IMHO, based upon watching the evolution of ER medicine for 30 years: ER docs spend a lot of time reading the literature and evaluating new products. They do not use quik clot or any other miraculous products. They contend that direct pressure stops bleeding every single time. sometimes the direct pressure needs to be a forcep-hemostat-kelly clamp applied to the artery involved, but mostly it involves a nurse pushing on a dressing. I have pushed on dressings for hours upon occasion. It's a living.If you sprinkle anything into a wound-corn starch, antibiotic powder or ointment, whatever-you create a place for bacteria to hang out. If you irrigate the wound with peroxide, alcohol, merthiolate, or iodine, you will kill the bacteria, but you will also kill the healthy sells at the margins of the wound and do more harm than good. Current Er doc thinking suggests that the wound be copiously irrigated with sterile saline solution (boiled water, 1 tsp salt per quart of water) or clean water (tap water is fine) then wrapped in a pressure dressing( elastoplast tape is effective, but the skinflints won't buy it for the ER; we use ace bandages). orthopedic surgeons use tourniquets a lot, to control bleeding at the operative site (they call it orthopedic ooze) but they watch the time and release the tourniquet regularly. Tourniquets are risky, and make sense if the choices are sacrificing a limb or bleeding out.
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