3-6 TRANSPORTATION OF THE INJURED

LEARNING OBJECTIVES:

Thus far we have dealt with emergency methods used to move an injured person out of danger and into a position where first aid can be administered. As we have seen, these emergency rescue procedures often involve substantial risk to the casualty and should be used only when clearly necessary.

Once you have rescued the casualty from the immediate danger, SLOW DOWN! Casualties should not be moved before the type and extent of injuries are evaluated and the required emergency medical treatment is given. (The exception to this occurs, of course, when the situation dictates immediate movement for safety purposes. For example, it may be necessary to remove a casualty from a burning vehicle. The situation dictates that the urgency of casualty movement outweighs the need to administer emergency medical treatment.)

From this point on, handle and transport the casualty with every regard for the injuries that have been sustained. In the excitement and confusion that almost always accompany an accident, you are likely to feel rushed, wanting to do everything rapidly. To a certain extent, this is a reasonable feeling. Speed is essential in treating many injuries and in getting the casualty to a medical treatment facility. However, it is not reasonable to let yourself feel so hurried that you become careless and transport the victim in a way that will aggravate the injuries.

Emergency Vehicles

In most emergency situations, some form of ambulance will be available to transport the victim to a medical treatment facility. Ambulances vary in size and shape from the old “gray ghost” to modern van and modular units. Although there are many differences in design and storage capacity, most ambulances are equipped to meet the same basic emergency requirements. They contain equipment and supplies for emergency airway care, artificial ventilation, suction, oxygenation, hemorrhage control, fracture immobilization, shock control, blood pressure monitoring, and poisoning. They will also contain litters, spine boards, and other supplies and equipment.

Many locations now have zccess to helicopter MEDEVAC support. Helicopters are ideal for use in isolated areas but are of limited practical use at night, in adverse weather, under certain tactical conditions, or in developed areas where building and power lines interfere. In addition to taking these factors into consideration, the medical technician must decide if the victim’s condition is serious enough to justify a call for a helicopter.

Some injuries require very smooth transportation or are affected by pressure changes that occur in flight. The final decision will be made by the unit commander, who is responsible for requesting the helicopter support.

Preparing the Patient for Transport

Once emergency medical care has been completed on-scene, the patient must be transferred to the medical treatment facility. A process known as packaging provides the means of properly positioning, covering, and securing the patient to avoid any unnecessary aggravation to the patient’s condition. (Covering helps maintain the patient’s body temperature, prevents exposure to the elements, and provides privacy.) Do not “package” a badly traumatized patient; it is more important to transport the critical or unstable patient to the medical treatment facility quickly. The most important aspect of each rescue or transfer is to complete it as safely and efficiently as possible.

Care of Patient en Route

The emergency care a Corpsman can offer patients en route is limited only by the availability of supplies, the level of external noise and vibrations, and the degree and ingenuity the Corpsman possesses.

Care at the Medical Treatment Facility

Do not turn the victim over to anyone without giving a complete account of the situation, especially if a tourniquet was used or medications administered. If possible, while en route, write down the circumstances of the accident, the treatment given, and keep a log of vital signs. After turning the patient over to the medical treatment facility, ensure that depleted ambulance supplies are replaced so that the vehicle is in every way ready to handle another emergency.