Another thing to remember is to count the number of gauze you pack into a wound. Mark on the casualty number of gauze and if hemostatic was used. This is important for hospital staff to know. Just like tourniquet time
When it comes to wound packing there seems to be conflicting instructions; some instructions say if bleeding continues through packing than remove guaze and add a new one, than there's instructions saying don't remove just add more packing on top as you mentioned. Personally, I feel adding more on top makes sense.
From what we have come to understand it is better to leave the gauze in place to prevent removing the clot. Adding more gauze on top seems to be the better option 👍🏻
Remember that wound packing is effective because the pressure is directed against the bleeding vessel inside the wound channel, occluding the bleed at the source. If the initial packing fails to stop the massive hemorrhage, its likely that pressure wasn't maintained against the severed vessel in the beginning, or the gauze wasn't packed uniformly & tightly, thus failing to apply the direct pressure required to form the clot (even Quik Clot needs to have direct pressure against the severed vessel; it just forms the clot much faster than regular gauze). If the underlying gauze is loosely packed / isn't pressing against the severed vessel, adding more gauze on top may not be effective. That's why the TCCC protocol is, IF additional gauze is available, to remove the failed gauze & repack the wound using a new hemostatic gauze. If only regular gauze is available, then start fresh using the regular gauze. Adding additional gauze on top is, however, absolutely appropriate if the wound is larger than one roll of gauze can completely & tightly fill. You would continue packing until the entire wound channel has been filled and the excess gauze is mounded up on top, so that your direct pressure is focused directly down to maintain the pressure occluding the bleed inside the wound.
@@ColdBoreTactical_LLCI was told as well during a livestock lab to digitally occlude vessel to clean out loose blood as much as possible with regular gauze in order to apply combat gauze to the injured vessel bleed for the kaolin to activate as close to the direct site as possible… but I can’t find a single video supporting this ideology. It makes sense to me and it was 18D that were passing the knowledge but I’d like to find some form of literature to support it.
@@Butttercup22 That is absolutely correct. Depending on the situation and environment, placing a finger directly against the bleeding vessel will stop (or at least significantly slow) the bleeding, buying time to prepare your gauze and wrap material. If you don't have lots of gauze handy to clear out the clots & stuff from the wound channel, you can gently scoop it out with fingers from your other gloved hand. Not as effective as cleaning / drying it up with plain gauze, but it will allow you to better visualize the wound tract & ensure that the hemostatic gauze is placed against the bleeder. This of course is predicated on the wound being large enough to get a finger inside to press against the vessel AND a couple fingers with plain gauze in there to clean it out. If the scene is otherwise safe but you're without an aid bag, you could even maintain the digital pressure against the vessel until first responders arrive with more resources. Although, if the casualty is still conscious, you may have difficulty in keeping them still while applying that digital pressure. 18Ds will administer meds that will disassociate their patient's mental state for this reason.
How much gauze would you recommend someone have in a first aid kit? North American Rescue sells 3 inch x 15 foot strips and it seems like 2 of those is a safe bet but I've never been fist deep in someone's shoulder so Idk
Another thing to remember is to count the number of gauze you pack into a wound. Mark on the casualty number of gauze and if hemostatic was used. This is important for hospital staff to know. Just like tourniquet time
Thanks for the great tip!
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Thank You Colin!
Phenomenal video for those less knowledgeable !
Glad it was helpful!
Thank you ,need to refresh my combat life saver training several years ago,as I AM going thru getting into Ukraine defense force,prior combet vet.
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Nicely done!
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Fantastic info. Thanks!!!
Happy you took some useful info away ✅🤘🏻
Excellent presentation... Thank you
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Very informative. Thank you.
Thank you for watching 👍
When it comes to wound packing there seems to be conflicting instructions; some instructions say if bleeding continues through packing than remove guaze and add a new one, than there's instructions saying don't remove just add more packing on top as you mentioned. Personally, I feel adding more on top makes sense.
From what we have come to understand it is better to leave the gauze in place to prevent removing the clot. Adding more gauze on top seems to be the better option 👍🏻
Remember that wound packing is effective because the pressure is directed against the bleeding vessel inside the wound channel, occluding the bleed at the source. If the initial packing fails to stop the massive hemorrhage, its likely that pressure wasn't maintained against the severed vessel in the beginning, or the gauze wasn't packed uniformly & tightly, thus failing to apply the direct pressure required to form the clot (even Quik Clot needs to have direct pressure against the severed vessel; it just forms the clot much faster than regular gauze). If the underlying gauze is loosely packed / isn't pressing against the severed vessel, adding more gauze on top may not be effective. That's why the TCCC protocol is, IF additional gauze is available, to remove the failed gauze & repack the wound using a new hemostatic gauze. If only regular gauze is available, then start fresh using the regular gauze.
Adding additional gauze on top is, however, absolutely appropriate if the wound is larger than one roll of gauze can completely & tightly fill. You would continue packing until the entire wound channel has been filled and the excess gauze is mounded up on top, so that your direct pressure is focused directly down to maintain the pressure occluding the bleed inside the wound.
@@ColdBoreTactical_LLCI was told as well during a livestock lab to digitally occlude vessel to clean out loose blood as much as possible with regular gauze in order to apply combat gauze to the injured vessel bleed for the kaolin to activate as close to the direct site as possible… but I can’t find a single video supporting this ideology. It makes sense to me and it was 18D that were passing the knowledge but I’d like to find some form of literature to support it.
@@Butttercup22 That is absolutely correct. Depending on the situation and environment, placing a finger directly against the bleeding vessel will stop (or at least significantly slow) the bleeding, buying time to prepare your gauze and wrap material. If you don't have lots of gauze handy to clear out the clots & stuff from the wound channel, you can gently scoop it out with fingers from your other gloved hand. Not as effective as cleaning / drying it up with plain gauze, but it will allow you to better visualize the wound tract & ensure that the hemostatic gauze is placed against the bleeder. This of course is predicated on the wound being large enough to get a finger inside to press against the vessel AND a couple fingers with plain gauze in there to clean it out. If the scene is otherwise safe but you're without an aid bag, you could even maintain the digital pressure against the vessel until first responders arrive with more resources. Although, if the casualty is still conscious, you may have difficulty in keeping them still while applying that digital pressure. 18Ds will administer meds that will disassociate their patient's mental state for this reason.
Smart Thank You.
Glad you enjoyed 🤘🏻
What about using a tourniquet before or after packing the gauze?
If the wound calls for a TQ. That comes first, then dress the wound. As the TQ will more effectively shut down the blood glow then anything else
great vid thank you
Thanks !!
How much gauze would you recommend someone have in a first aid kit? North American Rescue sells 3 inch x 15 foot strips and it seems like 2 of those is a safe bet but I've never been fist deep in someone's shoulder so Idk
Thanks for your comment! We would recommend two packs of gauze. This should be a sufficient amount for a major traumatic injury.