Forum Index > Trail Talk > Tourniquet Use Should Be One of Your Basic First Aid Skills
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Ringangleclaw
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PostFri Jul 13, 2018 10:23 pm 
Kascadia wrote:
Ringangleclaw wrote:
Instead she was a proponet of carrying sanitary napkins as dressings. I thought that was really weird and unprofessional.
Learned the same thing in MOFA. Why would it be "weird and unprofessional"?
To dismiss all battle dressings, which are designed exactly for bloody trauma, yet suggest something you get in gas station bathrooms seems weird. When I brought up the battle dressings, she said "I don't know why you would want to use something like that when there are better products" then started her spiel about tampons. I think the DoD may know more than her.

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grannyhiker
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PostSat Jul 14, 2018 9:32 am 
There's nothing wrong with sanitary napkins as a compress for those who take some along anyway. They are, after all, designed to absorb fairly large amounts of blood. Most women don't use them any more, and, of course, once we reach a certain age, we no longer need such products. The same is true of incontinence pads, which some of us getting well up in years need to carry. I definitely would not recommend buying a package just for the purpose, but if you have them available anyway, they work just fine as an emergency compress. I suspect you men are thinking of used products, which of course shouldn't be anywhere near an open wound. As sold, such pads are super clean and come individually wrapped. In the case of severe bleeding, the compress for immediate use doesn't have to be sterile anyway due to the volume of blood. Your first aid class will tell you to use anything within immediate reach that's absorbent. If a wound is bleeding severely there is no time to go searching for the perfect compress! You don't worry about sterility until the bleeding is stopped. The professional bandage that has been in your pack for 10-15 years is definitely no longer sterile, either, and. if it contains clotting medication, it is probably of an obsolete type that damages tissue and is no longer recommended (this per my latest WFA class). The statistical chances of a solo or 2-3 person party's needing a specialized compress are so small that, IMHO, it's not worth buying and carrying, except in the leader's first aid kit for a larger group. In 76 years of backpacking, I've never encountered a case of serious bleeding. Abrasions are far more likely.

May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view.--E.Abbey
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Ringangleclaw
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PostSat Jul 14, 2018 9:53 am 
Grannyhiker wrote:
There's nothing wrong with sanitary napkins as a compress for those who take some along anyway. They are, after all, designed to absorb fairly large amounts of blood. Most women don't use them any more, and, of course, once we reach a certain age, we no longer need such products. The same is true of incontinence pads, which some of us getting well up in years need to carry. I definitely would not recommend buying a package just for the purpose, but if you have them available anyway, they work just fine as an emergency compress.
But would you recommend either of those products in leu of sterile battle dressings made for that very use and well within their use dates? That’s what the instructor in North Bend recommended, the use of sanitary napkins instead of new battle dressings. That I can’t fathom.

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Ringangleclaw
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PostSat Jul 14, 2018 9:56 am 
Grannyhiker wrote:
The professional bandage that has been in your pack for 10-15 years is definitely no longer sterile, either
What is that assumption based on?

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Seventy2002
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PostSat Jul 14, 2018 1:47 pm 
Ringangleclaw wrote:
Grannyhiker wrote:
The professional bandage that has been in your pack for 10-15 years is definitely no longer sterile, either
What is that assumption based on?
A test of "packaged implant components" found "the contents remained sterile for 6 to 11 years after the expiration dates." I have a couple Israeli bandages in my kit. One is 11 years old and 6 years past "expiry date." It was originally vacuum-packed but is now more like a pillow. I don't trust it to be sterile. The other is 2 years past "expiry date" but the vacuum seal is intact. That one I trust, but probably not for much longer.

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Ringangleclaw
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PostSat Jul 14, 2018 2:09 pm 
Okay. They last several years before their expiration date, add to that the quoted six to eleven years and there is no reason to think that a 10-15 year old battle dressing in an intact factory package is compromised. It should be replaced because it is expired, but the alarmist post is misplaced.

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nordique
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PostSat Jul 14, 2018 5:44 pm 
I somehow expected first aid/first responder people to set us all straight on this issue, very quickly--but that does not to be happening--and I've no idea why. Why? Any responders?

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Frango
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PostSat Jul 14, 2018 7:09 pm 
nordique wrote:
I somehow expected first aid/first responder people to set us all straight on this issue, very quickly--but that does not to be happening--and I've no idea why. Why? Any responders?
OK so I am but a lowly ER nurse, but here goes. If someone is bleeding badly, the bleeding needs to be stopped so that the patient survives to make it to definitive treatment (aka the ER). Stopping the bleeding doesn’t require a degree in rocket science. It requires compression. This may include direct pressure or a tourniquet. Direct pressure: put something between your hands and the wound, and push. Hard. What you use depends on what you have. If you have a fancy Israeli battle dressing, use it. If you have quick clot impregnated gauze, use it. If you have a sanitary pad, use it. And if all you have is a dirty T-shirt...guess what - use that. Expired, not expired - makes no difference. If you have an expired impregnated gauze and the chemical is no longer active, what do you have? A piece of gauze! If direct pressure doesn’t work and you are able to do so, pack the wound. This means literally stuffing gauze inside the wound until you can’t get any more in. Then, go back to the direct pressure...see the paragraph above. If you need to, and the wound is on a limb, use a tourniquet. Place it a couple inches ABOVE the wound (between the wound and the heart),pull it tight and then start twisting the windlass. How tight should you go? Until the bleeding stops. It will hurt like a mofo and there’s WILL be swearing. The point is, do what you have to do to stop the bleeding. Once the person is brought to me, we will clean it out and provide the definitive care. Trust me - we have more drugs than you have germs in whatever you use to stop the bleed. All we ask is that you keep our patient alive long enough that we can use them.

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Leafguy
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PostSat Jul 14, 2018 7:35 pm 
From classes I have been required to take at work and classes I have taken on my own, I say that if you have a sputter, where blood is spurring out, not just running or oozing, a tourniquet may be the only way to save someone from bleeding out. Otherwise, use whatever you have to provide compression and slow or stop the bleeding. Wildernessed has tons of experience with this from his ER days in bang bang shoot em up Ohio. Please chime in here Rob. Your knowledge is probably a lot more extensive and helpful than guys like me. Also, thanks so much Nordique for your sacrifices for us.

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HitTheTrail
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PostSat Jul 14, 2018 7:53 pm 
Leafguy wrote:
Wildernessed has tons of experience with this from his ER days in bang bang shoot em up Ohio. Please chime in here Rob.
I get the feeling he would rather forget all those years of nightly trauma. That's why he quit and moved out to the mountains to hike.

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Kascadia
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PostSat Jul 14, 2018 8:01 pm 
Ringangleclaw wrote:
To dismiss all battle dressings, which are designed exactly for bloody trauma........When I brought up the battle dressings, she said "I don't know why you would want to use something like that when there are better products" then started her spiel about tampons. I think the DoD may know more than her.
I understand what you were responding to, now. Your first post didn't tell the whole story, thanks for explaining.

It is as though I had read a divine text, written into the world itself, not with letters but rather with essential objects, saying: Man, stretch thy reason hither, so thou mayest comprehend these things. Johannes Kepler
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Leafguy
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PostSat Jul 14, 2018 9:24 pm 
HitTheTrail wrote:
Leafguy wrote:
Wildernessed has tons of experience with this from his ER days in bang bang shoot em up Ohio. Please chime in here Rob.
I get the feeling he would rather forget all those years of nightly trauma. That's why he quit and moved out to the mountains to hike.
I’m sure you’re dead on there. I was just looking at him as maybe an expert that could give us the straight stuff on the subject.

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nordique
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PostSun Jul 15, 2018 7:20 pm 
NO such thing as a lowly ER nurse. "Nurse, how are you doing with my morphine?" Sadly, in my ER experience, patient intake procedures and paperwork come first, as I'm gasping and moaning. It's SO nice to have outgrown kidney stones! Luckily, for me, my pain was dealt with VERY speedily, in Vietnam, once we got to the hospital.

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bobcoleman0321recon
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PostMon Jul 16, 2018 8:41 am 
There is a national Stop the Bleed campaign https://stopthebleedingcoalition.org/ Serious bleeds are rare, but if you or someone else has one don't mess around. Sufficient information on appropriate products and techniques is available. EMT 1983-1991 OEC 2013 Present EMT 2014 Present

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Schenk
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PostMon Jul 16, 2018 9:41 am 
How do people feel about using something like "QuickClot" as compared with a tourniquet? Will QuickClot work on arterial bleeding effectively as a properly applied tourniquet? https://quikclot.com/QuikClot/Solutions-for-Every-Situation/Public-Access

Nature exists with a stark indifference to humans' situation.
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