tampons, Israeli's, Combat Gauze, and CATs. that's what I got my grubby gorilla-sized hands on, so we'll see how it goes. and let's not forget our trusty ace wraps and a shit-ton of kerlix....
Hemostatic agents.
- Thread starter Muppet
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The theory behind using a tampon to plug a "hole" is good in theory (acedemic) but I feel that it misses the mark entirely when applied to bleeders in the field.
Wound packing is performed to occlude, by placing pressure on, the vessel hemorrhaging; it is not simply to fill a void thereby allowing the hemorrhage to continue until such time that the space is filled with O2 carrying hemoglobin. Hence the term, "pack the bleeder, not the space."
I carry, as does my team, very few Israeli dressings, which is more of a single use item (though it can be used for a couple things) and instead choose to carry copious amounts of kerlix and ace wraps with a few rolls of coban thrown in.
IMHO, kerlix and aces are a better alternative, but to each his own.
Crip
I agree to a point, which is why even though I have a few of the "cool toys" I still have lots of what works. I have never used tampons on a trauma patient.... only for nose bleeds, their intended use for my female soldiers, and as pranks for my males. ("quit crying, here's a tampon" 
) in theory, it seems like the'yd work, so I have some tampax supers. though, as I think about it, you'd have to work quickly, because as soon as they get wet, they expand, and you want them to apply pressure on the bleed, not just sponge up all the red stuff.
I was careful to pack them in pouches where I had space, but not enough to fit more kerlix. in other words, the tampons are augmenting the kerlix... I'm not leaving rolls of kerlix out to make room for them. as for the CATs... I'd like a couple of SOF-Ts, but I haven't been able to get those.... so since it's all I have, and I've had good experience with them, I packed as many as I could (9). the israeli's are handy tools. I like them. the combat gauze, I'm a little sketchy on, though..... seems liike it works great in practice, sounds like it would make a big difference....... but I'm not ready to replace all my regular white fluffy stuff with it. so again, I packed it where it fit, but not at the expense of Kerlix.
I'm carrying 7 ace wraps, 15 rolls of kerlix, 9 kravats, 6 tampons, 9 CATs, 6 israeli's, and 4 rolls of combat gauze..... and a few random items like an eye dressing, 2 abdominal dressings, and some original Quickclot. that's all my bleeding items. I've got enough stuff where I feel comfortable I can handle what comes my way. if not, I'll improvise. semper gumby.
the only place I really disagree with you is the coban.... that stuff is wonderful, but it always seems to get squished inside my bag and then i can't get it to unroll and be useful, especially with gloves on. Ace wraps and tapeworks every time, though.
) in theory, it seems like the'yd work, so I have some tampax supers. though, as I think about it, you'd have to work quickly, because as soon as they get wet, they expand, and you want them to apply pressure on the bleed, not just sponge up all the red stuff.I was careful to pack them in pouches where I had space, but not enough to fit more kerlix. in other words, the tampons are augmenting the kerlix... I'm not leaving rolls of kerlix out to make room for them. as for the CATs... I'd like a couple of SOF-Ts, but I haven't been able to get those.... so since it's all I have, and I've had good experience with them, I packed as many as I could (9). the israeli's are handy tools. I like them. the combat gauze, I'm a little sketchy on, though..... seems liike it works great in practice, sounds like it would make a big difference....... but I'm not ready to replace all my regular white fluffy stuff with it. so again, I packed it where it fit, but not at the expense of Kerlix.
I'm carrying 7 ace wraps, 15 rolls of kerlix, 9 kravats, 6 tampons, 9 CATs, 6 israeli's, and 4 rolls of combat gauze..... and a few random items like an eye dressing, 2 abdominal dressings, and some original Quickclot. that's all my bleeding items. I've got enough stuff where I feel comfortable I can handle what comes my way. if not, I'll improvise. semper gumby.
the only place I really disagree with you is the coban.... that stuff is wonderful, but it always seems to get squished inside my bag and then i can't get it to unroll and be useful, especially with gloves on. Ace wraps and tapeworks every time, though.
Is it a bad idea to use quick clot (or other shell fish based hemo products) on someone who is allergic to shell fish? I have heard (from non med types) it's not a problem because it's made out of the shell part, not the fish, but never got a firm answer on it.
that's the consensus amongst all the providers I've ever worked for. I don't recall that all hemostatic agents are shellfish-based.... I thought that was only the Hemcon bandage.
Thats why I take it out of the package (cutting open one end), and dog ear the end. Roll it back on itself a couple times and the tail becomes fairly easy to find even when wearing gloves. ;) After which you place the roll back in the package...
Crip
Celox, and some of the other hemostatic dressings out there contain Chisotan, which is an ultra purified polysaccharide derivative of shrimp shells. There have been no reported cases of shellfish allergy secondary to administration of Celox.
If there have been problems, i havent seen them in print!
If there have been problems, i havent seen them in print!
nice. I'll try that. thanks!
- Joined
- Apr 24, 2009
- Messages
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TQ's:
I'd like to throw in a plug for the NATO TQ... I've used it on about 10 live tissue extremity bleeders (the same TQ!) and it's awesome.
Plus: Indestructible, fits both large and very small extremities, and easy to ratchet down.
Minus: Needs to be padded for patient comfort and operator needs to be trained since it's not obvious how to use at first. It's not 'tactical', though, due to it's moving metal parts so it was bagged in the socom recommendations.
CAT: The new cat's are wider than the old ones, beefier, and they have a nice tab on which you can record when the TQ was applied. Be warned though, if you're using the new cat around the upper thigh, I found it has to be ratcheted down to hell before it's effective at stopping arterial flow. It'll feel like the TQ's about to break and that's how tight it needs to be.
Minus: Technically one use only, it's not the best at stopping bleeding, but it works pretty well generally speaking.
Hemostatic agents:
I would go with the 2008 TCCC reccomendations corrected for the recent woundstat findings... celox for those cavernous fast bleeders (real scientific haha!), and combat gauze or the less effective hemcon for converting tourniquets. If you have it and know how to use it well, quick clot works very well.
I'd like to throw in a plug for the NATO TQ... I've used it on about 10 live tissue extremity bleeders (the same TQ!) and it's awesome.
Plus: Indestructible, fits both large and very small extremities, and easy to ratchet down.
Minus: Needs to be padded for patient comfort and operator needs to be trained since it's not obvious how to use at first. It's not 'tactical', though, due to it's moving metal parts so it was bagged in the socom recommendations.
CAT: The new cat's are wider than the old ones, beefier, and they have a nice tab on which you can record when the TQ was applied. Be warned though, if you're using the new cat around the upper thigh, I found it has to be ratcheted down to hell before it's effective at stopping arterial flow. It'll feel like the TQ's about to break and that's how tight it needs to be.
Minus: Technically one use only, it's not the best at stopping bleeding, but it works pretty well generally speaking.
Hemostatic agents:
I would go with the 2008 TCCC reccomendations corrected for the recent woundstat findings... celox for those cavernous fast bleeders (real scientific haha!), and combat gauze or the less effective hemcon for converting tourniquets. If you have it and know how to use it well, quick clot works very well.
