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3-7. First Aid for Abdominal Wounds

a . Evaluate the Casualty. Be prepared to perform basic first aid measures. Always check for both entry and exit wounds. If there are two wounds (entry and exit), treat the wound that appears more serious first (for example, the heavier bleeding, protruding organs, larger wound, and so forth). It may be necessary to improvise dressings for the second wound by using strips of cloth, a T-shirt, or the cleanest material available.

b . Position the Casualty. Place and maintain the casualty on his back with his knees in an upright (flexed) position (Figure 3-8). The kneesup position helps relieve pain, assists in the treatment of shock, prevents further exposure of the bowel (intestines) or abdominal organs, and helps relieve abdominal pressure by allowing the abdominal muscles to relax.

Figure 3-8. Casualty positioned (lying) on back with knees (flexed) up.

c. Expose the Wound.

(1) Remove the casualty’s loose clothing to expose the wound. However, DO NOT attempt to remove clothing that is stuck to the wound; removing it may cause further injury.
CAUTION

DO NOT REMOVE protective clothing in a chemical environment. Apply dressings over the protective clothing.
(2) Gently pick up any organs that may be on the ground. Do this with a clean, dry dressing or with the cleanest available material. Place the organs on top of the casualty’s abdomen (Figure 3-9).

Figure 3-9. Protruding organs placed near wound.

NOTE

DO NOT probe, clean, or try to remove any foreign object from the abdomen. DO NOT touch with bare hands any exposed organs. DO NOT push organs back inside the body.

d . Apply the Field Dressing. Use the casualty’s field dressing, not your own. If the field dressing is not large enough to cover the entire wound, the plastic wrapper from the dressing may be used to cover the wound first (placing the field dressing on top). Open the plastic wrapper carefully without touching the inner surface. If necessary, other improvised dressings may be made from clothing, blankets, or the cleanest materials available.

WARNING

If there is an object extending from the wound, DO NOT remove it. Place as much of the wrapper over the wound as possible without dislodging or moving the object. DO NOT place the wrapper over the object.

(1) Grasp the tails in both hands.
(2) Hold the dressing with the white side down directly over the wound. DO NOT touch the white (sterile) side of the dressing or allow anything except the wound to come in contact with it.
(3) Pull the dressing open and place it directly over the wound (Figure 3-10). If the casualty is able, he may hold the dressing in place.

Figure 3-10. Dressing placed directly over the wound.

(4) Hold the dressing in place with one hand and use the other hand to wrap one of the tails around the body.
(5) Wrap the other tail in the opposite direction until the dressing is completely covered. Leave enough of the tail for a knot.
(6) Loosely tie the tails with a square knot at the casualty’s side (Figure 3-11).

Figure 3-11. Dressing applied and tails tied with a square knot.

WARNING

When the dressing is applied, DO NOT put pressure on the wound or exposed internal parts, because pressure could cause further injury (vomiting, ruptured intestines, and so forth). Therefore, tie the dressing ties (tails) loosely at casualty’s side, not directly over the dressing.

(7) Tie the dressing firmly enough to prevent slipping without applying pressure to the wound site (Figure 3-12).

Figure 3-12. Field dressing covered with improvised material and loosely tied.

Field dressings can be covered with improvised reinforcement material (cravats, strips of torn T-shirt, or other cloth) for additional support and protection. Tie improvised bandage on the opposite side of the dressing ties firmly enough to prevent slipping but without applying additional pressure to the wound.

CAUTION

DO NOT give casualties with abdominal wounds food or water (moistening the lips is allowed).

e. Seek Medical Assistance. Notify medical personnel.