(b) Check the casualty for breathing. Place your ear over the
casualty's mouth and nose with your face toward the casualty's chest while maintaining
the casualty's airway (head-tilt/chin-lift or jaw-thrust). Look for the rise and fall of the
casualty's chest and abdomen. Listen for sounds of breathing. Feel for his breath on
the side of your face.
1 If the casualty is not breathing, begin rescue breathing.
2 If the casualty is breathing on his own, insert a nasopharyngeal
airway (NPA) to maintain the airway.
Procedures for opening the airway, performing rescue breathing, and
inserting a nasopharyngeal airway are described in Lesson 3 of this
e. Chest. Assess and treat the casualty for chest injuries (Lesson 4).
(1) Expose the chest and check for equal rise and fall. Remove the
minimum of clothing required to expose and treat injuries. Protect the casualty from the
environment (heat and cold) as much as possible.
(2) Examine the chest for wounds. Check for both entrance and exit
wounds (sucking chest wounds).
(3) Immediately seal any penetrating injuries to the chest with an occlusive
dressing. Sealing the wound keeps air from entering the wound. If air can freely enter
through the wound, the casualty's affected lung will collapse.
(4) Monitor the casualty for progressive severe respiratory distress
(breathing becomes more labored and faster). If respiration becomes progressively
worse, consider this a tension pneumothorax and decompress the affected chest side
with a 14-gauge needle inserted at second intercostal space (ICS) at midclavicular line
(MCL). Secure the catheter in place.
Only perform needle chest decompression on a casualty with a
penetrating (sucking) chest wound.
f. Bleeding. Identify and control major bleeding (see Lesson 5).
Apply a tourniquet to a major amputation of the extremity.
Apply an emergency bandage and direct pressure to a severely bleeding