Battlefield First Aid: a simple, systematic approach for every soldier.

First aid training for the trained soldier has been modified to incorporate the best available current clinical evidence and clinical experience. This annual training requirement will be achieved in one day and is introduced as Individual Training Directive (Army) 3 (ITD(A) 3) on 1 April 1999. With the exception of a short introductory video, the course is entirely taught and assessed on practical models. ITD(A) 3 teaches a systematic approach to every incident and to each injured soldier. This is presented in a robust, waterproof pocket aide memoire of Battlefield First Aid Drills, which is an individual issue item. The soldier must start with the MASTER DRILL to control the incident, and will then follow the INJURED SOLDIER DRILL to identify and treat life-threatening injuries. The best available clinical experience has resulted in the replacement of the three-sided dressing with the Asherman Chest Seal for open pneumothorax, and the introduction of a simple physiology based triage system. The best available clinical evidence has led to the removal of basic life support in the context of a soldier with no vital signs on the battlefield. It is retained as an 'add on' package for peace and peace-keeping environments.