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#289542 - 06/21/18 07:26 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1847
Loc: Emerald City, OZ
Does the QuikClot 3" x 4 yds Bleeding Control Dressing have any advantage over the QuikClot Advanced Clotting Sponge?

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289544 - 06/21/18 09:45 PM Re: Customizing Your Medical Kit [Re: Montanero]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6540
Loc: southern Cal
Good post, Montanero, and your perspective is quite valuable. Basically we carry about the same things, although I do regard the T as just a bit too specialized. But we have lots of things to wrap the victim up tightly where and when necessary. I am pretty sure my omnipresent red bandanna would wind up in whatever T I might have to improvise.

I suspect there is a further difference in combat/non-combat settings. Hopefully when in combat you are not isolated and someone is handy who sees blood spurting from an artery and can apply a T fairly promptly. In a lot of outdoor situations, the trauma results from a fall of varying length, say ten to 300 feet, and considerable time may lapse before help is at hand.

I recall an instance where we were tending a fall victim (90 foot drop; she survived primarily because she landed on her companion who expired. The physician treating her called to our nearby base asking for iV fluid. "What kind?" was the immediate response. 'Anything, anything at all," just get it here quickly. She had lost so much blood from multiple breaks that the concern was to simply get enough fluid back in her system so that the heart would have something to pump. Bleeding was controlled in this case with pressure bandages and splints. Thanks to rapid helo transport and the doctors care, she did indeed survive.

I think I have the same feeling about Quik-Clot - surely useful for deep penetrating wounds, not nearly so necessary for more common (in my experience, at least) bump and bang trauma. Keep the pressure on!!

I suppose the bottom line is, since there is only so much space in one's pack, to carry what you can use, and be ready to improvise, because there is almost more than one problem. Nothing beats a good patient survey.
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#289546 - 06/22/18 12:34 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1847
Loc: Emerald City, OZ
In a long-term situation, medical tape is essential. I never needed CoFlex in the past; I did stretch gauze. I replaced the CoFlex with 3" stretch gauze. Now I have room for another roll of tape.

The kit comes with excellent bleeding control items. Why do I need six 5" x 9" trauma pads? Isn't two enough? Petroleum gauze is excellent for long-term care situations; other than as an improvised chest seal, does it belong in emergency medicine? Non-adherent dressings come in handy in first aid. I put two in the kit.

Dentemp is not huge; the awkwardly shaped packaging makes it hard to fit. I moved it to the front.

I want to get activated charcoal. I looked at two potential spots. I don't know if it will fit; I'll give it a try.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289547 - 06/22/18 01:30 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1374
Loc: North Carolina
In combat, everyone is carrying a TQ, usually multiple. You have to reduce the threat before you can evacuate wounded, so if you are the wounded and are conscious, you need to be able to do as much as you can.

I have tried (on real patients) an improvised TQ, and they are not very good. It usually takes multiple tries to get it tight enough, if you can at all without ripping the material.

As for Quick-Clot, get training, use the gauze, know what you are dealing with. It works if used properly.

In military operations they do not use IVs for replacing blood loss. It just produces red "koolaide". It provides very little benefit to the casualty beyond a certain point. They use whole blood when they have it. IVs are gold for other issues, such as dehydration (which may be the most common casualty in the timing/camping world) and people suffering from biological infections, to keep them hydrated and give them some minerals and energy.

Unless there is spurting blood, I will try a pressure bandage first, except in cases where the bullets are flying and help may be a while. The SWAT-T and elastic wraps can help a lot with this. The pressure needed is great. You can't just press with your fingers if it is really serious. You are pressing with your hands, arms straight, and with your body weight behind it. It will cause pain to the casualty (as will a TQ), another person there to control the casualty is very helpful.

Blunt trauma is different from penetrating trauma. TQs may not be as necessary for blunt trauma, where pressure usually works.

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#289549 - 06/22/18 04:34 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2014
Loc: Colorado
Originally Posted By: Jeanette_Isabelle
The kit comes with excellent bleeding control items. Why do I need six 5" x 9" trauma pads? Isn't two enough?

I stock my kit with feminine sanitary pads. Cheaper and easier to obtain than trauma pads.

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#289552 - 06/22/18 12:22 PM Re: Customizing Your Medical Kit [Re: haertig]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1847
Loc: Emerald City, OZ
Aside from the feminine pads being shaped to be more comfortable, I know they and trauma pads are the same. As for easier to obtain? Not really unless you are in the middle of nowhere and the only store is a gas station. Cheaper? Again, not really. There is a slight difference; not enough to impact one's decision.

Even if you are slightly OCD, your line of thinking would be feminine pads belong with other personal care items; trauma pads belong in a first aid kit.

Back to my original question. Do we need six trauma pads when the kit already has a tourniquet, QuikClot, two 4" trauma bandages and two compress gauzes?

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289553 - 06/22/18 01:08 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6540
Loc: southern Cal
It isn't that hard to exhaust the contents of any normal FAK and who says you will be dealing with only one casualty in an incident?

On one operation with one seriously banged up victim, I was now improvising splints, casting questing eyes at a small pine tree along the trail, and I had removed my pants to use them for splint padding. I had another pair in my pack and treatment and stabilization was a higher priority. This one victimnearly exhausted my fairly extensive FAK.

You might even have to use a non-sterile material to staunch blood flow in an extreme case. Not recommended,, of course but if you can deliver a patient to the ER still containing appropriate liquids, they have the resources to compensate for infection.
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Geezer in Chief

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#289554 - 06/22/18 01:20 PM Re: Customizing Your Medical Kit [Re: Montanero]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6540
Loc: southern Cal
Most interesting discussion. I am intrigued by your statements about the versatility of some tourniquets. Having regarded them as very specialized items, they just might find a place in my kit.

With respect to "red Kool-aid," I am sure that is what we delivered to the ER, a 20 minute helo flight away from the scene. They had enough of the Real Thing to pull our victim through. What was really important in the successful outcome of this event was the extremely good helo pilot who landed and took off in an extremely narrow canyon.

As I understand it, rapid transport to definitive care has made a real difference in outcomes, both on the battlefield and in civilian life.

I just love helicopters.....
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Geezer in Chief

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#289557 - 06/22/18 01:53 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1374
Loc: North Carolina
TQs are strong, long, and easy to adjust. With good padding between the limb and the splinting material they can provide a good lashing. Because they are already designed to go around a limb, and they are easy to adjust, you can use them for a pressure bandage. You do not have to tighten them all of the way. You just need the gauze and other material to put under it to press on the right spot.

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#289561 - 06/22/18 04:30 PM Re: Customizing Your Medical Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1847
Loc: Emerald City, OZ
Thanks. That helps.

The other question I asked is, aside from improvising a chest seal, does petroleum gauze belong in a first aid kit? I can't think of any reason I would need other than the reason I stated.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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