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ONE THING EVERY EDC'er SHOULD HAVE

Discussion in 'First Aid Station' started by Nate320, Aug 9, 2008.

  1. dovk0802

    dovk0802 Loaded Pockets

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    The perspective of the military is that, with appropriate training, all personnel should carry a clotting agent and a tourniquet in their Individual First Aid Kit. Understand of course that environment doesn't need to worry too much about legal ramifications (while your buddy may not sue you, he may kick your butt if you screw up).
     
  2. Stelth

    Stelth Banned

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    I should have mentioned military as well as medics because it is obviously appropriate for them. There's a huge difference between being a soldier who engages in fire-fights and deals with IED's and an untrained civilian dumping clotting agent on someone because he thinks he's helping.
     
  3. jag-engr
    • Administrator

    jag-engr Semper Bufo!
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    Now this would be worth having in a first aid kit. I've never had a bad nose bleed, but I've known people who were prone to them. They could really use a lot of blood! :green:
     
  4. tmedina

    tmedina EDC Junkie!!!!!

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    That was part of the demonstration of Quikclot at CLS class on Anaconda. The cup crumpled in and collapsed.

    At the time, the only application was in powdered form which is highly problematic in windy environments - getting even a little in your eyes wouldn't be fun, never mind trying to apply enough to the wound site to do any good.

    -Trevor
     
  5. tinmaddog

    tinmaddog Empty Pockets

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    Ok, I've got a question. I get why the original QC could cause a lot of damage, and why:

    But with Celox or QC ACS+ or Combat Gauze, does this same logic apply? I'm not being flippant, I'm really trying to figure this out. With the sponge/gauze applicators and no (or virtually no) exothermic reaction, aren't you taking away the two potential significant problems with these products - burning and removal of the agent? (granted, the Celox granules only remove one of those)

    My instinct is that these newer/safer products fall into the "rather have them and not need them..." category, and as long as they're treated as a last resort are a valuable part of a trauma kit. Am I missing something?

    Also, as for WoundStat, here's some worrying news. I guess the Army has stopped using the stuff (or does someone have newer news?). So that's off my list.
     
  6. Mark123

    Mark123 Empty Pockets

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    I actually purchased and carried clotting agents in all of my glove compartments a while back...all of the products expired and it cost me about $50 for a little piece of mind.

    Now, I just read in Army Times that they recalled a whole line of clotting agents because it caused blood clots in the bloodstream that could lead to strokes.

    So, unless I'm on the battlefield, and without any training, I'm going to stay away from them. Direct pressure, elevation, and a tourniquet if necessary until the professionals arrive...beyond that, it's in God's hands.
     
  7. Synaptic Misfire
    • In Omnia Paratus

    Synaptic Misfire Loaded Pockets

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    I am on blood thinner therapy and Celox is designed for use with heparinized blood or coumadin therapy. I asked my Doc if it would be wise to get some to keep with me. He said he could not encourage the use of any of those products. Take that as you will.
     
  8. Schattenwolf

    Schattenwolf Empty Pockets

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    I allways carry Celox with me in my duty pant and in my large tactical vest FAK. Near the tournique, bandage and sticky tape is it a very important part in my FAK.
     
  9. dovk0802

    dovk0802 Loaded Pockets

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    I'd recommend some training for using a tourniquet too. Furthermore, if someone hasn't had training, I'd bet a soda, they don't know how to do direct pressure (for serious stuff, not finger cuts).
     
  10. drjohnson36

    drjohnson36 Empty Pockets

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    Hemostatic agents should not be used, period. 99.9% of bleeding can be controlled with pressure and elevation. Gunshots are their own category because of the huge number of possible variables involved. Nevertheless, you should NEVER use a hemostatic agent to control bleeding. Should the agent infiltrate into the bloodstream and reach the coronary arteries, it can cause a heart attack. If it reaches the brain, it can cause a stroke.

    On the liability side of the page, Good Samaritan laws currently protect laypersons so long as they do not perform procedures that would require a medical professional to authorize. Just because you read about how to intubate a patient on the internet, and you happen to carry laryngoscope and an ETT, doesn't mean you can legally perform such a procedure. Clotting agents are the same. You are introducing a substance to the body, and should anything go wrong or so much as a SCRATCH land on that person as a result of your actions, you are completely liable and open to lawsuit. It is a chance I would not take.
     
  11. WVDAVE

    WVDAVE Loaded Pockets

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    As always very informative for us newbies.
     
  12. ncdoc

    ncdoc Empty Pockets

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    The granulated Quick Clot is being replaced with the "Combat Gauze". I would like to point out that Quick clot was designed to control arterial bleeding. Even before the QC is applied, direct pressure, tourniquet, and a pressure dressing is tried. QC should be used only when other means of hemorrhage control don't work.
     
  13. mikeindallas

    mikeindallas Empty Pockets

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    +1 on that! :ty:
     
  14. dovk0802

    dovk0802 Loaded Pockets

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    I get a bit uncomfortable when terms like "always" & "never" are used. This technology has saved hundreds, if not thousands of lives in Iraq & Afghanistan. While those environments & situations may not be the norm for most of the readers of the forums, there is some overlap here & ideas have a way of spreading. I hope to minimize the idea that these products are in some way bad. They are specialized tools; that like most everything else, requires proper training.

    I also offer that keeping up with progress, especially with technology, can be difficult. However, things change. I discussed this topic with our Group Medical Officer, who is heavily involved in emergency medicine in SOCOM. He said that while there are issues with particular products & methodologies, the move in the military & civilian communities is towards integrating clotting agents in to the standard of care protocols.

    I welcome critique & dialogue, I just feel that caution should be given to dismissing or marginalizing something this important. Thanks.
     
  15. vivek16

    vivek16 Loaded Pockets

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    I saw some microscopic sieves that sucked the water out of the blood that helped clots form faster, I can't remember where though, it was on a wilderness survival/camping site. Those seem like a safer alternative. I'll try to find a link.

    -Vivek
     
  16. Corbs

    Corbs Loaded Pockets

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    Niton sell them mate ;)
     
  17. Corbs

    Corbs Loaded Pockets

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    Some AFOs have reccomended Tampons for when space is really an issue.
     
  18. madkins007

    madkins007 Loaded Pockets

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    I'm a First Aid and CPR instructor with a EMT background, and I see a lot of naughty words in this thread when we are talking about civvy responders... tourniquets, pressure points, clotting agents or other chemical-based agents...

    These sorts of discussions need some sort of coding attached- trained professionals only, 'away' medicine only (more than 30 minutes from 911 response), etc. I know most of you are talking about combat conditions, injuries in remote areas, industrial or specialized response accidents, but the layperson near 911 response would use a different tactic.

    I can use my Red Cross First Aid Basics training to effectively treat any bleeding injury a human can survive with no special tools or techniques, and keep that person stable until paramedics arrive (in an average of 9 minutes locally). Applying direct pressure with my and/or the victim's hands, making pressure bandages out of gauze pads and roller gauze- or field expedient equivalents (T-shirts are such handy things, aren't they?) Femoral bleed? Pack and direct pressure, or jam a finger in there. Amputation of the leg? Direct pressure to the main vessels. Abdominal wound? Cover with a warm/wet, clean, lint-free cloth (T-shirt again), cover with some sort of food-quality wrap (foil, wax paper, zippered bags opened flat) and tape in place. Treat all for shock. It ain't gonna be fun or pretty- but it would not be with the other techniques either.

    The Red Cross and many other organizations stopped teaching or recommending tourniquets decades ago, and stopped elevating wounds and using pressure points in 2005, with no real change in pre-hospital survival. The lesson the Red Cross, etc. has learned is the simpler the better when it comes to things like first aid that have to be used in stressful situations.

    Again- applying my own labels, this would be for laypeople who live near good 911 response.
     
  19. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    I too am a First Aid/EMT-P instructor (actually course director), and county EMS director. I was an EMT before I became a physician. What the red cross teaches (or doesn't) is irrelevant and frequently wrong, for years (for example) they were in a urinary output contest over the 'correct' procedures to follow with an obstructed airway. Since they didn't invent the Heimlich maneuver, they didn't endorse it, no matter how many people died as a result. Even today their training is geared towards professional responders coming within 5 minutes after you dial 9-1-1 (which doesn't happen in any jurisdiction I know of).

    Tourniquets are currently the standard of care for uncontrollable bleeding in limbs: Their use was pioneered on the battlefields, and is currently a SKILL STATION for basic EMT's from the NREMT - http://www.nremt.org/nremt/downloads/bleedingcontrolshock.pdf Note: That is a basic level skill.... Tourniquets can be (correctly designed and) applied and left on limbs for several hours without dangerous sequelae - they are used every day in various types of surgeries to create a bloodless field, and to prevent exsanguination on the battlefield.

    There is much taught in EMT courses, the red cross, and other such organizations that is woefully out of date, lacking in any evidence showing that the dogma is better than what is argued against, or in fact has much basis in even theoretical physiology or biology. Another old bugaboo is the idea that you shouldn't give oxygen to a patient in oxygen distress because they have COPD....just brilliant!
     
  20. madkins007

    madkins007 Loaded Pockets

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    Most of what the Red Cross teaches is based on the recommendations of the ECC (Emergency Cardio-vascular Care Committee?) - they don't come up with it themselves. Not arguing they are right, but the ECC is supposedly on top of the most recent research. We have taught abdominal thrusts for as long as I have been associated with them, and since 2005 added back blows per ECC research showing that no one technique was always successful (oddly, the AHA which has a better relationship with the ECC, ignored this recommendation, which even Heimlich's son agreed with. By the way, have you read any of Peter Heimlich's commentary about his dad?)

    As for tourniquets, people who take Red Cross First Aid almost never see this sort of trauma, and I am not really sure I want laypeople with a couple hours training once every three years applying them- while WHEN and HOW to use them is not that difficult, when NOT to use them is what scares me. After years of teaching not to do it, people still try to jam things in the mouth of people having seizures. Heck, I get people in class who want to do tracheotomies and do CPR on people who are breathing.

    Oh, and the Red Cross assumes the 911 response is within 30 minutes. If you are going to bash us, let me know- I have lots of ammo for ya!

    Besides- I clearly labeled my post as being for laypeople close to a 911 response. I was not even SUGGESTING that the comments applied to anyone with anything resembling real training. If I lop my arm off, I want my wife or neighbor to call 911 ASAP and basically kneel on the stump until you get there to do the tourniquet and other cool stuff.