If the casualty has suffered from a blast or penetrating trauma and has no
signs of life (no pulse, no respirations), do not perform cardiopulmonary
resuscitation (CPR). These casualties will probably not survive and you may
expose yourself to enemy fire.
c. Level of Consciousness. When possible, determine the casualty's level of
consciousness using the AVPU system. Ask questions that require more than a "yes"
or "no" answer, such as, "What is your name? What is the date? Where are we?"
Recheck the casualty's level of consciousness about every 15 minutes to determine if
the casualty's condition has changed. Report your findings to the combat medic or
combat lifesaver when he comes.
A--The casualty is alert, knows who he is, the date, where he is, etc.
V--The casualty is not alert, but does responds to verbal commands.
P--The casualty responds to pain, but not verbal commands.
U--The casualty is unresponsive.
Maintaining a check on the casualty's level of consciousness is especially
important when the casualty has suffered a head injury.
If the casualty is alert or responds to voice, do not check the casualty's
response to pain.
To check a casualty's response to pain, rub his breastbone briskly with a
knuckle or squeeze his first.
d. Airway. Assess and secure the casualty's airway.
(1) If the casualty is conscious, able to speak, and is not in respiratory
distress, no airway intervention is needed.
If the casualty is unconscious, perform the following.
(a) Use a head-tilt/chin-lift or jaw thrust to open the airway. The head-
tilt/chin-lift is the normal method of opening the casualty's airway. The jaw thrust is
used if you suspect the casualty has suffered injury to the head, jaw, or spine (back).
The muscles of an unconscious casualty's tongue may have relaxed, causing
his tongue to slide to the back of his mouth and cover the opening to his
trachea (windpipe). Using the head-tilt/chin-lift or jaw thrust removes the
blockage by moving the tongue away from the trachea. Moving the tongue
away from the opening to the trachea may result in the casualty breathing on
his own again without the need for rescue breathing techniques.