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11.14.1 Principles of First Aid and Survival

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Survival

Alone and injured, people have survived in almost impossible circumstances. The determination to beat the situation and the will to survive is the survivor's strongest weapons. Military SAR will not give up searching for downed aircrew.

The peacetime priorities of survival are listed below:

  • PROTECTION: The elements of protection are:
    • First Aid - breathing must be restarted within 3 minutes;
    • Clothing;
    • Shelter - in harsh weather a shelter will be required in less than 3 hours; and
    • Fire.
  • LOCATION: Most survivors are located within 3 days.
  • WATER: In Australia's arid centre water must be found within 3 days.
  • FOOD: Survival without food for at least 30 days is possible. Therefore, food is the lowest priority. Food information is contained in the JUNGLE SURVIVAL section.

Basic survival rules are outlined in the following sections:

  • Location;
  • First Aid;
  • Desert Survival;
  • Sea Survival;
  • Jungle Survival; and
  • Cold Weather Survival;

Rapidly adapt to the new situation - DO NOT WASTE TIME. Even if SAR is expected quickly develop a plan of action that will assist SAR and improve living conditions. Start working to beat the situation as soon as possible.

Safety Equipment

When moving always carry location aids and protect them from deterioration. Do not fire pyrotechnics until SAR is sighted. Consider the best use of aids:

  • survival radios/beacons,
  • signal mirror,
  • day/night flares,
  • rockets,
  • strobe,
  • signal panels, and
  • sea dye marker.
Improvised Aids
  • Improve rescue chances by constructing fires and ground signals.
  • Signal Fires:
    • Initially use campfire
    • 3 fires 30M apart in line or triangle.
    • Burn greenery or wreckage to produce smoke during the day
Ground Signals

Ground signals should be 1 M wide and 6 M long and must contrast with environment by using angles, colour, reflective material and shadow.

First Aid

FIRST AID KITS IN AIRCRAFT: LOW CAPACITY AIRCRAFT LESS THAN 30 PAX

First Aid - Adults
  • Reassure the casualty.
  • Always monitor ABC (See para 4.2.5)/ level of consciousness in every case.
  • Give Oxygen.
  • Aviation Rescue Fire Fighting provide: First Aid response, Oxygen and Defibrillation.
The Chain of Survival
  • Early access to emergency services
  • Early CPR to buy time for defibrillation
  • Early defibrillation to revert heart back to a normal rhythm
  • Early advanced life support for drug administration and advanced airway management
Danger
  • Protect yourself, then others, then the casualty.
  • If unsafe - remain clear.
  • Move casualty only to prevent further injury / allow urgent treatment
Response / ABC

Is the casualty conscious? Check ABC.

  • Airway - must be clear and open. Roll onto side only if there is a need to clear the airway
  • Breathing - Mouth to Mask / Mouth / Nose. 10-12 inflations per/minute. If avail, use Oxygen
  • Circulation
    • Check pulse at neck. If absent, or unsure if absent, start chest compressions, 80 -100 per minute.
    • One and Two operator CPR: 15 compressions / 2 breaths (5-6 cycles per minute).
    • If unconscious and breathing more than 10 times per minute with chest raise and fall, place in a stable side position.
  • Monitor pulse, respirations, maintain ABC.
Head Injury
  • Lay with injured side down, if possible
  • Do not give drugs, water or food
Stop Bleeding
  • Apply direct pressure to wound with gloved hands / bandages;
  • If direct pressure insufficient, use a broad bandage to apply constrictive pressure at top of effected limb.
  • Do not remove embedded objects. Use a ring pad around protrusions.
  • Elevate the limb unless broken;
  • Tourniquets not used.
Chest Injury
  • Cover sucking chest wounds with a non porous bandage sealed on three sides (acts as one-way valve). If casualty becomes worse, remove the non-porous bandage;
  • Immobilise unstable chest by circumferential bandaging - firm not tight.
  • Posture casualty: Half-sitting with injured side down, if possible.
  • Do not give pain killers
Wounds
  • Use clean / sterile dressings
  • Do not remove embedded objects, use a ring pad around protrusions
  • Do not touch or replace internal organs. Cover with a sterile, wet pad (or gladwrap), do not apply pressure.
Fractures

Support and Immobilise:

  • Arms: Splint and strap to body;
  • Legs: Splint and strap together.
Burns

Cool and Cover:

  • Cool with water - 20 minutes
  • Do not remove material from wound
  • Cover with wet, sterile / non-stick dressing (or gladwrap)
Shock

Casualty looks pale, skin feels cold and clammy:

  • Lay conscious casualty on back, elevate legs
  • Maintain normal body temperature
  • Rest, reassure, no alcohol or drugs
Minor Wounds

Treat all minor wounds including scratches and cuts (prevent infection):

Dehydration

Dark / pungent urine requires an increase in fluid intake:

  • Rest in shade and cool
  • Drink fluids (water is best) - not alcohol / caffeine
Acute Care

Snakebite
  • Victim must remain calm. Use pressure Immobilisation Technique.
  • Firmly bandage whole limb. Start atop bite site then bandage limb upwards.
  • Bandage firm but not so tight as to cut off circulation.
  • Do not allow casualty to move - must remain still.
  • Splint the limb, immobilising as you would a fracture.
  • Monitor ABC / level of consciousness and circulation to effected limb.
Carbon Monoxide (CO) Poisoning
  • Remove casualty to fresh air - Casualties skin colour may sometimes look normal;
  • If available give concentrated oxygen;
  • Symptoms may include; headache, nausea, drowsiness, confusion;
  • CO is a colourless, odourless, tasteless gas.
Desert Survival

Immediate Action:

  • Activate ELT immediately: and
  • Rest in solid shade 0.3M above ground. (Do not use aircraft interior, if no shade is available then erect a shelter)
Desert Survival Rules

Note: With temperatures above 30DEG C most of the body's water loss is through sweating. The body sweats to cool itself. Survivors must reduce body heat gains to minimise sweating and then procure water at night. Night temperatures may be cold:

  • Rest in shade 0.3M above or 75CM below ground. Avoid gaining heat from ground conduction or hot air layer above ground.
  • Do essential work when sun down and temperature has dropped to about 20DEG C;
  • Stay fully clothed. A single loose layer of clothing minimises heat gains and maximises sweat cooling;
  • Ration water to stay hydrated. Check colour of urine. Dehydrating will impair performance and does not decrease water consumption;
  • Eat only carbohydrates and only if water is available. Avoid greasy or fatty foods;
  • Do not travel unless sure of water. Walking in sun instead of resting in shade will at least halve survival time.
Water Procurement

Sterilise all water sources except plastic bag procurement methods. Instructions for setting up water procurement devices are contained with water transpirator bags:

  • TRANSPIRATOR BAGS: Best water procurement device, set up immediately;
  • DESERT STILL: Set up at night;
  • DEW/RAIN;
  • PLANTS: Unreliable source, look for damp patches on trees and insect life; and
  • GROUND WATER: Some indicators are terrain, birdlife, vegetation, animal tracks and insects.
Sea Survival

Immediate Action:

  • Secure and deploy raft.
  • Activate ELT immediately.
  • Gather useful equipment and board raft (dry if possible).
  • Roll call - locate missing persons.
  • Cut adrift, tie rafts together on 8M line and secure one man to raft.
  • Check raft, adjust sea anchor length to half distance between waves, and in cold weather inflate floor and canopy.
  • Retrieve, secure (to prevent loss if capsized) and inventory equipment.
  • Develop a plan of action.
  • Elect a leader, allocate duties.
Allocation of Duties

A fully loaded liferaft is cramped and uncomfortable:

  • Rotate duties.
  • Exercise, keep occupied and work as a team to minimise discomfort.
  • Allocation of duties should include, lookouts with location aids, raft maintenance, maintaining water devices and food procurement.
  • Plan pyrotechnic operations to avoid damaging raft.
Essential Rules For Sea Survival - If Short of Water
  • Ration water to stay hydrated. Check colour of urine, dehydration impairs performance and does not decrease water consumption. Hold reliable water sources in reserve;
  • In hot areas wear clothes dampened during day and remain in shade.This will halve water loss by minimising sweating. Protect eyes and skin against sun. Do not exit raft to swim;
  • Fish should not be eaten if short of water, sun dry until rain provides sufficient water.
  • Fish that have an unusual shape, features or skin instead of scales should not be eaten;
  • Avoid seasickness. Use seasick tablets, seasickness will wear off.
  • Do not drink seawater, urine or the blood of sea birds.

Keep Raft Dry, Avoid immersion, foot and raft sores by regularly changing position.

Discourage Predators
  • Do not trail attractive items.
  • Discard waste well away from raft at night.
Travel

A small amount of control is possible by adjusting raft for wind or currents. Deploy sea anchor to travel with the current or retrieve it to travel with the wind.

Jungle Survival

Immediate Action

  • Orientate and rendezvous with crew. (Stay fully clothed when moving in jungle);
  • If wreckage is hidden, move to nearby clearing to assist SAR.
  • activate ELT immediately.
Essential Rules For Jungle Survival
  • Protection - water and food will be readily available in the jungle but location by SAR will be difficult.
  • Set up location aids. Select sites to give location aids best possible ranges. Build fires with smoke to penetrate canopy (refer to "Improvised Aids in Location" section).
  • Sterilise water and animal food. Boil water for 5 minutes or use sterilising tablets. Discard animal food that shows any sign of disease. Always cook animal food to kill parasites.
  • If food is not recognised as safe, apply edibility test.
    • Discard stinging plants, fungi, plants with milky sap or with the smell of almonds or peaches.
    • Discard food that irritates sensitive skin areas such as inside of elbow after 5 mins.
    • Chew a teaspoon quantity and spit out, discard if reaction occurs in 5 minutes.
    • Eat a teaspoon quantity and discard if reaction occurs in 4 hours and
    • Eat two teaspoons quantities-plant is safe if no reaction occurs in 4 hours.
  • Do not travel unless habitation seen nearby or search scaled down. Travel rate can be as slow as 500M/HR. Creeks and ridgelines will give fastest travel. Leave messages at crashsite and camp and blaze trail if travelling.
Shelters
  • A shelter will be required in rain or if overnighting.
  • Two taut separated layers of parachute or natural thatching at 60DEG will provide a waterproof shelter.
  • A single taut layer of parachute at 45DEG will provide a shower proof shelter.
  • Keep off the ground to avoid insects and parasites.
Cold Weather Survival

Immediate Action:

  • Adjust clothing - protect hands and head.
  • Shelter from high winds. (Aircraft interior will provide windproof shelter but little thermal protection).
Essential Rules For Cold Weather Survival
  • A drop in body core temperature will mentally effect the survivor, impairing work. The onset is difficult to detect and shivering should be taken as the first warning that heat losses must be minimised. Dressed only in flying clothing, survival chances are good, if a thermal windproof shelter is constructed quickly.
  • Keep clothing dry. Heat loss from wet clothing is 20 times greater than dry.
  • Remove clothing before commencing work to avoid sweating;
    • Do not let snow melt on clothing;
    • Keep feet dry by preventing snow entering boots;
    • Loosen clothing to trap air.
    • Use a windproof layer to stop wind chill.
  • Construct a shelter. If rescue is delayed then the windproof shelter used in the immediate action must be improved with insulation to provide thermal protection.
    • 25CM of snow will provide good insulation.
    • Rafts, sound proofing or branches will provide insulation from ground.
    • A one man snow cave can be built in one hour.
    • In bad weather without a windbreaker an enclosed shelter is more useful than a fire.
  • Maintain location aids.
    • Keep battery powered equipment warm.
    • The insulation of a snow shelter will prevent survivors hearing SAR aircraft. Windproof ground signals should be constructed and kept free of snow.
  • Do not travel unless habitation seen nearby or search scaled down. Travel is strenuous and as slow as 4KM/day. Crevasses and avalanches are hazards in ice and mountainous country.
Medical Hazards

When outdoors, work in pairs. Observe partner to detect onset of cold injuries.

  • Hypothermia. (Lowering of body core temperature). Hypothermia can occur in above zero temperatures. The symptoms are incoherence, slowing down, stumbling and weakness. These symptoms may be mistaken for fatigue. To treat hypothermia protect casualty from wind change wet clothing for dry and use body warmth and insulation to warm.
  • Frostbite.The symptoms are tingling numbing sensation with waxy white appearance. Gently rewarm areas using body heat if nothing else is available. If deep frostbite has occurred leave frozen until rescued.
  • Carbon Monoxide Poisoning. Ventilate shelters where a stove is used with two 6CM holes in door and roof. Do not light fires inside enclosed shelters.
  • Snow Blindness. Prevent too much light entering eyes by using sunglasses or eyeshields. Keep eyes covered to recover from snow blindness.
  • Dehydration. Cold will decrease thirst sensation. Check frequency and colour of urine to avoid unintentional dehydration. To maintain body core temperature drink warm water.
Shelters

The Lean-to with fire and reflector will provide good protection in wooded temperate conditions. An improvised igloo can be made by covering branches, rafts etc, with a parachute and covering with 25CM of snow, letting set and then removing the core. The A-Frame must be modified with 25 CM of snow cover to provide thermal protection. The quickest shelter to build without a shovel is the snow cave. Probe before building to check snow depth. Smooth walls to prevent dripping and construct a cold sump. Stay dry when digging. A snow trench may be constructed with a saw in hard snow.