychiatric Complications. Although the behaviors described
( a through c above) usually diminish with time, some do not. A person
who has not improved somewhat within a day, even though he has been
given warm food, time for sleep, and opportunity to ventilate, or who
becomes worse, deserves specialized medical/psychiatric care. Do not
wait to see if what he is experiencing will get better with time.
8-7
FM 21-11
8-12. Severe Stress or Battle Fatigue Reactions
You do not need specialized training to recognize severe stress or battle
fatigue reactions that will cause problems to the soldier, the unit, or the
mission. Reactions that are less severe, however, are more difficult to
detect. To determine whether a person needs help, you must observe him
to see whether he is doing something meaningful, performing his duties,
taking care of himself, or behaving in an unusual fashion or acting out of
character.
8-13. Application of Psychological First Aid
The emotionally disturbed soldier has built a barrier against fear. He
does this for his own protection, although he is probably not aware that
he is doing it. If he finds that he does not have to be afraid and that there
are normal, understandable things about him, he will feel safer in
dropping this barrier. Persistent efforts to make him realize that you
want to understand him will be reassuring, especially if you remain calm.
Nothing can cause an emotionally disturbed person to become even more
fearful than feeling that others are afraid of him. Try to remain calm.
Familiar things, such as a cup of coffee, the use of his name, attention to
a minor wound, being given a simple job to do, or the sight of familiar
people and activities will add to his ability to overcome his fear. He may
not respond well if you get excited, angry, or abrupt.
a. Ventilation. After the soldier becomes calmer, he is likely to
have dreams about the stressful event. He also may think about it when
he is awake or even repeat his personal reaction to the event. One benefit
of this natural pattern is that it helps him master the stress by going over
it just as one masters the initial fear of jumping from a diving board by
doing it over and over again. Eventually, it is difficult to remember how
frightening the event was initially. In giving first aid to the emotionally
disturbed soldier, you should let him follow this natural pattern.
Encourage him to talk. Be a good listener. Let him tell, in his own words,
what actually happened (or what he thinks happened). If home front
problems or worries have contributed to the stress, it will help him to talk
about them. Your patient listening will prove to him that you are
interested in him, and by describing his personal catastrophe, he can
work at mastering his fear. If he becomes overwhelmed in the telling,
suggest a cup of coffee or a break. Whatever you do, assure him that you
will listen again as soon as he is ready. Do try to help put the soldier’s
perception of what happened back into realistic perspective; but, DO
NOT argue about it. For example, if the soldier feels guilty that he
survived while his teammates were all killed, reassure him that they
would be glad he is still alive and that others in the unit need him now. If
he feels he was responsible for their deaths because of some oversight or
mistake (which may be true), a nonpunishing, nonaccusing attitude may
8-8
FM 21-11
help him realize that accidents and mistakes do happen in the confusion
of war, but that life, the unit, and the mission must go on. (These same
principles apply in civilian disaster settings as well.) With this
psychological first aid measure, most soldiers start toward recovery
quickly.
b. Activity.
(1) A person who is emotionally disturbed as the result of a
combat action or a catastrophe is basically a casualty of anxiety and fear.
He is disabled because he has become temporarily overwhelmed by
anxiety. A good way to control fear is through activity. Almost all
soldiers, for example, experience a considerable sense of anxiety and fear
while they are poised, awaiting the opening of a big offensive; but this is
normally relieved, and they actually feel better once they begin to move
into action. They take pride in effective performance and pleasure in
knowing that they are good soldiers, perhaps being completely unaware
that overcoming their initial fear was their first major accomplishment.
(2) Useful activity is very beneficial to the emotionally
disturbed soldier who is not physically incapacitated. After you help a
soldier get over his initial fear, help him to regain some self-confidence.
Make him realize his job is continuing by finding him something useful to
do. Encourage him to be active. Get him to carry litters, (but not the
severely injured), help load trucks, clean up debris, dig foxholes, or assist
with refugees. If possible, get him back to his usual duty. Seek out his
strong points and help him apply them. Avoid having him just sit
around. You may have to provide direction by telling him what to do and
where to do it. The instructions should be clear and simple; they should
be repeated; they should be reasonable and obviously possible. A person
who has panicked is likely to argue. Respect his feelings, but point out
more immediate, obtainable, and demanding needs. Channel his
excessive energy and, above all, DO NOT argue. If you cannot get him
interested in doing more profitable work, it may be necessary to enlist aid
in controlling his overactivity before it spreads to the group and results
in more panic. Prevent the spread of such infectious feelings by
restraining and segregating if necessary.
(3) Involvement in activity helps a soldier in three ways:
He forgets himself.
He has an outlet for his excessive tensions.
He proves to himself he can do something useful. It
is amazing how effective this is in helping a person overcome feelings of
fear, ineffectiveness, and uselessness.
8-9
•
•
•
FM 21-11
c. Rest. There are times, particularly in combat, when physical
exhaustion is a principal cause for emotional reactions. For the weary,
dirty soldier, adequate rest, good water to drink, warm food, and a change
of clothes, with an opportunity to bathe or shave may provide spectacular
results.
d. Group Activity. You have probably already noticed that a
person works, faces danger, and handles serious problems better if he is a
member of a closely-knit group. Each individual in such a group supports
the other members of the group. For example, you see group spirit in the
football team and in the school fraternity. Because the individuals share
the same interests, goals, and problems, they do more and better work;
furthermore, they are less worried because everyone is helping. It is this
group spirit that wins games or takes a strategic hill in battle. It is so
powerful that it is one of the most effective tools you have in your
“psychological first aid bag.” Getting the soldier back into the group and
letting him see its orderly and effective activity will reestablish his sense
of belonging and security and will go far toward making him a useful
member of the unit.
8-14. Reactions and Limitations
a. Up to this point the discussion has been primarily about the
feelings of the emotionally distressed soldier. What about your feelings
toward him? Whatever the situation, you will have emotional reactions
(conscious or unconscious) toward this soldier. Your reactions can either
help or hinder your ability to help him. When you are tired or worried,
you may very easily become impatient with the person who is unusually
slow or who exaggerates. You may even feel resentful toward him. At
times when many physically wounded lie about you, it will be especially
natural for you to resent disabilities that you cannot see. Physical
wounds can be seen and easily accepted. Emotional reactions are more
difficult to accept as injuries. On the other hand, will you tend to be
overly sympathetic? Excessive sympathy for an incapacitated person
can be as harmful as negative feelings in your relationship with him. He
needs strong help, but not your sorrow. To overwhelm him with pity will
make him feel even more inadequate. You must expect your buddy to
recover, to be able to return to duty, and to become a useful soldier. This
expectation should be displayed in your behavior and attitude as well as
in what you say. If he can see your calmness, confidence, and competence,
he will be reassured and will feel a sense of greater security.
b. You may feel guilty at encouraging this soldier to recover and
return to an extremely dangerous situation, especially if you are to stay
in a safer, more comfortable place. Remember though, that if he returns
to duty and does well, he will feel strong and whole. On the other hand, if
he is sent home as a psycho, he may have self-doubt and often disabling
symptoms the rest of his life.
8-10
FM 21-11
c. Another thing to remind yourself is that in combat someone
must fight in this soldier’s place. This temporarily battle fatigued
soldier, if he returns to his unit and comrades, will be less likely to
overload again (or be wounded or killed) than will a new replacement.
d. Above all, you must guard against becoming impatient,
intolerant, and resentful, on one hand, and overly solicitous on the other.
Remember that such emotion will rarely help the soldier and can never
increase your ability to make clear decisions.
e. As with the physically injured soldier, the medical personnel
will take over the care of the emotionally distressed soldier who needs
this specific care as soon as possible. The first aid which he has received
from you will be of great value to his recovery.
f. Remember that every soldier (even you) has a potential
emotional overload point which varies from individual to individual, from
time to time, and from situation to situation. Because a soldier has
reacted abnormally to stress in the past does not necessarily mean he will
react the same way to the next stressful situation. Remember, any
soldier, as tough as he may seem, is capable of showing signs of anxiety
and stress. No one is absolutely immune.
8-15. Tables. See Tables 8-1, 8-2, and 8-3 for more information.
8-11
FM 21-11
8-12
Table 8-1. Mild Battle Fatigue
PHYSICAL SIGNS*
1. Trembling, tearful
2. Jumpiness, nervous
3. (',-,]rl c,u,pi,t, rlry mnnt.h
4. Pounding heart,
dizziness
5. Nausea, vomiting,
diarrhea
6. Fatigue
7. "Thousand-yard stare"
EMOTIONAL SIGNS*
1. Anxiety, indecisive
2. Irritable, complaining
3. Forgetful, 11m1hlP
to concentrate
4. Insomnia, nightmares
5. Easily startled by
noises, movement
6. Grief, tearful
7. Anger, beginning to
lose confidence in self
an.d unit
8. Difficulty thinking,
speaking, and
communicating
SELF AND BUDDY AID
1. Continue mission performance, focus on immediate mission.
2. Expect soldier to perform assigned duties.
3. Remain calm at all times; be directive and in control.
4. Let soldier know his reaction is normal, and that there is nothing
seriously wrong with him.
5. Keep soldier informed of the situation, objectives, expectations,
and support. Control rumors.
6. Build soldier's confidence, talk about succeeding.
7. Keep soldier productive (when not resting) through recreational
activities, equipment maintenance.
8. Ensure soldier maintains good personal hygiene.
9. Ensure soldier eats, drinks, and sleeps as soon as possible.
10. Let soldier talk about his feelings. DO NOT "put down" his
feelings of grief or worry. Give practical advice and put emotions
into perspective.
*Most or all of these signs are present in mild battle fatigue. They can
be present in any normal soldier in combat yet he can still do his job.
FM 21-11
8-13
Table 8-2. More Serious Battle Fatigue
PHYSICAL SIGNS* EMOTIONAL SIGNS*
I. Constantly moves around I. Rapid and/or
2. Flinching or ducking at inappropriate talking
sudden sounds and 2. Argumentative, reckless
movement actions
3. Shaking, trembling 3. Inattentive to personal
(whole body or arms) hygiene
4. Cannot use part of 4. Indifferent to danger
body, no physical 5. Memory loss
reason (hand, arm, legs) 6. Severe stuttering,
5. Cannot see, hear, or mumbling, or cannot
feel (partial or speak at all
complete loss) 7. Insomnia, nightmares
6. Physical exhaustion, 8. Seeing or hearing
crying things that do not exist
7. Freezing under fire, 9. Rapid emotional shifts
or total immobility 10. Social withdrawal
8. Vacant stares, staggers, 11. Apathetic
sways when stands 12. Hysterical outbursts
9. Panic running under fire 13. Frantic or strange behavior
TREATMENT PROCEDURES**
I. If soldier's behavior endangers the mission, self or others, do
whatever necessary to control soldier.
2. If soldier is upset, calmly talk him into cooperating.
3. If concerned about soldier's reliability:
• Unload soldier's weapon.
• Take weapon if seriously concerned.
• Physically restrain soldier only when necessary for safety or
transportation.
4. Reassure everyone that the signs are probably just battle fatigue
and will quickly improve.
5. If battle fatigue signs continue:
• Get soldier to a safer place.
• DO NOT leave soldier alone, keep someone he knows with him.
• Notify senior NCO or officer.
• Have soldier examined by medical personnel.
6. Give soldier easy tasks to do when not sleeping, eating, or resting.
7. Assure soldier he will return to full duty in 24 hours; and, return
soldier to normal duties as soon as he is ready.
*These signs are present in addition to the signs of mild battle
fatigue reaction.
**Do these procedures in addition to the self and buddy aid care.
FM 21-11
8-14
Table 8-3. Preventive Measures to Combat Battle Fatigue
1. Welcome new members into your team, get to know them
qni<'kly. Tf yon HrP. nP.w, hP. HC't.ivP. in mHking friP.nds.
2. Be physically fit (strength, endurance, and agility).
3. Know and practice life-saving self and buddy aid.
4. Practice rapid relaxation techniques (FM 26-2).
5. Help each other out when things are tough at home or in the unit.
6. Keep informed; ask your leader questions, ignore rumors.
7. Work together to give everyone food, water, shelter, hygiene, and
,:mnit.Ht.ion.
8. Sleep when mission and safety permit, let everyone get time to
sleep.
• Sleep only in safe places and by SOP.
• If possible, sleep 6 to 9 hours per day.
• Try to get at least 4 hours sleep per day.
• Get good sleep before going on sustained operations.
• r. .. tn<ip u,l,,:,n ynn l"<in, hnt. <illnur t.imA t.n ur<ik"A np fnlly.
• Catch up on sleep after going without.
CHANGE
No. 1
FM 21-11
C 1
HEADQUARTERS
DEPARTMENT OF THE ARMY
Washington, DC, 28 August 1989
FIRST AID FOR SOLDIERS
FM 21-11, 27 October 1988, is changed as follows:
1. New or changed material is indicated by a star ( H ).
2. Remove old pages and insert new ones as indicated below:
Remove pages Insert pages
C-9 through C-12 C-9 and C-10
Index-1 and Index-2 Index-1 and Index-2
3. File this transmittal sheet in front of the publication.
DISTRIBUTION RESTRICTION: Distribution authorized to US Government
agencies only. This limited distribution is intended to protect technical or
operational information from automatic dissemination under the International
Exchange Program or by other means. This determination was made on 27 July
1988. Other requests for this document will be referred to Commandant, AHS,
USA, ATTN: HSHA-TLD, Fort Sam Houston, TX 78234-6100.
DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of
contents or reconstruction of the document.
By Order of the Secretary of the Army:
CARL E. VUONO
General, United States Army
Chief of Staff
Official:
WILLIAM J. MEEHAN II
Brigadier General, United States Army
The Adjutant General
DISTRIBUTION:
Active Army, USAR and ARNG: To be distributed in accordance with DA
Form 12-11E, requirements for FM 21-11, First Aid for Soldiers (Qty rqr
block no. 161).
CHANGE
No. 2
FM 21-11
C 2
HEADQUARTERS
DEPARTMENT OF THE ARMY
Washington, DC, 4 December 1991
FIRST AID FOR SOLDIERS
FM 21-11, 27 October 1988, is changed as follows:
1. New or changed material is indicated by a star ( H ).
2. Remove old pages and insert new ones as indicated below:
Remove pages
Cover
i through xviii
1-3 through 1-6
2-1 through 2-6
2-9 through 2-14
2-15 through 2-20
2-21 and 2-22
2-25 and 2-26
2-37 through 2-40
3-1 and 3-2
3-5 and 3-6
3-13 and 3-14
3-23 and 3-24
3-27 and 3-28
4-3 and 4-4
5-3 through 5-8
5-17 and 5-18
5-21 and 5-22
6-5 and 6-6
6-13 through 6-16
D-1 through D-4
Glossary-1 and Glossary-2
References-1 and References-2
Index-1 through Index-8
Insert pages
Cover
i through xvii
1-3 through 1-6
2-1 through 2-6
2-9 through 2-14
None
2-21 and 2-22
2-25 and 2-26
2-37 through 2-40
3-1 and 3-2
3-5 and 3-6
3-13 and 3-14
3-23 and 3-24
3-27 and 3-28
4-3 and 4-4
5-3 through 5-8
5-17 and 5-18
5-21 and 5-22
6-5 and 6-6
6-13 through 6-16
None
Glossary-1 and Glossary-2
References-1 through References-3
Index-0 through Index-6
3. File this transmittal sheet in front of the publication.
DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited.
By Order of the Secretary of the Army:
GORDON R. SULLIVAN
General, United States Army
Chief of Staff
Official:
MILTON H. HAMILTON
Administrative Assistant to the
Secretary of the Army
00105
DISTRIBUTION:
Active Army, USAR and ARNG: To be distributed in accordance with DA
Form 12-11E, requirements for FM 21-11, First Aid for Soldiers (Qty rqr
block no. 161).
FM 21-11
APPENDIX A
FIRST AID CASE AND KITS,
DRESSINGS, AND BANDAGES
A-1. First Aid Case with Field Dressings and Bandages
Every soldier is issued a first aid case (Figure A-1A) with a field first aid
dressing encased in a plastic wrapper (Figure A-1B). He carries it at all
times for his use. The field first aid dressing is a standard sterile (germfree)
compress or pad with bandages attached (Figure A-1C). This
dressing is used to cover the wound, to protect against further
contamination, and to stop bleeding (pressure dressing). When a soldier
administers first aid to another person, he must remember to use the
wounded person’s dressing; he may need his own later. The soldier must
check his first aid case regularly and replace any used or missing
dressing. The field first aid dressing may normally be obtained through
the medical unit’s assigned medical platoon or section.
A-2. General Purpose First Aid Kits
General purpose first aid kits listed in paragraph A-3 are also listed in
CTA 8-100. These kits are carried on Army vehicles, aircraft, and boats
for use by the operators, crew, and passengers. Individuals designated by
unit standing operating procedures (SOP) to be responsible for the kits
are required to check them regularly and replace all items used, or replace
the entire kit when necessary. The general purpose kit and its contents
can be obtained through the unit supply system.
A-1
0
®
OUTER EDGES -
D-- ATTACHED G) ")) BANDAGES
-ti..!---- TAILS
Figure A-1. Field first aid case and dressing.
FM 21-11
NOTE
Periodically check the dressings (for holes or
tears in the package) and the medicines (for
expiration date) that are in the first aid kits. If
necessary, replace defective or outdated items.
A-3. Contents of First Aid Case and Kits
The following items are listed in the Common Table of Allowances (CTA)
as indicated below. However, it is necessary to see referenced CTA for
stock numbers.
Unit of
CTA Nomenclature Issue Quantity
a. 50-900 . . . . . CASE FIELD FIRST AID DRESSING each . . . . . . .
Contents:
8-100 . . . . . . . . Dressing, first aid field, individual
troop, white, 4 by 7 inches . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
b. 8-100 . . . . . . . FIRST AID KIT, general purpose . . . . . . . . . . . each . . . . . . .
(Rigid Case)
Contents:
Case, medical instrument and supply
set, plastic, rigid, size A,
7 ½ inches long by 4 ½ inches
wide by 2¾ inches high . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
Ammonia inhalation solution, aromatic,
ampules, 1/3 ml, 10s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . package.
Povidone-iodine solution, USP: 10%,
½ fl oz, 50s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . box . . . . . . . . .
Dressing, first aid, field, individual
troop, camouflaged, 4 by 7 inches . . . . . . . . . each . . . . . . .
Compress and bandage, camouflaged,
2 by 2 inches, 4s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . package.
Bandage, gauze, compressed,
camouflaged, 3 inches by 6 yards . . . . . . . . . . each . . . . . . .
Bandage, muslin, compressed,
camouflaged, 37 by 37 by 52 inches . . . . . . each . . . . . . .
Gauze, petrolatum, 3 by 36 inches, 3s . . . . . . package.
1
1
1
1
1
1/50
3
1
2
11
A-2
FM 21-11
Unit of
CTA Nomenclature Issue Quantity
Adhesive tape, surgical,
1 inch by 1 ½ yards, 100s, . . . . . . . . . . . . . . . . . . . . package.
Bandage, adhesive, ¾ by 3 inches,
300s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . box . . . . . . . . . .
Blade, surgical preparation razor,
straight, single edge, 5s . . . . . . . . . . . . . . . . . . . . . . . . . package.
First aid kit, eye dressing . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
Instruction card, artificial
respiration, mouth-to-mouth
resuscitation (Graphic Training
Aid 21-45) (in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
Instruction sheet, first aid
(in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
Instruction sheet and list of
contents (in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . .
c. 8-100 . . . . . . .. FIRST AID KIT, general purpose . . . . . . . . . . . each . . . . . . .
In Upper
Pocket . . . . . .
In Lower
Pocket . . . . .
(panel-mounted)
Contents:
Case, medical instrument and supply
set, nylon, nonrigid, No. 2,
7 ½ inches long by 4 3/8 inches
wide by 4 ½ inches high . . . . . . . . . . . . . . . . . . . . . . .
Ammonia Inhalation Solution,
aromatic, ampules, 1/3 ml, 10s . . . . . . . . . . . . . .
Compress and bandage, camouflaged,
2 by 2 inches, 4s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bandage, muslin, compressed,
camouflaged, 37 by 37 by 52 inches, . . . . .
Gauze, petrolatum, 3 by 36 inches, 12s . . . .
Blade, surgical preparation razor,
straight, single edge, 5s . . . . . . . . . . . . . . . . . . . . . . . . .
Pad, Povidone-Iodine, 100s . . . . . . . . . . . . . . . . . . . . . .
Dressing, first aid, field, individual
troop, camouflaged, 4 by 6 inches.. . . . . . . .
Bandage, gauze, compressed,
camouflaged, 3 inches by 6 yards . . . . . . . . . .
Adhesive tape, surgical,
1 inch by 1 ½ yards, 100s . . . . . . . . . . . . . . . . . . . . .
each . . . . . . .
package.
package.
each . . . . . . .
package.
package.
box . . . . . . . .
each . . . . . . .
each . . . . . . .
package.
3/100
18/300
1
1
1
1
1
1
1
1
1
1
3/12
1
10/100
3
2
3/100
A-3
FM 21-11
Unit of
CTA Nomenclature Issue Quantity
Bandage, adhesive, ¾ by 3 inches,
300s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . box . . . . . . . . . 18/300
First aid kit, eye dressing . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . . 1
Instruction card, artificial
respiration, mouth-to-mouth
resuscitation (Graphic Training
Aid 21-45) (in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . . 1
Instruction sheet, first aid
(in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . . 1
Instruction sheet and list of
contents (in English) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . each . . . . . . . 1
A-4. Dressings
Dressings are sterile pads or compresses used to cover wounds. They
usually are made of gauze or cotton wrapped in gauze (Figure A-1C). In
addition to the standard field first aid dressing, other dressings such as
sterile gauze compresses and small sterile compresses on adhesive strips
may be available under CTA 8-100. See paragraph A-3 above.
A-5. Standard Bandages
a. Standard bandages are made of gauze or muslin and are used
over a sterile dressing to secure the dressing in place, to close off its edge
from dirt and germs, and to create pressure on the wound and control
bleeding. A bandage can also support an injured part or secure a splint.
b. Tailed bandages maybe attached to the dressing as indicated
on the field first aid dressing (Figure A-1C).
A-6. Triangular and Cravat (Swathe) Bandages
a. Triangular and cravat (or swathe) bandages (Figure A-2) are
fashioned from a triangular piece of muslin (37 by 37 by 52 inches)
provided in the general purpose first aid kit. If it is folded into a strip, it
is called a cravat. Two safety pins are packaged with each bandage.
These bandages are valuable in an emergency since they are easily
applied.
A-4
FM 21-11
b. To improvise a triangular bandage, cut a square of available
material, slightly larger than 3 feet by 3 feet, and FOLD it
DIAGONALLY. If two bandages are needed, cut the material along the
DIAGONAL FOLD.
c. A cravat can be improvised from such common items as
T-shirts, other shirts, bed linens, trouser legs, scarfs, or any other item
made of pliable and durable material that can be folded, torn, or cut to the
desired size.
A-5
~+ 3 FEET /
~ ·--------:-\---,/,
I\\ \. / \1 \ \1 ' /1
\ / \
0 I X, / '
\,~'?-Cj /
/\\,
/ ~\,
I\ /
\1, / 'I
/ \\ / \ .,.._, ________ ~+
SQUARE ~
®
TRIANGULAR BANDAGE
©
CRAVAT (ONE FOLD)
®
CRAVAT (TWO FOLDS)
CRAVAT (THREE FOLDS)
Figure A-2. Triangular and cravat bandages
(Illustrated A thru E).
FM 21-11
NOTES
A-6
FM 21-11
APPENDIX B
RESCUE AND TRANSPORTATION
PROCEDURES
B-1. General
A basic principle of first aid is to treat the casualty before moving him.
However, adverse situations or conditions may jeopardize the lives of
both the rescuer and the casualty if this is done. It may be necessary first
to rescue the casualty before first aid can be effectively or safely given.
The life and/or the well-being of the casualty will depend as much upon
the manner in which he is rescued and transported as it will upon the
treatment he receives. Rescue actions must be done quickly and safely.
Careless or rough handling of the casualty during rescue operations can
aggravate his injuries and possibly cause death.
B-2. Principles of Rescue Operations
a. When faced with the necessity of rescuing a casualty who is
threatened by hostile action, fire, water, or any other immediate hazard,
DO NOT take action without first determining the extent of the hazard
and your ability to handle the situation. DO NOT become a casualty.
b. The rescuer must evaluate the situation and analyze the
factors involved. This evaluation involves three major steps:
Identify the task.
Evaluate circumstances of the rescue.
Plan the action.
B-3. Task (Rescue) Identification
First determine if a rescue attempt is actually needed. It is a waste of
time, equipment, and personnel to rescue someone not in need of
rescuing. It is also a waste to look for someone who is not lost or
needlessly risk the lives of the rescuer(s). In planning a rescue, attempt to
obtain the following information:
Who, what, where, when, why, and how the situation
happened?
How many casualties are involved and the nature of their
injuries?
B-1
•
•
•
•
•
FM 21-11
What is the tactical situation?
What are the terrain features and the location of the
casualties?
Will there be adequate assistance available to aid in the
rescue/evacuation?
Can treatment be provided at the scene; will the
casualties require movement to a safer location?
What equipment will be required for the rescue
operation?
Will decon procedures and equipment be required for
casualties, rescue personnel and rescue equipment?
B-4. Circumstances of the Rescue
a. After identifying the job (task) required, you must relate to
the circumstances under which you must work. Do you need additional
people, security, medical, or special rescue equipment? Are there
circumstances such as mountain rescue or aircraft accidents that may
require specialized skills? What is the weather like? Is the terrain
hazardous? How much time is available?
b. The time element will sometimes cause a rescuer to
compromise planning stages and/or treatment which can be given. A
realistic estimate of time available must be made as quickly as possible
to determine action time remaining. The key elements are the casualty’s
condition and the environment.
c. Mass casualties are to be expected on the modern battlefield.
All problems or complexities of rescue are now multiplied by the number
of casualties encountered. In this case, time becomes the critical element.
B-5. Plan of Action
a. The casualty’s ability to endure is of primary importance in
estimating the time available. Age and physical condition will differ from
casualty to casualty. Therefore, to determine the time available, you will
have to consider—
Endurance time of the casualty.
B-2
•
•
•
•
•
•
•
FM 21-11
Type of situation.
Personnel and/or equipment availability.
Weather.
Terrain.
b. In respect to terrain, you must consider altitude and
visibility. In some cases, the casualty may be of assistance because he
knows more about the particular terrain or situation than you do.
Maximum use of secure/reliable trails or roads is essential.
c. When taking weather into account, ensure that blankets
and/or rain gear are available. Even a mild rain can complicate a normally
simple rescue. In high altitudes and/or extreme cold and gusting winds,
the time available is critically shortened.
d. High altitudes and gusting winds minimize the ability of
fixed-wing or rotary wing aircraft to assist in operations. Rotary wing
aircraft may be available to remove casualties from cliffs or inaccessible
sites. These same aircraft can also transport the casualties to a medical
treatment facility in a comparatively short time. Aircraft, though vital
elements of search, rescue or evacuation, cannot be used in all situations.
For this reason, do not rely entirely on their presence. Reliance on aircraft
or specialized equipment is a poor substitute for careful planning.
B-6. Mass Casualties
In situations where there are multiple casualties, an orderly rescue may
involve some additional planning. To facilitate a mass casualty rescue or
evacuation, recognize separate stages.
First Stage. Remove those personnel who are not trapped
among debris or who can be evacuated easily.
Second Stage. Remove those personnel who may be
trapped by debris but require only the equipment on hand and a
minimum amount of time.
Third Stage. Remove the remaining personnel who are
trapped in extremely difficult or time-consuming situations, such as
under large amounts of debris or behind walls.
Fourth Stage. Remove the dead.
B-3
•
•
•
•
•
•
•
•
FM 21-11
B-7. Proper Handling of Casualties
a. You may have saved the casualty’s life through the
application of appropriate first aid measures. However, his life can be
lost through rough handling or careless transportation procedures.
Before you attempt to move the casualty—
Evaluate the type and extent of his injury.
Ensure that dressings over wounds are adequately
reinforced.
Ensure that fractured bones are properly immobilized
and supported to prevent them from cutting through muscle, blood
vessels, and skin. Based upon your evaluation of the type and extent of
the casualty’s injury and your knowledge of the various manual carries,
you must select the best possible method of manual transportation. If the
casualty is conscious, tell him how he is to be transported. This will help
allay his fear of movement and gain his cooperation and confidence.
b. Buddy aid for chemical agent casualties includes those
actions required to prevent an incapacitated casualty from receiving
additional injury from the effects of chemical hazards. If a casualty is
physically unable to decontaminate himself or administer the proper
chemical agent antidote, the casualty’s buddy assists him and assumes
responsibility for his care. Buddy aid includes—
skin.
emplaced.
Administering the proper chemical agent antidote.
Decontaminating the incapacitated casualty’s exposed
Ensuring that his protective ensemble remains correctly
Maintaining respiration.
Controlling bleeding.
Providing other standard first aid measures.
Transporting the casualty out of the contaminated area.
B-8. Transportation of Casualties
a. Transportation of the sick and wounded is the responsibility
of medical personnel who have been provided special training and
B-4
•
•
•
•
•
•
•
•
•
•
FM 21-11
equipment. Therefore, unless a good reason for you to transport a
casualty arises, wait for some means of medical evacuation to be
provided. When the situation is urgent and you are unable to obtain
medical assistance or know that no medical evacuation facilities are
available, you will have to transport the casualty. For this reason, you
must know how to transport him without increasing the seriousness of
his condition.
b. Transporting a casualty by litter (FM 8-35) is safer and more
comfortable for him than by manual means; it is also easier for you.
Manual transportation, however, may be the only feasible method
because of the terrain or the combat situation; or it may be necessary to
save a life. In these situations, the casualty should be transferred to a
litter as soon as one can be made available or improvised.
B-9. Manual Carries (081-831-1040 and 081-831-1041)
Casualties carried by manual means must be carefully and correctly
handled, otherwise their injuries may become more serious or possibly
fatal. Situation permitting, evacuation or transport of a casualty should
be organized and unhurried. Each movement should be performed as
deliberately and gently as possible. Casualties should not be moved
before the type and extent of injuries are evaluated and the required
emergency medical treatment is given. The exception to this occurs when
the situation dictates immediate movement for safety purposes (for
example, it may be necessary to remove a casualty from a burning
vehicle); that is, the situation dictates that the urgency of casualty
movement outweighs the need to administer emergency medical
treatment. Manual carries are tiring for the bearer(s) and involve the risk
of increasing the severity of the casualty’s injury. In some instances,
however, they are essential to save the casualty’s life. Although manual
carries are accomplished by one or two bearers, the two-man carries are
used whenever possible. They provide more comfort to the casualty, are
less likely to aggravate his injuries, and are also less tiring for the
bearers, thus enabling them to carry him farther. The distance a casualty
can be carried depends on many factors, such as—
Strength and endurance of the bearer(s).
Weight of the casualty.
Nature of the casualty’s injury.
Obstacles encountered during transport.
a. One-man Carries (081-831-1040).
B-5
•
•
•
•
FM 21-11
(1) Fireman’s carry (081-831-1040). The fireman’s carry
(Figure B-1) is one of the easiest ways for one person to carry another,
After an unconscious or disabled casualty has been properly positioned,
he is raised from the ground. An alternate method for raising him from
the ground is illustrated (Figure B-1 I). However, it should be used only
when the bearer believes it to be safer for the casualty because of the
location of his wounds. When the alternate method is used, take care to
prevent the casualty’s head from snapping back and causing a neck
injury. The steps for raising a casualty from the ground for the fireman’s
carry are also used in other one-man carries.
B-6
0 KNEEL AT THE CASUAL TY'S UNINJURED SIDE. PLACE HIS
ARMS ABOVE HIS HEAD AND CROSS HIS ANKLE FARTHER
FROM YOU OVER THE ONE CLOSER TO YOU. PLACE ONE OF
YOUR HANDS ON THE SHOULDER FARTHER FROM YOU AND
YOUR OTHER HAND IN THE AREA OF HIS HIP OR THIGH.
0 ROLL HIM TOWARD YOU ONTO HIS ABDOMEN.
Figure B-1. Fireman's carry (Illustrated A thru N).
FM 21-11
B-7
© AFTER ROLLING THE CASUAL TY ONTO HIS ABDOMEN,
STRADDLE HIM; THEN PLACE YOUR HANDS UNDER HIS CHEST
AND LOCK THEM TOGETHER.
RAISE/LIFT THE CASUAL TY TO HIS KNEES
AS YOU MOVE BACKWARD.
© CONTINUE TO MOVE BACKWARD, THUS
STRAIGHTENING THE CASUAL TY'S LEGS
AND LOCKING HIS KNEES.
1//h1\\\\\!@J1
Figure B-1. Continued.
FM 21-11
B-8
0 WALK FORWARD, BRINGING THE CASUAL TY TO
A STANDING POSITION BUT TILTED SLIGHTLY
BACKWARD TO PREVENT HIS KNEES FROM
BUCKLING.
0 AS YOU MAINTAIN CONSTANT SUPPORT OF
THE CASUAL TY WITH ONE ARM, FREE YOUR
OTHER ARM, OUICKL Y GRASP HIS WRIST,
AND RAISE HIS ARM HIGH.
Figure B-1. Continued.
FM 21-11
B-9
® INSTANTLY PASS YOUR HEAD UNDER HIS
RAISED ARM, RELEASING IT AS YOU PASS
UNDER IT.
MOVE SWIFTLY TO FACE THE CASUAL TY AND SECURE
YOUR ARMS AROUND HIS WAIST. IMMEDIATELY PLACE
YOUR FOOT BETWEEN HIS FEET AND SPREAD THEM
(APPROXIMATELY 6 TO 8 INCHES APART).
Figure B-1. Continued.
xFM 21-11
NOTE
The alternate method of raising the casualty
from the ground should be used only when the
bearer believes it to be safer for the casualty
because of the location of his wounds. When
the alternate method is used, take care to
prevent the casualty’s head from snapping
back and causing a neck injury.
B-10
0 ALTERNATE METHOD OF LIFTING.
QJ KNEEL ON ONE KNEE AT THE CASUAL TY'S HEAD, FACING HIS
FEET, THEN EXTEND YOUR HANDS UNDER HIS ARMPITS,
DOWN HIS SIDES, AND ACROSS HIS BACK.
[Ij AS YOU RISE, LIFT THE CASUAL TY TO HIS
KNEES; THEN SECURE A LOWER HOLD AND
RAISE HIM TO A STANDING POSITION WITH
HIS KNEES LOCKED.
Figure B-1. Continued.
FM 21-11
B-11
0
@J SECURE YOUR ARMS AROUND THE CASUAL TY'S
WAIST, WITH HIS BODY TILTED SLIGHTLY BACKWARD
TO PREVENT HIS KNEES FROM BUCKLING. PLACE YOUR
FOOT BETWEEN HIS FEET AND SPREAD THEM (ABOUT
6 TO 8 INCHES APART).
GRASP THE CASUAL TY'S WRIST AND RAISE
HIS ARM HIGH OVER YOUR HEAD.
Figure B-1. Continued.
FM 21-11
B-12
0 STOOP/BEND DOWN AND PULL THE
CASUAL TY'S ARM OVER AND DOWN
YOUR SHOULDER, THUS BRINGING
HIS BODY ACROSS YOUR SHOULDERS.
AT THE SAME TIME, PASS YOUR ARM
BETWEEN HIS LEGS.
GRASP THE CASUAL TY'S WRIST WITH
ONE HAND AND PLACE YOUR OTHER
HAND ON YOUR KNEE FOR SUPPORT.
Figure B-1, Continued.
FM 21-11
(2) Support carry (081-831-1040). In the support carry
(Figure B-2), the casualty must be able to walk or at least hop on one leg,
using the bearer as a crutch. This carry can be used to assist him as far as
he is able to walk or hop.
B-13
® RISE WITH THE CASUAL TY CORRECTLY POSITIONED.
YOUR OTHER HAND IS FREE FOR USE AS NEEDED.
Figure B-1. Continued.
FM 21-11
(3) Arms carry (081-831-1040). The arms carry is used
when the casualty is unable to walk. This carry (Figure B-3) is useful
when carrying a casualty for a short distance and when placing him on a
litter.
B-14
RAISE THE CASUAL TY TO A STANDING POSITION
FROM GROUND AS IN FIREMAN'S CARRY. GRASP
THE CASUALTY'S WRIST AND DRAW HIS ARM
AROUND YOUR NECK. PLACE YOUR AR~v1 AROUND
HIS WAIST.
(THE CASUAL TY IS THUS ABLE TO WALK, USING
YOU AS A CRUTCH.)
Figure B-2. Support carry.
RAISE/LIFT THE CASUAL TY TO A ST ANDING
POSITION OFF GROUND AS IN FIREMAN'S
CARRY. PLACE ONE ARM UNDER THE
CASUAL TY'S KNEES AND YOUR OTHER ARM
AROUND HIS BACK AND LIFT. CARRY
CASUALTY HIGH TO LESSEN FATIGUE.
Figure B-3. Arms carry.
FM 21-11
(4) Saddleback carry (081-831-1040). Only a conscious
casualty can be transported by the saddleback carry (Figure B-4),
because he must be able to hold onto the bearer’s neck.
(5) Pack-strap carry (081-831-1040). This carry is used
when only a moderate distance will be traveled. In this carry (Figure B-5),
the casualty’s weight rests high on the bearer’s back. To eliminate the
possibility of injury to the casualty’s arms, the bearer must hold the
casualty’s arms in a palms-down position.
B-15
RAISE CASUAL TY TO UPRIGHT POSITION AS IN FIREMAN'S
CARRY. SUPPORT CASUAL TY BY PLACING AN ARM AROUND
HIS WAIST AND MOVE IN FRONT OF HIM (YOUR BACK TO HIM).
HAVE CASUAL TY ENCIRCLE HIS ARMS AROUND YOUR NECK.
STOOP, RAISE HIM UPON YOUR BACK, AND CLASP YOUR
HANDS TOGETHER BENEATH HIS THIGHS IF POSSIBLE.
Figure B-4. Saddleback carry.
FM 21-11
B-16
0
0
LIFT CASUAL TY FROM GROUND TO A STANDING
POSITION AS IN FIREMAN'S CARRY. SUPPORTING
THE CASUAL TY WITH YOUR ARMS AROUND HIM,
GRASP HIS WRIST CLOSER TO YOU AND PLACE HIS
ARM OVER YOUR HEAD AND ACROSS YOUR
SHOULDER. MOVE IN FRONT OF HIM WHILE
SUPPORTING HIS WEIGHT AGAINST YOUR BACK.
GRASP HIS OTHER WRIST, AND PLACE THIS
ARM OVER YOUR SHOULDER.
BEND FORWARD AND RAISE/HOIST HIM AS
HIGH ON YOUR BACK AS POSSIBLE SO THAT
ALL HIS WEIGHT IS RESTING ON YOUR BACK.
Figure B-5. Pack-strap carry (Illustrated A and B),
FM 21-11
(6) Pistol-belt carry (081-831-1040). The pistol-belt carry
(Figure B-6) is the best one-man carry when the distance to be traveled is
long. The casualty is securely supported by a belt upon the shoulders of
the bearer. The hands of both the bearer and the casualty are left free for
carrying a weapon or equipment, climbing banks, or surmounting
obstacles. With his hands free and the casualty secured in place, the
bearer is also able to creep through shrubs and under low hanging
branches.
B-17
0
0
LINK TWO PISTOL BEL TS (OR THREE, IF NECESSARY)
TOGETHER TO FORM A SLING. IIF PISTOL BEL TS ARE NOT
AVAILABLE FOR USE, OTHER ITEMS, SUCH AS ONE RIFLE
SLING, TWO CRAVAT BANDAGES, TWO LITTER STRAPS, OR
ANY SUITABLE MATERIAL WHICH WILL NOT CUT OR BIND THE
CASUAL TY, MAY BE USED.) PLACE THIS SLING UNDER THE
CASUALTY'S THIGHS AND LOWER BACK SO THAT A LOOP
EXTENDS FROM EACH SIDE.
LIE FACE UP BET\"JEEN THE r a~11at TY'~ n11T~TRFTf':HJ:n
LEGS. THRUST YOUR ARMS THROUGH THE LOOPS, GRASP HIS
HAND AND TROUSER LEG ON HIS INJURED SIDE.
Figure B-6. Pistol-belt carry (Illustrated A thru F).
FM 21-11
B-18
©
0
ROLL TOWARD THE CASUAL TY'S UNINJURED SIDE ONTO
YOUR ABDOMEN, BRINGING HIM ONTO YOUR BACK. ADJUST
SLING AS NECESSARY.
RISE TO A KNEELING POSITION. THE BELT
WILL HOLD THE CASUAL TY IN PLACE.
PLACE ONE HAND ON YOUR KNEE FOR
SUPPORT AND RISE TO AN UPRIGHT
POSITION.
.~'/i' i / ,~,
Figure B-6. Continued.
FM 21-11
(7) Pistol-belt drag (081-831-1040). The pistol-belt drag
(Figure B-7) and other drags are generally used for short distances. In
this drag the casualty is on his back. The pistol-belt drag is useful in
combat. The bearer and the casualty can remain closer to the ground in
this drag than in any other.
B-19
0 THE CASUAL TY IS NOW SUPPORTED ON YOUR
SHOULDERS. CARRY THE CASUAL TY WITH YOUR
HANDS FREE FOR USE IN RIFLE-FIRING, CLIMBING
BANKS, OR SURMOUNTING OBSTACLES.
Figure B-6. Continued.
Figure B-7. Pistol-belt drag.
FM 21-11
(8) Neck drag (081-831-1040). The neck drag (Figure B-8) is
useful in combat because the bearer can transport the casualty when he
creeps behind a low wall or shrubbery, under a vehicle, or through a
culvert. This drag is used only if the casualty does not have a broken/
fractured arm. In this drag the casualty is on his back. If the casualty is
unconscious, protect his head from the ground.
B-20
ADJUST/EXTEND TWO PISTOL BEL TS (OR THREE, IF
NECESSARY) OR SIMILAR OBJECTS TO THEIR FULL LENGTH
AND JOIN THEM TOGETHER TO MAKE ONE LOOP. ROLL THE
CASUAL TY ONTO HIS BACK. PASS THE LOOP OVER THE
CASUAL TY'S HEAD AND POSITION IT ACROSS HIS CHEST AND
UNDER HIS ARMPITS; THEN CROSS THE REMAINING PORTION
OF THE LOOP, THUS FORMING A FIGURE EIGHT. KEEP TENSION
ON THE BEL TS SO THEY DO NOT BECOME UNHOOKED. LIE ON
YOUR SIDE FACING THE CASUAL TY, RESTING ON YOUR
ELBOW. SLIP THE LOOP OVER YOUR ARM AND SHOULDER
THAT YOU ARE LEANING ON AND TURN A WAY FROM THE
CASUAL TY ONTO YOUR ABDOMEN, THUS ENABLING YOU TO
DRAG THE CASUAL TY AS YOU CRAWL.
Figure B-7. Continued.
TIE THE CASUAL TY'S HANDS TOGETHER AT THE WRISTS. IF
CASUALTY IS CONSCIOUS, HE MAY CLASP HIS HANDS
TOGETHER AROUND YOUR NECK. STRADDLE THE CASUAL TY
IN A KNEELING FACE-TO-FACE POSITION. LOOP THE
CASUALTY'S TIED HANDS OVER/AROUND YOUR NECK.
CRAWL FORWARD, LOOKING FORWARD, DRAGGING THE
CASUALTY WITH YOU. IF THE CASUAL TY IS UNCONSCIOUS,
PROTECT HIS HEAD FROM THE GROUND.
Figure B-8. Neck drag.
FM 21-11
(9) Cradle drop drag (081-831-1040). The cradle drop drag
(Figure B-9) is effective in moving a casualty up or down steps. In this
drag the casualty is lying down.
B-21
0
0
WITH THE CASUAL TY LYING ON HIS BACK, KNEEL AT HIS
HEAD. THEN SLIDE YOUR HANDS, WITH PALMS UP, UNDER
THE CASUAL TY'S SHOULDERS AND GET A FIRM HOLD UNDER
HIS ARMPITS.
PARTIALLY RISE, SUPPORTING THE CASUAL TY'S HEAD ON
ONE OF YOUR FOREARMS. (YOU MAY BRING YOUR ELBOWS
TOGETHER AND LET THE CASUAL TY'S HEAD REST ON BOTH
OF YOUR FOREARMS.)
Figure B-9. Cradle drop drag (Illustrated A thru D).
FM 21-11
B-22
0
© WITH THE CASUAL TY IN A SEMI-SITTING POSITION,
RISE AND DRAG THE CASUAL TY BACKWARDS.
THEN BACK DOWN THE STEPS, SUPPORTING THE
CASUAL TY'S HEAD AND BODY AND LETTING HIS HIPS AND
LEGS DROP FROM STEP TO STEP. IF THE CASUAL TY NEEDS TO
BE MOVED UP THE STEPS, THEN YOU SHOULD BACK UP THE
STEPS, USING THE SAME PROCEDURE.
Figure B-9. Continued.
FM 21-11
b. Two-man Carries (081-831-1041).
(1) Two-man support carry (081-831-1041). The two-man
support carry (Figure B-10) can be used in transporting both conscious or
unconscious casualties. If the casualty is taller than the bearers, it may
be necessary for the bearers to lift the casualty’s legs and let them rest on
their forearms.
B-23
0 TWO 'BEARERS HELP THE CASUAL TY TO HIS FEET AND
SUPPORT HIM WITH THEIR ARMS AROUND HIS WAIST. THEY
GRASP THE CASUAL TY'S WRISTS AND DRAW HIS ARMS
AROUND THEIR NECKS.
Figure B-10. Two-man support carry (Illustrated A and B).
FM 21-11
(2) Two-man arms carry (081-831-1041). The two-man arms
carry (Figure B-11) is useful in carrying a casualty for a moderate
distance. It is also useful for placing him on a litter. To lessen fatigue, the
bearers should carry him high and as close to their chests as possible. In
extreme emergencies when there is no time to obtain a board, this manual
carry is the safest one for transporting a casualty with a back/neck
injury. Use two additional bearers to keep his head and legs in alignment
with his body.
B-24
IF A CASUAL TY IS TALLER THAN THE BEARERS, IT MAY BE
NECESSARY FOR THE BEARERS TO LIFT HIS LEGS AND LET
THEM REST ON THEIR FOREARMS.
Figure B-10. Continued.
FM 21-11
B-25
0
0
TWO BEARERS KNEEL AT ONE SIDE OF THE CASUAL TY AND
PLACE THEIR ARMS BENEATH THE CASUAL TY'S BACK
(SHOULDERS), WAIST, HIPS, AND KNEES.
THE BEARERS LIFT THE CASUAL TY AS THEY RISE TO THEIR
KNEES.
NOTE
Keeping the casualty's body level will prevent
unnecessary movement and further injury.
Figure B-11. Two-man arms carry (Illustrated A thru D).
FM 21-11
B-26
© AS THE BEARERS RISE TO THEIR FEET, THEY TURN THE
CASUALTY TOWARD THEIR CHESTS.
0 THEY CARRY HIM HIGH TO LESSEN FATIGUE.
Figure B-11. Continued.
FM 21-11
(3) Two-man fore-and-aft carry (081-831-1041). The foreand-
aft carry (Figure B-12) is a most useful two-man carry for transporting a
casualty for a long distance. The taller of the two bearers should position
himself at the casualty’s head. By altering this carry so that both bearers face
the casualty, it is also useful for placing him on a litter.
B-27
0 THE SHORTER BEARER SPREADS THE CASUAL TY'S LEGS,
KNEELS BETWEEN THE LEGS WITH HIS BACK TO THE
CASUAL TY, AND POSITIONS HIS HANDS BEHIND THE
CASUAL TY'S KNEES. THE OTHER (TALLER) BEARER KNEELS AT
THE CASUAL TY'S HEAD, SLIDES HIS HANDS UNDER THE
ARMS AND ACROSS, AND LOCKS HIS HANDS TOGETHER.
NOTE
The taller of the two bearers should position
himself at the casualty's head.
Figure B-12. Two-man fore-and-aft carry (Illustrated A thru CJ.
FM 21-11
B-28
© AL TERNA TE POSITIONFACING
CASUAL TY.
0
NOTE
THE BEARERS RISE TOGETHER,
LIFTING THE CASUAL TY.
By altering the carry so that both bearers face
the casualty; it is also useful for placing him on
a litter.
Figure B-12. Continued.
FM 21-11
(4) Two-hand seat carry (081-831-1041). The two-hand
seat carry (Figure B-13) is used in carrying a casualty for a short distance and
in placing him on a litter.
B-29
0 FRONTVIEW
0 BACK VIEW
WITH CASUAL TY LYING ON HIS BACK, A
BEARER KNEELS ON EACH SIDE OF HIM
AT THE CASUALTY'S HIPS. EACH BEARER
PASSES HIS ARMS UNDER THE
CASUAL TY'S THIGHS AND BACK, AND
GRASPS THE OTHER BEARER'S WRISTS.
THE BEARERS RISE, LIFTING THE CASUAL TY.
Figure B-13. Two-hand seat carry (Illustrated A and B).
FM 21-11
(5) Four-hand seat carry (081-831-1041). Only a conscious
casualty can be transported with the four-hand seat carry (Figure B-14)
because he must help support himself by placing his arms around the
bearers’ shoulders. This carry is especially useful in transporting the casualty
with a head or foot injury and is used when the distance to be traveled is
moderate. It is also useful for placing a casualty on a litter.
B-30
®
0 EACH BEARER GRASPS ONE OF HIS
WRISTS AND ONE OF THE OTHER
BEARER'S WRISTS, THUS FORMING
A PACK$ADDLE.
THE TWO BEARERS LOWER THEMSELVES
SUFFICIENTLY FOR THE CASUAL TY TO
SIT ON THE PACKSADDLE; THEN THEY
HAVE THE CASUALTY PLACE HIS ARMS
AROUND THEIR SHOULDERS FOR SUPPORT
BEFORE THEY RISE TO AN UPRIGHT
POSITION.
Figure B-14. Four-hand seat carry (Illustrated A and B).
FM 21-11
B-10. Improvised Litters (Figures B-15 through B-17)
(081-831-1041)
Two men can support or carry a casualty without equipment for only
short distances. By using available materials to improvise equipment,
the casualty can be transported greater distances by two or more
rescuers.
a. There are times when a casualty may have to be moved and a
standard litter is not available. The distance may be too great for manual
carries or the casualty may have an injury, such as a fractured neck,
back, hip, or thigh that would be aggravated by manual transportation.
In these situations, litters can be improvised from certain materials at
hand. Improvised litters are emergency measures and must be replaced
by standard litters at the first opportunity to ensure the comfort and
safety of the casualty.
b. Many different types of litters can be improvised, depending
upon the materials available. Satisfactory litters can be made by securing
poles inside such items as blankets, ponchos, shelter halves, tarpaulins,
jackets, shirts, sacks, bags, and bed tickings (fabric covers of
mattresses). Poles can be improvised from strong branches, tent
supports, skis, and other like items. Most flat-surface objects of suitable
size can also be used as litters. Such objects include boards, doors,
window shutters, benches, ladders, cots, and poles tied together. If
possible, these objects should be padded.
c. If no poles can be obtained, a large item such as a blanket can
be rolled from both sides toward the center. The rolls then can be used to
obtain a firm grip when carrying the casualty. If a poncho is used, make
sure the hood is up and under the casualty and is not dragging on the
ground.
d. The important thing to remember is that an improvised litter
must be well constructed to avoid the risk of dropping or further injuring
the casualty.
e. Improvised litters may be used when the distance may be too
long (far) for manual carries or the casualty has an injury which may be
aggravated by manual transportation.
B-31
FM 21-11
B-32
0
®
OPEN THE PONCHO AND LAY THE TWO
POLES (OR LIMBS) LENGTHWISE ACROSS
THE CENTER. REACH IN AND PULL THE
HOOD TOWARD YOU AND LAY IT FLAT
ON THE PONCHO.
I
FOLD THE PONCHO OVER THE FIRST POLE.
© FOLD THE REMAINING FREE EDGES OF
THE PONCHO OVER THE SECOND POLE.
Figure B-15. Improvised litter with poncho and poles
(Illustrated A thru C).
FM 21-11
B-33
0 BUTTON TWO OR THREE SHIRTS
OR JACKETS AND TURN THEM
INSIDE OUT, LEAVING THE SLEEVES
INSIDE.
0 PASS POLES THROUGH THE
SLEEVES.
Figure B-16. Improvised litter made with poles and jackets
(Illustrated A and B).
Figure B-17. Improvised litters made by inserting poles
through sacks or by rolling blanket.
FM 21-11
f. Any of the appropriate carries may be used to place a
casualty on a litter. These carries are:
The one-man arms carry (Figure B-3).
The two-man arms carry (Figure B-11).
The two-man fore-and-aft carry (Figure B-12).
The two-hand seat carry (Figure B-13).
The four-hand seat carry (Figure B-14).
WARNING
Unless there is an immediate life-threatening
situation (such as fire, explosion), DO NOT
move the casualty with a suspected back or
neck injury. Seek medical personnel for
guidance on how to transport.
g. Either two or four soldiers (head/foot) may be used to lift a
litter. To lift the litter, follow the procedure below.
(1) Raise the litter at the same time as the other
carriers/bearers.
(2) Keep the casualty as level as possible.
NOTE
Use caution when transporting on a sloping
incline/hill.
B-34
•
•
•
•
•
FM 21-11
APPENDIX C
COMMON PROBLEMS/CONDITIONS
Section I. HEALTH MAINTENANCE
C-1. General
History has often demonstrated that the course of battle is influenced
more by the health of the troops than by strategy or tactics. Health is
largely a personal responsibility. Correct cleanliness habits, regular
exercise, and good nutrition have much control over a person’s wellbeing.
Good health does not just happen; it comes with conscious effort
and good habits. This appendix outlines some basic principles that
promote good health.
C-2. Personal Hygiene
a. Because of the close living quarters frequently found in an
Army environment, personal hygiene is extremely important. Disease or
illness can spread and rapidly affect an entire group.
b. Uncleanliness or disagreeable odors affect the morale of
workmates. A daily bath or shower assists in preventing body odor and is
necessary to maintain cleanliness. A bath or shower also aids in
preventing common skin diseases. Medicated powders and deodorants
help keep the skin dry. Special care of the feet is also important. You
should wash your feet daily and keep them dry.
C-3. Diarrhea and Dysentery
a. Poor sanitation can contribute to conditions which may
result in diarrhea and dysentery (a medical term applied to a number of
intestinal disorders characterized by stomach pain and diarrhea with
passage of mucus and blood). Medical personnel can advise regarding the
cause and degree of illness. Remember, however, that intestinal diseases
are usually spread through contact with infectious organisms which can
be spread in human waste, by flies and other insects, or in improperly
prepared or disinfected food and water supplies.
b. Keep in mind the following principles that will assist you in
preventing diarrhea and/or dysentery.
(1) Fill your canteen with treated water at every chance.
When treated water is not available you must disinfect the water in your
canteen by boiling it or using either iodine tablets or chlorine ampules.
Iodine tablets or chlorine ampules can be obtained through your unit
supply channels or field sanitation team.
C-1
FM 21-11
(a) To treat (disinfect) water by boiling, bring water to
a rolling boil in your canteen cup for 5 to 10 minutes. In an emergency,
boiling water for even 15 seconds will help. Allow the water to cool before
drinking.
(b) To treat water with iodine—
Remove the cap from your canteen and fill the
canteen with the cleanest water available.
Put one tablet in clear water or two tablets in
very cold or cloudy water. Double amounts if using a two quart canteen.
Replace the cap, wait 5 minutes, then shake
the canteen. Loosen the cap and tip the canteen over to allow leakage
around the canteen threads. Tighten the cap and wait an additional 25
minutes before drinking.
(c) To treat water with chlorine—
Remove the cap from your canteen and fill
your canteen with the cleanest water available.
Mix one ampule of chlorine with one-half
canteen cup of water, stir the mixture with a mess kit spoon until the
contents are dissolved. Take care not to cut your hands when breaking
open the glass ampule.
Pour one canteen capful of the chlorine
solution into your one quart canteen of water.
Replace the cap and shake the canteen. Loosen
the cap and tip the canteen over to allow leakage around the threads.
Tighten the cap and wait 30 minutes before drinking.
(2) DO NOT buy food, drinks, or ice from civilian vendors
unless approved by medical personnel.
(3) Wash your hands for at least 30 seconds after using the
latrine or before touching food.
(4) Wash your mess kit in a mess kit laundry or with
treated water.
(5) Food waste should be disposed of properly (covered
container, plastic bags or buried) to prevent flies from using it as a
breeding area.
C-2
•
•
•
•
•
•
•
FM 21-11
C-4. Dental Hygiene
a. Care of the mouth and teeth by daily use of a toothbrush and
dental floss after meals is essential. This care may prevent gum disease,
infection, and tooth decay.
b. One of the major causes of tooth decay and gum disease is
plaque. Plaque is an almost invisible film of decomposed food particles
and millions of living bacteria. To prevent dental diseases, you must
effectively remove this destructive plaque.
C-5. Drug (Substance) Abuse
a. Drug abuse is a serious problem in the military. It affects
combat readiness, job performance, and the health of military personnel
and their families. More specifically, drug abuse affects the individual. It
costs millions of dollars in lost time and productivity.
b. The reasons for drug abuse are as different as the people who
abuse the use of them. Generally, people seem to take drugs to change the
way they feel. They may want to feel better or to feel happier. They may
want to escape from pain, stress, or frustration. Some may want to
forget. Some may want to be accepted or to be sociable. Some people take
drugs to escape boredom; some take drugs because they are curious. Peer
pressure can also be a very strong reason to use drugs.
c. People often feel better about themselves when they use
drugs or alcohol, but the effects do not last. Drugs never solve problems;
they just postpone or compound them. People who abuse alcohol or drugs
to solve one problem run the risk of continued drug use that creates new
problems and makes old problems worse.
d. Drug abuse is very serious and may cause serious health
problems. Drug abuse may cause mental incapacitation and even cause
death.
C-6. Sexually Transmitted Diseases
Sexually transmitted diseases (STD) formerly known as venereal
diseases are caused by organisms normally transmitted through sexual
intercourse. Individuals should use a prophylactic (condom) during
sexual intercourse unless they have sex only within marriage or with one,
steady noninfected person of the opposite sex. Another good habit is to
wash the sexual parts and urinate immediately after sexual intercourse,
Some serious STDs include nonspecific urethritis (chlamydia), gonorrhea,
syphilis and Hepatitis B and the Acquired Immunodeficiency Syndrome
(AIDS). Prevention of one type of STD through responsible sex, protects
C-3
FM 21-11
both partners from all STD. Seek the best medical attention if any
discharge or blisters are found on your sexual parts.
a. Acquired Immunodeficiency Syndrome (AIDS). 1 AIDS is the
end disease stage of the HIV infection. The HIV infection is contagious,
but it cannot be spread in the same manner as a common cold, measles, or
chicken pox. AIDS is contagious, however, in the same way that sexually
transmitted diseases, such as syphilis and gonorrhea, are contagious.
AIDS can also be spread through the sharing of intravenous drug needles
and syringes used for injecting illicit drugs.
b. High Risk Group. Today those practicing high risk behavior
who become infected with the AIDS virus are found mainly among
homosexual and bisexual persons and intravenous drug users.
Heterosexual transmission is expected to account for an increasing
proportion of those who become infected with the AIDS virus in the
future.
(1) AIDS caused by virus. The letters A-I-D-S stand for
Acquired Immunodeficiency Syndrome. When a person is sick with
AIDS, he is in the final stages of a series of health problems caused by a
virus (germ) that can be passed from one person to another chiefly during
sexual contact or through the sharing of intravenous drug needles and
syringes used for “shooting” drugs. Scientists have named the AIDS
virus “HIV.” The HIV attacks a person’s immune system and damages
his ability to fight other disease. Without a functioning immune system
to ward off other germs, he now becomes vulnerable to becoming infected
by bacteria, protozoa, fungi, and other viruses and malignancies, which
may cause life-threatening illness, such as pneumonia, meningitis, and
cancer.
(2) No known cure. There is presently no cure for AIDS.
There is presently no vaccine to prevent AIDS.
(3) Virus invades blood stream. When the AIDS virus
enters the blood stream, it begins to attack certain white blood cells
(T-Lymphocytes). Substances called antibodies are produced by the
body. These antibodies can be detected in the blood by a simple test,
usually two weeks to three months after infection. Even before the
antibody test is positive, the victim can pass the virus to others.
(4) Signs and Symptoms.
Some people remain apparently well after infection
with the AIDS virus. They may have no physically apparent symptom of
illness. However, if proper precautions are not used with sexual contacts
and/or intravenous drug use, these infected individuals can spread the
virus to others.
1 The Surgeon General’s Report on Acquired Immunodeficiency Syndrome (U.S. Public
Health Service, 1986).
C-4
•
FM 21-11
The AIDS virus may also attack the nervous
system and cause delayed damage to the brain. This damage may take
years to develop and the symptoms may show up as memory loss,
indifference, loss of coordination, partial paralysis, or mental disorder.
These symptoms may occur alone, or with other symptoms mentioned
earlier.
(5) AIDS: the present situation. The number of people
estimated to be infected with the AIDS virus in the United States is over
1.5 million as of April 1988. In certain parts of central Africa 50% of the
sexually active population is infected with HIV. The number of persons
known to have AIDS in the United States to date is over 55,000; of these,
about half have died of the disease. There is no cure. The others will soon
die from their disease. Most scientists predict that all HIV infected
persons will develop AIDS sooner or later, if they don’t die of other
causes first.
(6) Sex between men. Men who have sexual relations with
other men are especially at risk. About 70% of AIDS victims throughout
the country are male homosexuals and bisexuals. This percentage
probably will decline as heterosexual transmission increases. Infection
results from a sexual relationship with an infected person.
(7) Multiple partners. The risk of infection increases
according to the number of sexual partners one has, male or female. The
more partners you have, the greater the risk of becoming infected with
the AIDS virus.
(8) How exposed. Although the AIDS virus is found in
several body fluids, a person acquires the virus during sexual contact
with an infected person’s blood or semen and possibly vaginal secretions.
The virus then enters a person’s blood stream through their rectum,
vagina or penis. Small (unseen by the naked eye) tears in the surface
lining of the vagina or rectum may occur during insertion of the penis,
fingers, or other objects, thus opening an avenue for entrance of the virus
directly into the blood stream.
(9) Prevention of sexual transmission—know your partner.
Couples who maintain mutually faithful monogamous relationships (only
one continuing sexual partner) are protected from AIDS through sexual
transmission. If you have been faithful for at least five years and your
partner has been faithful too, neither of you is at risk.
(10) Mother can infect newborn. If a woman is infected with
the AIDS virus and becomes pregnant, she has about a 50% chance of
passing the AIDS virus to her unborn child.
C-5
•
FM 21-11
(11) Summary. AIDS affects certain groups of the
population. Homosexual and bisexual persons who have had sexual
contact with other homosexual or bisexual persons as well as those who
“shoot” street drugs are at greatest risk of exposure, infections and
eventual death. Sexual partners of these high risk individuals are at risk,
as well as any children born to women who carry the virus. Heterosexual
persons are increasingly at risk.
(12) Donating blood. Donating blood is not risky at all. You
cannot get AIDS by donating blood.
(13) Receiving blood. High risk persons and every blood
donation is now tested for the presence of antibodies to the AIDS virus.
Blood that shows exposure to the AIDS virus by the presence of
antibodies is not used either for transfusion or for the manufacture of
blood products. Blood banks are as safe as current technology can make
them. Because antibodies do not form immediately after exposure to the
virus, a newly infected person may unknowingly donate blood after
becoming infected but before his antibody test becomes positive.
(14) Testing of military personnel. You may wonder why the
Department of Defense currently tests its uniformed services personnel
for presence of the AIDS virus antibody. The military feels this
procedure is necessary because the uniformed services act as their own
blood bank in a combat situation. They also need to protect new recruits
(who unknowingly may be AIDS virus carriers) from receiving live virus
vaccines. HIV antibody positive soldiers may not be assigned overseas
(includes Alaska and Hawaii). They must be rechecked every six months
to determine if the disease has become worse. If the disease has
progressed, they are discharged from the Army (policy per AR 600-110).
This regulation requires that all soldiers receive annual education classes
on AIDS.
Section II. FIRST AID FOR COMMON PROBLEMS
C-7. Heat Rash (or Prickly Heat)
a. Description. Heat rash is a skin rash caused by the blockage
of the sweat glands because of hot, humid weather or because of fever. It
appears as a rash of patches of tiny reddish pinpoints that itch.
b. First Aid. Wear clothing that is light and loose and/or
uncover the affected area. Use skin powders or lotion.
C-6
FM 21-11
C-8. Contact Poisoning (Skin Rashes)
a General.
(1) Poison Ivy grows as a small plant (vine or shrub) and
has three glossy leaflets (Figure C-1).
(2) Poison Oak grows in shrub or vine form; and has
clusters of three leaflets with wavy edges (Figure C-2).
(3) Poison Sumac grows as a shrub or small tree. Leaflets
grow opposite each other with one at tip (Figure C-3).
C-7
Figure C-1. Poison ivy.
Figure C-2. Wes tern poison oak.
Figure C-3. Poison sumac.
FM 21-11
b. Signs/Symptoms.
Redness.
Swelling.
Itching.
Rashes or blisters.
Burning sensation.
General headaches and fever.
NOTE
Secondary infection may occur when blisters
break.
c. First Aid.
(1) Expose the affected area: remove clothing and jewelry.
(2) Cleanse affected area with soap and water.
(3) Apply rubbing alcohol, if available, to the affected
areas.
(4) Apply calamine lotion (helps relieve itching and
burning).
(5) Avoid dressing the affected area.
(6) Seek medical help, evacuate if necessary. (If rash is
severe, or on face or genitals, seek medical help.)
C-9. Care of the Feet
Proper foot care is essential for all soldiers in order to maintain their
optimal health and physical fitness. To reduce the possibilities of serious
foot trouble, observe the following rules:
a. Foot hygiene is important. Wash and dry feet thoroughly,
especially between the toes. Soldiers who perspire freely should apply
powder lightly and evenly twice a day.
C-8
•
•
•
•
•
•
C1, FM 21-11
b. Properly fitted shoes/boots should be the only ones issued.
There should be no binding or pressure spots.
c. Clean, properly fitting socks should be changed and washed
daily. Avoid socks with holes or poorly darned areas; they may cause
blisters.
d. Attend promptly to common medical problems such as
blisters, ingrown toenails, and fungus infections (like athlete’s foot).
e. Foot marches are a severe test for the feet. Use only properly
fitted footgear and socks. Footgear should be completely broken-in. DO
NOT break-in new footgear on a long march. Any blisters, sores, and so
forth, should be treated promptly. Keep the feet as dry as possible on the
march; carry extra socks and change if feet get wet (socks can be dried by
putting them under your shirt, around your waist or hanging on a rack).
Inspect feet during rest breaks. Bring persistent complaints to the
attention of medical personnel.
H C-10. Blisters
Blisters are a common problem caused by friction. They may appear on
such areas as the toes, heels, or the palm of the hand (anywhere friction
may occur). Unless treated promptly and correctly, they may become
infected. PREVENTION is the best solution to AVOID blisters and
subsequent infection. For example, ensure boots are prepared properly
for a good fit, whenever possible always keep feet clean and dry; and,
wear clean socks that also fit properly. Gloves should be worn whenever
extensive manual work is done.
NOTE
Keep blisters clean. Care should be taken to
keep the feet as clean as possible at all times.
Use soap and water for cleansing. Painful
blisters and/or signs of infection, such as
redness, throbbing, drainage, and so forth, are
reasons for seeking medical treatment. Seek
medical treatment only from qualified medical
personnel.
C-9
C1, FM 21-11
NOTES
C-10
FM 21-11
APPENDIX E
DIGITAL PRESSURE
Apply Digital Pressure
Digital pressure (also often called “pressure points”) is an alternate
method to control bleeding. This method uses pressure from the fingers,
thumbs, or hands to press at the site or point where a main artery
supplying the wounded area lies near the skin surface or over bone
(Figure E-1). This pressure may help shut off or slow down the flow of
blood from the heart to the wound and is used in combination with direct
pressure and elevation. It may help in instances where bleeding is not
easily controlled, where a pressure dressing has not yet been applied, or
where pressure dressings are not readily available.
E-1
If blood is spurting from wound (artery). press at the point or site where main
artery supplying the wounded area lies near skin surface or over bone as shown.
This pressure shuts off or slows down the flow of blood from the heart to the
wound until a pressure dressing can be unwrapped and applied. You will know
you have located the artery when you feel a pulse.
Figure E-1. Digital pressure (pressure with fingers, thumbs or hands).
FM 21-11
NOTES
E-2
FM 21-11
APPENDIX F
DECONTAMINATION PROCEDURES
F-1. Protective Measures and Handling of Casualties
a. Depending on the theater of operations, guidance issued may
dictate the assumption of a minimum mission-oriented protective
posture (MOPP) level. However, a full protective posture (MOPP 4) level
will be assumed immediately when the alarm or command is given.
(MOPP 4 level consists of wearing the protective overgarment, mask,
hood, gloves, and overboots.) If individuals find themselves alone
without adequate guidance, they should mask and assume the MOPP 4
level under any of the following conditions.
(1) Their position is hit by a concentration of artillery,
mortar, rocket fire, or by aircraft bombs if chemical agents have been
used or the threat of their use is significant.
(2) Their position is under attack by aircraft spray.
(3) Smoke or mist of an unknown source is present or
approaching.
(4) A
(5) A
suspicious odor or a suspicious liquid is present.
toxic chemical or biological attack is suspected.
(6) They are entering an area known to be or suspected of
being contaminated with a toxic chemical or biological agent.
(7) During any motor march, once chemical warfare has
been initiated.
(8) When casualties are being received from an area where
chemical agents have reportedly been used.
(9) They have one or more of the following signs/symptoms:
(a) An unexplained sudden runny nose.
(b) A feeling of choking or tightness in the chest or
throat.
(c) Blurring of vision and difficulty in focusing the
eyes on close objects.
(d) Irritation of the eyes (could be caused by the
presence of several toxic chemical agents).
F-1
FM 21-11
(e) Unexplained difficulty in breathing or increased
rate of breathing.
(f) Sudden feeling of depression.
(g) Dread, anxiety, restlessness.
(h) Dizziness or light-headedness.
(i) Slurred speech.
(10) Unexplained laughter or unusual behavior noted in
others.
(11) Buddies suddenly collapsing without evident cause.
b. Stop breathing don the protective mask, seat it properly,
clear it, and check it for seal; then resume breathing. The mask should be
worn until unmasking procedures indicate no chemical agent is in the air
and the “all clear” signal is given. (See FM 3-4 for unmasking
procedures.) If vomiting occurs, the mask should be lifted momentarily
and drained— while the eyes are closed and the breath is held—and
replaced, cleared, and sealed.
c. Casualties contaminated with a chemical agent may
endanger unprotected personnel. Handlers of these casualties must wear
a protective mask, protective gloves, and chemical protective clothing
until the casualty’s contaminated clothing has been removed. The
battalion aid station should be established upwind from the most heavily
contaminated areas, if it is expected that troops will remain in the area
six hours or more. Collective protective shelters must be used to
adequately manage casualties on the integrated battlefield. Casualties
must be undressed and decontaminated, as required, in an area equipped
for the removal of contaminated clothing and equipment prior to entering
collective protection. Contaminated clothing and equipment should be
placed in airtight containers or plastic bags, if available, or removed to a
designated dump site downwind from the aid station.
F-2. Personal Decontamination
Following contamination of the skin or eyes with vesicants (mustards,
lewisite, and so forth) or nerve agents, personal decontamination must be
carried out immediately. This is because chemical agents are effective at
very small concentrations and within a very few minutes after exposure,
decontamination is marginally effective. Decontamination consists of
either removal and/or neutralization of the agent. Decontamination after
F-2
FM 21-11
absorption occurs may serve little or no purpose. Soldiers will
decontaminate themselves unless they are incapacitated. For soldiers
who cannot decontaminate themselves, the nearest able person should
assist them as the situation permits.
NOTE
In a cyanide only environment, there would be
no need for decontamination.
a. Eyes. Following contamination of the eyes with any chemical
agent, the agent must be removed instantly. In most cases, identity of
the agent will not be known immediately. Individuals who suspect
contamination of their eyes or face must quickly obtain overhead shelter
to protect themselves while performing the following decontamination
process:
(1) Remove and open your canteen.
(2) Take a deep breath and hold it.
(3) Remove the mask.
(4) Flush or irrigate the eye, or eyes, immediately with
large amounts of water. To flush the eyes with water from a canteen (or
other container of uncontaminated water), tilt the head to one side, open
the eyelids as wide as possible, and pour water slowly into the eye so that
it will run off the side of the face to avoid spreading the contamination.
This irrigation must be carried out despite the presence of toxic vapors in
the atmosphere. Hold your breath and keep your mouth closed during
this procedure to prevent contamination and absorption through the
mucous membranes. Chemical residue flushed from the eyes should be
neutralized along the flush path.
(5)
breathing.
WARNING
DO NOT use the fingers or gloved hands for
holding the eyelids apart. Instead, open the
eyes as wide as possible and pour the water as
indicated above.
Replace, clear, and check your mask. Then resume
(6) If contamination was picked up while flushing the eyes,
then decontaminate the face. Follow procedure outlined in paragraph
b (2) (a)-(ae) below.
F-3
FM 21-11
b. Skin (Hands, Face, Neck, Ears, and Other Exposed Areas).
The M258A1 Skin Decontamination Kit (Figure F-1) is provided
individuals for performing emergency decontamination of their skin (and
selected small equipment, such as the protective gloves, mask, hood, and
individual weapon).
(1) Description of the M258A1 kit. The M258A1 kit
measures 1 3/4 by 2 3/4 by 4 inches and weighs 0.2 pounds. Each kit
contains six packets: three DECON-1 packets and three DECON-2
packets. DECON-1 packet contains a pad premoistened with
hydroxyethane 72%, phenol 10%, sodium hydroxide 5%, and ammonia
0.2%, and the remainder water. DECON-2 packet contains a pad
impregnated with chloramine B and sealed glass ampules filled with
hydroxyethane 45%, zinc chloride 5%, and the remainder water. The case
fits into the pocket on the outside rear of the M17 series protective mask
carrier or in an inside pocket of the carrier for the M24 and M25 series
protective mask. The case can also be attached to the web belt or on the D
ring of the protective mask carrier.
F-4
---TE,._ .. __
1 1
THREE DECON-1 PACKETS
THREE DECON-2 PACKETS
' I
\
• ,:~ ,: >> L;i~J'.;t;\I'.:}~i!\
FOLDED WIPE (WET)
-NYLON PACKET WITH
THREE AMPULES
Figure F-1. M258Al Skin Decontamination Kit.
FM 21-11
(2) Use of the M258A1 kit. It should be noted that the
procedures outlined in paragraphs (a) thru (ae) below were not intended to
replace or supplant those contained in STP 21-1-SMCT but, rather, to
expand on the doctrine of skin decontamination.
WARNING
The ingredients of the DECON-1 and
DECON-2 packets of the M258A1 kit are,
poisonous and caustic and can permanently
damage the eyes. KEEP PADS OUT OF THE
EYES, MOUTH, AND OPEN WOUNDS. Use
water to wash the toxic agent out of the eyes or
wounds, except in the case of mustard,
Mustard may be removed by thorough
immediate wiping.
WARNING
The complete decon (WIPES 1 and 2) of the
face must be done as quickly as possible–
3 minutes or less.
WARNING
DO NOT attempt to decontaminate the face or
neck before putting on a protective mask.
NOTE
Use the buddy system to decontaminate
exposed skin areas you cannot reach.
NOTE
Blisters caused by blister agents are actually
burns and should be treated as such. Blisters
which have ruptured are treated as open
wounds.
(a) Put on the protective mask (if not already on).
(b) Seek overhead cover or use a poncho for protection
against further contamination.
F-5
FM 21-11
(c) Remove the M258A1 kit. Open the kit and remove
one DECON-1 WIPE packet by its tab.
(d) Fold the packet on the solid line marked BEND,
then unfold it.
(e) Tear open the packet quickly at the notch, and
remove the wipe and fully open it.
(f) Wipe your hands.
NOTE
If you have a chemical agent on your face, do
steps (g) through (t). If you do not have an
agent on your face, do step (m), continue to
decon other areas of contaminated skin, then
go to step (n).
NOTE
You must hold your breath while doing steps
(g) through (l). If you need to breathe before
you finish, reseal your mask, clear it and check
it, then continue.
(g) Hold your breath, close your eyes, and lift the hood
and mask from your chin.
(h) Scrub up and down from ear to ear.
1. Start at an ear.
2. Scrub across the face to the corner of the nose.
3. Scrub an extra stroke at the corner of the nose.
4. Scrub across the nose and tip of the nose to the
corner of the nose.
5. Scrub an extra stroke at the corner of the nose.
6. Scrub across the face to the other ear.
(i) Scrub up and down from the ear to the end of the
jawbone.
F-6
FM 21-11
mouth.
mouth.
the upper lip.
the mouth.
mouth.
jawbone.
1. Begin where step (h) ended.
2. Scrub across the cheek to the corner of the
3. Scrub an extra stroke at the corner of the
4. Scrub across the closed mouth to the center of
5. Scrub an extra stroke above the upper lip.
6. Scrub across the closed mouth to the corner of
7. Scrub an extra stroke at the corner of the
8. Scrub across the cheek to the end of the
(j) Scrub up and down from one end of the jawbone to
the other end of the jawbone.
1. Begin where step (i) ended.
2. Scrub across and under the jaw to the chin,
cupping the chin.
the jawbone.
the face.
breathing.
and the ears.
3. Scrub an extra stroke at the cleft of the chin.
4. Scrub across and under the jaw to the end of
(k) Quickly wipe the inside of the mask which touches
(l) Reseal, clear, and check the mask. Resume
(m) Using the same DECON-1 WIPE, scrub the neck
(n) Rewipe the hands.
(o) Drop the wipe to the ground.
F-7
FM 21-11
(p) Remove one DECON-2 WIPE packet, and crush
the encased glass ampules between the thumb and fingers. DO NOT
KNEAD.
(q) Fold the packet on the solid line marked CRUSH
AND BEND, then unfold it.
(r) Tear open the packet quickly at the notch and
remove the wipe.
(s) Fully open the wipe. Let the encased crushed glass
ampules fall to the ground.
(t) Wipe your hands.
NOTE
If you have an agent on your face, do steps (u)
through (ae). If you do not have an agent on
your face, do step (aa), continue to decon other
areas of contaminated skin, then go to step
(ab).
NOTE
You must hold your breath while doing steps
(u) through (z). If you need to breathe before
you finish, reseal your mask, clear it and check
it, then continue.
(u) Hold your breath, close your eyes, and lift the hood
and mask away from your chin.
(v) Scrub up and down from ear to ear.
1. Start at an ear.
2. Scrub across the face to the corner of the nose.
3. Scrub an extra stroke at the corner of the nose.
4. Scrub across the nose and tip of the nose to the
corner of the nose.
5. Scrub an extra stroke at the corner of the nose.
F-8
FM 21-11
jawbone.
mouth.
mouth.
the upper lip.
the mouth.
mouth.
jawbone.
6. Scrub across the face to the other ear.
(w) Scrub up and down from the ear to the end of the
1. Begin where step (v) ended.
2. Scrub across the cheek to the corner of the
3. Scrub an extra stroke at the corner of the
4. Scrub across the closed mouth to the center of
5. Scrub an extra stroke above the upper lip.
6. Scrub across the closed mouth to the corner of
7. Scrub an extra stroke at the corner of the
8. Scrub across the cheek to the end of the
(x) Scrub up and down from one end of the jawbone to
the other end of the jawbone.
1. Begin where step (w) ended.
2. Scrub across and under the jaw to the chin,
cupping the chin.
3. Scrub an extra stroke at the cleft of the chin.
4. Scrub across and under the jaw to the end of
the jawbone.
(y) Quickly wipe the inside of the mask which touches
the face.
(z) Reseal, clear, and check the mask. Resume
breathing.
(aa) Using the same DECON-2 WIPE, scrub the neck
and ears.
(ab) Rewipe the hands.
F-9
FM 21-11
(ac) Drop the wipe to the ground.
(ad) Put on the protective gloves and any other
protective clothing, as appropriate. Fasten the hood straps and neck
cord.
(ae) Bury the decontaminating packet and other items
dropped on the ground, if circumstances permit.
C. Clothing and Equipment. Although the M258A1 may be
used for decontamination of selected items of individual clothing and
equipment (for example, the soldier’s individual weapon), there is
insufficient capability to do more than emergency spot decontamination.
The M258A1 is not used to decontaminate the protective overgarment.
The protective overgarment does not require immediate decontamination
since the charcoal layer is a decontaminating device; however, it must be
exchanged, using the procedures outlined in FM 3-5. The Individual
Equipment Decontamination Kit (DKIE), M280 (similar in configuration
to the M258A1), is used to decontaminate equipment such as the weapon,
helmet, and other gear that is carried by the individual.
F-3. Casualty Decontamination
Contaminated casualties entering the medical treatment system are
decontaminated through a decentralized process. This is initially started
through self-aid and buddy aid procedures. Later, units should further
decontaminate the casualty before evacuation. Casualty
decontamination stations are established at the field medical treatment
facility to further decontaminate these individuals (clothing removal and
spot decontamination, as required) prior to treatment and evacuation.
These stations are manned by nonmedical members of the supported unit
under supervision of medical personnel. There are insufficient medical
personnel to both decontaminate and treat casualties. The medical
personnel must be available for treatment of the casualties during and
after decontamination by nonmedical personnel. Decontamination is
accomplished as quickly as possible to facilitate medical treatment,
prevent the casualty from absorbing additional agent, and reduce the
spread of chemical contamination.
F-10
FM 21-11
APPENDIX G
SKILL LEVEL 1 TASKS
(STP 21-1-SMCT Soldier’s Manual of
Common Tasks [Skill Level I])
Task Number
081-831-1000
081-831-1003
081-831-1005
081-831-1007
081-831-1008
081-831-1009
081-831-1016
081-831-1017
081-831-1025
081-831-1026
081-831-1030
081-831-1031
Task Title
Evaluate a Casualty
Clear an Object from the
Throat of a Conscious
Casualty
Prevent Shock
Give First Aid for Burns
Recognize and Give First
Aid for Heat Injuries
Give First Aid for Frostbite
Put on a Field or Pressure
Dressing
Put on a Tourniquet
Apply a Dressing to an Open
Abdominal Wound
Apply a Dressing to an Open
Chest Wound
Administer Nerve Agent
Antidote to Self (Self-Aid)
Administer First Aid to a
Nerve Agent Casualty
(Buddy Aid)
FM Paragraph
1-1, 1-2, 2-2, 2-22,
3-2, 3-3, 3-4, 4-2,
4-9, 4-10.
2-13.
2-23.
3-14.
5-1.
5-2.
2-15, 2-17, 2-18,
2-19.
2-20.
3-12.
3-9, 3-10.
7-5, 7-7, 7-8.
7-5, 7-7, 7-8.
G-1
FM 21-11
Task Number Task Title FM Paragraph
081-831-1033 Apply a Dressing to an Open 3-3, 3-4, 3-8.
Head Wound
081-831-1034 Splint a Suspected Fracture 4-4, 4-5, 4-6, 4-7.
081-831-1040 Transport a Casualty Using a B-9.
One-Man Carry
081-831-1041 Transport a Casualty Using a B-9, B-10.
Two-Man Carry or an
Improvised Litter
081-831-1042 Perform Mouth-to-Mouth 2-2, 2-3, 2-5, 2-6,
Resuscitation 2-14.
G-2
C2, FM 21-11
H GLOSSARY
AC
AIDS
BZ
cc
CG
CK
CL/cl
CS or CN
CSR
CTA
CX
DA
DECON/decon
DKIE
DP
ECC
fl
FM
HD
HIV
HN
IPE
IV
L
MILES
MKI
ml
MOPP
NAAK
NAPP
NATO
NBC
oz
2 PAM C1
PS
SMCT
hydrogen cyanide
acquired immunodeficiency syndrome
anticholinergic drugs
cubic centimeter
phosgene
cyanogen chloride
chlorine
tear agents
combat stress reaction
common table of allowances
phosgene oxime
Department of the Army
decontaminate
individual equipment decontamination kit
diaphosgene
emergency cardiac care
fluid
Field Manual
mustard
human immunodeficiency virus
nitrogen mustards
individual protective equipment
intravenous infusion
lewisite
multiple integrated laser engagement
simulation
Mark I
milliliter
mission-oriented protective posture
nerve agent antidote kit
nerve agent pyridostigmine pretreatment
North Atlantic Treaty Organization
nuclear, biological, chemical
ounce
pralixodime chloride
chloropicrin
soldiers manual of common tasks
Glossary-1
160-065 0 - 94 - 4
C2, FM 21-11
SOP
STANAG
STD
STP
WP
Glossary-2
standing operating procedure
standardization agreement
sexually transmitted disease
soldiers training publication
white phosphorus
C2, FM 21-11
H REFERENCES
SOURCES USED
These are the sources quoted or paraphrased in this publication.
Joint and Multiservice Publications
DOD Medical Catalog, Volume II. Sets, Kits and Outfits. June 1990.
TB MED 81. Cold Injury (NAVMED P-5052-29; AFP 161-11).
30 September 1976.
TB MED 507. Occupational and Environmental Health Prevention,
Treatment and Control of Heat Injury (NAVMED P-5052-5; AFP
160-1). 25 July 1980.
FM 8-285. Treatment of Chemical Agent Casualties and Conventional
Military Chemical Injuries (NAVMED P-5041; AFM 160-12).
28 February 1989.
Army Publications
AR 310-25. Dictionary of United States Army Terms (Short Title AD)
(Reprinted with Basic Including Change 1). 15 October 1983,
C1 May 1986.
AR 310-50. Authorized Abbreviations, Brevity Codes, and Acronyms.
15 November 1985.
TM 3-4230-216-10. Operator’s Manual for Decontaminating Kit, Skin:
M258A1 (NSN 4230-01-101-3984) and Training Aid Skin
Decontaminating: M58A1 (6910-01-101-1768). 17 May 1985.
CTA 8-100. Army Medical Department Expendable/Durable Items.
1 August 1990.
CTA 50-900. Clothing and Individual Equipment. 1 August 1990.
Nonmilitary Publications
American Heart Association. Instructor’s Manual for Basic Life
Support. Dallas: American Heart Association. 1987.
References-1
C2, FM 21-11
DOCUMENTS NEEDED
These documents must be available to the intended users of this
publication.
Joint and Multiservice Publications
FM 3-100. NBC Operations (FMFM 11-2). 23 May 1991.
Army Publications
DA PAM 351-20. Army
27 April 1990.
FM 3-4. NBC Protection.
Correspondence Course Program Catalog.
21 October 1985.
FM 3-5. NBC Decontamination. 24 June 1985.
FM 21-10. Field Hygiene and Sanitation. 22 November 1988.
STP 21-1-SMCT. Soldier’s Manual of Common Tasks (Skill Level 1).
1 October 1990.
RECOMMENDED READINGS
These readings contain relevant supplemental information.
Joint and Multiservice Publications
FM 8-9. NATO Handbook on the Medical Aspects of NBC Defensive
Operations (NAVMED P-5059; AFP 161-3). 31 August 1973,
C1 May 1983.
FM 8-33. Control of Communicable Diseases in Man, 14th Edition
(NAVMED P-5038). 20 January 1985.
References-2
C2, FM 21-11
Army Publications
AR 600-110. Identification, Surveillance, and Administration of
Personnel Infected with Human Immunodeficiency Virus (HIV).
11 March 1988, C1 May 1989.
DA PAM 40-12. Who Needs It— Venereal Diseases. 15 February 1984.
DA PAM 600-63-10. Fit to Win–Stress Management. September 1987.
FM 3-7. NBC Handbook. 27 September 1990.
FM 8-35. Evacuation of the Sick and Wounded. 22 December 1983.
(To be superseded by FM 8-10-6, Medical Evacuation in a Theater
of Operations-Tactics, Techniques, and Procedures.)
FM 8-50. Prevention and Medical Management of Laser Injuries.
8 August 1990.
FM 8-230. Medical Specialist. 24 August 1984.
References-3
C2, FM 21-11
Index-0
* INDEX
Para Page
Abdominal Thrust ............................................ 2-13c .................... 2-23
Acquired immunodeficiency syndrome.
See Sexually transmitted diseases.
Airway:
Defined ........................................................... l-3a ...................... 1-8
Opening of... ................................................... 2-3, 2-13, 2-14 ...... 2-3, 2-22, 2-26
Arteries .............................................................. l-3b ...................... 1-9
Artificial respiration.
See Rescue breathing.
Bandages:
Cravat ............................................................ 3-4h, 3-8e(2) ......... 3-13, 3-22
3-15b, 3-16 ........... 3-38, 3-39
3-17b, 3-18 ........... 3-41, 3-42
3-19 ...................... 3-42
Tailed............................................................. 3-4e ...................... 3-8
Triangular ...................................................... 3-4g, 3-l 7a ........... 3-12, 3-40
3-20 ...................... 3-43
Bandaging of body parts:
Abdomen (stomach)...................................... 3-l 2d ...... .............. · 3-30
Armpit ........................................................... 3-15b .................... 3-38
Cheek .............................................................. 3-8b...................... 3-18
Chest .............................................................. 3-l0c.................... 3-24
Ear .................................................................. 3-Sc...................... 3-20
Elbow ............................................................. 3-16 ...................... 3~39
Eyes ................................................................ 3-8a ...................... 3-16
Foot................................................................ 3-20...................... 3-43
Hand............................................................... 3-1 7 ...................... 3-40
Head ............................................................... 3-4e, 3-4{ .............. 3-8, 3-9
3-4g, 3-4h............. 3-12, 3-13
Jaw ................................................................. 3-8e ...................... 3-22
Knee ............................................................... 3-19 ...................... 3-42
Leg .................................................................. 3-18 ...................... 3-42
Shoulder......................................................... 3-15................. ... . . 3-3 7
Battle fatigue.
See Psychological first aid.
Biological agents, protection from .................. 7-14...................... 7-27
Bites:
Animal............................................................ 6-3........................ 6-9
Human ........................................................... 6-3 ........................ 6-9
Insect............................................................. 6-5 ...... ........... ....... 6-11
Snake .............................................................. 6-2 ........................ 6-5
Spider............................................................. 6-5a.. ........... ....... .. 6-11
C2, FM 21-11
Index-1
Para Page
Bleeding, control of:
Digital pressure ............................................. App E .................. E-1
Elevating the limb ......................................... 2-18b, 2-19 ........... 2-36
Manual pressure ............................................ 2-18 ...................... 2-35
Pressure dressing .......................................... 2-19 ...................... 2-36
Tourniquet..................................................... 2-20...................... 2-39
Blisters.............................................................. C-10 . . . . . . . . . . . . . . . .. . . . . C-9
Blister agent.
See Toxic environment.
Blood:
Circulation..................................................... 1-3b...................... 1-9
Loss ................................................................ 1-4b ...................... 1-11
Vessels ........................................................... 1-3b ...................... 1-9
Breathing.
See Respiration.
Burns:
Chemical........................................................ 3-8a(4)(a) .............. 3-17
3-14a(3) ................ 3-34
Electrical. ....................................................... 3-14a(2) ................ 3-34
Incendiaries, from ......................................... 7-13 ...................... 7-26
Laser ................................. : ............................. 3-8a(4)(c).............. 3-17
3-14a(4) ................ 3-35
Thermal .......................................................... 3-8a(4)(b) .............. 3-17
3-14a(l) ................ 3-33
Types .............................................................. 3-13 ...................... 3-33
Canteen cap ....................................................... C-3 ....................... C-1
Capillaries......................................................... 1-3b...................... 1-9
Carbon dioxide .................................................. 1-3b...................... 1-9
Carries, manual:
One-man carries:
Arms carry ................................................. Fig B-3 ................ B-14
r-, ___ .Jl _ _.] ___ .J __ -
vn1.u1e urup un:1.g- ....................................... .
Fireman's carry ......................................... .
Neck drag .................................................. .
Pack-strap carry ....................................... .
Pistol belt:
Carry ...................................................... .
Drag ........................................................ .
Saddleback carry ...................................... .
Support carry ............................................ .
Two-man carries:
Arms carry ................................................ .
Fore-and-aft carry ..................................... .
Four-hand seat carry ................................ .
Support carry ............................................ .
Two-hand seat carry ................................. .
D! ...... DO
J.'lb LJ·.:1 ••••••••••••••••
Fig B-1. .............. .
Fig B-8 ............... .
Fig B-5 ............... .
Fig B-6 ............... .
Fig B-7 ............... .
Fig B-4 ............... .
Fig B-2 ............... .
Fig B-11... .......... .
Fig B-12 ............. .
Fig B-14 ............. .
Fig B-10 ............. .
Fig B-13 ............. .
B-21
B-6
B-20
B-16
B-17
B-19
B-15
B-14
B-25
B-27
B-30
B-23
B-29
C2, FM 21-11
Index-2
Para Page
Chemical-biological agents:
Blister............................................................ 7-3a...................... 7-3
Blood.............................................................. 7-3a...................... 7-3
Choking .......................................................... 7-3a ...................... 7-3
Incapacitating............................................... 7-3a...................... 7-3
Nerve.............................................................. 7-3a...................... 7-3
Protection from:
Nerve agent antidote kit, Mark 1.. ........... 7-2e, 7-6 ............... 7-3, 7-6
Nerve agent pyridostigmine
pretreatment ........................................... 7-2c...................... 7-2
Vomiting ........................................................ 7-3, 7-5c ............... 7-3, 7-5
Chemical attack, first aid for ........................... 7-5 ........................ 7-5
CheAt eage......................................................... 1 -~n....................... 1-8
Chlamydia.
See Sexually transmitted diseases.
Circulation ......................................................... 1-3b ...................... 1-9
Cold, conditions caused by ............................... 5-2d ...................... 5-10
Combat lifesaver ............................................... Preface ................ xvii
Combat stress reaction.
See Psychological first aid.
Contamination.................................................. 1-4d...................... 1-12
Contents of First Aid Case and Kits ............... App A .................. A-1
Diaphragm........................................................ 1-3a...................... 1-8
Digital pressure ................................................ App E .................. E-1
Disaster, reactions to ....................................... 8-3, 8-8 ................. 8-2, 8-4
Diseases, sexually transmitted.
See Sexually triiiismitted diseases.
Dislocation of bone ........................................... 4-la ...................... 4-1
Dressing:
Field first aid ................................................. App A.................. A-1
Wounds.......................................................... 3-4e,f.................... 3-8, 3-9
3-lOc,d,e .............. 3-24, 3-~
3-12d .................... 3-30
3-14c .................... 3-36
Ear, injury of ..................................................... 3-8c ...................... 3-20
Elevation of lower extremities ......................... 2-18b .................... 2-36
Emotional disability ......................................... 8-7 ........................ 8-3
Equipment.
See First Aid.
Exhalation ......................................................... 1-3a...................... 1-8
Eye, injury ......................................................... 3-8a ...................... 3-16
First aid:
Case, field ....................................................... App A .................. A-1
Definition ....................................................... Preface ................ xvii
Dn's end dn nnt's... ..... ............................... 1-1 ........................ 1-1
Equipment for toxic environment ............... 7-2 ........................ 7-1
C2, FM 21-11
Index-3
Para Page
First aid (continued)
Importance of ................................................ 1-1........................ 1-1
Kit:
Decontaminating ....................................... 7-2d, F-2b ............ 7-2, F-4
General purpose ......................................... App A .................. A-1
Laser ............................................................... 3-8a(4)(c), 3-13 ..... 3-17, 3-33
3-14a(4) ................ 3-35
Psychological. ................................................ 8-13 ...................... 8-8
Foot:
Frostbite........................................................ 5-2d(3).................. 5-12
Immersion...................................................... 5-2d(2).................. 5-11
Trench ............................................................ 5-2d(2) .................. 5-11
Fractures:
Closed ............................................................. 4-la ...................... 4-1
Open ............................................................... 4-lb ...................... 4-1
Signs of. ......................................................... 4-2........................ 4-2
Splinting and immobilizing:
Bandages for .............................................. 4-4c ...................... 4-2
Collarbone .................................................. 4-8 ........................ 4-17
Improvisations for ..................................... 4-4a ...................... 4-2
Jaw .............................................................. 4-8 ........................ 4-17
Lower extremities...................................... 4-7 ........................ 4-14
Neck ............................................................ 4-10 ...................... 4-22
Padding for ................................................. 4-4b ...................... 4-2
Purpose for ................................................. 4-3........................ 4-2
Rules for ..................................................... 4-5 ........................ 4-3
Shoulder . . . . . .......... ............ ........... ............... 4-8.... ..... .. . . . . . ........ 4-1 7
Slings .......................................................... 4-4d ...................... 4-2
Spinal column............................................. 4-9..... .......... ......... 4-19
Upper extremities ...................................... 4-6 ........................ 4-10
Frostbite ............................................................ 5-2d(3) .................. 5-12
Germs................................................................ l-4d...................... 1-12
Gonorrhea.
See Sexually transmitted diseases.
Heart, defined ................................................... 1-3b...................... 1-9
Heartbeat.......................................................... 1-3b(l), 2-8 ........... 1-9, 2-13
Heat:
Cramps ........................................................... 5-le(l) .................. 5-3
Table 5-1............. 5-6
Exhaustion .................................................... 5-le(2).................. 5-4
Table 5-1............. 5-6
Heatstroke ..................................................... 5-le(3).................. 5-5
Table 5-1........ ... . . 5-6
Heimlich hug.
See Abdominal thrust.
C2, FM 21-11
Index-4
Para Page
Hepatitis B.
See Sexually transmitted diseases.
Immersion foot................................................. 5-2d(2)............ ...... 5-11
Infection, prevention of................................... l-4d...................... 1-12
Inhalation .......................................................... l-3a...................... 1-8
Injector,.nerve agent antidote ......................... 7-8 ........................ 7-8
Injuries:
Abdominal..................................................... 3-11, 3-12............. 3-28, 3-29
Chest.............................................................. 3-9, 3-10 ............... 3-23
Ear .................................................................. 3-8c ...................... 3-20
Eye ................................................................. 3-8a ...................... 3-16
Face ................................................................ 3-5, 3-7 ................. 3-13, 3-14
3-8b ...................... 3-18
Head ............................................................... 3-1, 3-2, 3-3 .......... 3-1, 3-2
Jaw ................................................................. 3-8e ...................... 3-22
Laser ............................................................... 3-8a(4)(c) .............. 3-i 7
3-14a(4) ................ 3-35
Mouth ............................................................. 3-7 ........................ 3-14
Neck ............................................................... 3-6, 3-7 ................. 3-14
.!'--Jose .•....••........•..•..•........•............•..•.•......•.... , .. 3=8d ...................... 3=21
Kit:
Decontaminating .......................................... 7-2d, F-2b ............ 7-2, F-4
First aid, general purpose............................. App A.................. A-1
Litters, improvised........................................... B-10..... .. . . . ........... B-31
Lungs ................................................................. l-3a...................... 1-8
Mask, protective:
Conditions for use ......................................... 7-4 ........................ 7-4
Equipment ..................................................... 7-2 ........................ 7-1
Nerve agents ..................................................... 7-6, 7-7, 7-8 .......... 7-6, 7-7, 7-8
Nose, injury of ................................................... 3-8d ...................... 3-21
Nuclear, biological, chemical.
See Chemical-biological agents.
One-man carries................................................ App B, B-9a........ B-5
Oxygen .............................................................. 1-3, 1-4 ................. 1-7, 1-11
Positioning injured soldier with/for:
Abdominal (stomach) wound ........................ 3-12b .................... 3-29
Artificiai respiration (rescue breathing)...... 2-4........................ 2-7
Chest, sucking wound of ............................... 3-10[. .................... 3-28
Conscious....................................................... 3-7 c.......... ... . . . . . . . . . 3-14
Face wound .................................................... 3-7c ...................... 3-14
Neck ............................................................ 4-10 ...................... 4-22
Spinal column............................................. 4-9. .. . . . . . . . . . . . ... . . . . . . . 4-19
Head injury .................................................... 3-4c ...................... 3-6
Neck injury .................................................... 4-10,,,.,,,,,,,,,,,,,,,,,, 4-22
Shock prevention.......................................... 2-23...................... 2-45
C 2, FM 21-11
Index-5
Para Page
Positioning injured soldier with/for (continued)
Snakebite....................................................... 6-2c .... .. . .......... ..... 6-6
Unconscious.................................................. 3-4c... .......... .. ....... 3-6
Pressure points................................................. App E.................. E-1
Psychological first aid:
Basic guides ................................................... 8-2, 8-6 ................. 8-1, 8-3
Battle fatigue ............................................... .
Combat stress reactions .............................. .
Defined .......................................................... .
Goals of ......................................................... .
Importance of ............................................... .
Measures ....................................................... .
Need for ......................................................... .
Principles of .................................................. .
Reaction requiring ....................................... .
Pulse ................................................................. .
Rate of:
Pulse .............................................................. .
Rescue breathing .......................................... .
Reassuring injured soldier .............................. .
Rescue breathing; method of:
8-10 ..................... .
8-10 ..................... .
8-1 ....................... .
8-5 ....................... .
8-2 ....................... .
Table 8-1.. .......... .
8-13 ..................... .
8-4 ....................... .
8-3, 8-11. ............. .
1-3b ..................... .
8-5
8-5
8-1
8-3
8-1
8-12
8-8
8-2
8-2, 8-5
1-9
1-3b...................... 1-9
2-6b ...................... 2-11
8-6 ........................ 8-3
Mouth-to-mouth............................................ 2-6 ........................ 2-8
Mouth-to-nose ............................................... 2-7 ........................ 2-13
Respiration:
Artificial......................................................... 2-4, 2-5................. 2-7
Defined ........................................................... 1-3........................ 1-7
Scorpion sting ................................................... 6-5 ........................ 6-11
Sexually transmitted diseases:
Acquired Immunodeficiency Syndrome ..... C-6a ..................... C-4
Chlamydia...................................................... C-6 ....................... C-3
Gonorrhea...................................................... C-6 ....................... C-3
Hepatitis B.................................................... C-6 ....................... C-3
Syphilis.......................................................... C-6 . .......... ..... .. . . . . . C-3
Shock:
Defined........................................................... 1-4c, 2-21 ............. 1-12, 2-44
Prevention..................................................... 2-23 ...................... 2-45
Signs.:............................................................. 2-22...................... 2-44
Snakebite........................................................... 6-2........................ 6-5
Snow blindness ................................................. 5-2d(4) .................. 5-15
Spider bite......................................................... 6-5.... .......... .......... 6-11
Splinting of fracture.
See Fractures, splinting.
Sprains ............................................................... 4-la ...................... 4-1
Sunstroke.
See Heat
C2, FM 21-11
Index-6 U.S. GOVERNMENT PRINTING OFFICE : 1994 0 - 160-065
Para Page
Supplies.
See First aid.
Syphilis.
See Sexually transmitted diseases.
Throat, foreign body in .................................... 2-3, 2-13, 2-14 ...... 2-3, 2-22, 2-26
Thrusts:
Abdominal..................................................... 2-13c, 2-14b......... 2-23. 2-26
Chest.............................................................. 2-13c, 2-14c......... 2-23, 2-27
Jaw ................................................................. 2-3b ...................... 2-4
Tourniquet:
Application of................................................ 2-20...................... 2-39
Marking ......................................................... 2-20c(6)&(7) ......... 2-43
Toxic environment:
First aid for:
Blister agents ............................................. 7-9c ...................... 7-22
Blood agents .............................................. 7-llc .................... 7-25
Chemical attack ......................................... 7-llc .................... 7-25
Choking agents .......................................... 7-l0c.................... 7-23
Incapacitating agents ............................... 7-12 ...................... 7-25
Incendiaries ................................................ 7-13c.................... 7-27
Nerve agents .............................................. 7-8 ........................ 7-8
Vomiting ..................................................... 7-9c(4), 7-10c(2) ... 7-23, 7-24
Protection from ............................................. 7-2 ........................ 7-1
Transporting the wounded soldier .................. App B, B-7, B-8 .. B-1, B-4
B-9, B-10 ............. B-5, B-31
Trench foot........................................................ 5-2d(2).................. 5-11
Two-man carries ................................................ App B, B-9b ........ B-1, B-23
Veins .................................................................. 1-3b ...................... 1-9
Vital body functions ......................................... 1-3, 1-4 ................. 1-7, 1-11
Wounds:
All................................................................... 2-16, 3-3, 3-4........ 2-32, 3-2, 3-5
Severe:
Abdominal (stomach)................................ 3-11, 3-12............. 3-28, 3-29
Burns.......................................................... 3-13...................... 3-33
Chest, sucking .............................. , ............. 3-9, 3-10 ............... 3-23
Face............................................................. 3-5........................ 3-13
Head ............................................................ 3-1, 3-4................. 3-1, 3-5
Neck .................... 1 ...................................... 3-6 ........................ 3-14
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