Lesson 24 MANAGE A CASUALTY WITH COMBAT STRESS REACTION (BATTLE FATIGUE)

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Combat Life Saver
Lesson 24MANAGE A CASUALTY WITHCOMBAT STRESS
REACTION (BATTLE FATIGUE)
Compiled and edited by, 2LT John C. Miller, PA-C
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Lesson 24MANAGE A CASUALTY WITHCOMBAT STRESS
REACTION (BATTLE FATIGUE)

• INTRODUCTION
• Not all casualties have bleeding wounds, broken
  bones, or chemical agent poisoning. Some
  casualties suffer psychological injuries,
  commonly referred to as combat stress reaction,
  but since World War II it has also been called
  battle fatigue. Most combat stress casualties can
  be treated without evacuating them out of the
  combat zone. Sometimes the treatment is simply
  making sure the soldier gets a good night's rest,
  warm food, and a change of clothing.

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MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)

• INTRODUCTION (cont)
• Combat stress can be mild to severe. Mild cases
  do not seriously interfere with the soldier's
  effectiveness. If the combat stress is moderate
  to severe, the soldier is ineffective and usually
  requires evacuation. Moderate and severe combat
  stress reactions are sometimes referred to as
  "more serious" combat stress.

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MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)

• TASK
• Identify characteristics of combat stress
  reaction and its treatment.
• CONDITIONS
• Given written items pertaining to the
  identification and treatment of combat stress
  reaction.
• STANDARD
• Score 70 or more points on the 100-point written
  examination.

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IDENTIFY THE CAUSES OF COMBAT STRESS

• Some of the problems which contribute to the
  development of combat stress are
• Physical exhaustion.
• Constant alertness.
• Loss of sleep.
• Trauma of seeing fellow soldiers wounded or
  killed.
• Fear of being killed or maimed.
• Fear of killing other people.
• Fear of failure or disgrace.
• Worry about family problems back home.

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IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION

• Physical Signs and Symptoms
• Tenseness, jumpy, startled at sudden sounds or
  movement.
• Headache, backache, pain in old wounds.
• Fidgeting, fine trembling of the hands, fumbling.
• Cold sweat, dry mouth, pale skin.
• Blurred vision.

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IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION

• Pounding heart, feeling dizzy or light-headed.
• Feeling "out of breath," breathing too rapidly.
• Tingling, cramps, or numbness in fingers and
  toes.
• Upset stomach, "dry heaves," or actual vomiting.
• Uncontrollable emptying of bowels and bladder
  when danger suddenly appears.
• Fatigue, feeling drained of energy.
• Blank, haunted, "1000-yard" stare.

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IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION

• Mental and Emotional Signs and Symptoms
• Anxiety, worrying, bothered by little things.
• Irritability, complaining.
• Difficulty in paying attention or remembering
  details.
• Difficulty in thinking, speaking, and
  communicating.
• Sleeping difficulties, such as being awakened by
  bad dreams.
• Grieving, tearfulness, crying for a dead or
  wounded buddy.

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IDENTIFY THE SIGNS AND SYMPTOMS OFMILD COMBAT
STRESS REACTION

• Feeling guilty about mistakes made or at things
  that had to be done.
• Anger, resentment.
• Feeling let down others, loss of confidence in
  self and/or others.

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TREAT A CASUALTY WITH MILD COMBAT STRESS REACTION

• Be calm.
• Keep the soldier focused on the unit's immediate
  mission.
• Encourage the soldier to eat, bathe, and sleep as
  the tactical mission and safety permit.
• Keep the soldier busy when he is not resting.
• Get the soldier to perform simple, well-learned
  tasks.
• Have the soldier use relaxation techniques (take
  a deep breath and let it out slowly, etc.).

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TREAT A CASUALTY WITH MILD COMBAT STRESS REACTION

• Allow and encourage the soldier to ventilate his
  feelings.
• Remind the soldier that some degree of combat
  stress reaction is normal and to be expected.

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IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION

• Physical Signs and Symptoms
• Cannot keep still, constantly moving around.
• Arms or whole body shake.
• Cowering in terror.
• Flinching or ducking at almost any sudden sound
  or movement.
• Sudden paralysis (hand, arm, leg) with no injury.
• Sudden blindness or deafness (partial or
  complete) with no injury.

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IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION

• Total immobility (freezing) under fire.
• Total physical exhaustion (just stands or sits).
• Staggering or swaying when standing.

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IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION

• Mental and Emotional Signs and Symptoms
• Rapid talking, constantly making suggestions.
• Starting fights, recklessness, "vicious" behavior
  within own group, uncontrollable anger.
• Social withdrawal (silence, sulking, prolonged
  sadness).
• Inattentiveness to self-care and hygiene, no
  interest in eating.
• Apathetic and indifferent to danger.

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IDENTIFY THE SIGNS AND SYMPTOMS
OFMODERATE/SEVERE COMBAT STRESS REACTION

• Cannot remember orders, how to perform duties, or
  where he is.
• Inability to concentrate or make decisions.
• Severe speech problems, including stuttering and
  inability to talk.
• Fear of sleeping, even in a relatively safe area.
• Sees things which are not there (usually after
  severe sleep loss).
• Rapid emotional swings, hysteria, strange
  behavior.
• Panic running under fire.

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TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION

• A soldier suffering from moderate or severe
  combat stress reaction usually requires routine
  evacuation. Combat stress reaction patients
  should be managed separately from other patients.
  Combat stress reaction casualties usually recover
  completely after resting in a safe area, being
  able to clean up, and receiving hot, nutritious
  meals. About 70 to 85 percent of evacuated combat
  stress reaction casualties are capable (with good
  management) of returning to their combat units
  within three days.

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TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION

• Early on, these patients need to talk, ventilate
  to any medical person. All combat stress reaction
  patients should be treated with the expectation
  of their going back to duty. Most of the
  remainder will return to their own unit or to
  another unit within two weeks.
• Appear to be calm and in control of the
  situation.
• Calmly try to talk the casualty into cooperating
  if he is responsive.

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TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION

• If the soldier appears to be dangerous, take his
  weapon away from him.
• Physically restrain the casualty if the soldier
  is a
• danger to himself or others.
• Get medical assistance if possible.
• Evacuate the casualty if he does not improve or
  if he is dangerous. Restrain the casualty if
  needed.

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TREAT A CASUALTY WITHMODERATE/SEVERE COMBAT
STRESS REACTION

• Question
• What are some of the things done to help mild and
  more serious combat stress casualties recover?
• Response
• Normal activities such as sleeping, eating, and
  getting cleaned up which the soldier has been
  denied due to combat conditions.
• Question
• About how many combat stress casualties that are
  evacuated return to the unit within three days?
• Response
• 70 to 85 percent.

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MANAGE A CASUALTY WITHCOMBAT STRESS REACTION
(BATTLE FATIGUE)

• CLOSING
• Procedures used to treat mild combat stress
  reaction casualties can also be used to prevent
  combat stress from developing. When a combat
  stress reaction casualty returns to the unit,
  welcome him back. Be willing to talk about what
  happened and express your confidence in him. Make
  him feel part of the unit again. Remember, no one
  is immune to combat stress reaction.
• This lesson is tested in the written
  multiple-choice examination.

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Questions