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BST First Aid – Treat A Cold Injury

Treat a cold injury  

Training Support Package (TSP) for the Marine Battle Skills Test (BST)

 

TASK: Treat a cold injury

CONDITION: Given a casualty

STANDARD: To prevent further injury

ESTIMATED TIME TO TRAIN: 15 minuets

ESTIMATD TIME TO EVALUATE: 5 minutes per Marine

PERFORMANCE STEPS: 
  1. Describe the types of cold injuries
  2. Describe the symptoms for each cold injury
  3. Describe first aid measures for each cold injury
REFERENCES:
1.   MCRP 3-40A.9 First Aid
2.   TB MED 508 Prevention and Management of Cold-Weather Injuries
3.   Pre-Hospital Trauma Life Support, Military Version, Current Edition
SUPPORT REQUIREMENTS: N/A

PERFORMANCE STEP 1Describe the types of cold injuries.

Types of cold injuries:                 

  1. Frostbite. Actual freezing of tissue fluids in the skin and subcutaneous tissues.  Ice crystals form between and inside the cells with resulting tissue destruction.  The most susceptible body parts are those areas farthest from the body’s core, such as the hands, fingers, feet, toes, and male genitalia.
  1. Superficial frostbite: Primarily involves the skin and the tissue (subcutaneous) just beneath the skin and can result in clear blisters when warmed.
  1. Deep frostbite (freezing): Always preceded by superficial frostbite and involves freezing of the subcutaneous (below the skin) tissue, and possibly even muscle and bone. Deep frostbite is very serious and requires prompt first aid to avoid or to minimize the loss of parts or all of the fingers, toes, hands, feet, etc.
  1. Trench Foot (Immersion syndrome). Trench foot results from prolonged (more than 12 hours) exposure to wet conditions at temperatures from approximately 32°F to 50°F.  Inactive feet in damp or wet socks and boots, or tightly laced boots which impair circulation, are even more susceptible to injury.  This injury can be very serious; it can lead to loss of toes or parts of the feet.
  1. Hypothermia. This cold weather injury occurs when the body’s core temperature drops below normal range, becoming too low to maintain bodily functions (95°F).  Hypothermia can occur from exposure to temperatures above freezing, especially from immersion in cold water, wet-cold conditions, or from the effect of wind.   Physical exhaustion, traumatic injuries, and insufficient food intake may also increase the risk of hypothermia.

PERFORMANCE STEP 2Describe the symptoms for each cold injury.

Symptoms of frostbite:           

Superficial:

  1. Appears white or yellowish plaque at the site of injury and redness on the surrounding area
  2. The affected area is numb
  3. Blistering can occur 12-36 hours after exposure

Deep: 

  1. Painless, white or yellowish waxy looking
  2. Swollen or wooden to the touch
  3. Poor to no muscle movement
Symptoms of trench foot:
  1. Affected parts are cold and painless
  2. Parts may feel hot with burning and shooting pains
  3. Blistering
  4. Swelling
  5. Skin is pale with bluish cast (later stages)
Symptoms of hypothermia:
  1. Shivering (body’s attempt to generate heat)
  2. Drowsy or mentally slow
  3. Stiffness, uncoordinated
  4. Speech may be slurred
  5. Breathing becomes slow, shallow, and the pulse becomes weaker and absent

PERFORMANCE STEP 3:  Describe first aid measures for each cold injury.

First aid for superficial and deep frostbite:
  1. Prevent further exposure
  2. Remove wet or constrictive clothing
  3. Rewarm superficial frostbite gradually by direct skin-to-skin contact between injured area and non-injured skin of the victim, or a buddy
    1. Do Not rewarm if it could refreeze during evacuation
    2. Do Not rewarm feet if victim must walk for medical treatment
    3. Do Not rewarm over open flame or radiant heat
  4. Transport to medical treatment facility as soon as possible
First aid for trench foot:
  1. Rewarm injured part by gradually exposing to warm air
  2. Protect from trauma and secondary infections
  3. Elevate to relieve swelling
  4. Layer with dry, loose clothing/coverings
  5. Transport to medical treatment facility as soon as possible
First aid for hypothermia:
  1. Prevent further heat loss
  2. Move casualty to shelter, if available
  3. Remove wet and constrictive clothing
  4. Cover head & body with blankets, towels etc.
  5. Provide warm, high-caloric or sweet fluids
  6. Transport to medical treatment facility as soon as possible

 

 

Treat a cold injury

Evaluation Checklist

MARINE BEING EVALUATED:

EVALUATOR:

DATE:

SUPPORT REQUIREMENTS: NA

EVALUATOR NOTE: Marines must perform all the steps below without omitting key elements in order to pass this event. The evaluator will guide the Marine through the checklist by asking questions.

Performance Step Instructor Notes Pass or Remediate
1. Describe the types of cold injuries Marine should state all three types of cold injuries:

1.     Frostbite (superficial and deep)

2.     Trench foot

3.     Hypothermia

 
2. Describe the symptoms for each cold injury Marine should state two symptoms per type of injury:

Superficial frostbite:

1.     Appears white or yellowish plaque at the site of injury and redness on the surrounding area.

2.     The affected area is numb.

3.     Blistering can occur 12-36 hours after exposure

Deep Frostbite:

1.     Painless, white or yellowish waxy looking.

2.     Swollen or wooden to the touch.

3.     Poor to no muscle movement

Trench foot:

1.     Affected parts are cold and painless

2.     Parts may feel hot with burning and shooting pains

3.     Blistering

4.     Swelling

5.     Skin is pale with bluish cast (later stages)

Hypothermia:

1.     Shivering

2.     Drowsy or mentally slow

3.     Stiffness, uncoordinated

4.     Speech may be slurred

5.     Breathing becomes slow, shallow, and the pulse becomes weak or absent

 
3. Describe first aid measures for each cold weather injury Marine should state three measures per injury:

Superficial and deep frostbite:

1.     Prevent further exposure.

2.     Remove wet or constrictive clothing.

3.     Rewarm superficial frostbite gradually by direct skin-to-skin contact between injured area and non-injured skin of victim, or a buddy.

4.     Transport to medical treatment facility as soon as possible.

Trench foot:

1.     Rewarm injured part by gradually exposing to warm air.

2.     Protect from trauma and secondary infections.

3.     Elevate to relieve swelling.

4.     Layer with dry, loose clothing/coverings.

5.     Transport to medical treatment facility as soon as possible.

Hypothermia:

1.     Prevent further heat loss.

2.     Move casualty to shelter, if available.

3.     Remove wet and constrictive clothing.

4.     Cover head & body with blankets, towels etc.

5.     Provide warm, high-caloric or sweet fluids.

6.     Transport to medical treatment facility as soon as possible.

 

Treat a cold injury  Training Support Package (TSP) for the Marine Battle Skills Test (BST)