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ROYAL AIR FORCE. COMMON CORE AND DEPLOYMENT SKILLS AIDE-MEMOIRE

CONDUCT AFTER CAPTURE

THE BIG 4 TOGETHER WITH THE ADDITIONAL ID DISC INFORMATION ARE KNOWN AS THE BIG 6.

◉ NAME. Only answer to 'what is your name?' Give it as first, middle and last names, in that order. If asked for your names individually your reply is to be: "I cannot answer that question, (ICATQ) Sir/Ma'am".

◉ RANK. Only answer to 'what is your rank?' "ICATQ Sir/Ma'am," if the question is posed any other way.

◉ NUMBER. Only answer to 'what is your Service Number/Number?' "ICATQ Sir/Ma'am," if the question is posed any other way.

◉ DOB. Only answer to 'what is your date of birth?' "ICATQ Sir/Ma'am," if the question is posed any other way.

◉ BLOOD GROUP. Only answer to 'what is your blood group?' "ICATQ Sir/Ma'am," if the question is posed any other way.

◉ RELIGION. Only answer to 'what is your religion?' Do not abbreviate, ie, C of E, etc, "ICATQ Sir/Ma'am," if the question is posed any other way.

TO ANY OTHER QUESTION YOU ARE ASKED YOU ARE TO REPLY: "ICATQ SIR/MA'AM".

DO NOT GET INTO AN ARGUMENT, SIGN ANYTHING, READ ANYTHING ALOUD, MAKE A VIDEO, SAY "YES" OR "NO".

FIRST AID

FIRST AID AND ACTIONS AT AN EMERGENCY

FIRST AID

First aid is the initial assistance or treatment given to someone who is injured or suddenly taken ill.

ACTIONS AT AN EMERGENCY

You must follow a clear plan of action, using the following priorities of first aid:

Assess the situation:

◉ Take in what has happened quickly and calmly.

◉ Assess any dangers to you or the casualty.

◉ Don't put yourself at risk.

Make the area safe:

◉ Protect the casualty and yourself from danger, but beware of your limitations.

Assess all casualties and give immediate First Aid:

◉ If you are faced with more than one casualty, follow the findings of your assessment to decide treatment priorities.

Get help:

◉ As quickly as possible, ensuring that any specialist help has been requested and is on the way.

DEALING WITH CASUALTIES CHECKLISTS

ITEM ACTIONS
H Hazard Are or the casualty in danger?
R Response Is the casualty conscious?
A Airway Is the airway open and clear?
B Breathing Is the casualty breathing?
C Circulation Are there any signs of circulation?

ACT ON YOUR FINDINGS

FINDINGS ACTIONS
Unconscious, not breathing.Refer to the protocol flow chart
Unconscious, not breathing and NO SIGNS of circulationRefer to the protocol flow chart
Unconscious, breathing and signs of circulationTreat any life threatening injury. Place casualty in the recovery position. Get help
Conscious, breathing and signs of circulationTreat as appropriate. Get help if necessary

Dial 999 on landlines, 112 on mobiles or Stn emergency number ...... or use radio if available.

ASSESSING THE CASUALTY (HRABC)

◉ HAZARD - First check for hazards. Ensure that hazards to yourself are removed. Prevent further injury to the casualty by removing any hazards away from the casualty or move the casualty away from the hazard.

◉ RESPONSE - Next, check for consciousness. Assess casualty's response level using AVPU.

Then, if necessary, follow the ABC of resuscitation:

◉ AIRWAY - Make - Check - Maintain. Place your hand on the casualty's forehead and gently tilt the head well back. Check for obvious obstructions. Clear the airway of any obvious obstruction if necessary. Maintain the airway by lifting the jaw and placing two fingers under the chin. This will maintain the airway in an open position.

◉ BREATHING - Look - Listen - Feel. Check for breathing by placing your ear near the casualty's nose and mouth, look for chest movement, listen for sounds of breathing and feel for breath on your cheek. Check for up to 10 seconds to decide if breathing is absent.

◉ CIRCULATION - Look - Listen - Feel. Check for signs of circulation, ie: pulse, colour, breathing, coughing and signs of major bleeding.

Check for up to 10 seconds to decide if a circulation is present.

RESCUE BREATHS

Use HRABC to assess the casualty. The following techniques are used when giving rescue breaths to a casualty not breathing but showing signs of circulation:

◉ Make sure that the airway is still open.

◉ Pinch the casualty's nose closed (or hold mouth closed) and blow into the mouth (or nose, as appropriate) until you can see the chest rise; it will normally take about 2 seconds.

◉ Take your mouth off the casualty's mouth, and watch the chest fall.

◉ If the chest rises visibly as you blow, and falls fully when you lift your mouth away, you have given an effective breath.

◉ Give two effective breaths and check for signs of circulation.

◉ Circulation present, continue with rescue breaths, 1 every 6 seconds, after 10 breaths re-check for circulation.

If you cannot achieve effective breaths:

◉ Recheck that the airway is still open.

◉ Remove any obvious obstructions, but do not do a finger sweep of the mouth.

◉ Make no more than 5 attempts to achieve 2 effective breaths.

◉ If 2 effective breaths are not achieved, then check for signs of circulation.

IF THE CASUALTY HAS CHOKED, AND YOU CANNOT ACHIEVE EFFECTIVE BREATHS, IMMEDIATELY BEGIN CHEST COMPRESSIONS AND RESCUE BREATHS TO TRY AND RELIEVE OBSTRUCTION

CARDIO-PULMONARY RESUSCITATION (CPR)

Use HRABC to assess the casualty. The following techniques are used when giving CPR to a casualty who is NOT BREATHING and has NO SIGNS OF CIRCULATION:

◉ Place heel of 1 hand 2 finger widths above the point where the casualty's bottom ribs meet the breastbone.

◉ Bring other hand down over it and interlock fingers.

◉ Keep your arms straight and depress the chest by about 4-5 cm.

◉ Release the pressure without removing your hands from their chest.

◉ Complete 15 compressions at a rate of approximately 100 per minute.

◉ Give a further 2 rescue breaths, followed by a further 15 compressions.

◉ Continue giving CPR at this rate until the casualty shows signs of recovery, emergency help arrives and takes over or you are too exhausted to continue.

These procedures are for adults only. Different procedures exist for babies (1 year and under) and children (aged 1-7 years)

CPR SUMMARY FOR AN ADULT

◉ If you are alone and you suspect a heart attack go for help once you have determined there is no breathing.

◉ If you are alone and you suspect injury, drowning or choking, carry out resuscitation sequence for 1 minute then go for help.

CPR FOR A CHILD (1-7 YEARS)

Note: See additional CPR precautions.

IF YOU ARE ACCOMPANIED SEND FOR HELP AS SOON AS YOU HAVE FOUND THAT THE CHILD IS NOT BREATHING

CPR FOR A BABY (0-12 MONTHS)

Note: See additional CPR precautions.

IF YOU ARE ACCOMPANIED SEND FOR HELP AS SOON AS YOU HAVE FOUND THAT THE BABY IS NOT BREATHING

ADDITIONAL CPR PRECAUTIONS FOR BABIES AND YOUNG CHILDREN

Care must be exercised when giving CPR to the very young or old. Child CPR is a specialist course, which is not routinely covered in the RAF. The following points serve to highlight the major differences between child and adult resuscitation:

◉ For young children (aged 1-7 years) use only one hand for compressions at a rate of 100 per minute, to a depth of 1/3 of the chest followed by 1 effective rescue breath into the child's mouth, aim for one effective rescue breath every 3 seconds. The ratio of compressions to ventilations is 5:1.

◉ For a baby (0-12 months), ensure that its body is on a flat surface. Support the head and neck, then give compressions with 2 fingers only at a rate of 100 per minute, to a depth of 1/3 of the chest followed by 1 effective rescue breath into the child's mouth and nose, aim for one effective rescue breath every 3 seconds. The ratio of compressions to ventilations is 5:1.

INFLATION/COMPRESSION RATES AND DEPTHS TABLE

BREATHSCOMPRESSIONSRATIODEPTHS
ADULTS10 per minute100 per minute15:24-5cm of the chest
CHILDREN20 per minute100 per minute5:11/3 of the chest
INFANTS/BABIES20 per minute100 per minute5:11/3 of the chest

UNCONSCIOUSNESS

AVPU

A Is the casualty Alert?

V Does the casualty respond to Voice?

P Does the casualty respond to Pain?

U Is the casualty Unresponsive?

YOUR AIMS

◉ To maintain Airway, Breathing and Circulation.

◉ To assess and record the level of response (use AVPU) initially.

◉ To treat any associated injuries.

◉ To arrange urgent removal to medical aid, if necessary.

◉ To gather and retain any evidence as to the cause of the condition.

YOUR ACTIONS

◉ Use HRABC to assess the casualty.

◉ Carry out a quick check of the casualty for major bleeds.

◉ Examine the casualty thoroughly for other injuries or conditions. (Secondary Survey).

◉ Treat urgent injuries as appropriate, if the casualty starts to vomit immediately place in the recovery position.

◉ Place casualty in the recovery position, if injuries allow.

◉ If the casualty does not regain full consciousness immediately, call for medical aid, and once all first aid measures have been completed, carry out a more detailed check of response levels using the tables. Repeat and record the assessment every 10 minutes.

RECOVERY POSITION

◉ Keeping the casualty's hand pressed against their cheek, pull on the far leg and roll the casualty towards you and on to their side.

LEVEL OF RESPONSE OBSERVATION CHART

It may be some time before medical help arrives. By recording the casualty's level of response you will be able to determine if a deterioration of the casualty's condition is taking place. Complete the chart by placing the appropriate score in the column after each check. The completed form will provide useful information for medical personnel and should remain with the casualty.

>>>>
DATE: CASUALTY'S NAME:
LEVEL OF RESPONSE
TIMES OF OBSERVATIONS EVERY 10 MINUTES 0 10 20 30 40 50
EYES
Observe for reaction while testing other responses
Open spontaneously 4
Open to speech 3
Open to painful stimulus 2
No response 1
SPEECH
When testing responses, speak clearly and directly, close to the casualty's ear
Responds sensibly to questions 5
Seems confused 4
Uses inappropriate words 3
Incomprehensible sounds 2
No response 1
MOVEMENT
Apply painful stimuli: pinch ear lobe or skin on back of hand
Obeys commands 6
Points to pain 5
Withdraws from painful stimuli 4
Bends limbs in response to pain 3
Straightens limbs in response to pain 2
No response 1
TOTAL CORE

PULSE AND BREATHING OBSERVATION CHART

Complete the chart by placing a tick in the appropriate column after each check.

LEVEL OF RESPONSE
TIMES OF OBSERVATIONS EVERY 10 MINUTES01020304050
PULSE
Note rate and whether beats are weak (W) or strong (S), regular (R) or irregular (Irreg)
Over 110
101-110
91-100
81-90
71-80
61-70
Below 61
BREATHING
Note rate and whether breathing is quiet (Q) or noisey (N), easy (E) or difficult (Diff)
Over 40
31-40
21-30
11-20
Below 11

CHOKING PROTOCOL FOR A CONSCIOUS ADULT

YOUR AIM

◉ To remove the obstruction and restore normal breathing.

SIGNS AND SYMPTOMS

◉ Difficulty in speaking and breathing.

◉ Blueness of the skin (cyanosis).

◉ Distressed signs from the casualty, such as pointing to the throat or grasping the neck.

YOUR ACTIONS

◉ Encourage coughing and remove any obvious obstructions from the mouth.

◉ Slightly bend the casualty over and give up to 5 sharp blows to the back, between the shoulder blades, with the flat of the hand (check mouth again).

◉ If the backslaps fail, give up to 5 abdominal thrusts. (NB this is only if backslaps have failed!)

◉ If this does not free the blockage, then keep trying, alternating 5 backslaps with 5 abdominal thrusts.

◉ If, after 3 sets of backslaps and abdominal thrusts, the obstruction does not clear, obtain medical aid. Then continue the cycle until help arrives.

If the casualty becomes unconscious open the airway, check breathing and give rescue breaths. If you can not achieve effective rescue breaths, immediately begin CPR

SHOCK

Shock results from the inadequate circulation of blood to the brain and vital organs.

YOUR AIMS

◉ To recognise shock.

◉ To treat the cause.

◉ To improve blood supply to the heart, brain and lungs.

◉ To evacuate casualty to medical aid.

SIGNS AND SYMPTOMS (not all of these may be present)

◉ Weakness, faintness or giddiness.

◉ Anxiousness, restlessness or even aggressiveness.

◉ Thirst, nausea and possible vomiting.

◉ Pale, grey skin.

◉ Sweating, cold and clammy skin.

◉ Rapid pulse (initially).

◉ A weak 'thready' pulse.

◉ Shallow and rapid breathing.

◉ Unconsciousness and heart failure in severe cases.

SHOCK CAUSES

◉ Blood loss.

◉ Dehydration (vomiting, diarrhoea and inadequate fluid intake).

◉ Heart attack.

◉ Bums.

◉ Infection.

◉ Anaphylaxia (allergic reactions).

◉ Emotional trauma.

YOUR ACTIONS

◉ Treat the cause of shock.

◉ Lie the casualty down, keeping the head lower than the heart.

◉ Elevate legs if possible.

◉ Loosen any tight clothing.

◉ Shelter and insulate casualty.

◉ Moisten lips with water if casualty is thirsty.

◉ Treat any other injuries.

◉ Check and record breathing, pulse and response level.

◉ Resuscitate as necessary.

◉ Evacuate casualty to medical aid.

DO NOT leave the casualty unattended. Reassure constantly.

DO NOT let the casualty eat, drink or smoke, or move unnecessarily.

DO NOT try to warm casualty with a hot-water bottle or any other direct source of heat.

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