Life saving First Aid in a mass casualty situation.

[Sylvain]

That video is eye opening on several levels. You can learn about and believe how fast someone can exsanguinate from the femoral artery, but to see it happen in real time is a different story. In terms of saving that guy's life, it was very, very fast.

On the other side, there are two important self-defense points to note. One, from the point of view of how much time that guy could have kept fighting, it was a long, long time. He could have done a a lot of damage in the time he had left had he not made the decision that he was done.

Second, it also illustrates how stupid it is to believe that shooting someone in the leg is somehow less lethal than targeting the more preferred areas for the quickest end to hostility. How many times have we heard "they didn't have to kill him! Why didn't they just shoot him in the leg?"

Agreed.It's both fast and slow.
Slow if you still have to fight the guy.He has plenty of time to pull out a gun and shoot you multiple times.

Fast if you want to save the guy's life.No time to run to your car parked 100 yards away to grab your first aid kit in the trunk (that hopefully contains a tourniquet) and get back to your bleeding victim.

Also how it's important to locate the source of the bleeding before you apply a tourniquet.

 

[rhino]

Agreed.It's both fast and slow.
Slow if you still have to fight the guy.He has plenty of time to pull out a gun and shoot you multiple times.

Fast if you want to save the guy's life.No time to run to your car parked 100 yards away to grab your first aid kit in the trunk (that hopefully contains a tourniquet) and get back to your bleeding victim.

Also how it's important to locate the source of the bleeding before you apply a tourniquet.

Amen!

When I started learning more in-depth things about first aid, one of the things that was key was examining someone thoroughly for all injuries (when you had time). Finding three holes and plugging them helps, but might not be a enough if you miss a fourth.

 

[Sylvain]

Amen!

When I started learning more in-depth things about first aid, one of the things that was key was examining someone thoroughly for all injuries (when you had time). Finding three holes and plugging them helps, but might not be a enough if you miss a fourth.

Also why you go as high as you can when you apply a tourniquet, and not just a few inches above the wound like it was previously taught, less chances of missing a hole if you have several holes on the same limb (like with bullet fragments).

 

[2A_Tom]

Back to the subject.

Hemostatics vs, non treated gauze.

In the stop the bleed class that I took recently we were taught wound packing. They supplied Training Combat Gauze. We packed the wounds with this product and the wound cavity was completely filled and very hard.

After the class we 3 INGOers stayed and talked to the instructors who were all EMT's or Paramedics and one wife who is the head trauma nurse in a hospital in Hammond (for those who do not know that is the East border of the DMZ between Illinois and Indiana).

One thing we discussed was the adverse effects of hemostatics. Hemostatics and all residue of them must be removed from the wound. Hemostatics also have an expiration date. For these reasons she said that plain gauze would be best for civilian use.

I believe that Rhino has made the same observation.

The other factor is $COST$ hemostatic gauze is around $45 a pack.

https://www.rescue-essentials.com/hemostatics-1/

Plain z-fold gauze is around $6 per pack.

https://www.rescue-essentials.com/bandages/

In $dollars and sense, you can buy much more z-fold gauze for the same money and it has no expiration as long as the packaging is sound.

 

[rhino]

Back to the subject.

Hemostatics vs, non treated gauze.

In the stop the bleed class that I took recently we were taught wound packing. They supplied Training Combat Gauze. We packed the wounds with this product and the wound cavity was completely filled and very hard.

After the class we 3 INGOers stayed and talked to the instructors who were all EMT's or Paramedics and one wife who is the head trauma nurse in a hospital in Hammond (for those who do not know that is the East border of the DMZ between Illinois and Indiana).

One thing we discussed was the adverse effects of hemostatics. Hemostatics and all residue of them must be removed from the wound. Hemostatics also have an expiration date. For these reasons she said that plain gauze would be best for civilian use.

I believe that Rhino has made the same observation.

The other factor is $COST$ hemostatic gauze is around $45 a pack.

https://www.rescue-essentials.com/hemostatics-1/

Plain z-fold gauze is around $6 per pack.

https://www.rescue-essentials.com/bandages/

In $dollars and sense, you can buy much more z-fold gauze for the same money and it has no expiration as long as the packaging is sound.

I can't take credit for it, but Doc Gunn made an observation that makes really good sense. For hemostatics to work properly, you must apply direct pressure. Direct pressure, not by coincidence, also works without the hemostatics. So why bother with them? If you have to pack a wound cavity, it's the physical presence of the gauze allowing the externally applied pressure to be transmitted to where it is need that does the trick, not whether or not the gauze is treated with something.

 

[Sylvain]

Back to the subject.

Hemostatics vs, non treated gauze.

In the stop the bleed class that I took recently we were taught wound packing. They supplied Training Combat Gauze. We packed the wounds with this product and the wound cavity was completely filled and very hard.

After the class we 3 INGOers stayed and talked to the instructors who were all EMT's or Paramedics and one wife who is the head trauma nurse in a hospital in Hammond (for those who do not know that is the East border of the DMZ between Illinois and Indiana).

One thing we discussed was the adverse effects of hemostatics. Hemostatics and all residue of them must be removed from the wound. Hemostatics also have an expiration date. For these reasons she said that plain gauze would be best for civilian use.

I believe that Rhino has made the same observation.

The other factor is $COST$ hemostatic gauze is around $45 a pack.

https://www.rescue-essentials.com/hemostatics-1/

Plain z-fold gauze is around $6 per pack.

https://www.rescue-essentials.com/bandages/

In $dollars and sense, you can buy much more z-fold gauze for the same money and it has no expiration as long as the packaging is sound.

You can also get non-z-folded gauze for $1 a roll or cheaper.
I believe non-sterile rolls of gauze is even cheaper.
Since you're going to pack the wound with your non-sterile gloves, or your non-sterile bare hands, you don't need sterile gauze anyway.

I believe with the hemostatic agent the clotting process will be a little bit quicker, it's why they brag that it "stops bleeding fast".
But a sock packed inside a wound, with direct pressure, will stop the bleeding as fast as QuikClot or regular gauze.

Maybe with Quikclot you will need to hold direct pressure for 5 minutes where with regular gauze it will take 6 or 7 minutes ... but either way the bleeding would have stopped as soon as you applied proper direct pressure.

Hemostatic agents only affect the clotting process, not the bleeding.

If QuikClot is not packed properly it won't stop the bleeding.It's not a magic product.

 

[rhino]

You can also get non-z-folded gauze for $1 a roll or cheaper.
I believe non-sterile rolls of gauze is even cheaper.
Since you're going to pack the wound with your non-sterile gloves, or your non-sterile bare hands, you don't need sterile gauze anyway.

I believe with the hemostatic agent the clotting process will be a little bit quicker, it's why they brag that it "stops bleeding fast".
But a sock packed inside a wound, with direct pressure, will stop the bleeding as fast as QuikClot or regular gauze.

Maybe with Quikclot you will need to hold direct pressure for 5 minutes where with regular gauze it will take 6 or 7 minutes ... but either way the bleeding would have stopped as soon as you applied proper direct pressure.

Hemostatic agents only affect the clotting process, not the bleeding.

If QuikClot is not packed properly it won't stop the bleeding.It's not a magic product.

 

[2A_Tom]

I have plenty of gauze,2x2, 4x4, 4x8, pads,2", 4", and 6" rolls in various bags, I mentioned the Z-fold because of it's design to be easy to be manipulated and it's more durable packaging.

 

[Sylvain]

I have plenty of gauze,2x2, 4x4, 4x8, pads,2", 4", and 6" rolls in various bags, I mentioned the Z-fold because of it's design to be easy to be manipulated and it's more durable packaging.

It depends where you keep your kit(s).At home in a medicine cabinet having regular rolls of gauze will be fine.
In a small bag having compact vacuum packed z-folded gauze might be more interesting.

 

[rhino]

It depends where you keep your kit(s).At home in a medicine cabinet having regular rolls of gauze will be fine.
In a small bag having compact vacuum packed z-folded gauze might be more interesting.

I have two decent sized rolls of 4" gauze in the same cargo pocket where I carry my IBD and SOFTT-W. More in my car. More in my bag.

 

[actaeon277]

That video is eye opening on several levels. You can learn about and believe how fast someone can exsanguinate from the femoral artery, but to see it happen in real time is a different story. In terms of saving that guy's life, it was very, very fast.

On the other side, there are two important self-defense points to note. One, from the point of view of how much time that guy could have kept fighting, it was a long, long time. He could have done a a lot of damage in the time he had left had he not made the decision that he was done.

Second, it also illustrates how stupid it is to believe that shooting someone in the leg is somehow less lethal than targeting the more preferred areas for the quickest end to hostility. How many times have we heard "they didn't have to kill him! Why didn't they just shoot him in the leg?"

Most of those same people also think you can "shoot the gun/knife out of their hand".

 

[2A_Tom]

I've seen it many times in old Horse Operas.

 

[Sylvain]

Most of those same people also think you can "shoot the gun/knife out of their hand".

You actually can.

[video=youtube;BVnwkDbeARw]https://www.youtube.com/watch?v=BVnwkDbeARw[/video]

 

[CampingJosh]

You actually can.

Someone can, sure. I can't.

 

[Hoosierkav]

https://www.ncbi.nlm.nih.gov/pubmed/21496135

Use whatever type of gauze you got. And, use it well.

 

[rhino]

https://www.ncbi.nlm.nih.gov/pubmed/21496135

Use whatever type of gauze you got. And, use it well.

CONCLUSIONS:

  In this swine model of uncontrolled penetrating hemorrhage, SG dressing performed similarly to the hemostatic agents tested. This supports the concept that proper wound packing and pressure may be more important than the use of a hemostatic agent in small penetrating wounds with severe vascular trauma.

Quoted for emphasis!

SG = standard gauze packing plus direct pressure, no hemostatic

 

[2A_Tom]

 

[Oliver]

Expert: NO.
Look, for nearly every "situation" that most civilians will encounter involving a casualty they're not looking to "treat" any wounds; they're looking to prevent death. The steps to do this are stopping all extremity bleeds, ensuring there's an open airway, and possibly preventing hypothermia. Other than that, unless you're in a very remote area, more qualified personnel will be on site or available to the casualty fast enough so long as those immediate threats have been assessed and maintained.
Bleeds: apply CAT high and tight. Check for continued bleeding. Done.
Airway: head tilt chin lift....insert NPA if unconscious or roll into recovery position to allow drainage. Obviously cric if knowledge allows and situation dictates. Done.
Respiration: if knowledge allows and situation dictates plug holes and apply needle D to affected side of chest cavity; apply as many needles as required. You're not going to kill someone by giving them a needle D. Done.
Hypothermia: Keep the casualty warm. Even if its mid indiana summer a severe loss of blood will induce a rapid loss of core body temperature resulting in the start of a bad triple cycle of more blood loss and more colder casualty leading to shock. A wool blanket or heated blanket works well.
By the time these treatments are performed assistance should be on the way, and your job is to monitor and record vitals. Your work as a death preventor is mostly done. All this work requires repeated training. Again, just advice from a guy on the internet.

 

[2A_Tom]

[video=youtube;DadXqNaLNj8]https://www.youtube.com/watch?v=DadXqNaLNj8[/video]

 

[rhino]

That is cool! Gauze and a second dressing included with what was already a winner.

LIKE.