Page 58 - PJ MED OPS Handbook 8th Ed

6. Utilize the belly of the scalpel blade (not the point), and incrementally go deeper as needed. Do
not commit to going deep on the initial incision. When the tension is released, it should appear
obvious. This technique will ensure that the cut is not excessively deep.
7. Control bleeding with pressure and ligation (suture) as needed.
8. After procedure completion, check for improved respiratory/circulatory status.
9. Apply bulky dressing and elevate burned extremities.
10. Monitor for signs of hemorrhage, loss of circulatory/sensory/motor functions, and infection.

Escharotomy Precautions:
REFER TO DIAGRAM ON NEXT PAGE
• FINGERS are incised along both sides of each finger involved.
• LEGS are decompressed with mid-medial and mid-lateral incisions.
• TOES are done in similar manner as fingers.
• CHEST is decompressed with incisions in the mid-axillary line from clavicle to costal margin
inferiorly and may be joined by transverse incisions connecting the mid-axillary incisions if
adequate relief of constriction is not obtained.

56 n Pararescue Medical Operations Handbook / 8th Edition