When encountering a casualty simulation requiring more than one casualty to be treated, the patrol must effectively prioritise the casualties to be dealt with. This is done by the process of triage. The British Army sets down a specific method for doing this, and this is specific for a combat environment.
The first thing to do is remove any walking casualties from the equation. The very fact that a casualty is able to walk speaks volumes for their health, and despite any noise they may be making, it is important to check for others who may not be walking, or able to shout for help. These casualties can be graded as T3 - this should be written on the casualty's cheek, or where clearly visible. Then immediately move onto the next casualty.
(Non-Walking) Non-Breathing Casualties
Now, all casualties that are checked should be unable to walk. Now check if the casualty is able to breathe. Listen for 10 seconds, whilst simultaneously looking for the rise and fall of the chest which would indicate breathing. If the casualty is not breathing, ensure that the airway is clear and open. If this results in the casualty beginning to breathe again, place the casualty in the 3/4 prone position and write T1 on their cheek, or where clearly visible.
If this does not work, and the casualty remains non-breathing, a number of options can be taken:
- If the patrol is under effective enemy fire, then the casualty can, at this point, be thought to be dead, and you should move on to the next casualty.
- If the patrol is not under effective fire, then call for assistance and begin carrying out basic life support.
(Non-Walking, Breathing) Catastrophic Limb Bleeds
If the casualty is breathing, but immobile, and with a catastrophic limb bleed, they can be graded as a T1 casualty. Apply a tourniquet and move on.
(Non-Walking, Breathing, No Catastrophic Bleeds) Breathing and Pulse Rates
Assuming the casualty is immobile, breathing, and not suffering any catastrophic bleeds, their breathing and pulse should be checked. If their breathing rate is between 10-30 breaths a minute then this is considered within acceptable bounds. Any casualty outside of these rates should be graded as T1.
Assuming a normal breathing rate, pulse rate should now be checked. If a casualty is either unconscious, or their pulse rate is over 120/minute, they can be graded as T1. If the pulse rate is below 120/minute, they can be graded as T2.