Burns, Breaks & Bleeding — Field First Aid Guide
The three injuries most likely to kill you before help arrives: catastrophic bleeding, severe burns, and fractures with shock. This is the complete field first-aid guide — the same techniques taught in Stop the Bleed and Wilderness First Aid courses, condensed to what you can actually do in the first 10 minutes.
- 01 TRIAGE FIRSTBefore you touch anyone
- 02 STOP THE BLEEDINGMinutes count — direct pressure, tourniquet, pack
- 03 BURNSCool, cover, transport
- 04 BREAKS + SPRAINSImmobilize, ice, elevate
- 05 SHOCK MANAGEMENTThe silent killer
- 06 YOUR KITThe minimum that works
The Rule of 3s
The first 30 seconds after an injury are the most important. Get those 30 seconds right and most people survive. Get them wrong and even a minor injury can turn fatal.
The rules are simple: check the scene, check the airway, check for bleeding, check for shock. In that order. Do not run to the patient before the scene is safe — you will become the second casualty.
The 30-second assessment
- ☐ Scene safety: is the injury source still active? (fire, falling debris, attacker, traffic)
- ☐ Wake them up: tap, shout, "Can you hear me?" If no response, move to the airway check
- ☐ Airway: look/listen for breathing for 5 seconds. No breathing = CPR if you are trained
- ☐ Catastrophic bleeding: check legs, arms, head, torso. Any pumping blood = tourniquet NOW
- ☐ Shock signs: pale, cold, confused, rapid breathing — the body is shutting down peripheral circulation
- ☐ Call 911 or have someone call while you work
Catastrophic bleeding kills in 3-5 minutes. If you can see blood pumping from an extremity or spraying from a neck or groin wound, your only job is to stop it — everything else is secondary until it is controlled.
The modern protocol is DIRECT PRESSURE → TOURNIQUET → WOUND PACKING in that order. Direct pressure works for most bleeding. Tourniquets are for catastrophic extremity bleeding only. Wound packing (with QuikClot or hemostatic gauze) is for junction wounds where a tourniquet cannot be applied.
Actions in order
- ☐ Direct pressure: both hands, firm, do not lift to check. 5-10 minutes minimum.
- ☐ If blood soaks through: DO NOT remove the bandage. Add more on top and keep pressing.
- ☐ Arterial extremity bleed: genuine CAT tourniquet, 2-3 inches above the wound, over the muscle → Buy
- ☐ Tighten until bleeding STOPS and the distal pulse is gone. Note the time on the tourniquet.
- ☐ Junctional wound (groin, armpit, neck): pack with QuikClot gauze, hold pressure 3 minutes → Buy
- ☐ Israeli bandage for anything else — single-handed pressure dressing → Buy
- ☐ Loss of consciousness from blood loss = they need a hospital NOW. Call it in.
Burns look dramatic and feel worse. The treatment protocol is simple: cool the burn, cover it cleanly, and transport to a hospital for anything serious. The biggest mistakes are using ice (makes it worse), popping blisters (invites infection), and underestimating fluid loss.
Burns are classified by depth: first-degree (red, like sunburn), second-degree (blisters), third-degree (white or charred, nerve damage so no pain). Anything larger than the patient palm, deeper than first-degree, or on the face/hands/genitals/joints is a hospital case.
Treatment protocol
- ☐ Stop the burning: remove clothing that's not stuck, remove jewelry (fingers swell fast)
- ☐ Cool running water for 20 minutes. NOT ice. NOT butter. NOT toothpaste. Just cool water.
- ☐ Cover loosely with sterile non-stick gauze or clean plastic wrap (oxygen speeds healing)
- ☐ Do NOT pop blisters — they are a sterile wound cover protecting the healing skin underneath
- ☐ Burn gel or silver sulfadiazine (Silvadene) if you have it, after cooling
- ☐ Fluids: burns cause severe dehydration. Small sips of water or electrolyte solution
- ☐ Pain: ibuprofen + acetaminophen work better together than either alone
- ☐ Transport to ER for: face, hands, feet, genitals, joints, 3rd degree, >10% body surface
You can rarely tell a bad sprain from a break in the field. The treatment is the same: stabilize the joint or bone in the position you found it, do not try to push anything back into place unless circulation is compromised, and transport.
The mnemonic is RICE: Rest, Ice, Compression, Elevation — for sprains. For suspected breaks, skip the compression (it can make things worse) and focus on immobilization with a splint.
Action plan
- ☐ Stabilize in place: do NOT try to "set" the bone unless circulation is cut off
- ☐ Check circulation: is the skin past the injury warm and pink? Can they wiggle fingers/toes?
- ☐ SAM splint: moldable aluminum foam, works for any joint, weighs nothing → Buy
- ☐ Improvise: rolled magazine + duct tape, tent pole + towel, two sticks + paracord
- ☐ Immobilize the joint ABOVE and the joint BELOW the fracture (or the bone on each side of the joint)
- ☐ RICE for sprains: Rest, Ice (15 min on/off), Compression wrap, Elevate above heart
- ☐ Ibuprofen for inflammation + acetaminophen for pain (stack both, different mechanisms)
- ☐ Open fracture (bone visible): cover with sterile dressing, do NOT touch the bone, transport NOW
Shock is what kills people after the initial injury. The body reroutes blood away from the extremities and brain to protect vital organs. Left unchecked, shock kills within 30 minutes to several hours.
You cannot reverse shock in the field. Your only job is to slow it down: keep them warm, keep them flat, elevate their legs, reassure them, and get professional help on the way.
Shock protocol
- ☐ Recognize: pale, cold skin, rapid weak pulse, shallow breathing, confusion, thirst
- ☐ Lay them flat on their back
- ☐ Elevate feet 12 inches above the heart (unless spine or leg injury)
- ☐ Keep them warm — mylar blanket, jacket, anything insulating → Buy
- ☐ Do NOT give food or water (they may need surgery; liquids in the stomach are dangerous)
- ☐ Reassure them — panic accelerates shock. Calm voice, steady presence.
- ☐ Monitor breathing and pulse every 2 minutes. If they stop breathing: start CPR.
- ☐ Professional help is the only real treatment. Call 911 if you have not already.
A "first aid kit" from the drugstore is a collection of bandaids. A real trauma kit has the specific tools needed for the top killers: catastrophic bleeding, airway compromise, and shock.
Build your kit around real threats. Skip the "100 pieces!" marketing and focus on: tourniquet, hemostatic gauze, pressure bandage, chest seal, trauma shears, nitrile gloves, CPR mask, SAM splint. That is 80% of what saves lives.
The minimum viable trauma kit
- ☐ Pre-built trauma kit (MyMedic MyFAK or equivalent) → Buy
- ☐ Genuine CAT tourniquet (buy from North American Rescue, avoid counterfeits) → Buy
- ☐ QuikClot hemostatic gauze → Buy
- ☐ Israeli emergency bandage (6-inch) → Buy
- ☐ Chest seal (vented preferred) → Buy
- ☐ SAM splint universal → Buy
- ☐ Trauma shears → Buy
- ☐ Nitrile gloves (multiple pairs — NOT latex, allergies)
- ☐ CPR face shield
- ☐ Space/mylar blanket for shock management
- ☐ Small laminated field reference card
- ☐ Your medications: 7-day supply minimum
This free checklist covers the essentials. The Complete Prep Bundle covers everything after — scenario playbooks, 12 skill tracks, a diagnostic quiz, printable templates, and lifetime Premium access.
- 📖 The FlintReady Field Manual (140+ pages)
- 📋 5 Printable Checklists
- 📓 4 Scenario Playbooks (Hurricane, Blackout, Water Cut, Vehicle)
- 🗂️ Family Plan + Pantry Rotation Templates
- ⭐ Premium Lifetime Access
Affiliate links throughout. At no cost to you, FlintReady earns a small commission on Amazon orders, which keeps the site and checklist free. flintready.com/disclosure
