Combat Lifesaver Course (CLS)
Combat Lifesaver answers: care under fire, tactical field care, MARCH assessment, tourniquets and hemorrhage control, airway management, and casualty evacuation.
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01Of the deaths that occur during ground combat, about what percent die before reaching a medical treatment facility?
90 percent
02Your unit is in ground combat. You see a soldier fall as though he has been shot. Your primary duty is to:
Continue firing at the enemy
03Tactical combat casualty care has three phases. List the phases.
1) Care under fire; 2) Tactical field care; 3) Tactical evacuation care
04What medical term means bleeding, usually severe?
Hemorrhage
05Is the combat lifesaver considered to be a medical soldier?
No
06What are the three most common medically preventable causes of death on the modern battlefield?
1) Extremity hemorrhage; 2) Tension pneumothorax; 3) Airway obstruction
07A casualty is being transported to a collection point using a non-medical vehicle. Which of the following terms apply?
CASEVAC
08A pad of material placed on the wound to absorb the blood is called the ----- while the material used to keep the pad from slipping off the wound is called the -----.
1) Dressing; 2) Bandage
09Of the three most preventable causes of battlefield death, which results in the most deaths?
Extremity hemorrhage
10How does evaluation and treatment of a casualty in a care under fire situation differ from secure (tactical field care) situation?
While under fire you only treat life-threatening bleeding from a limb. Once secure you can start evaluating and working on airway, open chest wounds, fractures etc.
11What type of preventable condition do more soldiers die from during ground combat before reaching a medical treatment facility?
Bleeding from wounds to the extremities
12When performing care under fire, which of the following actions can be performed before moving the casualty to a safe location?
Apply a tourniquet to control bleeding
13You and another soldier are in the open and separated when you both come under enemy fire. The other soldier is wounded, but is conscious and able to fire his weapon. What should you tell him to do?
1) Seek cover; 2) Return fire; 3) Administer self-aid
14You have come under enemy fire. you and another soldier have taken cover together. The other soldier has a severe bleeding wound to his arm. You can administer treatment without endangering the mission or yourself. What treatment should you administer?
Apply a tourniquet to control bleeding
15You are going to the aid of an injured soldier while under fire. What should be your first action upon reaching the soldier?
Check the soldier for responsiveness
16A casualty is lying very still. He does not respond to any of your questions or commands. He does show a reaction when you rub is breastbone briskly with your knuckle. How would you classify the casualty on the AVPU scale?
P- for physical
17You are determining the casualty's level of responsiveness. The casualty tells you that he has been shot in his leg and that he is in pain. How would you classify the casualty on the AVPU scale?
A- FOR ALERT
18When should you plan how to move a wounded soldier out of enemy fire?
Before you leave your cover
19You have been wounded and are still under enemy fire. You are unable to return fire and there is no safe cover nearby. What should you do?
Play dead
20You can move a casualty out of enemy fire and to a safe location. Should you also try to move the casualty's weapon to the safe location?
Yes
21You applied a tourniquet to a soldier's wounded leg before dragging him to a safe location. What should you do about the tourniquet once you and the casualty are safe?
Examine the wound to see if the bleeding can be controlled using other means
22You applied a tourniquet to a soldier about eight hours ago. The tactical situation now allows the casualty to be evacuated. Should you loosen the tourniquet and try to control the bleeding with a pressure dressing before evacuation the casualty?
No
23What is the advantage in using a two-person drag or carry to move a casualty to a safe location while in a care under fire situation?
A two-person drag or carry is easier and quicker
24What is the disadvantage in using a two-person drag or carry to move a casualty to a safe location while in a care under fire situation?
Two rescuers are exposed to enemy fire rather than one
25You are crossing a battlefield after the fighting has stopped and the enemy has retreated. A soldier steps on a land mine and it explodes, giving the soldier a severe wound to his thigh. What type of care will you render?
Tactical field care
26A soldier in your squad has been injured. You are in a tactical field care situation. When should you notify your unit leader of the soldier's injury?
ASAP
27You see a soldier sitting on the ground. You approach the soldier and ask, "Are you okay?" The soldier responds, "Yeah but I twisted my ankle when I stepped in a hole." How would you classify this soldier's level of consciousness?
A- for attentive
28When evaluating a casualty in a tactical field care setting, what position should the casualty be in?
On his back (supine)
29You are going to turn a casualty from a prone position to a supine position. Which of the following is a correct procedure?
Use one hand to support the casualty's head and neck. With your free hand, reach across the casualty's back and grasp the casualty's clothing under the arm (far armpit area). Then pull steadily and roll the casualty toward you and onto his back.
30You have turned a casualty onto his back. What should you do with his arms?
Position them by his side
31You are in a tactical field care situation. An unconscious casualty is breathing on his own and appears to have no other injuries. What should you do?
1) Insert a nasopharyngeal airway; 2) Place the casualty in the recovery position (on his side)
32Which of the following should you treat first if you and the casualty are in a protected area?
Severe arterial bleeding from a limb
33You are in a tactical field care situation. A casualty has a cut on his arm with heavy bleeding. What should you do?
Apply an emergency bandage from the casualty's IFAK
34The look-listen-feel method is used to:
Determine if the casualty is breathing
35Why must a penetrating chest wound be sealed?
To keep air from entering through the wound
36The casualty has severe bleeding from a head wound. Should you apply a tourniquet to control the bleeding?
No
37You are treating a soldier with a fractured bone in the forearm. The sharp end of the broken bone has pierced the skin and is sticking out through the wound. Should you attempt to force the bone back into alignment before applying a splint?
No
38You are applying a splint to a casualty's limb. Which of the following is a general rule to follow?
Immobilize the joint above the fracture and the joint below the fracture
39What is the combat pill pack that you and other soldiers may carry in combat?
Pain medications and antibiotics
40You have controlled the bleeding from a wound on the casualty's thigh. The casualty lost a good deal of blood. Also, the casualty's skin appears to be pale, cool, and clammy. He is breathing faster than normal and he is acting agitated. The casualty is probably suffering from:
Shock
41You have controlled the bleeding to a casualty with a severe would to the leg and immobilized the leg. The casualty has been placed on a litter and will be evacuated by air ambulance. What else can you do to help the casualty?
1) Cover the casualty to keep him from being chilled; 2) Loosen any binding clothing; 3) Reassure the casualty
42You have applied a tourniquet to a casualty. Should you cover the tourniquet with a blanket, poncho, or similar material to protect it from contamination by dirt and dust?
No
43What Department of Defense document is used to record the care given to a casualty in the field?
Combat Casualty Card
44You are accompanying an unconscious casualty during evacuation. What should you do?
1) Monitor the casualty's breathing; 2) Monitor bleeding from the casualty's wounds; 3) Reinforce dressings, as needed
45You are going to administer a combat pill pack to a casualty. You should use:
The casualty's pack
46What is the leading preventable cause of death on the battlefield?
Bleeding (hemorrhaging) from an extremity (limb)
47Why should you push away any loose clothing near a casualty's open wound before applying a dressing?
To see the extent of the wound
48A casualty is bleeding from a leg wound. Part of the trouser material next to the wound is stuck to the wound. You should:
Cut around the stuck material so as not to pull the material from the wound
49What part of the emergency bandage should be applied directly over an open wound?
The dressing pad
50You have just applied a pressure dressing to a wound on the casualty's arm. Under what circumstance would you loosen the cravat?
There is no pulse in the limb below (distal to) the bandage
51You have applied a field dressing to a bleeding wound on the casualty's forearm. What else should you do to help control the bleeding?
Apply manual pressure
52You have applied a field dressing to a bleeding wound casualty's forearm. What should you do now?
Apply a pressure dressing
53The "wad" of material that is part of an improvised pressure dressing is placed:
On top of the original dressing and over the wound
54The portion of the limb below the pressure dressing is cool to the touch and the nail beds on the limb are bluish. The pressure dressing should be ----- and ------. If the condition does not improve, ----- the casualty.
1) Loosened; 2) Retied (or reapplied); 3) Evacuate
55You are going to apply digital pressure to help control severe bleeding from an open wound on the thigh. Use ---- to apply pressure to the pressure point at the front, center part of the crease in the groin in order to press the artery against the bone.
The heel of your hand or your knee
56You are applying an emergency bandage to a wound on the limb. Indicate the order in which the following steps are performed by writing the numbers 1 (first) through 7 (last) in the blanks before the steps.
1) Place the dressing pad on the wound; 2) Wrap the elastic bandage around the wounded limb; 3) Insert the elastic bandage completely into the pressure bar; 4) Pull the elastic bandage back over the top of the pressure bar, forcing the bar down onto the pad.; 5) Wrap the elastic bandage tightly over the pressure bar.; 6) Continue to wrap the elastic bandage around the limb so that all edges of the pad are covered; 7) Secure the hooking end of the closing bar into the elastic bandage
57The combat gauze bandage is used for:
Serious arterial bleeding
58After you apply the combat gauze bandage to a wound, you should immediately:
Apply manual pressure to the combat gauze
59The combat gauze bandage works by
A chemical reaction that promotes blood clotting
60Which of the following is applied with the intent of stopping blood circulation?
Tourniquet
61Both you and the casualty are in a place of safety and you have sufficient time to treat a casualty. In which of the following situations, if any would you apply a tourniquet without first trying to control the bleeding with a pressure dressing?
Amputation of the forearm four inches below the elbow
62When applying the CAT, the friction adaptor buckle is not necessary for proper application to a(n) ------, but it must be used as added protection when using two hands to apply the CAT to a(n) -----.
1) Arm (upper extremity); 2) Thigh
63Which one of the following would be preferred for an improvised tourniquet band?
A square of cloth (one yard on each side) cut diagonally and folded into a cravat
64You are going to apply an improvised tourniquet band made from a muslin bandage. The tourniquet band should be at least ----- wide when folded.
Two inches
65You are going to apply a tourniquet to an amputation that is about one inch below the elbow joint. Which of the following is an appropriate site for the tourniquet band?
A little above the elbow
66A soldier has just had his forearm amputated slightly above the wrist. The bleeding form the amputation site is not severe. What should you do first?
Apply a tourniquet two inches above the amputation site
67Which one of the following gives a proper rule for tightening a tourniquet?
A tourniquet is to be tightened until the bright red bleed has stopped and the distal pulse is gone; darker blood oozing from the wound can be ignored
68Once you have tightened an improvised tourniquet, you must:
Secure the windlass so that the tourniquet will not unwind
69The lower part of the casualty's arm has been amputated. You have applied a tourniquet. How is the stump treated?
A stump is dressed and bandaged
70You applied an improvised tourniquet to a casualty's left leg. Which one of the following is a proper method of marking the casualty?
Write a "T" and the time of application on the casualty's skin
71You find a soldier who appears to be unconscious. You are not in danger of enemy fire. Which of the following should be your first action in rendering aid to the soldier?
conduct L.O.C (LEVEL OF CONCIOUS)
72you are going to check the casualty to see if he is breathing. How should you position the casualty?
On his back
73When you check for breathing, you should:
1)Watch the casualty's chest to see if it rises and falls; 2) Listen for sounds of breathing; 3) Feel for any exhaled breath blowing against your face
74What are three indicators that a nasopharyngeal airway should be inserted into a casualty who is breathing on his own?
1) Casualty's respiration rate is less than 2 breaths every 15 seconds; 2) Casualty is making snoring or gurgling sounds; 3) Casualty is unconscious
75What should you do with the nasopharyngeal tube before inserting it into the casualty's nostril?
Lubricate the outside of the tube with water or sterile lubricating jelly
76Normally, the nasopharngeal tube is inserted into the casualty's ----- nostril.
Right
77You are inserting a nasopharyngeal tube into the casualty's nostril when resistance is met. What should you do?
Remove the tube and insert it into the other nostril
78You have inserted a nasopharyngeal airway. How should you position the casualty?
In the recovery position
79A soldier has suffered a wound to the chest. You are not sure if the chest wall has been penetrated. What should you do?
Apply airtight material over the wound and tape down all four sides of the material,
80List three signs or symptoms other than the sound of air passing through the wound that may indicate the casualty has an open chest wound.
1) Coughing up blood; 2) Breathing problems; 3) Pain increases when breathing; 4) Rapid, but weak, pulse; 5) Bubbles in blood on chest; 6) Abnormal chest actions; 7) Cyanosis
81A soldier has been shot. The bullet passed through the left side of his chest leaving entrance and exit wounds. Which of the following is the preferred method of treatment?
Apply airtight material over each wound and tape down all four sides of the material for each wound
82You have treated a casualty with a chest wound. The casualty does not want to sit up. How should you position the casualty?
On his side, wounded side down
83Which of the following is a sign or symptom of tension pneumothorax? (More than one response may be correct)
1) The casualty develops progressive respiratory distress; 2) You can no longer feel the casualty's pulse at his wrist
84You are going to insert a needle to relieve tension pneumothorax. You should choose an insertion site that is:
On the top of the chest and on the injured side
85The insertion site to relieve tension pneumothorax should be:
Slightly above the third rib
86The insertion site to relieve tension pneumothorax is located along the casualty's mid-clavicular line. What else is located on or near this imaginary line?
Nipple
87You are inserting a needle to relieve tension pneumothorax. How can you tell when you have penetrated the chest wall and the tip of the needle is now in plural space?
Feel a "pop" and hear air escaping
88Once you have penetrated the plural space with a large bore needle/catheter, you should:
Advance the needle/catheter all the way to the hub, remove the needle while leaving the catheter, and tape the catheter hub to the chest.
89A casualty who has been treated for tension pneumothorax with needle chest decompression is being evacuated on a litter. How should he be positioned?
On his injured side ( the side with the catheter)
90A "priority" casualty should be evacuated within:
4 hours
91A "urgent" or "urgent surgical" casualty should be evacuated within:
2 hours
92Manual drags are used to move a casualty for a ----- distance.
Short
93You and three other soldier are preparing to lift a casualty lying on a litter. the litter bearers should face the same direction with:
The knee nearest the litter on the ground
94When a litter team rises:
all four litter bearers rise at the same time
95What are the three phases of TCCC?
1. Care Under Fire; 2. Tactical Field Care; 3. Tactical Evacuation Care
96What is a C.A.T.?
Combat Application Tourniquet.
97What percent of deaths occur during ground combat before evacuation to a medical facility?
90 percent
98Your primary duty is what?
Your combat duties are your primary mission
99What is TCCC?
Tactical Combat Casualty Care
100What are the steps to evaluating a casualty?
1. Control Hemorrhaging; 2. Clear Airway; 3. Check Breathing; 4. Control Shock; 5. Treat and prepare for transport
101What are the steps to controlling hemorrhaging
1. Bandage; 2. Manual Pressure; 3. Pressure Dressing; 4. Elevation; 5. Tourniquet
102What are the three reasons you would use an NPA?
1. Casualty is unconscious and breathing on their own.; 2. Hear snoring or gurgling in airway.; 3. Less than two respirations every 15 seconds
103How do you treat Tension Pneumothorax?
With a needle decompression in the second intercostal space at the mid-clavicular line on the same side of the chest as the injury
104What is distal?
Farther away from heart
105What is proximal?
Closer to the heart
106What is a combat lifesaver?
A non-medical Soldier trained in advanced first aid techniques as a part of their secondary mission.
107What are the three most preventable causes of death?
1. Hemorrhaging; 2. Tension Pneumothorax; 3. Airway problems
108What is an ETD?
Emergency trauma dressing
109A pad of material placed on a wound to absorb blood?
Dressing
110The material used to keep the dressing from slipping of the wound?
Bandage
111What is the only action that can be done to a casualty when performing care under fire?
Apply a tourniquet to control bleeding
112What is the APVU scale?
Helps determine the level of consciousness. Alert, verbal, pain, unresponsive
113Where would you place combat gauze?
Anywhere a tourniquet can not be placed. Armpit, neck, groin.
114What are the two types of tourniquets?
Hasty and deliberate
115What are signs of an open chest wound?
Sucking or hissing sounds. Coughing up blood. Frothy blood coming from wound. Chest not rising normally.
116What is tension pneumothorax?
Buildup of air outside the lung in the plural space and air cannot escape.
117You are treating a casualty while under fire. He has been shot in the leg. Which of the following can you perform before moving the casualty to a place of safety?
Apply a tourniquet to control severe bleeding on the limb
118The wrist is ----- to the elbow. The elbow is ----- to the wrist. Hint (Do, pro
1) Distal; 2) Proximal
119Inserting a nasopharyngeal to maintain the casualty's airway is part of which part of TCCC:
Tactical field care
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