here's one thing ... and I want to get the opinion especially of the paramedics on this forum.

for a case of serious (or critical) bledding from an extremity I am considering the following technique.

1. While one person gets gear ready (bandages, celox dressings, water for irrigation), a second person applies immediate pressure at the site of the wound.

2. when ready to go, someone takes a piece of surgical tubing and wraps it around the uppermost part of the extremity with some tightness. not enough to be a tourniqet, but enough to reduce blood pressure in the extremity.

3. with blood flow temporarily reduced ... wound is uncovered, irrigated to clean out foreign matter, new bandages applied, pressure applied again on new banadages. goal of this step - 60 secs maximum time.

4. surgical tubing is removed and pressure is maintained on the wound site.

the idea of this technique is to temporarily reduce blood flow to allow quick cleaning and better application of proper bandages. the aim is to be smooth and fast, so blood pressure to the extremity is only reduced for a short time.

and by the way, you could essentially do the same thing if you used a blood pressure cuff on the extremity (and pumped it up) to reduce blood flow. just don't pump it to the point where it gets to systolic pressure - allow some blood to keep flowing.

thoughts??

Pete2