Hey Sam! Tip I learned in school for the improvised binder. Put a BP cuff underneath the sheet or blanket and inflate it. It will add needed pressure and assist in stabilizing it.
What you should definetly cover in this video is the 4P- rule: pockets (make sure pockets are empty to prevent causing more damage and breaking the iphone against patients pelvis), painkillers (in my experience, usually applying the binder causes pain), pulses (make sure to check peripheral pulses before and after applying the binder to make sure youn don't cut the circulation off) and penis (I've seen one pretty mangled penis after it was releases under the binder after 1 hour of pressure)
It's not about where the blood is in general, but where it can bleed into and how much blood that space will hold. E.g. you can bleed about half a liter into your forearm, 2 liters into your thigh etc
Nice video! Just a guestion about where you mentioned "pushing down on the iliac crest". In the system i work (europe), we are prohibited to spring the pelvis as a part of our trauma assessment. Even hems doctors rarely do it because of the poor reliability of the test in other than major pelvic disruptions. It's thought that the risk of dislodging the clots is way too high for the potential information we get so we just put t-pod based on the mechanism of trauma.
We are being taught KIPP Kinematic?: Look at the mechanism of injury? Inspection?: visually look at the pelvic area. Is there obvious deformation or haematoma? Pain?: Does the (trauma) patient complain of pain in the pelvic region? Stabilise! If any of the above answer with yes, put a pelvic binder on
It's actually interesting that it's not indicated for hip fx. I was taught and have been practicing this type of binding for hip fx for some years. Every time I've used a sheet binding with a fractured hip it results in far less pain for transport. I'll be looking more into it now though.
Sam, great work as always! I really love your medical skills and EMS career videos. Your gear review stuff is good too but I enjoy your skills stuff the most, keep them coming. As a Navy Hospital Corpsman I used the SAM pelvic binder a lot on dismounted IED blast patients. It works well and I have one in my main med bag. Keep up the great work!
Excelente trabajo, es un poco complicado obtener estos equipos en Mexico, tal y como estan las cosas actualmente, pero es interesante conocerlo, luego el idioma, pero poco a poco lo entendemos, fuerte saludo, excelente trabajo.
Plz keep making these I learn different and these videos help so much like you said to read the chapters before the class I watch these videos there so well put together and you use the correct terms there great and help me so much and I’m sure they help other people too I LOVE THIS CHANNEL PLZ KEEP MAKING THESE VIDEOS💙💙
Im not sam but maybe this can help u: 1. Keep calm 2. Never take tonge 3. Secure scene 3. Put from side the body of epilepsy guy 4. Wait to the end of the attack Sorry my bad english, but im sure that u understand me.
Not sam but: Keep calm Secure the scene Put the patient on his side (google lateral recovery position) Do NOT attempt to put stuff in their mouth Check for chemichals or other materials that could have induced the episode call for an ambulance wait for the episode to pass. If there are chemicals or toxins that could have induced the episode, releay that information to the team when calling for 911
I use a sheet for all of my hip fractures and it really does work well to stabilize the fracture/dislocation to at least help with comfort especially during transport. Not trying to argue, just giving my two cents. I’d really like to hear your side on why it’s contraindicated.
I prefer the T-POD device. Only one size for nearly all patients. That's in my opinion a big advantage compared to the SAM pelvic sling. Also you can pull the T-POD with one person because you doesn't need to pull from the other side at the same time. The special tension buckle is a advantage of the SAM pelvic sling. The effect of a Pelvic sling is much higher when you rotate and fixate the feet to the inside and to bind the femur together.
For improvised application, what about using a belt over a blanket to assist in stability (belt outside of blanket > slide together under pelvis > tighten blanket first > close and tighten belt over blanket)?
thx for the good overview on this topic! Maybe immobilisation of the knees/ankels are also a good point, but no real game changer if you use a spine board or vacuumimmobilsation (german). I like the T-POD one size fits all, small package, but I really love the click effekt on the SAM Tourniqets/Binders if you have applied enough power. Sorry for my drunken, english, I think you get the idea. Thx for the chanal, keep going, best wishes from Leipzig!
This is why at one of my units a failure drill (shots to body ineffective possibly due to armor) we would end in the pelvis rather than head. Bigger target and very effective
Remember that CoTCCC recommends applying the Pelvic Binder during Circulation in MARCH. Also you never discussed the CoTCCC indications for putting a pelvic binder on in the first place.
Dear Sam. May I say thank you. You mention this is not the treatment for hip fractures in seniors. So in that instance, may I respectfully ask [a] what is the recommended reasonable treatment please? [b] Additionally, we are experiencing long ambo wait times (in the UK). Could you point me to a video of what to watch for whilst we wait, for a long time, for the ambulance? UK response times should be 10-20 mins, but at present are reported to be getting to hour(s). The crux of the question being at what point(s) is the decision to "load & go" in non-ambo transport justified from a medical perspective? Any pointers on these topics wold be very welcome & timely. In the meantime, well done on sharing your knowledge & experience in a very accessible way. All my best & kindest regards M
En el mercado hay fajas de uso para deportistas que son igual de amplias como la que muestras en video, ¿ crees que es posible modificarla y lograr casi el mismo nivel de estabilidad, que con las SAM?
Buena pregunta.. no sé pero me da la impresión que las fajas que dices son muy elásticas y si ayuda en algo será muy poco. Pueda que este equivocado. Saludos
I have kind of a silly but interesting question. Would there be an instance that you would apply the Pelvic Sling backwards i.e. on a prone patient or would you simultaneously roll the patient to a supine position onto a litter with Pelvic Binder on the litter in preparation? Great Video and Thanks!
@@danielwalicke6635 tbh, I was in about the same boat in the early 00s in Georgia, But I feel they should have been kept. I have some strong reservations with the decision to take them off of trucks and remove them as a tool available to crews.
Re: hip fracture: what if patient DID have pelvic fracture and femoral neck fracture? Seems like that medial pressure on the proximal femur could cause a lot of damage, but leaving the pelvic fracture unaddressed seems like a problem, too?
2 questions: 1. Is there a good way to find the trochanter? Just feeling around on my hip I have a guess where it is, but I'm not sure. 2. For getting and maintaining the proper tension with the improvised version, could you use a windlass like with an improvised TQ (obviously not as tight as TQ but the general concept)?
Hi! My name is Jacob and I am currently a junior in high school. I really want to be a firefighter paramedic and I have done quite a bit of research in different paths that will get me there. After watching your videos I have a couple questions that may help guide my decision process. A local college offers accredited fire and ems certifications that I need in my state. I really want to jump in straight after HS and start working and then get my bachelors later on. I was wondering, since your in the process, what is it like working full time as a first responder while getting a college degree? Would you recommend getting a four year degree before getting into the fire service? I really hope you see this and can respond, you have been a huge inspiration for me. Thank you! (I would also appreciate comments from anyone with insight on this topic)
They thought me that the SOFT -T tourniquet with either one or two cups were best as they are multipurpose and way lighter than those industrial pelvis devices. But that is for TCCC. Maybe they have a different teaching for civilians and law enforcement.
Seal the wound with a chest seal (bullet paths are weird and can turn and penetrate the lung making the “abdominal wound” a “sucking chest wound”) and evacuate quickly. Keep very warm (nice and toasty) on the evac.
Man, you do the same with a nylon weightlifting belt!!! For 12 bucks! Don't kid me, we using that for years, not the fancy stuff you advertise. If you are supposed to care for such emergency, have a XL nylon weightlifting belt with you.
People also used 3:2 CPR but we found better ways to do it. Improvised is worse in almost all facets of medicine, handy to know how to do in a pinch but not a high standard of care.
@@PrepMedic My friend, I'm an emergency medicine physician for 25 y. I can assure you that to improvise, in the field or ER is a highly important skill... You rarely have all the technology gimmicks and either you have the capacity to " Make without " or you are doomed. In fact I suggest you a very good book on how to improvise in emergency medicine. Improvised Medicine: Providing Care in Extreme Environments, 2nd edition
Like is said, understand that improvising is an important skill but also understand that it is not the standard of care. There is NO literature supporting improvising over commercial devices. Purpose built pelvic slings are not gimmicks the same as a Moldable splint is a gimmick.
@@PrepMedic My friend,impossible to argue with you. Not only we are not in same league but also you blindly promote your patrons. Anyway, I got here by mistake. Have a nice day.
“Good news! The Doctor said all my bleeding was internal. That’s where the blood’s supposed to be!”
Who doesnt like a good brooklyn 99 reference
Noice 👍🏻👍🏻
Noice
Noice
Hey Sam! Tip I learned in school for the improvised binder. Put a BP cuff underneath the sheet or blanket and inflate it. It will add needed pressure and assist in stabilizing it.
What you should definetly cover in this video is the 4P- rule: pockets (make sure pockets are empty to prevent causing more damage and breaking the iphone against patients pelvis), painkillers (in my experience, usually applying the binder causes pain), pulses (make sure to check peripheral pulses before and after applying the binder to make sure youn don't cut the circulation off) and penis (I've seen one pretty mangled penis after it was releases under the binder after 1 hour of pressure)
I appreciate that there was disclaimer re the lack research on a binder's efficacy. Fortunately standards of care r always revised.
*A large SAM splint and two CAT tourniquets connected together should do the trick.*
Thrue
Wow. I never knew there was that much blood in that area of the body. Thanks.
It's not about where the blood is in general, but where it can bleed into and how much blood that space will hold. E.g. you can bleed about half a liter into your forearm, 2 liters into your thigh etc
Nice video! Just a guestion about where you mentioned "pushing down on the iliac crest". In the system i work (europe), we are prohibited to spring the pelvis as a part of our trauma assessment. Even hems doctors rarely do it because of the poor reliability of the test in other than major pelvic disruptions. It's thought that the risk of dislodging the clots is way too high for the potential information we get so we just put t-pod based on the mechanism of trauma.
We are being taught KIPP
Kinematic?: Look at the mechanism of injury?
Inspection?: visually look at the pelvic area. Is there obvious deformation or haematoma?
Pain?: Does the (trauma) patient complain of pain in the pelvic region?
Stabilise! If any of the above answer with yes, put a pelvic binder on
It's actually interesting that it's not indicated for hip fx. I was taught and have been practicing this type of binding for hip fx for some years. Every time I've used a sheet binding with a fractured hip it results in far less pain for transport.
I'll be looking more into it now though.
Sam, great work as always! I really love your medical skills and EMS career videos. Your gear review stuff is good too but I enjoy your skills stuff the most, keep them coming. As a Navy Hospital Corpsman I used the SAM pelvic binder a lot on dismounted IED blast patients. It works well and I have one in my main med bag. Keep up the great work!
Excelente trabajo, es un poco complicado obtener estos equipos en Mexico, tal y como estan las cosas actualmente, pero es interesante conocerlo, luego el idioma, pero poco a poco lo entendemos, fuerte saludo, excelente trabajo.
¡Tengo suerte y cuiado!
Don't worry, a surgeon is part of my EDC, rides along with me every day.
Plz keep making these I learn different and these videos help so much like you said to read the chapters before the class I watch these videos there so well put together and you use the correct terms there great and help me so much and I’m sure they help other people too I LOVE THIS CHANNEL PLZ KEEP MAKING THESE VIDEOS💙💙
Dear Sam,
What can you do in the face of a epilepsy episode???
Thanks.
Merry Christmas for you and yours.🎉🎊
Im not sam but maybe this can help u:
1. Keep calm
2. Never take tonge
3. Secure scene
3. Put from side the body of epilepsy guy
4. Wait to the end of the attack
Sorry my bad english, but im sure that u understand me.
Not sam but:
Keep calm
Secure the scene
Put the patient on his side (google lateral recovery position)
Do NOT attempt to put stuff in their mouth
Check for chemichals or other materials that could have induced the episode
call for an ambulance
wait for the episode to pass.
If there are chemicals or toxins that could have induced the episode, releay that information to the team when calling for 911
@@Fede_uyz clearly ur english is better than me xD. At least we know the same hahah.
@@DragonSiciliano no problem about the english! And yeah! Same care 💪
Watching this in Donbas now. I’ve only used in training before. Never know… thank you for this!! 🙏🇺🇦
I use a sheet for all of my hip fractures and it really does work well to stabilize the fracture/dislocation to at least help with comfort especially during transport. Not trying to argue, just giving my two cents. I’d really like to hear your side on why it’s contraindicated.
Great video Sam
Quick an easy. Thanks for sharing
I prefer the T-POD device.
Only one size for nearly all patients.
That's in my opinion a big advantage compared to the SAM pelvic sling.
Also you can pull the T-POD with one person because you doesn't need to pull from the other side at the same time.
The special tension buckle is a advantage of the SAM pelvic sling.
The effect of a Pelvic sling is much higher when you rotate and fixate the feet to the inside and to bind the femur together.
For improvised application, what about using a belt over a blanket to assist in stability (belt outside of blanket > slide together under pelvis > tighten blanket first > close and tighten belt over blanket)?
Fast yet well well explained : very good !
My pelvis can hold a bit more blood than that.
thx for the good overview on this topic! Maybe immobilisation of the knees/ankels are also a good point, but no real game changer if you use a spine board or vacuumimmobilsation (german). I like the T-POD one size fits all, small package, but I really love the click effekt on the SAM Tourniqets/Binders if you have applied enough power. Sorry for my drunken, english, I think you get the idea. Thx for the chanal, keep going, best wishes from Leipzig!
Great video Sam! Any future videos on junctional TQs? The SAM junctional TQ is my fav, just super bulky for kits
That fracture sounds ouch, I mean, the OUCH.
This is why at one of my units a failure drill (shots to body ineffective possibly due to armor) we would end in the pelvis rather than head. Bigger target and very effective
Great informational topic.
Remember that CoTCCC recommends applying the Pelvic Binder during Circulation in MARCH. Also you never discussed the CoTCCC indications for putting a pelvic binder on in the first place.
Dear Sam. May I say thank you. You mention this is not the treatment for hip fractures in seniors. So in that instance, may I respectfully ask [a] what is the recommended reasonable treatment please? [b] Additionally, we are experiencing long ambo wait times (in the UK). Could you point me to a video of what to watch for whilst we wait, for a long time, for the ambulance? UK response times should be 10-20 mins, but at present are reported to be getting to hour(s). The crux of the question being at what point(s) is the decision to "load & go" in non-ambo transport justified from a medical perspective? Any pointers on these topics wold be very welcome & timely. In the meantime, well done on sharing your knowledge & experience in a very accessible way. All my best & kindest regards M
Great description, and good advice thanks
When are you going to do an intubation video? Curious to see it
any right information is good information..
Sam splints are used in UK
AEMT here, any words of wisdom for basalar skull fracs? Had one recently and wondering what else I could've done besides normal c-spine and backboard
En el mercado hay fajas de uso para deportistas que son igual de amplias como la que muestras en video, ¿ crees que es posible modificarla y lograr casi el mismo nivel de estabilidad, que con las SAM?
Buena pregunta.. no sé pero me da la impresión que las fajas que dices son muy elásticas y si ayuda en algo será muy poco. Pueda que este equivocado. Saludos
Good info....thank u
I have kind of a silly but interesting question. Would there be an instance that you would apply the Pelvic Sling backwards i.e. on a prone patient or would you simultaneously roll the patient to a supine position onto a litter with Pelvic Binder on the litter in preparation? Great Video and Thanks!
Reminds me of MAST pants
Wish those were kept.
@@Jay-ho9io I never got to use them. When I got my EMT cert. We learned about them, but they were for the most part heading out the door.
@@danielwalicke6635 tbh, I was in about the same boat in the early 00s in Georgia, But I feel they should have been kept. I have some strong reservations with the decision to take them off of trucks and remove them as a tool available to crews.
Re: hip fracture: what if patient DID have pelvic fracture and femoral neck fracture? Seems like that medial pressure on the proximal femur could cause a lot of damage, but leaving the pelvic fracture unaddressed seems like a problem, too?
I think applying pressure on the pelvic to check for a fracture is now prohibited
Hi Sam! What kind of hoodie do you wear?
2 questions:
1. Is there a good way to find the trochanter? Just feeling around on my hip I have a guess where it is, but I'm not sure.
2. For getting and maintaining the proper tension with the improvised version, could you use a windlass like with an improvised TQ (obviously not as tight as TQ but the general concept)?
would this work if someone is trapped between say between two cars if there is a high speed impact
Word that work for the internal bleeding in the lungs to?
No you need to do a needle decompression or pass a chest tube
Hi! My name is Jacob and I am currently a junior in high school. I really want to be a firefighter paramedic and I have done quite a bit of research in different paths that will get me there. After watching your videos I have a couple questions that may help guide my decision process. A local college offers accredited fire and ems certifications that I need in my state. I really want to jump in straight after HS and start working and then get my bachelors later on. I was wondering, since your in the process, what is it like working full time as a first responder while getting a college degree? Would you recommend getting a four year degree before getting into the fire service? I really hope you see this and can respond, you have been a huge inspiration for me. Thank you! (I would also appreciate comments from anyone with insight on this topic)
I subbed to your channel bc you are in the same state as me
What ever happened to MAST pants ??
Are you going to be adding this to edc or your vehicle carry?
Placing a pelvic binder after extrication is just as bad as placing a cervical collar after extrication.
They thought me that the SOFT -T tourniquet with either one or two cups were best as they are multipurpose and way lighter than those industrial pelvis devices. But that is for TCCC. Maybe they have a different teaching for civilians and law enforcement.
I think you are confusing a junctions tourniquet and a pelvic binder.
@@PrepMedic damn, you are right. I did got confused with a junction tourniquet.
How would u treat an abdominal wound such as a gunshot in a shtf scenario?
Seal the wound with a chest seal (bullet paths are weird and can turn and penetrate the lung making the “abdominal wound” a “sucking chest wound”) and evacuate quickly. Keep very warm (nice and toasty) on the evac.
Sounds like the concept is basically just an oversized tourniquet.
Pelvic b.... what? That's a lifting belt my guy.
I think you placed the binder too high in your demo. Feel the trochanter as orientation first.
😂I can assure you I did not.
@@PrepMedic thx, great topic and always a good learning...
I am very uncomfortable while watching this video. But i have to
Man, you do the same with a nylon weightlifting belt!!!
For 12 bucks!
Don't kid me, we using that for years, not the fancy stuff you advertise.
If you are supposed to care for such emergency, have a XL nylon weightlifting belt with you.
People also used 3:2 CPR but we found better ways to do it. Improvised is worse in almost all facets of medicine, handy to know how to do in a pinch but not a high standard of care.
@@PrepMedic My friend, I'm an emergency medicine physician for 25 y.
I can assure you that to improvise, in the field or ER is a highly important skill...
You rarely have all the technology gimmicks and either you have the capacity to " Make without " or you are doomed.
In fact I suggest you a very good book on how to improvise in emergency medicine.
Improvised Medicine: Providing Care in Extreme Environments, 2nd edition
Like is said, understand that improvising is an important skill but also understand that it is not the standard of care. There is NO literature supporting improvising over commercial devices. Purpose built pelvic slings are not gimmicks the same as a Moldable splint is a gimmick.
@@PrepMedic My friend,impossible to argue with you.
Not only we are not in same league but also you blindly promote your patrons.
Anyway, I got here by mistake.
Have a nice day.
@@jorgeace7745 So you accidentally came to another man's house to tell him he's wrong about everything.....how progessive and flexible you are.