wherever shoes rub. If you have blisters and they
burst, leave the skin in place and apply a clean
dressing. Carrying an extra pair of socks in your
survival vest is suggested. At least once per day,
clean, dry, and massage your feet to ensure
adequate circulation. Remember, trench foot is
caused by prolonged exposure to wet, usually
cold, conditions; but it may be developed in the
tropics. If symptoms of trench foot appear-that
is, tingling, numbness, swelling, blisters, or
sorespay extra attention to your feet and give
them proper care.
Control of Bleeding
The control of heavy bleeding is extremely
important under all conditions, but it is of even
greater importance in a survival situation since
transfusions are not possible. When breathing
ceases in conjunction with heavy bleeding, you
must first take action to initiate breathing, then
to stop the bleeding.
NOTE: Never apply a tourniquet unless that
is the only way to stop bleeding from an extremity.
Restoration of Breathing
When breathing signs are absent, the most
common cause is blockage of the airway. If
normal first-aid procedures fail to clear the
airway and restore breathing, you have one
alternate procedure. This procedure is called a
cricothyroidotomy and can be performed suc-
cessfully by unskilled nonmedical personnel. To
perform a cricothyroidotomy, proceed as follows:
1. Locate the thyroid cartilage (Adams
apple), which is the largest bony protrusion in the
center line of the neck.
2. Locate the cricoid cartilage (the first
circular ridge below the Adams apple). The point
of incision is the depression immediately above
the cricoid cartilage.
3. Using a sterile surgical razor blade, if
available, or any other cutting instrument in an
emergency, make a lateral incision one-fourth to
one-half of an inch wide and approximately
one-fourth of an inch deep into the trachea.
4. Insert the lower half of a ball-point pen
barrel or any similar rigid tube into the incision
one-half to three-fourths of an inch or until
movement of air is felt or heard.
5. Secure the tube with tape if it is to be left
in place for an extended period of time or if the
victim is to be transported.
Control of Pain
Control of pain accompanying disease or
injury is extremely difficult because pain cannot
be measured. The severity of pain accompanying
any disease or injury is relative to the individuals
ability to withstand or cope with that pain.
Although some individuals can tolerate a great
deal of pain, others cannot. Psychological injury
m a y a l t e r a n i n d i v i d u a l s p a i n t h r e s h o l d.
Regardless of this difficulty, every effort should
be made to control or eliminate pain, not only
because of its adverse effect on morale, but also
because it contributes to shock and makes a
survivor less capable of performing other essen-
tial tasks. The ideal method for pain reduction
is to eliminate its cause. Since this is not always
possible, the following methods are recom-
. Reduce movement of the painful area.
Immobilize the wounded area in a position that
p r o v i d e s m a x i m u m c o m f o r t a n d e a s e of
maintenance. Use splints and bandages.
. Apply a clean dressing that will protect the
wound from the air and from painful contacts
with objects in the environment.
l Apply hot or cold compresses. Try both
hot and cold compresses to determine which
offers the most relief.
. A common injury sustained by downed
aircrew members is broken teeth. This results in
extreme pain because the nerves are exposed to
air. To ease the pain, take the following steps:
. Cover broken teeth with pine or other
tree saps or any waxy substance.
. Drink tea made from the boiled inner
bark of a willow tree. The bark contains an
active substance called salicylate, which is an
aspirin substitute. Aspirin will prevent blood from
clotting. Pain-relieving drugs should be given
sparingly, and then only to relieve true pain, not
to soothe the victims apprehension. The only
ready-made pain reliever available to aircrew
members is the aspirin located in the SRU-31/P
Medical Packet #1.
Control of Shock
Shock is frequently the most serious conse-
quence of an injury. You should become familiar