First Aid for Face and Neck Injuries
Soft tissue injuries of the face and scalp are common. Abrasions
(scrapes) of the skin cause no serious problems. Contusions (injury
without a break in the skin) usually cause swelling. A contusion
of the scalp looks and feels like a lump. Laceration (cut) and
avulsion (torn away tissue) injuries are also common. Avulsions
are frequently caused when a sharp blow separates the scalp from
the skull beneath it. Because the face and scalp are richly supplied
with blood vessels (arteries and veins), wounds of these areas
usually bleed heavily.
3-6. Neck Injuries
Neck injuries may result in heavy bleeding. Apply manual pressure
above and below the injury and attempt to control the bleeding.
Apply a dressing. Always evaluate the casualty for a possible
neck fracture/spinal cord injury; if suspected, seek medical treatment
Establish and maintain the airway in cases of facial or neck
injuries. If a neck fracture or
spinal cord injury is suspected,
immobilize or stabilize casualty. See Chapter 4 for further information on treatment of spinal injuries.
When a casualty has a face or neck injury, perform the measures
a. Step ONE. Clear the airway. Be prepared to perform
any of the basic lifesaving steps. Clear the casualty's airway
(mouth) with your fingers, remove any blood, mucus, pieces of
broken teeth or bone, or bits of flesh, as well as any dentures.
b. Step TWO. Control any bleeding, especially bleeding
that obstructs the airway. Do this by applying direct pressure
over a first aid dressing or by applying pressure at specific
pressure points on the face, scalp, or temple. (See Appendix E for further information on pressure points.) If the casualty is
bleeding from the mouth, position him as indicated (c below) and
apply manual pressure.
Take care not to apply too much pressure to the scalp if a
skull fracture is suspected.
c. Step THREE. Position the casualty. If the casualty
is bleeding from the mouth (or has other drainage, such as mucus,
vomitus, or so forth) and is conscious, place him in a comfortable
sitting position and have him lean forward with his head tilted
slightly down to permit free drainage (Figure 3-12).
DO NOT use the sitting position if--
- It would be harmful to the casualty because of other injuries.
- The casualty is unconscious, in which case, place him on his
side (Figure 3-13). If there is a suspected
injury to the neck or spine immobilize the head before turning
the casualty on his side.
If you suspect the casualty has a neck/spinal injury, then
immobilize his head/neck and
treat him as outlined in Chapter 4.
d. Step FOUR. Perform other measures.
(1) Apply dressings/bandages to specific areas of the face.
(2) Check for missing teeth and pieces of tissue. Check for
detached teeth in the airway. Place detached teeth, pieces of
ear or nose on a field dressing and send them along with the casualty
to the medical facility. Detached teeth should be kept damp.
(3) Treat for shock and seek medical treatment IMMEDIATELY.
and Bandages (081-831-1033)
a. Eye Injuries. The eye is a vital sensory organ, and
blindness is a severe physical handicap. Timely first aid of the
eye not only relieves pain but also helps prevent shock, permanent
eye injury, and possible loss of vision. Because the eye is very
sensitive, any injury can be easily aggravated if it is improperly
handled. Injuries of the eye may be quite severe. Cuts of the
eyelids can appear to be very serious, but if the eyeball is not
involved, a person's vision usually will not be damaged. However,
lacerations (cuts) of the eyeball can cause permanent damage or
loss of sight.
(1) Lacerated/torn eyelids. Lacerated eyelids may bleed
heavily, but bleeding usually stops quickly. Cover the injured
eye with a sterile dressing. DO NOT put pressure on the wound
because you may injure the eyeball. Handle torn eyelids very carefully
to prevent further injury. Place any detached pieces of the eyelid
on a clean bandage or dressing and immediately send them with
the casualty to the medical facility.
(2) Lacerated eyeball (injury to the globe). Lacerations
or cuts to the eyeball may cause serious and permanent eye damage.
Cover the injury with a loose sterile dressing. DO NOT put pressure
on the eyeball because additional damage may occur. An important
point to remember is that when one eyeball is injured, you should
immobilize both eyes. This is done by applying a bandage to both
eyes. Because the eyes move together, covering both will lessen
the chances of further damage to the injured eye.
DO NOT apply pressure when there is a possible laceration
of the eyeball. The eyeball contains fluid. Pressure applied over
the eye will force the fluid out, resulting in
APPLY PROTECTIVE DRESSING WITHOUT ADDED
(3) Extruded eyeballs. Soldiers may encounter casualties
with severe eye injuries that include an extruded eyeball (eyeball
out-of-socket). In such instances you should gently cover the
extruded eye with a loose moistened dressing and also cover the
unaffected eye. DO NOT bind or exert pressure on the injured eye
while applying a loose dressing Keep the casualty quiet, place
him on his back, treat for shock (make warm and comfortable),
and evacuate him immediately.
(4) Burns of the eyes. Chemical burns, thermal (heat)
burns, and light burns can affect the eyes.
(a) Chemical burns. Injuries from chemical burns require
immediate first aid. Chemical burns are caused mainly by acids
or alkalies. The first aid is to flush the eye(s) immediately
with large amounts of water for at least 5 to 20 minutes, or as
long as necessary to flush out the chemical. If the burn is an
acid burn you should flush the eye for at least 5 to 10 minutes.
If the burn is an alkali burn, you should flush the eye for at
least 20 minutes. After the eye has been flushed apply a bandage
over the eyes and evacuate the casualty immediately.
(b) Thermal burns. When an individual suffers burns of
the face from a fire, the eyes will close quickly due to extreme
heat. This reaction is a natural reflex to protect the eyeballs;
however, the eyelids remain exposed and are frequently burned.
If a casualty receives burns of the eyelids/face, DO NOT apply
a dressing; DO NOT TOUCH; seek medical treatment immediately.
(c) Light burns. Exposure to intense light can burn an
individual. Infrared rays, eclipse light (if the casualty has
looked directly at the sun), or laser burns cause injuries of
the exposed eyeball. Ultraviolet rays from arc welding can cause
a superficial burn to the surface of the eye. These injuries are
generally not painful but may cause permanent damage to the eyes.
Immediate first aid is usually not required. Loosely bandaging
the eyes may make the casualty more comfortable and protect his
eyes from further injury caused by exposure to other bright lights
In certain instances both eyes are usually bandaged; but,
in hazardous surroundings
leave the uninjured eye uncovered so
that the casualty may be able to see.
b. Side-of-Head or Cheek Wound (081-831-1033).
Facial injuries to the side of the head or the cheek may bleed profusely
(Figure 3-14). Prompt action is necessary
to ensure that the airway remains open and also to control the
bleeding. It may be necessary to apply a dressing. To apply a
(3) Hold the dressing directly over the
wound with the white side down and place it directly on the wound
(Figure 3-15 A).
(4) Hold the dressing in place with one hand (the casualty may
assist if able). Wrap the top tail over the top of the head and
bring it down in front of the ear (on the side opposite the wound),
under the chin (Figure 3-15 B) and up
over the dressing to a point just above the ear (on the wound
When possible, avoid covering the casualty's ear with the
dressing, as this will decrease
his ability to hear.
(5) Bring the second tail under the chin,
up in front of the ear (on the side opposite the wound) and over
the head to meet the other tail (on the wound side) (Figure 3-16).
(6) Cross the two tails (on the wound
side) (Figure 3-17) and bring one end
across the forehead (above the eyebrows) to a point just in front
of the opposite ear (on the uninjured side).
(7) Wrap the other tail around the back
of the head (at the base of the skull), and tie the two ends just
in front of the ear on the uninjured side with a nonslip knot
c. Ear Injuries. Lacerated (cut) or avulsed (torn) ear
tissue may not, in itself, be a serious injury. Bleeding, or the
drainage of fluids from the ear canal, however, may be a sign
of a head injury, such as a skull fracture. DO NOT attempt to
stop the flow from the inner ear canal nor put anything into the
ear canal to block it. Instead, you should cover the ear lightly
with a dressing. For minor cuts or wounds to the external ear
apply a cravat bandage as follows:
(1) Place the middle of the bandage over the ear (Figure 3-19 A).
(2) Cross the ends, wrap them in opposite directions around the
head, and tie them (Figures 3-19 B and 3-19 C).
(3) If possible, place some dressing material between the back
of the ear and the side of the head to avoid crushing the ear
against the head with the bandage.
d. Nose Injuries. Nose injuries generally produce bleeding.
The bleeding may be controlled by placing an ice pack over the
nose, or pinching the nostrils together. The bleeding may also
be controlled by placing torn gauze (rolled) between the upper
teeth and the lip.
DO NOT attempt to remove objects inhaled in the nose. An untrained
removes such an object could worsen the casualty's
condition and cause permanent
e. Jaw Injuries. Before applying a bandage to a casualty's
jaw, remove all foreign material from the casualty's mouth. If
the casualty is unconscious, check for obstructions in the airway.
When applying the bandage, allow the jaw enough freedom to permit
passage of air and drainage from the mouth.
(1) Apply bandages attached to field first aid dressing to
the jaw. After dressing the wound, apply the bandages using
the same technique illustrated in Figures 3-5, 3-6, 3-7, and
The dressing and bandaging procedure outlined for the jaw
serves a twofold purpose.
In addition to stopping the bleeding
and protecting the wound, it also immobilizes a
(2) Apply a cravat bandage to the jaw.
(a) Place the bandage under the chin and carry its ends
upward. Adjust the bandage to make one end longer than the other
(Figure 3-20 A).
(b) Take the longer end over the top of the head to meet
the short end at the temple and cross the ends over (Figure 3-20 B).
(c) Take the ends in opposite directions to the other
side of the head and tie them over the part of the bandage that
was applied first (Figure 3-20 C).
The cravat bandage technique is used to immobilize a fractured
jaw or to maintain a
sterile dressing that does not have tail
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