Officer Down Bleeder Kit

[nking]

Some might want to have a look at this video if they haven't seen it before. It's a sucking chest wound so it's a tad bit gross, but it demonstrates the lack of blood (and why it's called a sucking wound :P).

http://www.naemt.org/Education/V06%2...0Wound%201.mpg

This is going to be a dumb question, but humor the neophyte. I have only had a few formal first aid classes. How is the guy in that video not dead? Isn't the wound directly over where the heart would be? What would make a hole that large?

[CBTech]

there isn't a ton that you can do easily for a chest wound that's bleeding a lot. Anything centerline is probably going to be fatal anyway. You can try to reduce a pneumo/hemothorax with a needle decompression but you'll likely have an paramedic on scene pretty quickly that should be able to do that.

The furthest extent I would go and tell someone else to go for this would be to skip the needle thoracentesis and just stay with a Bolin chest seal for chest wound. There could be a chance you could damage the intercostal arteries. By the time all that needed to happen anyway the EMT's would be on scene. It takes some time to depress the respiratory system. I would definately do it in the (battle) field but not in CONUS. Just a Bolin and put them in the recovery position.

Also, while I would not hesitate to do a tracheotomy in the field and is the one thing I can't **** up if I tried to, I would not do this in CONUS unless the patient had a mandable missing or maxillofacial trauma and was unconscious. One thing to make sure is in your kit IS an NPA, nasopharyngeal airway tube, so the victim doesn't choke on their tongue if their lights go out.

Like the NInja said, skip the hemostatic agents and go with direct pressure and a tourniquet. You don't need to be putting shit in people, the ambu WILL be there shortly. Direct pressure and tourniquete. The SOF-T is what we use and it is better than previous issued ones. The Combat Application Tourniquet is a POS. The plastic windlas almost always snaps on me.

When you roll up on a ****ed up dude go through these steps MARCH.
Massive Hemmorage-direct pressure/tourniquete
Airway- fingersweep/NPA/recovery position
Respiratory- Rescue breaths
Circulation- Chest Compressions
Head To Toe- Go back over your work, sweep their back again for addition wounds and blood, take a smoke break.....

I would stick with stopping the massive hemmorage and make sure they are breathing and get the Pro's there ASAP.

[citizensoldier16]

I would not do anything past trying to control bleeding while en-route to the hospital, thats why I'M asking for suggestions on how to do this effectively with items I can obtain from the INTERNET and local sources.

Good idea. As Ninjamedic said...get yourself some trauma dressings, a glove, and your hand. Direct pressure buys the most time.

I'M trained only as a American Red Cross Basic First Aid/CPR/AED First Responder

There are places where even Paramedics cannot use hemostatic agents to stop bleeding. You're talking about a major headache if you try to use those on the streets. Using them on yourself is probably okay though. You can't easily sue yourself.

ADD: Unless you're a trained and currently certified EMT or Paramedic a) operating within your district AND b) on the clock or volunteering AND c) operating under the medical direction of a physician (MD), if you choose to implement one of the abovementioned devices on another person, you are practicing medicine without a license and doing so can get you in loads of legal trouble. IMHO, it's not worth it. As I said above...direct pressure and drive fast.

[Ferris2son]

There is a celox applicator thats pretty much like a tampon applicator. You push it into a wound and push the celox out into it.

Celox applicator that I have in my kit.
http://stores.homestead.com/Laruetac...ail.bok?no=424

I also have Celox gauze roll that can be stuffed into wounds and Israeli pressure bandages. Here is a supply site"
http://www.redflarekits.com/mm5/merchant.mvc

[kmrtnsn]

I recommend that you get a SWAT-T tourniquet and practice with it as this is something you'll more likely be placing on yourself than on another officer. I'd also recommend getting a second SOF tourniquet to practice with. Also, get the red/orange version of the SOF for your use, in your environment tactical black serves no purpose.

[JC5611]

Great thread and a lot of good info....I appreciate those with the knowledge sharing it with us. I'm trained as an EMT (not medic), training I went through for my agency (LE).

I have no formal training with quickclot, celox, etc (so I don't use it)...I learned pressure, tourniquet, chest seals, and the other methods discussed here and I try to stay within my limitations.

With the new quickclot/celox combat gauze, is that advisable to use in a manner consistent with other dressings along with pressure? I understand the issues with placing anything into a wound that will delay treatment at an ER, where a dr/nurse will have to clean it out prior to treating the person.....just looking for advise since everyone seems to carry these in medical kits now and there has been reference to only using this type of agent in specific circumstances.

Thank you in advance and I appreciate all the help.

JC

[LUCKY MEDIC25]

JC5611- We are starting to switch to just using QuikClot combat guaze. This stuff is awesome, it obsorbs super amounts of blood and stops bleeeding quickly. Yes along with the the hemostatic agent in the guaze, the quaze will not fill most cavities and apply the amount of pressure you need for a major bleed, packing kerlex or Zfold quaze over that and then applying an emergency bandage or ace wrap over that will work wonders.

To be honest, their aren't too many bleeds you can't stop with a good pressure dressing(packing the wound tight with guaze and wrapping a good ETB over that) Without the use of combat guaze or any other hemostatic agent as long as your pressure dressing is applied properly.

[LUCKY MEDIC25]

I forgot I wanted to touch on the tourniquet topic.
In my opinion the CAT is awesome! The problem I've seen over here is that people will try to use them more than once, they are only meant for single use. Using it more than once will put a lot of strain on the adhesive that is used and it will eventually fail.
The second reason I have seen that causes the windless to break is that people try to do too many rotations with it. If you cinch the strap down as tight as you can get it like you are supposed to, you should only need to turn the windless a few times in order to stop bleeding to the extremity, many people will barely tighten the strap and then crank down on the windless causing it to snap, or the adhesive holding the strap to break loose.
Personally, I feel the SOF-T has too many parts to operate which when your brain goes into caveman mode(which will happen in a trauma situation) their are too many steps you can miss or not do properly.
Just my personal opinion and experiance.

[LUCKY MEDIC25]

On the cave man mode topic, the Navy is using a tourniquet that I wasn't sure about at first, but after doing some trials with it, I really like.
It's called the TK4 and it is made by H&H
It's basically an 1 1/2" wide elastic band that has a hook on one end that looks like a fish and a regular looking hook on the other end. You wrap it around the extremety once and then bring it back through the fish looking hook then wrap it the rest of the way and secure it with the other hook.
My directions might sound confusing but it really is a very simple tourniquet to use and surprise it really does stop bleeding well!