NORTH KOREA COUNTRY HANDBOOK

If you must use a tourniquet, place it around the extremity between the
wound and the heart, 5 to 10 cms about the wound site. Never place it
directly over the wound or fracture. Use a stick as a handle to tighten it
only enough to stop the blood flow. When you have tightened the tourniquet,
bind the free end of the stick to the limb to prevent unwinding.
After you secure the tourniquet, clean and bandage the wound.
SUCKING CHEST WOUND
1. Examine casualty and expose a large area around the wound.
Remember to check for exit wound on opposite side. Cut away clothing,
if necessary.
2. All penetrating chest wounds will be treated as sucking chest
wounds.
NOTE: The characteristic hissing, sucking, and fluttering noise that is
produced as the patient breathes may not be present.
3. A sucking chest wound must be closed immediately by any means
available. Use the palm of your hand initially to seal the wound and
prevent additional air from entering the chest (thoracic) cavity. The
wound should be sealed after the patient forcibly exhales. Treatment
should not be delayed to prepare dressings.
4. Prepare an air tight (occlusive) dressing of plastic. Sterility should
be maintained to prevent further wound contamination. The rescuer
might consider using the inside of the plastic wrappers from trauma
pads, IV bags, or other medical supplies as these are relatively sterile.
The occlusive dressing should be at least 2 inches wider than the diameter
of the wound.
5. Cut plastic to required size. Place in palm of hand (clean side up)
and apply directly to the wound. Secure three sides of the plastic to the
patient with 3-inch adhesive tape. Have the patient forcibly exhale. At
the end of the exhalation, seal the remaining side with adhesive tape.
When sweating prevents maintaining a seal (i.e., tape does not stick to
the patient) or if the wound is massive, trauma pads should be placed
with cravats.
F-6