@@Vinnytwotimeik this is an old comment, but I think there’s a serious problem with that approach: you’re actively breaking all the formed blood clots and removing all pressure, so it’s just undoing and wasting what you did already while the casualty still keeps bleeding? if the original wound packing was done with poor technique and there’s still a large cavity inside, you can just keep packing and fill that cavity with additional gauze. If the wound has been packed with proper technique and blood is still seeping out, I’d place more gauze on top of the wound site, and continue to apply direct pressure.
@@Mike-ww3bq The reason why that doesn't work, is because the infiltrated vessel has not yet been occluded. When the artery is compromised, we create a powerball, find the bleeder with our finger, and replace our finger with the gauze. Kerlix and other hemostatic gauzes are designed to occlude, not absorb. So, when you pack sub-par and it starts to bleed through, you need to take it out because the gauze it just a sponge now. It no longer is doing it's job. If it is bleeding through the gauze then there are no clots that have formed. Does that make sense? I'm currently a licensed paramedic, TP-C, tccc instructor, stb instructor, live tissue instructor, reconnaissance medic, and other things.... I see junctional wounds often and this is the only way to get it to stop bleeding. You'd be amazed how much gauze it could take.
@@VinnytwotimeI guess I’d agree with you then regarding swapping out the gauze if the wound packing technique wasn’t good and there wasn’t direct pressure on the artery, which you’re absolutely right is what’s actually needed. But would you still say the same for the scenario where even with good packing technique, blood is still seeping out? As far as hemostatic gauzes go, shouldn’t you still maintain direct pressure with your hands, because it can take around 3 minutes to fully form the clots. If even then it was still bleeding, would you not add more gauze on top and maintain strong pressure, as per the manufacture’s instructions. Just ripping it out and starting again is kinda hasty in my opinion?
@@Mike-ww3bq Technique is good, but it's still bleeding? I don't quite understand the question. If it's bleeding through your gauze, then the technique wasn't done correctly. Now, does blood slightly soak into your gauze when first applying, yes. But you have several yards of more gauze to continue packing. As far as direct pressure, for hemostatic it's 3-5 minutes and for kerlix it's 5-10 minutes. If there is too much blood in the wound cavity, you can also "scoop" it out. I find taking a few 4x4s and "sweeping" it out works OK. I hope all of this makes sense. Would love to explain this in person. I'm in South Texas if you ever get the chance.
Love this content thank you for sharing your knowledge
If the orignal woundpacking gauze doesn't take. do we 1. unpack the original and replace or 2. pack more gauze on top and add a pressure dressing?
You rip it all out and repack it. Thus is why it's important to carry lots of gauze. Hope that helps!
@@Vinnytwotimeik this is an old comment, but I think there’s a serious problem with that approach: you’re actively breaking all the formed blood clots and removing all pressure, so it’s just undoing and wasting what you did already while the casualty still keeps bleeding?
if the original wound packing was done with poor technique and there’s still a large cavity inside, you can just keep packing and fill that cavity with additional gauze.
If the wound has been packed with proper technique and blood is still seeping out, I’d place more gauze on top of the wound site, and continue to apply direct pressure.
@@Mike-ww3bq The reason why that doesn't work, is because the infiltrated vessel has not yet been occluded. When the artery is compromised, we create a powerball, find the bleeder with our finger, and replace our finger with the gauze. Kerlix and other hemostatic gauzes are designed to occlude, not absorb. So, when you pack sub-par and it starts to bleed through, you need to take it out because the gauze it just a sponge now. It no longer is doing it's job. If it is bleeding through the gauze then there are no clots that have formed. Does that make sense?
I'm currently a licensed paramedic, TP-C, tccc instructor, stb instructor, live tissue instructor, reconnaissance medic, and other things.... I see junctional wounds often and this is the only way to get it to stop bleeding. You'd be amazed how much gauze it could take.
@@VinnytwotimeI guess I’d agree with you then regarding swapping out the gauze if the wound packing technique wasn’t good and there wasn’t direct pressure on the artery, which you’re absolutely right is what’s actually needed.
But would you still say the same for the scenario where even with good packing technique, blood is still seeping out? As far as hemostatic gauzes go, shouldn’t you still maintain direct pressure with your hands, because it can take around 3 minutes to fully form the clots. If even then it was still bleeding, would you not add more gauze on top and maintain strong pressure, as per the manufacture’s instructions. Just ripping it out and starting again is kinda hasty in my opinion?
@@Mike-ww3bq Technique is good, but it's still bleeding? I don't quite understand the question. If it's bleeding through your gauze, then the technique wasn't done correctly. Now, does blood slightly soak into your gauze when first applying, yes. But you have several yards of more gauze to continue packing. As far as direct pressure, for hemostatic it's 3-5 minutes and for kerlix it's 5-10 minutes. If there is too much blood in the wound cavity, you can also "scoop" it out. I find taking a few 4x4s and "sweeping" it out works OK.
I hope all of this makes sense. Would love to explain this in person. I'm in South Texas if you ever get the chance.