Plate carrier first aid

[stephen87]

A significant number of experienced emergency medical professionals do not carry or use hemostatic agents, probably for the same reasons you do not.

I'm not used to it, so I'm very iffy on it. I might talk to a few docs that I know and see if they have opinions about it.

In my humble opinion, the smallest, safest (for the non-medical specialists) and easiest GSW kit to carry, is a SOFTT-W, H&H Z-fold sterile gauze and 4" Israeli Bandage. Simple, fairly cheap to acquire, no hemo's, chest seals or needles (so no treatment of tension pneumothorax), but good stuff to carry everyday. (I carry a CAT simply because it's what I have but the SOFTT-W folds smaller.)

1. Apply TQ
2. Stuff wound with gauze
3. Apply Izzy dressing

I agree. Those will definitely get the job done, as long as bleeding is your issue and not a compromised airway or a pneumo. I'm trained in the use of some things, just not a decompression needle. Until I get the training, I probably won't carry one, unless I get a heck of a deal on one.

 

[lester]

A significant number of experienced emergency medical professionals do not carry or use hemostatic agents, probably for the same reasons you do not.

There a new hemostatic I have stumbled onto called NuStat. It is supposed to be the 'next level - but I am not in the medical field, so I don't understand the depth of the issues. But I do know people who think it is the new best thing.

[video=youtube;NaJ0VKBHV18]https://www.youtube.com/watch?v=NaJ0VKBHV18[/video]

https://nelsonuniform.com/collections/vendors?q=Beeken BioMedical

 

[CavMedic]

I carry a TQ that is held to my carrier with a velcro tie. That's it. That's the only thing I would use in a point of contact situation.

 

[freekforge]

My flc, plate carrier, car bag and SAR belt all have the same IFAK the contents are as follows:
quick clot gauze x2
cat tq x2
mojo dart x1 (i have a history of pneumothoracies)
chest seals x4 (2 through and through gsw)
israeli bandage x1
nasal pharyngeal air way w/ lube x1
2 pair nitrile gloves
kerlix x1
abd pad x2

this was built with the input of 2 ER docs a swat medic and a nurse/volunteer paramedic. if it wasn't for my medical past i would probably leave out the mojo dart since they are kinda sketchy but i flagged it saying to only use it if qualified. it all fits in a regular army ifak/saw pouch. i also keep a quick clot trauma kit from walmart in my butt pack

 

[SMiller]

A significant number of experienced emergency medical professionals do not carry or use hemostatic agents, probably for the same reasons you do not.

Would love to hear the reason as the is the dumbest thing I have ever heard!

What do you think a tourniquet is going to do for a pelvis or neck shot???

The reason it is not on some trucks is because the citys are CHEAP!

 

[SMiller]

There a new hemostatic I have stumbled onto called NuStat. It is supposed to be the 'next level - but I am not in the medical field, so I don't understand the depth of the issues. But I do know people who think it is the new best thing.

[video=youtube;NaJ0VKBHV18]https://www.youtube.com/watch?v=NaJ0VKBHV18[/video]

https://nelsonuniform.com/collections/vendors?q=Beeken BioMedical

I am not going to say that is a bad product but "most" gunshot wounds are small, that is some huge gauze! Quick-clot and the other products like it are on much smaller gauze which could be pushed deeper and in to smaller wounds. Again not saying that their is a bad one but I would take two quick-clots over one of those.

Not only that but there is also no Z-fold so you will be dragging gauze through the ground and into the wound.

 

[lester]

I am not going to say that is a bad product but "most" gunshot wounds are small, that is some huge gauze! Quick-clot and the other products like it are on much smaller gauze which could be pushed deeper and in to smaller wounds. Again not saying that their is a bad one but I would take two quick-clots over one of those.

Not only that but there is also no Z-fold so you will be dragging gauze through the ground and into the wound.

Good feedback. Thanks!

Beeken offers two sizes of NuStat: a vacuum packed 2"x36" z-fold and a vacuum pack with two 4x4 pads. The 2x36 is lengthy for sure, but it is only 2-inch wide compared to the Quikclot Combat Gauze z-fold which is 3 inches wide and 12 feet long.

See them both here: https://nelsonuniform.com/collections/vendors?q=Beeken BioMedical

I hope enough professionals try it out so there is performance data to study - is it indeed different and/or better? Some people already think so. If not, I keep Quiklot in my stash too, and we also have Quikclot for sale at the store if that is someone's preference.

 

[rhino]

Would love to hear the reason as the is the dumbest thing I have ever heard!

What do you think a tourniquet is going to do for a pelvis or neck shot???

The reason it is not on some trucks is because the citys are CHEAP!

How could it be "the dumbest thing" you have ever heard if you haven't heard the reasons?

What does a tourniquet have to do it?

Feel free to contact Doc Gunn (Anthony Barrera, MD). He's a board certified trauma surgeon with over 30 years of experience, one of the DTI (John Farnam) instructors, and trained extensively with Chris Dwiggins in "tactical medicine." Doc is the guy who teaches the "Tactical Treatment of Gunshot Wounds" class every year at Boone Co and elsewhere around the country.

The reason he gave us: hemostatic agents require direct pressure to be effective (on anything deeper than a very shallow wound or an abrasion). That same direct pressure is effective without the hemostatic agents under the same circumstances. Applying those agents wastes time for little or no benefit. Lesser issues are added complication of cleaning/debriding the wound afterward and tissue damage (from the older version of quikclot).

Whether you agree with it or not is your business, but if it's "the dumbest thing" you have ever heard, you're leading an unusual life.

 

[SMiller]

How could it be "the dumbest thing" you have ever heard if you haven't heard the reasons?

What does a tourniquet have to do it?

Feel free to contact Doc Gunn (Anthony Barrera, MD). He's a board certified trauma surgeon with over 30 years of experience, one of the DTI (John Farnam) instructors, and trained extensively with Chris Dwiggins in "tactical medicine." Doc is the guy who teaches the "Tactical Treatment of Gunshot Wounds" class every year at Boone Co and elsewhere around the country.

The reason he gave us: hemostatic agents require direct pressure to be effective (on anything deeper than a very shallow wound or an abrasion). That same direct pressure is effective without the hemostatic agents under the same circumstances. Applying those agents wastes time for little or no benefit. Lesser issues are added complication of cleaning/debriding the wound afterward and tissue damage (from the older version of quikclot).

Whether you agree with it or not is your business, but if it's "the dumbest thing" you have ever heard, you're leading an unusual life.

Well now you are changing the story.

It was said that quick-clot was not carried as there was something wrong with it when what was ment was that it shouldn't be used UNLESS direct pressure can continue to be applied.

Don't go and change the story on us.

I stick to what I said, it does work and it does save lives, it would be stupid NOT to carry it.

Show us where a hemostatic agent hurts a patient, we are not taking the old stuff that burned or got in eyes or some other bs, fact is if you have time to push a z-fold into someone then you have time to wrap with a H-bar or Israeli bandage otherwise you drag the patient out of the hot zone and treat behind cover.

 

[MindfulMan]

Man .... all this medical talk is making me woozy. At 65, I hope I don't need to go to the "hot zone" !

 

[Double T]

If you have a through and through, quick clot isn't going to do a lot. Quick clot to the outside edges of a wound are only going to make a hematoma under the clot. Best bet for prolific bleeding is moistened gauze packing and a TQ. And to that, I wouldn't expect someone from a "first aid" level class, to understand how to pack a GSW.

YMMV, but my kit has no hemostatic agents. Just gauze and TQ's.

 

[rhino]

Well now you are changing the story.

The only story that is changing is the one inside of your head. Your assertion about me changing a "story" is wrong, and insulting as well. Furthermore, I didn't provide a "story," so there was nothing to change. Here is exactly what I said (which you quoted previous, no less):

A significant number of experienced emergency medical professionals do not carry or use hemostatic agents, probably for the same reasons you do not.

I was speculating that the person to whom I responded was operating under policies made by people (perhaps himself) that understand that direct pressure is the effective treatment, with or without hemostatic agents. You assumed too much. I provided you with the reason why I don't keep hemostatic agents in my supplies and have no intent to use them based on what I was taught, as you requested.

It was said that quick-clot was not carried as there was something wrong with it when what was ment was that it shouldn't be used UNLESS direct pressure can continue to be applied.

Don't go and change the story on us.

I stick to what I said, it does work and it does save lives, it would be stupid NOT to carry it.

Show us where a hemostatic agent hurts a patient, we are not taking the old stuff that burned or got in eyes or some other bs, fact is if you have time to push a z-fold into someone then you have time to wrap with a H-bar or Israeli bandage otherwise you drag the patient out of the hot zone and treat behind cover.

 

[rhino]

Man .... all this medical talk is making me woozy. At 65, I hope I don't need to go to the "hot zone" !

Me too!

The problem is, the hot zone may come to you. Gunshots and other weapons are not the only way to sustain a serious wound that bleeds profusely. I fell and hit my head back in the 2009 and the wound was really bad, both the laceration and the crushing wound to some of the tissue near the laceration. Plus I had a concussion. I had to treat myself initially, so knowing how to manage injuries and other health issues can be a very helpful skillset. Having some gear to go with the skills makes it easier.

Everyone should at least know how to manage bleeding, airways, and CPR I think.

If you have a through and through, quick clot isn't going to do a lot. Quick clot to the outside edges of a wound are only going to make a hematoma under the clot. Best bet for prolific bleeding is moistened gauze packing and a TQ. And to that, I wouldn't expect someone from a "first aid" level class, to understand how to pack a GSW.

YMMV, but my kit has no hemostatic agents. Just gauze and TQ's.

That's a good point, and applies to any deep/big wound. You have to apply pressure as deeply as you can, which is what packing helps you do, so the clotting occurs all the way down and not just at the surface.

I'm lucky that I've never had to do anything for wound that required packing. I keep a few rolls of gauze in my truck kit, but not on my person. I have a plan to improvise, though!

 

[SMiller]

The only story that is changing is the one inside of your head. Your assertion about me changing a "story" is wrong, and insulting as well. Furthermore, I didn't provide a "story," so there was nothing to change. Here is exactly what I said (which you quoted previous, no less):



I was speculating that the person to whom I responded was operating under policies made by people (perhaps himself) that understand that direct pressure is the effective treatment, with or without hemostatic agents. You assumed too much. I provided you with the reason why I don't keep hemostatic agents in my supplies and have no intent to use them based on what I was taught, as you requested.

I was attempting to quote both you and the person you quoted, the other poster stated he had no experience and did not carry quick-clot which I am assuming is because his dept is cheap, I should have found a way to address that post instead of just quoting you.

I am in no way saying quick-clot is a absolute but you can bet your ass it is in my top 3 must haves, it will save a life, it will help do the job.

Tourniquets are quick and easy but unfortunately there are to many parts of the body that they simply can't be used on, hate to see someone bleed out because they didn't carry anything.


Those that recall the sheriff officer that was shot in the pelvis in Russiaville would know there is only a few products on the market that would help in that case, those products were not carried nor used in his case and the result was bad.



At the end of the day GET TRAINING and carry you load out.

 

[MindfulMan]

Me too!

The problem is, the hot zone may come to you. Gunshots and other weapons are not the only way to sustain a serious wound that bleeds profusely. I fell and hit my head back in the 2009 and the wound was really bad, both the laceration and the crushing wound to some of the tissue near the laceration. Plus I had a concussion. I had to treat myself initially, so knowing how to manage injuries and other health issues can be a very helpful skillset. Having some gear to go with the skills makes it easier.

Everyone should at least know how to manage bleeding, airways, and CPR I think.

You're absolutely correct, Mr. rhino. I guess I was just trying to lighten things up a bit.
My wife is a well-respected nurse, and she's usually with me. So I guess I depend on her for any medical help that I or others might need.

 

[stephen87]

Would love to hear the reason as the is the dumbest thing I have ever heard!

What do you think a tourniquet is going to do for a pelvis or neck shot???

The reason it is not on some trucks is because the citys are CHEAP!

Or could it be because I'm within 20 minutes of a hospital? As I said: I will not carry it because I have no experience with it.

 

[stephen87]

I am not going to say that is a bad product but "most" gunshot wounds are small, that is some huge gauze! Quick-clot and the other products like it are on much smaller gauze which could be pushed deeper and in to smaller wounds. Again not saying that their is a bad one but I would take two quick-clots over one of those.

Not only that but there is also no Z-fold so you will be dragging gauze through the ground and into the wound.

Mind if I ask what you do for a living? We carry rolled kerlix on our trucks. I can wrap 4 feet of it without dragging any through the dirt.

 

[stephen87]

I was attempting to quote both you and the person you quoted, the other poster stated he had no experience and did not carry quick-clot which I am assuming is because his dept is cheap, I should have found a way to address that post instead of just quoting you.

I am in no way saying quick-clot is a absolute but you can bet your ass it is in my top 3 must haves, it will save a life, it will help do the job.

Tourniquets are quick and easy but unfortunately there are to many parts of the body that they simply can't be used on, hate to see someone bleed out because they didn't carry anything.


Those that recall the sheriff officer that was shot in the pelvis in Russiaville would know there is only a few products on the market that would help in that case, those products were not carried nor used in his case and the result was bad.



At the end of the day GET TRAINING and carry you load out.

Absolutely. My EMS department is cheap. Again: I am within 20 minutes of a hospital, pick a direction. And again: I will not carry it because I have no experience with it. Why would I carry a tool with no experience with it? Would olyou expect me to carry stuff on my ambulance without training or experience with it?

 

[rhino]

You're absolutely correct, Mr. rhino. I guess I was just trying to lighten things up a bit.
My wife is a well-respected nurse, and she's usually with me. So I guess I depend on her for any medical help that I or others might need.

I applaud your effort!

Good to have a nurse with you for a lot of reasons! Ask her to teach you some basics just in case she is ever the one who needs first-aid.

 

[wally05]

As an EMT and officer, I carry the essentials in an active shooter bag, tq (cat and swat-t), lots of gauze, some kerlix, some hemostatic agents, gloves... That's about it. Carry 4x4s, rolled gauze, a tq, and probably get a pack of hemostatic stuff just to have it. You really don't need much training in the use of those agents. Just apply the stuff, use pressure, gauze it, elevate it if it's an extremity And use a tq if applicable. Another poster was right that you should have bleeding control items for areas that you can't wrap with a tq. The paramedic teaching our course recommended use of those agents.

The stuff out there now is pretty good stuff. Just research it before buying. It used to be that docs didn't want you to use it bc it was hard to clean out and the particles could get in the bloodstream and cause problems... I don't think that is an issue anymore. Don't overthink it. You're just trying to slow bleeding enough to get yourself or another person to advanced life support folks. If you're bleeding enough to need to use agents an a tq, you won't have long to think about it before you or your patient loses consciousness.