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#11883 - 01/08/03 09:02 AM The new Israeli type bandage question.
Stefan Offline
Newbie

Registered: 10/30/01
Posts: 55
Loc: Sweden, South
This does anyone know if the plastic part in the israeli bandage can cause pressure-damage to tissue? I have been taught not to use anything hard in bandage when I have to apply preassure to a wound. Soft stuff like socks, a rolled up T-shirt or similar would do. Any hard material would besides from pressing into the wound, probably cause ischemic(?) (deprivation of oxygen by lack of blood?) damage if left im place for some time. (sorry im Swedish, i dont know if thats the correct term). Does anyone have an opinion? I would especially like input from our docs and medics on this forum.

Stefan, Sweden.

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#11884 - 01/08/03 12:42 PM Re: The new Israeli type bandage question.
Trusbx Offline
addict

Registered: 01/16/02
Posts: 397
Loc: Ed's Country
I believe the Israeli bandage has a ?plastic bar by which you can thread the bandage material and double it back to apply additional pressure to the wound in question.
A few points to consider:
1. Ischaemic damage can occur with any kind of bandage tied tight enough. Even a t-shirt tied tight enough to stop any blood flow thru the area for a long enough time will cause ischaemic damage.

2. The point about hard objects probably refers to pressure necrosis. The soft part of the skin coming into contact with a hard object for a long enough time (your own body weight is enough to cause pressure sores) reduces the blood flow to the area in question and causes skin necrosis (death) over a longer period of time.

If the wound is severe enough to warrant an israeli type pressure bandage ( gunshot wound causing major arterial injury ), ischaemia of the limb is not the 1st consideration - stemming the life threatening blood loss is and hence the pressure requirement if the 1st dressing isn't doing its job. And if the pressure bandage doesn't stem the bleeding, the guy will be dead before ischaemia of the limb ever comes into the issue ! <img src="images/graemlins/grin.gif" alt="" />

Hope this helps!

_________________________
Trusbx


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#11885 - 01/08/03 01:17 PM Re: The new Israeli type bandage question.
Polak187 Offline
Veteran

Registered: 05/23/02
Posts: 1403
Loc: Brooklyn, New York
Proper dressing of the wound include:

-direct pressure and dressing
-elevate
-dressing
-pressure point
-tourniquet

None of the dressings I came in contact with in the field had any hard plastic in them (except for soft one). I don't think that plastic part would cause any type of damage to the tissue underneath if would was reassessed in the reasonable time. Discomfort maybe but damage very unlikely. Also it shouldn’t be placed directly over the wound since that would prevent absorption of blood and forming of scab. But if you think about it there can be couple of different scenarios to it. If you using such bandage to work over a laceration on the arm and when wrapping it up the plastic part ends up over brachial artery. Automatically that would slow (or stop) down blood flow to rest of your arm. That can be potentially dangerous. Such bandage would definitely be more dangerous to kids since they are more sensitive to lack of oxygen. Also if area of injury has a potential to swell and you have a plastic there that will not stretch or adjust this is another pressure point that may cut of blood supply. I think that when using Army type of medical supplies (I'm assuming you are talking about Israeli Army bandage) you have to remember that those things are designed to treat gunshots, amputations and battlefield injuries, not household type of emergencies. It is acceptable for the military to have certain amount of casualties while it is totally unacceptable in civilian life. But in conclusion I think it’s all about placement of the hard plastic tab and proper follow up care and checking on your interventions.

Matt

_________________________
Matt
http://brunerdog.tripod.com/survival/index.html

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#11886 - 01/09/03 03:17 PM A Couple Sources
Stefan Offline
Newbie

Registered: 10/30/01
Posts: 55
Loc: Sweden, South
Thank you guys!

I think that I will stick to the old type of bandages, they are cheaper. After all what good are bandages if you dont know how to apply them. Here´s a citation by supposedly a British surgeon after the Falkland War: "-All they did was to hide the wound from frightened eyes". <img src="images/graemlins/frown.gif" alt="" />

Stefan, Sweden.


Edited by Doug_Ritter (01/17/03 02:02 PM)

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#11887 - 01/17/03 02:38 AM Response From Bandage Inventor
Doug_Ritter Offline

Pooh-Bah

Registered: 01/28/01
Posts: 1966
When this thread started [I suggested to the company that they might want to interject some information in this thread. Bob Grau, the inventor, has finally responded, but for some reason they were unable to post a reply and asked that I post this for them]

To all those who expressed interest and/or an opinion regarding the Emergency Bandage, Thanks. I hope I can provide the missing information. My name is Bob and I am the inventor of the Emergency bandage, (EB). I am a medic in the IDF Reserves, in a combat infantry unit.

The device was designed to replace not only the personal field dressing, but also the often very useful non-sterile triangular dressing and sometimeseven a tourniquet. One of the main ideas behind the device is consolidation leading to focus, putting all the treatment equipment for traumatic hemorrhagic wounds into one piece. Primary dressing, pressure application, secondary sterile dressing, immobilization and tourniquet if needed. The caregiver has what he needs in his hands to treat another or himself without having to look for additional equipment or accessories. (A Dr. once said to
me that: " Disaster=Distraction". In the military, and many times in civilian cases there are more than one injured needing care. You're treating "A", and you need to go to your vest or kit only 5 meters away to get something and on the way "B" and "C" either call for your help or attract your attention; "A" could fall between the cracks). The EB consolidates the treatment equipment into a single unit, saving space, time and $.

The application of the EB is fast and quick, starting with a primary dressing to cover the wound site. The pressure bar is situated as seen in the photos on the topside of the dressing, opposite to the side coming in contact with the wound. The elastic leader engages the pressure bar and forces it down on to the pad creating an area of direct pressure through the pad on to the wound site. The possibility of some tissue damage exists, but is mitigated by a number of factors. 1. The plastic has no direct contact
with the wound, but through the pad; 2. of course the time factor is crucial, with the goal of a quick evacuation; 3. the amount of pressure applied is controllable depending upon the nature of the wound, serious wound-more pressure, less serious-less pressure; 4. I'll take ischemia and even necrosis vs a funeral. The pressure bar, in cases when absolutely no hard objects should be in the wound area such as with a foreign body embedded, or suspicion of spinal injury, can be cut or torn off the top of
the pad. In addition to its primary function of pressure application, the pressure bar facilitates bandaging enabling one handed application if needed as the pressure bar acts as a sort of a buckle, holding but not locking the wrapping leader and allowing the creation of traction, and also providing
the ability to change direction when bandaging. For example, with a head wound you can wrap the leader around the top of the head and under the chin and using the pressure bar you can turn the wrapping leader around it to wrap around the fore and back of the head, covering the pad and wound
site/area from two directions; this provides for good placement and keeps the bandage in place, this is important for other body parts, (groin, armpit, shoulder) as well, other than circular limbs or the torso.

The elasticized wrapping leader is woven to remain at its maximum width throughout and does not bunch up and become like a rope to create an inadvertent and sometimes unknown tourniquet. And as it stays wide all the time it covers and extends beyond the area of the pad creating a very good
secondary dressing covering the whole wound area with a sterile covering and keeps the pad and pressure in place. As the wrapping leader is a long elasticized bandage, there may be instances where after accomplishing the placement of the pad, pressure and secondary dressing there is enough leader left to be used as a sling or limb immobilization device. The closure bar at the end of the wrapping leader provides a very quick and easy means of closure. There are two clips, one at each end of the bar, looking like the clip at the top of a pen. Even one of them inserted to a previous revolution of the wrapping leader will hold the application in place. Knots come loose, tape and Velcro get wet, hooks puncture gloves and skin - if you tried hard, you couldn't scratch yourself or the victim with the clips on the closure bar.

The closure bar is the apparatus used to effect a tourniquet. Inserting it into one or more of the previous revolutions of the wrapping leader 5 cm above the wound site and twisting takes up the slack in the wrapping leader and tightens it until the blood flow is constricted. I want to stress that in almost all situations, tourniquets are to be avoided, and should be used only by those with first aid training and/or experience. Sometimes though, if you see that you have more than one wounded, or it is night and you can't really determine the extent of blood loss; or for example, the limb has more than one wound in it - you don't have the time, or sometimes the equipment to bandage every open wound, you apply a stringent blood constricting dressing or even tourniquet to the wound most proximal to the heart to stem the loss of blood from all the wounds. The wrapping leader as it remains wide over the pad and wound area presents a large enough surface area to write on - the exact time of tourniquet application.

The device was designed for use in the field, space and weight in a medic's vest are prime considerations, likewise in first aid kits or mobile units; helicopters and emergency rescue vehicles.
Consolidation saves $. Bandage to bandage, the EB may be only slightly more expensive, treatment to
treatment the EB is much less expensive, taking into account all the additional equipment that must be on hand. The savings is along the whole route. Purchasing, storing, training on 3 or 4 pieces of equipment vs. that same chain for one article. Don't misunderstand, I want to save lives, I also want to get rich <img src="images/graemlins/smile.gif" alt="" /> I want everyone to buy my bandage and no one to need it.

The bottom line is that the EB gives the caregiver a lot of freedom and focus at the same time. It was designed with a great deal of respect for the caregiver and for his/her ability to improvise. It's very versatile and gives the caregiver many options to apply an effective, God Willing, life saving dressing.

Bob Grau

[NOTE: images at http://www.equipped.org/pp/pic911.htm and Doug's article from the SAR conference with additional information at ]http://www.equipped.org/rw_sar_02.htm
_________________________
Doug Ritter
Editor
Equipped To Survive®
Chairman & Executive Director
Equipped To Survive Foundation
www.KnifeRights.org
www.DougRitter.com

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#11888 - 01/17/03 03:10 AM Re: The new Israeli type bandage question.
Anonymous
Unregistered


Has anybody managed find a source to purchase a small number of these dressings in the US? I know how to get them in lots of 100, but I was thinking more like 5-10.

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#11889 - 01/17/03 02:01 PM A Couple Sources
Doug_Ritter Offline

Pooh-Bah

Registered: 01/28/01
Posts: 1966
Quick Google Search turned up:

Brigade Quartermasters this is the military version

Landfall Navigation This is the civilian version

to name a few sources.
_________________________
Doug Ritter
Editor
Equipped To Survive®
Chairman & Executive Director
Equipped To Survive Foundation
www.KnifeRights.org
www.DougRitter.com

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#11890 - 01/18/03 02:53 AM Re: A Couple Sources
Anonymous
Unregistered


Thank-you Doug,
Quite a price gap between the two versions, do you have an opinion wrt the relative suitability for a civilian kit of the versions?

thanks again!

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