“FIST” – analysis of the tactical medicine protocol (“FIST-BARIN”)
Tactical medicine algorithm "FIST-BARIN" is a technique for providing first aid in combat or other emergency situations. It is intended for military medics, law enforcement officers and civilians who may be faced with the need to provide medical care in extreme conditions.
Application of a tourniquet. Photo: Youtube.com
First letter "TO" in the tactical medicine algorithm “FIST-BARIN” means “control bleeding (bleeding)" This is one of the first steps to take when providing first aid to a victim.
Examples of actions during the bleeding control phase:
1. Determination of the type of bleeding (arterial, venous, capillary).
2. Stop bleeding using a tourniquet, pressure bandage or other methods depending on the type of bleeding.
3. Monitoring the effectiveness of stopping bleeding.
What do we do?
It is imperative to examine and palpate the extremities, groin and axillary areas for ongoing bleeding. If the bleeding continues, it is necessary to increase the compression or apply a second tourniquet (correctly). It is also worth remembering that the tourniquet is applied to clothing or soft lining; under no circumstances apply the tourniquet to open areas of the body.
Letter "U" in the tactical medicine algorithm “FIST-BARIN” means “elimination of breathing problems (suffocation)" This stage involves ensuring the patency of the airway and carrying out measures to maintain breathing, if necessary.
Examples of actions at the stage of eliminating respiratory problems:
1. Check for breathing.
2. Clearing the airways from foreign bodies, vomit or other obstructions.
3. Carrying out artificial respiration (if the victim is not breathing).
4. Providing oxygen (if appropriate equipment is available).
Introduction of the Guedel air duct. Photo: Youtube.com
What do we do?
At this stage we have several options.
One of the first options is to give the wounded a stable lateral position (the “save” position), if the degree and nature of the injury allows this to be done - the victim’s knee and elbow rest on the ground.
The second option available is the use of a special airway (an example is the Guedel oropharyngeal airway).
Letter "L" in the tactical medicine algorithm “FIST-BARIN” means “lungs" This stage involves checking the chest and ensuring the lungs are sealed.
Examples of actions at the stage of eliminating lung problems:
1. Checking the person’s chest for penetrating wounds.
2. Application of an occlusive patch.
What do we do?
If the wounded person is on his back, then, without turning him over, first of all we close the wound with our hand, then we prepare an occlusive patch and apply it to the entrance (exit) hole.
In a situation where there is no occlusive patch, it is permissible to use the inner part of the Soviet-style PPI (individual dressing package) (gray packaging). We apply the inner part of the PPI to the inlet (outlet) hole and, using a plaster or tape, secure the edges of the improvised sealed bandage, but at the same time leave one of the corners open.
Next, we are obliged to check the anterior part of the chest for the presence of additional entrance (exit) holes, if there are wounds, then we also apply an occlusive patch or PPI.
After you have applied all the necessary bandages to the chest wounds in the front part of the body, turn the victim on his side and carry out the same measures with the exit (entry) holes.
Letter A in the tactical medicine algorithm “FIST-BARIN” means “arteries and veins».
This step of the algorithm involves assessing the condition of the victim's arteries and veins to determine the presence of bleeding. This is important to prevent further blood loss and ensure effective treatment.
To assess the condition of the arteries and veins, it is necessary to conduct a visual examination and palpation (palpation) of the site of suspected bleeding. If arterial bleeding is suspected, it must be stopped immediately using a tourniquet or pressure bandage. For venous bleeding, you can use a pressure bandage or elevate the limb above the level of the heart to slow the blood flow.
Also at this stage, the correct application of the tourniquet is checked and, if necessary, previous errors are corrected.
What do we do?
At this stage, we need to re-examine and feel the victim - we check the limbs, groin and axillary areas for ongoing bleeding. In the event that a tourniquet was previously applied incorrectly, then, if possible, we increase the compression.
To stop bleeding, special hemostatic agents are also used - bandages, powders. I will say right away that the most effective remedy of all, if the victim is severely injured, is a hemostatic bandage (z-folded). After tamponade, a pressure bandage or PPI is necessary. That is, at this stage we stop massive bleeding.
We bandage those wounds that are not accompanied by massive bleeding during the “BARIN” protocol (I’ll talk about this in the next article).
Applying a pressure bandage. Photo: Youtube.com
Second letter "TO" in the tactical medicine algorithm “FIST-BARIN” means “Kolotun" (hypothermia control).
This step of the algorithm includes measures to prevent and treat hypothermia in the victim. This is important to maintain normal body temperature and prevent hypothermia, which can lead to serious consequences, including death.
Hypothermia occurs when the body loses heat faster than it can produce it. This may occur as a result of prolonged exposure to cold, wet clothing, or blood loss. Signs of hypothermia include:
1. Trembling.
2. Confusion.
3. Drowsiness.
4. Pale skin.
5. Decreased heart rate and breathing.
Examples of situations where hypothermia control may be required:
1. The victim fell into cold water.
2. The victim was in the cold for a long time.
3. The victim is experiencing blood loss or shock.
Using an isothermal blanket. Photo: Youtube.com
To control hypothermia, the following measures must be taken:
1. Move the victim to a warm room or shelter.
2. Remove wet clothes (including stained ones) and replace them with dry ones.
3. Warm the victim using blankets, heating pads or other heat sources. It is important not to overheat the victim, as this can lead to other health problems.
4. Give the victim a warm drink if he is conscious (there is no abdominal injury).
What do we do?
At this stage, we use a thermal insulating blanket, with which we cover the victim. Having laid the victim on his side, we place a thermal insulating blanket under him and return him to his original position.
It is important to remember that a wounded person with blood loss quickly becomes hypothermic, so it is necessary to isolate him from cold surfaces (ground, stone, etc.). For this, you can also use special polyurethane mats, which are placed under the victim along with a thermal insulating blanket.
After the wounded person has returned to his original position, we get rid of wet (bloody) clothes and cover him.
Information