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Old December 5, 2005, 02:20 PM   #26
XavierBreath
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The only thing that I could add to the very good info given here is that in addition to stopping the bleeding and preventing shock until EMS arrives, you want to preserve function. Be aware that unnecessary movement of the victim can result in a great deal of permenant damage. It's estimated that more than 50% of paralysis occurs from post injury manipulation of the patient. I would be very hesitant about moving any victim hit in the torso without proper scoop type stretchers, unless it was absolutely necessary to prevent further injury.
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Old December 5, 2005, 04:10 PM   #27
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I was always told that old generic kotex pads make great cheap pressure bandages, usually wrapped to keep clean if not sterile.

Finally last really bad wound I have seen was a week ago at hockey, a kid had fallen and another player attempting to avoid the fallen player had jumped up and was planning to plant his foot on the far side of the fallen player but missed. the skate blade hit the fallen boys thigh about halfway up and slid along the bone neatly filleting a large slab of meat off the thigh bone. LOTs of blood, We tried to wrap the leg with a large towel to tighten up the loose piece and then tried to apply hand pressure above the wound until the para's showed up. they cut away all clothing and wrapped the whole thigh with that plastic wrap you use to bundle sticks together at the lumber yard. pulling it tight, they were able to reduce almost all bleeding without using adhesive, (which makes removing the temp bandage in the hospital much less likely to reinduce bleeding.) after starting an IV of fluids they transported the kid very soon after getting there, maybe fifteen minutes at most and they were on the way to the hospital. I talked with the boys dad last night, three operations but he has kept most of his feeling in the area and the tendons cut were repaired cleanly so now they are hoping he will home from hospital on friday. should be able to play again. someday..
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Old December 5, 2005, 05:49 PM   #28
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About a million years ago we were taught to treat a "sucking chest wound" as follows. Place clean plastic (cigarette pack cellophane was usually cited as being generally nearby) over the wound and wait for an inhalation to swell the chest cavity, then seal the plastic as well as possible. The inhalation swells the lungs and pushes foreign air out of the chest cavity, to some extent. When inhaling a slight vacuum against the plastic is hoped for.

So is the old training wrong on that?
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Old December 5, 2005, 05:57 PM   #29
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Definitely look into Quick clot. It's saved a lot of troops in the Field and a few LE. you can get it from uscav.com. about 30.00 bucks.
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Old December 5, 2005, 06:42 PM   #30
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Quote:
Originally Posted by Eng2
Definitely look into Quick clot. It's saved a lot of troops in the Field and a few LE
Yes, Eng, you are right, but...

Quick Clot also has inherent risks involved, and too many medics treat it as a "magic Bullet" for hemorrhage control.

- Hemorrhage must be a "eyes on bleeder" (don't expect it to seal a severed artery by simply dumping it on a wound

- Generates a LOT of heat (Approx 130c) upon contact with ANYTHING wet...Medics have been burned...One of my former students had some blown into his eyes...Not good

When we first started teaching it, we used to show our guys this way...Put some QuickClot in a spoon, then use an eyedropper to put a few drops of water on it...Then, watch it boil

As mentioned above, it works great when you have DIRECT visualization of, and can apply it directly to the bleeder.

If someone is just asking if it's a good thing to have for "the glove box", I'd say "no" due to the amount of training and familiarization involved.

QuickClot (along with HemCon) is great for a trained medic to have, but I'd shy away from recommending it to folks who may seldom apply first aid (for real bad stuff).

.02
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Old December 5, 2005, 06:47 PM   #31
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Quick Clot sounds kinda like what I read you should do in emergacy's.

If its buring at 130C then It will burn shut the wound. Maybe that would be good for me to have instead of thinking about using my lighter in Northern Ontario

What do you think ?? If you were in the middle of nowhere would you use Quick Clot or burn the wound to stop the bleeding since you know chances of them finding you before you bleed to death is slim to nothing ??

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Old December 5, 2005, 06:58 PM   #32
Weeg
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Quote:
Originally Posted by Dimitri
Quick Clot sounds kinda like what I read you should do in emergacy's.
Well, somewhat


Quote:
Originally Posted by Dimitri
If its buring at 130C then It will burn shut the wound. Maybe that would be good for me to have instead of thinking about using my lighter in Northern Ontario
It is made from a special blend of ground up volcanic rix mix...

It was never intended to cauterize (burn) wounds (even though many medics think this is how it works)...it works by removing ALL moisture from a solute. When applied to blood/bleeding vessel, it removes ALL water and plasma from the blood, thus leaving raw thrombin and clotting factors.

The process causes an "exothermic" reaction, which is where the heat comes from. It was never meant to "burn" wounds...The heat is a side effect.


Quote:
Originally Posted by Dimitri
What do you think ?? If you were in the middle of nowhere would you use Quick Clot or burn the wound to stop the bleeding since you know chances of them finding you before you bleed to death is slim to nothing ??
Hypothetrical question, and please respect this...I'm not going to give advice over a forum.

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Old December 5, 2005, 07:00 PM   #33
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Weeg,

Thanks fine, I understand your not wanting to give advice as someone might take it wrong and sue you or something .

Well thanks for the more information about Quick Clot.

Dimitri
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Old December 5, 2005, 07:04 PM   #34
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No problemo...

Quick Clot is wonderful, but it is ONE TOOL in a medic's "tool bag"...

It is most effective, when indicated

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Old December 5, 2005, 07:09 PM   #35
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Quickclot and the various products like it are great under certain situations where you KNOW you can't get ALS on scene quick enough to stabilize. In most scenarios however, ALS is probably close enough where using this stuff is more of a hinderance then a help. Your biggest issue is going to be getting the patient as far away from shock as possible. For a traumatic gunshot wound causing horrendous loss of blood, large bore IV intervention is the key to best chance survival. Quickclot products work great for their intended environment, but they are only "last resort" solutions where ALS intervention is not readily available.

Butch50, the problem with completely sealing off a sucking chest wound is pressure. You want to have some type of pressure relief "valve" that allows the pressure in the periteneal cavity to escape. As pressure builds up inside that cavity, it squeezes the lungs closed and collapses them. Having a dressing closed on only 3 sides allows the cavity to expel pressure instead of having it build up. As the patient inhales, the dressing will close itself and not allow outside pressure into the cavity. As they exhale, the pressure is released because the open side of the dressing allows it to relieve itself. If that pressure inside the cavity has no means of escape then it will quickly overcome the ability of the lungs to expand enough to support breathing. Not good!

The first thing my EMT instructor said to us in the first 5 minutes of class was this : "Blood goes round and round and air goes in and out. Any variation of the 2 is bad news!".
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Old December 5, 2005, 07:11 PM   #36
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It's not the reply you're looking for but the best method is to avoid the situation in which you receive said wound.
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Old December 6, 2005, 01:06 AM   #37
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Wow, lots of replies. So can we agree that the best course of action for an actively bleeding limb wound is to seal if off ASAP, and an actively bleeding chest wound is to apply pressure, but not seal it off? And how about turning the body over like someone suggested?
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Old December 6, 2005, 03:26 AM   #38
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I've herd before sugar can be used in the field as a coagulant when necessary and nothing else is available. I don't think there are any harmful side effects. I understand you have to use a relatively large amount and put it on a relatively clean wound and apply pressure on top of it. As the blood mixes with the sugar it creates a mixture thicker than just the blood and helps to slow the bleeding. It doesn't react or anything and somehow stop the bleeding it just helps to slow it but sometimes that little bit can make the difference.
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Old December 6, 2005, 05:38 AM   #39
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Absorbent wound dressings, such as field dressings, absorb up to a pint of blood, so the message is to keep the blood inside - you need it. The post about putting on a square of a non-porous material with three sides taped down is a live saving message.
On my first tour in Ireland we had a colleague shot through the lung and we were quite inexperienced then at handling such wounds; our multiple commander was a sergeant who had handled many such wounds. He had us take the cover the dressing comes in and apply it to the wound, three sides taped and then put the dressing on top. It allows blood and air to come out, but seals the wound to prevent sucking.
Gddyup said that in a few posts ago; it's a proven piece of advice for gunshot wounds.
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Old December 6, 2005, 05:57 AM   #40
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Sugar? I doubt it...

One of the LAST things you want is Dextrose directly on subcutaneous tissues...It breaks it down

Many folks here are making a simple issue way too sophisticated.

Any wound between navel and neck gets sealed with an occlusive dressing, and extremties (or a lot of blood anywhere) gets a pressure dressing.


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Old December 6, 2005, 08:27 AM   #41
Tim Burke
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Quote:
Originally Posted by Weeg
Any wound between navel and neck gets sealed with an occlusive dressing, and extremties (or a lot of blood anywhere) gets a pressure dressing.
Simple, succinct, and, if you are looking to this thread for advice on managing trauma, all you need to know. If you want to know more, then formal training is the way to go.
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Old December 6, 2005, 08:54 AM   #42
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Thanks Tim...

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Old December 6, 2005, 01:24 PM   #43
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Let's assume its a center mass hit from a pistol. Blood is leaking out somewhat quickly and you have no field dressings or anything of that sort. All you have is you, and the shirt you're wearing- what would the best course of action be then?
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Old December 6, 2005, 01:39 PM   #44
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Tear off your shirt or a piece thereof, fold it into a square and press it down onto the wound and keep it there. This will hopefully buy you some time as you ponder your next step.
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Old December 6, 2005, 03:22 PM   #45
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After reading the reply that said sugar would be bad for a wound I had to stop and think about where I herd that. After a minute or two I remembered. Several years ago I had a bad inguinal hernia repaired and after I went home from the hospital the incision began to bleed (I noticed when the blood soaked through to the outside of the dressing which had been changed before I left the hospital). I called the Dr. and he didn't seem worried at all and simply told me to put sugar on it. I don't remember if I did or not but I don't think a Dr would give faulty advice. I did a little searching and it seems the use of sugar as a treatment for wounds has been around since the times of the ancient Egyptians. Found a couple different journal articles saying a thick paste of sugar and iodine is excellent for wounds. I guess it’s commonly used with veterinarians but works well with people too.
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Old December 6, 2005, 06:05 PM   #46
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Quote:
I called the Dr. and he didn't seem worried at all and simply told me to put sugar on it. I don't remember if I did or not but I don't think a Dr would give faulty advice.
You may be right, but I know that when giving Dextrose IV, you have to make TRIPLE sure that it isn't leaking out into the tissue, as Sugar can be harmful for SQ tissues.


????


I'm stumped.
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Old December 6, 2005, 06:23 PM   #47
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I am going to be going to get occlusive dressings and pressure dressings,

When I do anything I rather be safe then sorry

Maybe Sugar is ok in the low solution its in Weeg comared to the pharmacutical stuff ??

Isnt Hydrogen Peroxide one of thouse chemecals that make the blood bubble up to stop bleeding ?? So wouldnt that work too in a way ??

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Old December 6, 2005, 07:16 PM   #48
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Many people think the bubbles from H2O2 indicate infection and the cleansing of it. When H2O2 contacts living tissue, an O atom is released making the bubble, and the remainder turns to H2O. H2O2 tears down tissue and slows the clotting process. It is therefore often used to reopen wounds, and the released O atom can be used to help combat anaerobic bacteria in a puncture wound. On an acute trauma, H2O2 is fine to flush with, but it has no healing properties, no coagulation properties, and no sterilization properties.

Approximately 15 years ago sugar was used in chronic wound care. The thinking was to provide nutrients to the wound bed. It has since fell out of favor, but many of us old wound care folks remember it's use. As far as sugar harming tissue that has been traumatized by a gunshot or other impact, I don't think it would hurt nor help if you applied sugar for a 20 minute trip to the ER for real medical service. A pound of sugar would probably be better than some things people grab to stop bleeding.

Infiltration of any IV fluid is somewhat harmful to tissues some temporary, others permanent, with NS being the least, D5W somewhat, and high strength antibiotics like gent, amikacin, and vanco coming next, then chemo.

At least that's my experience.
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Old December 6, 2005, 08:02 PM   #49
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Quote:
but it has no healing properties, no coagulation properties, and no sterilization properties.
Thanks! I didnt know much about it but that I put it on my shaving cuts because it doesnt burn like as alcohol.

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Old December 6, 2005, 08:10 PM   #50
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How many forum posters does it take to change a light bulb?

1 to change the light bulb and to post that the light bulb has been changed

14 to share similar experiences of changing light bulbs and how the light bulb could have been changed differently

7 to caution about the dangers of changing light bulbs

27 grammar Nazis to point out spelling/grammar errors

53 to flame the spell checkers

41 to correct spelling/grammar flames

6 to argue over whether it's "lightbulb" or "light bulb"

6 to condemn those 6 as anal-retentive

2 industry professionals to inform the group that the proper term is "lamp"

27 to post URL's where one can see examples of different light bulbs

14 to post that the URL's were posted incorrectly and then post the corrected URL's

12 to post to the group that they will no longer post because they cannot handle the light bulb controversy

4 to suggest that posters request the light bulb FAQ

44 to ask what is a "FAQ"

4 to say "didn't we go through this already a short time ago?"

143 to say "do a Google search on light bulbs before posting questions about light bulbs"

1 forum lurker to respond to the original post 6 months from now and start it all over again…
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