b. Initiate a Saline Lock. A saline lock (see Lesson 6) should be initiated any
time the casualty has suffered a severe loss of blood. If the casualty has an abnormal
mental status or no palpable radial (wrist) pulse on a uninjured arm, convert the saline
lock to an intravenous infusion (IV) and administer 500 ml of Hextend.
c. Splint the Limb, If Appropriate. Splinting the injured limb can reduce
additional damage to the limb and help to reduce pain and the risk of shock.
(1) If one or more bones in the limb have been fractured, apply a splint to
the injured limb. If a splint is not applied to the extremity, broken bone fragments may
grate on blood vessels and nerves and cause additional damage.
(2) It is good practice to splint the arm, forearm, thigh, or leg when a severe
wound is present even if the limb is not fractured. Immobilizing the limb helps to stop
bleeding and reduce pain. It reduces muscular activity, which can increase the rate of
blood flow and, therefore, blood loss.
If the casualty has suffered an incomplete amputation, splint the limb.
d. Prevent Chilling or Overheating.
(1) In cool weather, cover the casualty with a blanket, poncho, or other
available materials to keep him from loosing body heat. Place covering under the
casualty as well as over the casualty in order to prevent chilling.
Blood loss can cause a significant drop in body temperature even in hot
(2) In warm weather, keep the casualty in the shade. If natural shade is not
available, erect an improvised shade using a poncho and sticks or other available
materials. Fanning the casualty promotes the evaporation of perspiration and cools the
e. Reassure the Casualty. Keep the casualty calm. Tell the casualty that you
are helping him. Be confident in your ability to help the casualty and have a "take
charge" attitude. Your words and actions can do much to reduce his anxiety. Be
careful of any comments you make regarding the casualty's condition.