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Note: Cardiopulmonary resuscitation (CPR) may be necessary after cleaning the airway, but only after major bleeding is under control.
In a survival situation, you must control serious bleeding immediately because replacement fluids normally are not available and the victim can die within a matter of minutes. You can control external bleeding by direct pressure, indirect (pressure points) pressure, elevation, digital ligation, or tourniquet. The most effective way to control external bleeding is by applying pressure directly over the wound. If bleeding continues after having applied direct pressure for 30 minutes, apply a pressure dressing. Leave the pressure dressing in place for 1 or 2 days, after which you can remove and replace it with a smaller dressing. In the long-term survival environment, make fresh, daily dressing changes and inspect for signs of infection.
Raising an injured extremity as high as possible above the heart's level slows blood loss by aiding the return of blood to the heart and lowering the blood pressure at the wound. A pressure point is a location where the main artery to the wound lies near the surface of the skin or where the artery passes directly over a bony prominence (Figure 4-3). If you cannot remember the exact location of the pressure points, follow this rule: Apply pressure at the end of the joint just above the injured area. Maintain pressure points by placing a round stick in the joint, bending the joint over the stick, and then keeping it tightly bent by lashing. You can stop major bleeding immediately or slow it down by applying pressure with a finger or two on the bleeding end of the vein or artery. Use a tourniquet only when direct pressure over the bleeding point and all other methods did not control the bleeding. If you must use a tourniquet, place it around the extremity, between the wound and the heart, 5 to 10 centimeters above the wound site (Figure 4-4). If the victim is conscious, place him on a level surface with the lower extremities elevated 15 to 20 centimeters. If the victim is unconscious, place him on his side or abdomen with his head turned to one side to prevent choking on vomit, blood, or other fluids. Maintain body heat by insulating the victim from the surroundings and, in some instances, applying external heat.
If wet, remove all the victim's wet clothing as soon as possible and replace with dry clothing.
Use warm liquids or foods, a prewarmed sleeping bag, another person, warmed water in canteens, hot rocks wrapped in clothing, or fires on either side of the victim to provide external warmth. If the victim is conscious, slowly administer small doses of a warm salt or sugar solution, if available. If you are a lone survivor, lie in a depression in the ground, behind a tree, or any other place out of the weather, with your head lower than your feet. In a survival situation it’s realistic to expect at some point during the experience there will be injuries sustained from being in unfamiliar terrain in a stressful situation. While it’s unrealistic to expect an individual to possess a thorough understanding of medicine and human physiology, it’s not unrealistic to have a basic understanding of the human body and treatment options for common conditions. The following excerpt is taken from what’s widely considered the foremost survival manual: US Army Survivor Manual 21-76. Medical problems and emergencies you may be faced with include breathing problems, severe bleeding, and shock.
Inflammation and swelling of mouth and throat caused by inhaling smoke, flames, and irritating vapors or by an allergic reaction. Raising an injured extremity as high as possible above the heart’s level slows blood loss by aiding the return of blood to the heart and lowering the blood pressure at the wound. If wet, remove all the victim’s wet clothing as soon as possible and replace with dry clothing.
Use warm liquids or foods, a pre-warmed sleeping bag, another person, warmed water in canteens, hot rocks wrapped in clothing, or fires on either side of the victim to provide external warmth. The signs and symptoms of a fracture are pain, tenderness, discoloration, swelling deformity, loss of function, and grating (a sound or feeling that occurs when broken bone ends rub together). The dangers with a fracture are the severing or the compression of a nerve or blood vessel at the site of fracture.
Very strong muscles hold a broken thighbone (femur) in place making it difficult to maintain traction during healing. Using available material (vines, cloth, rawhide), tie the splint around the upper portion of the body and down the length of the broken leg.
With available material, fashion a wrap that will extend around the ankle, with the two free ends tied to the cross member.
Place a 10- by 2.5-centimeter stick in the middle of the free ends of the ankle wrap between the cross member and the foot. Continue twisting until the broken leg is as long or slightly longer than the unbroken leg. Dislocations are the separations of bone joints causing the bones to go out of proper alignment.
Signs and symptoms of dislocations are joint pain, tenderness, swelling, discoloration, limited range of motion, and deformity of the joint. Ticks can carry and transmit diseases, such as Rocky Mountain spotted fever common in many parts of the United States. The best way to avoid the complications of insect bites and stings is to keep immunizations (including booster shots) up-to-date, avoid insect-infested areas, use netting and insect repellent, and wear all clothing properly. If antibiotics are available for your use, become familiar with them before deployment and use them.

Immunizations can prevent most of the common diseases carried by mosquitoes and some carried by flies.
If stung by a bee, immediately remove the stinger and venom sac, if attached, by scraping with a fingernail or a knife blade.
If you know or suspect that you are allergic to insect stings, always carry an insect sting kit with you. The brown house spider or brown recluse spider is a small, light brown spider identified by a dark brown violin on its back. The chance of a snakebite in a survival situation is rather small, if you are familiar with the various types of snakes and their habitats.
The primary concern in the treatment of snakebite is to limit the amount of eventual tissue destruction around the bite area. A bite wound, regardless of the type of animal that inflicted it, can become infected from bacteria in the animal’s mouth.
Snake venoms not only contain poisons that attack the victim’s central nervous system (neurotoxins) and blood circulation (hemotoxins), but also digestive enzymes (cytotoxins) to aid in digesting their prey. Before you start treating a snakebite, determine whether the snake was poisonous or nonpoisonous. Breathing difficulty, paralysis, weakness, twitching, and numbness are also signs of neurotoxic venoms. Maintain an airway (especially if bitten near the face or neck) and be prepared to administer mouth-to-mouth resuscitation or CPR. 12 June 2013 — Speed Up Your Systema Training Even If You Have Not Been Training Long. There are some things that work even when we do not know why, but if anyone out there knows how this neat trick I use to stop nosebleeds works I would love to hear from you. When possible, purify all water you got from vegetation or from the ground by using iodine or chlorine, or by boiling. By drinking nonpotable water you may contract diseases or swallow organisms that can harm you.
To make a filtering system, place several centimeters or layers of filtering material such as sand, crushed rock, charcoal, or cloth in bamboo, a hollow log, or an article of clothing (Figure 6-9). Look for the cause of the injury and follow the ABCs of first aid, starting with the airway and breathing, but be discerning. Using a finger, quickly sweep the victim's mouth clear of any foreign objects, broken teeth, dentures, sand.
Using the jaw thrust method, grasp the angles of the victim's lower jaw and lift with both hands, one on each side, moving the jaw forward. With the victim's airway open, pinch his nose closed with your thumb and forefinger and blow two complete breaths into his lungs. If the forced breaths do not stimulate spontaneous breathing, maintain the victim's breathing by performing mouth-to-mouth resuscitation. See FM 21-20, the American Heart Association manual, the Red Cross manual, or most other first aid books for detailed instructions on CPR. This pressure must not only be firm enough to stop the bleeding, but it must also be maintained long enough to "seal off" the damaged surface. This dressing consists of a thick dressing of gauze or other suitable material applied directly over the wound and held in place with a tightly wrapped bandage (Figure 4-2). However, elevation alone will not control bleeding entirely; you must also apply direct pressure over the wound. You can use digital pressure on a pressure point to slow arterial bleeding until the application of a pressure dressing. Maintain the pressure until the bleeding stops or slows down enough to apply a pressure bandage, elevation, and so forth.
If you leave a tourniquet in place too long, the damage to the tissues can progress to gangrene, with a loss of the limb later. Injuries could range from something as small as a few bug bites to broken bones, infection, rashes, etc. It’s never a bad idea to start small and take a CPR course at a local Red Cross or hospital if available. When an individual is unconscious, the muscles of the lower jaw and tongue relax as the neck drops forward, causing the lower jaw to sag and the tongue to drop back and block the passage of air.
It is a clinical condition characterized by symptoms that arise when cardiac output is insufficient to fill the arteries with blood under enough pressure to provide an adequate blood supply to the organs and tissues. Using a finger, quickly sweep the victim’s mouth clear of any foreign objects, broken teeth, dentures, sand.
Using the jaw thrust method, grasp the angles of the victim’s lower jaw and lift with both hands, one on each side, moving the jaw forward.
With the victim’s airway open, pinch his nose closed with your thumb and forefinger and blow two complete breaths into his lungs.
If the forced breaths do not stimulate spontaneous breathing, maintain the victim’s breathing by performing mouth-to-mouth resuscitation. With an open (or compound) fracture, the bone protrudes through the skin and complicates the actual fracture with an open wound.
Notch the ends without forks and lash a 20- to 30-centimeter cross member made from a 5-centimeter diameter branch between them. These misalignments can be extremely painful and can cause an impairment of nerve or circulatory function below the area affected. You can use several methods, but manual traction or the use of weights to pull the bones are the safest and easiest. You can use any field-expedient material for a splint or you can splint an extremity to the body.

They not only cause irritations, but they are often carriers of diseases that cause severe allergic reactions in some individuals. If you cannot remember the exact dose rate to treat a disease, 2 tablets, 4 times a day for 10 to 14 days will usually kill any bacteria. Do not squeeze or grasp the stinger or venom sac, as squeezing will force more venom into the wound. With nonpoisonous as well as poisonous snakebites, this local infection is responsible for a large part of the residual damage that results. Excitement, hysteria, and panic can speed up the circulation, causing the body to absorb the toxin quickly.
However, purify water from lakes, ponds, swamps, springs, or streams, especially the water near human settlements or in the tropics. If you swallow flukes, they will bore into the bloodstream, live as parasites, and cause disease. A person may die from arterial bleeding more quickly than from an airway obstruction in some cases. A cut artery issues bright red blood from the wound in distinct spurts or pulses that correspond to the rhythm of the heartbeat.
It should be tighter than an ordinary compression bandage but not so tight that it impairs circulation to the rest of the limb. Pressure point control is not as effective for controlling bleeding as direct pressure exerted on the wound. An improperly applied tourniquet can also cause permanent damage to nerves and other tissues at the site of the constriction. Use a stick as a handle to tighten the tourniquet and tighten it only enough to stop blood flow.
In a buddy system, however, the buddy can release the tourniquet pressure every 10 to 15 minutes for 1 or 2 minutes to let blood flow to the rest of the extremity to prevent limb loss.
By starting small and taking progressively larger steps towards first aid in a survival situation, the chances of survival are drastically increased. The loss of 2 liters will produce a severe state of shock that places the body in extreme danger. If you notice the area below the break becoming numb, swollen, cool to the touch, or turning pale, and the victim shows signs of shock, a major vessel may have been severed. You can create traction by wedging a hand or foot in the V-notch of a tree and pushing against the tree with the other extremity. Once performed, reduction decreases the victim’s pain and allows for normal function and circulation.
In many parts of the world you will be exposed to serious, even fatal, diseases not encountered in the United States.
If you find ticks attached to your body, cover them with a substance, such as Vaseline, heavy oil, or tree sap, that will cut off their air supply.
Wash the sting site thoroughly with soap and water to lessen the chance of a secondary infection.
Systemic reaction includes respiratory difficulties, thick-feeling tongue, body spasms, drooling, gastric distention, double vision, blindness, involuntary rapid movement of the eyeballs, involuntary urination and defecation, and heart failure.
Bites from a poisonous snake may have rows of teeth showing, but will have one or more distinctive puncture marks caused by fang penetration.
Stand by, reassure the victim, and be ready to clear his airway and perform mouth-to-mouth resuscitation should he become unconscious. Because the blood in the arteries is under high pressure, an individual can lose a large volume of blood in a short period when damage to an artery of significant size occurs.
Once you apply the dressing, do not remove it, even when the dressing becomes blood soaked. When you have tightened the tourniquet, bind the free end of the stick to the limb to prevent unwinding.
Without an X ray, you can judge proper alignment by the look and feel of the joint and by comparing it to the joint on the opposite side. Necrosis does not occur in all bites, but usually in 3 to 4 days, a star-shaped, firm area of deep purple discoloration appears at the bite site. Death is rare, occurring mainly in children and adults with high blood pressure or illnesses. More than one-half of the snakebite victims have little or no poisoning, and only about one-quarter develop serious systemic poisoning.
Symptoms of a poisonous bite may be spontaneous bleeding from the nose and anus, blood in the urine, pain at the site of the bite, and swelling at the site of the bite within a few minutes or up to 2 hours later. If his airway is completely obstructed, administer abdominal thrusts until the obstruction is cleared. However, the chance of a snakebite in a survival situation can affect morale, and failure to take preventive measures or failure to treat a snakebite properly can result in needless tragedy.
Secondary infection and regional swollen lymph glands usually become visible at this stage. The outstanding characteristic of the brown recluse bite is an ulcer that does not heal but persists for weeks or months.
In addition to the ulcer, there is often a systemic reaction that is serious and may lead to death. Reactions (fever, chills, joint pain, vomiting, and a generalized rash) occur chiefly in children or debilitated persons.

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