Wednesday, February 10, 2016

Wilderness or Grid Down Medical Skills 2: Bleeding

Medical training is serious and should be given by competent medical professionals. This article and the whole medical series is not medical advice. It is for informational purposes only. Find good medical training in your area before actually doing the procedures in this series.
This is a series designed to give you a basic medical knowledge of what I consider medical skills you should have if there is no help in sight. The skills are:
Broken bones
Establishing an airway
Deliver a baby
Know The Symptoms of a Heart Attack, Heat Exhaustion or a Stroke
Basic Wound Dressing Techniques

Stop bleeding
Knowing how to stop bleeding could save someone’s life. Some uncommon ways to stop bleeding (for smaller wounds) include Sugar, cornstarch, Vaseline, vinegar and even spider webs in dire situations.
Abdominal and chest wounds can be quite serious because internal organs may be damaged, which can cause internal bleeding and even shock. Abdominal and chest wounds are considered an emergency, and you should call for immediate medical help, especially if there are symptoms of shock, such as dizziness, weakness, pale and clammy skin, shortness of breath, and increased heart rate.
While waiting for medical care, give first aid treatment for shock. Have the injured person lie quietly with his or her feet elevated about 12 inches. Cover him or her with a blanket to maintain body warmth.
First Aid for Cuts and Wounds
• Help the person to remain calm. If the cut is large or bleeding heavily, have them lie down. If the wound is on an arm or leg, raise the limb above the heart to slow bleeding.
• Remove obvious debris from the wound, such as sticks or grass. If the object is embedded in the body, do NOT remove it.
• If the cut is small, wash it out with soap and water. Do NOT clean a large wound.
• After putting on clean latex gloves, apply firm pressure to the wound with a folded cloth or bandage for about 10 minutes. Do not remove the bandage to look at the wound during this time, as it may begin bleeding again. If blood soaks through, add another cloth or bandage and continue holding pressure on the cut for an additional 10 minutes.
• When bleeding has stopped, tape a clean bandage over the cut.
Direct Pressure
Apply generous pressure to the wound site with a dressing, a piece of clothing, or even your bare hand if necessary. Time is not your friend when someone’s bleeding out, so don’t worry about rummaging for sterile dressings. An infection might take weeks to kill, but major blood loss kills within minutes. Use a combination of direct pressure, elevating the wound above heart level (if possible), and improvised dressings. If a dressing soaks through, don’t remove it. Just add another dressing on top and continue the pressure until the bleeding stops.
Pressure Points
If severe bleeding does not stop with direct pressure and elevation, switch tactics and apply direct pressure to the nearest artery. When you apply pressure to an artery, you stop bleeding by pushing the artery against bone. There are specific major arteries in the body where pressure should be placed. Press down firmly on the artery between the bleeding site and the heart, closer to the heart. After bleeding stops, do not continue to apply pressure to an artery for longer than five minutes. This technique requires knowledge of the major arterial pressure points. There are several pressure points used in emergency medical treatment of severe bleeding, but the two most common points are the femoral artery and the brachial artery.
• Femoral Artery
The femoral artery is the primary pressure point for the legs. There is one in each upper thigh, inside the thigh near the area of the groin. This artery can require much more pressure than other arteries because of its deeper location.
• Brachial Artery
Bleeding from the arms or hands can be reduced or stopped with pressure to the brachial artery. This point is on the inside of the upper arm, between the bicep and edge of the triceps, several inches down from the armpit. Feel for a pulse there and apply pressure with several fingers or your thumb.
If the injury is so severe that these methods aren’t stemming the flow of blood, it’s time to consider using a tourniquet. The victim might lose the body part due to lack of circulation, but this has been proven to be rare on the battle field. Remember though, we are talking about scenarios where additional medical care is not available. Select a strong, broad, flexible object, such as a rolled-up shirt, thick cord, rope, or belt. It should not be so thin as to cut into tissue and cause further injury or bleeding. Wrap the tourniquet around the limb as close to the injury as possible, and tie it off as tightly as you can. Alternatively, you can tie the tourniquet around the limb in a loose loop, then tie a handle such as a short, strong stick inside the knot of the loop. Turn the handle several times to twist and tighten. Whatever method you use, you should secure the tourniquet so that it does not come unwound. If possible, dress and bandage the wound, mark the time the tourniquet was applied so that you can later inform the professionals, then get the victim to medical care as soon as possible. Think of your role here more as plumber than doctor—squeeze off the pipes to stop the flow.
All of the above suggests the supplies to be successful. Most store bought first aid kits these days will not address any but the most basic of cuts. 2 to 4 gauze pads will do little in a serious wound. Build your own first aid kits. Blood stopping is one of goals of your first aid kit. This requires what I call “blood stoppers”. Surgical pads are usually thicker than regular pads. Often they are “4x4’s” larger than what are included in kits. It has been said that feminine pads can be used as blood stoppers. I guess that if you had nothing else this would help. Diapers have also been suggested in this case. These items are made to absorb. You don’t want a product to absorb blood, but to create a barrier to help the blood to clot and seal the wound. These two products in particular will wick blood away. You need blood stoppers, not absorbers. If that is all you have it’s better than a rag I suppose. Remember the idea is to stop the bleeding not to just keep the floor clean. So when you build your first aid kits, use actual gauze rather than sanitary pads or diapers. The cost is higher but the idea is to save life. This goes for bullet wounds. Do not use tampons if you can help it. Instead of these items a clean cotton shirt is probably a better choice. Effective hemorrhage control is to tightly pack gauze up against the damaged vessel, and inside the wound, and hold it under pressure. Medical gauze is specifically designed for this purpose. It puts a significant amount of ‘surface area’ in the form of the gauze fibers in the area where the blood is leaking out.
Quick clot is a proven product. But I would suggest not using Quick clot unless everything else does not work. If a wound will not stop bleeding with pressure then by all means use what will work. Quick clot is not a “magic wand” that will instantly stop bleeding. Also there has been concern with getting Quick clot in a wound rather than just on the surface to stop the bleeding. I would suggest something called an Israeli Battle Dressing. It is a 4x4 dressing connected to an elastic bandage with a pressure applicator. Learn how to use these correctly. They can even be applied one handed.
Stopping bleeding is not as basic as it seems but with some knowledge and some supplies it can become much easier.
Depending on the source of the hemorrhage death may only take 20 seconds to a couple of minutes. Exsanguination is the term for bleeding to death. If the bleeding is from an arterial source, time is of the essence. You can be ready for this.
As I tried to cover my butt before, I will do so again. I am not a doctor or medical professional. Get trained from a professional.
Semper Paratus
Check 6