Step 1 of 5 · now
Find every hole
Check chest, back, armpits, and neck. Bullet/fragment wounds come in pairs. Expose the chest. Roll as a unit if you suspect spine injury.
Use: Trauma shears — you marked this in kit
1 h to careBuddydelayed
Life threat — do the NOW steps before anything else.
When this applies · do not
- Hole, fragment, or stab in the chest, back, or just below the collarbone
- Sucking or bubbling chest wound
- Sudden worse breathing after a chest hit
- One side of the chest not moving
Red flags
- Getting worse after a seal: peel a corner (‘burp’ the seal) to let trapped air out, then reseal
- Tracheal shift, neck veins, absent breath sounds, collapsing: possible tension pneumothorax — this is a medic skill (needle decompression) if they are trained and authorized. Your job is the seal, position, and evac.
Do not
- Do not wait to find a ‘perfect’ commercial seal if they are drowning in their own chest — cover the hole.
- Do not tape all four sides of an improvised plastic seal and walk away without watching them.
- Do not try needle decompression unless you are trained and allowed to.
Recheck seals after every bump in the vehicle. Burp if worse.
Field aid tool — not a diagnosis, not a medic, not your unit’s official protocol. When a trained medic or doctor is there, follow them.