Hating on tampons in combat

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    • #82559
      Daniel
      Participant

        This fellow spends time on the subject of tampons for wound care.

        Hemorrhage Control – What Aunt Flow Didn’t Know

      • #82560
        Corvette
        Participant

          His arguments make perfect sense to me.
          I was always dubious about the tampons since they dont seem to actually control any bleeding but I accepted it since it was a common recommendation.

          .. and i leave this discussion to those more qualified than myself :)

        • #82561
          DuaneH
          Participant

            His rationale is spot on. I’ve been fighting the Tampon thing for ten years now. I do believe that it happened, but it was a rare case. There is a lot of dumb stuff in tactical/wilderness medicine including using gasoline as a wound cleaner.
            .
            The ONLY time you MIGHT use a tampon is if it is a LAST resort. IE you don’t have a t-shirt or a snot rag to stuff in there.
            .
            People who advocate this stuff typically have minimal if any experience.
            If people have seen gunshots, they would not be carrying a tampon.
            .
            You should be carrying some kind of compressed packing gauze like H&H. Or even something with a hemostatic in it.
            .

          • #82562
            Corvette
            Participant

              Pack with gauze until the new penetration tourniquet is available. Tampons are for pussies.

            • #82563
              DuaneH
              Participant

                “Pack with gauze until the new penetration tourniquet is available. Tampons are for pussies. ”

                You are quite literal-minded.

              • #82564
                HiDesertRat
                Participant

                  This isn’t about tampons (only good for absorption, nothing more) and such, but has to do with the compression aspect of hemorrhage control in difficult areas, ie the groin/femoral artery, and i believe can also be used on the upper body/shoulder area/axillary artery. worth a look see, not sure if available yet. check it out.

                  800.818 4726 | sammedical.com
                  Patent List for the SAM
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                  Pelvic Sling II
                  Brevet No. (FR)
                  1487317
                  Deutsches Bundespatent (DE)
                  1487317
                  Patentes marcado (ES)
                  1487317
                  Patent No. (UK)
                  1487317
                  U.S. Patent No.
                  6,554,784
                  U.S. Patent No.
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                  U.S. Patent No.
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                  Patents Pending
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                  FUNCTIONAL DESIGN
                  The SAM
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                  TWO WAYS TO CONTROL DIFFICULT BLEEDS
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                  ing the Target Compression Device (TCD) over
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                  For bi-lateral application, use
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                  .
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                  hear a second click once the belt is secure.
                  Use the hand pump to inflate the TCD until
                  hemorrhage stops. Monitor patient during
                  transport for hemorrhage control and adjust
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                  TO REMOVE
                  , unbuckle the belt.
                  4.

                  Multiple Indications

                  Inguinal hemorrhage

                  Axilla hemorrhage

                  Pelvic immobilization

                  < 25 second application time

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                  Also Immobilizes Pelvic Fractures
                  Part No.
                  Description
                  SJT 102
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                  SJT 100
                  Pelvic Sling
                  Apply the SJT to the patient under the arms,
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                  References
                  1
                  James C. Krieg, MD, Marcus Mohr, MS,
                  Thomas J. Ellis, MD, Tamara S. Simpson,
                  MD, Steven M. Madey, MD, and Michael
                  Bottlang, PhD.
                  Emergent Stabilization of Pelvic
                  Ring Injuries by Controlled Circumferential
                  Compression: A Clinical Trial Journal of Trauma.
                  59:659-664, 2005.
                  2
                  Davis JM, Stinner DJ, Bailey JR, Aden JK, Hsu
                  JR.
                  Skeletal Trauma Research Consortium.
                  Factors associated with mortality in combat-
                  related pelvic fractures
                  . J Am Acad Orthop Surg.
                  2012; 20 Suppl 1:S7-12.
                  3
                  Eastridge BJ, Mabry RL, Seguin P, Cantrell J,
                  Tops T, Uribe P, Mallett O, Zubko T, Oetjen-
                  Gerdes L, Rasmussen TE, Butler FK, Kotwal RS,
                  Holcomb JB, Wade C, Champion H, Lawnick M,
                  Moores L, Blackbourne LH.
                  Death on the battle

                  field (2001-2011): Implications for the future
                  of combat casualty care
                  . J Trauma Acute Care
                  Surg. 2012 Dec; 73(6 Suppl 5):S431-7.
                  4
                  Stannard A, Morrison JJ, Scott DJ, Ivatury
                  RA,Ross JD, Rasmussen TE.
                  The epidemiology
                  of noncompressible torso hemorrhage in the wars
                  in Iraq and Afghanistan.
                  J Trauma Acute Care
                  Surg. 2013 Mar; 74(3):830-4.
                  What if the patient has bi-lateral non-tourniquetable injuries?
                  The SAM
                  ®
                  Junctional Tourniquet can be applied with two bulbs to stop the flow of
                  bleeding bi-laterally. Place the TCDs over the affected areas to occlude blood flow and
                  inflate them individually until the bleeding stops.
                  Why does the SAM Junctional Tourniquet use pneumatic devices?
                  At SAM, we examined the strengths and weakness of both mechanical and pneumatic
                  approaches to hemorrhage control. The SAM Junctional Tourniquet incorporates the
                  best of both, with a strong mechanical buckle component based on our success

                  ful pelvic sling. This buckle controls baseline pressure and eliminates slack. The
                  pneumatic Target Compression Device (TCD) inflates quickly to minimize the loss of
                  blood from the patient. The TCD has a built-in pressure release valve to prevent over-
                  inflation at altitude.
                  What is the difference between the SAM Junctional Tourniquet and other devices
                  used for pelvic fracture immobilization?
                  The SAM Junctional Tourniquet is designed to prevent under-tightening. It is the only
                  pelvic binder that will ensure the compression force required to safely and effectively
                  stabilize pelvic ring fractures.
                  Studies show that 2% of all battlefield injuries and 15.1% of all torso injuries have an
                  associated pelvic fracture.
                  4
                  FAQ

                • #82565
                  HiDesertRat
                  Participant

                    i apologize for the length, should have edited.

                  • #82566
                    Max
                    Keymaster

                      We are faced with an unfortunate truth here.

                      In a SHTF situation, controlling a haemorrhage is serious business. Much of them will cause death no matter what we do. Unless there is skill around to do surgery within the golden hour.

                      Not saying that we should give up hope. Just saying that we need to be bold and think about how we are going to get in there and apply sutures to the artery.

                      Yes tourniquets and packing have their place. Yet for the subject to come out the other end we we have to be willing to get the scalpel out and get in there.

                      In a SHTF situation the local ER may not be an option.

                    • #82567
                      xsquidgator
                      Participant

                        We are faced with an unfortunate truth here.

                        In a SHTF situation, controlling a haemorrhage is serious business. Much of them will cause death no matter what we do. Unless there is skill around to do surgery within the golden hour.

                        Not saying that we should give up hope. Just saying that we need to be bold and think about how we are going to get in there and apply sutures to the artery.

                        Yes tourniquets and packing have their place. Yet for the subject to come out the other end we we have to be willing to get the scalpel out and get in there.

                        In a SHTF situation the local ER may not be an option.

                        I agree. My better half is a veterinarian and so I used to kind of check off the “we got the surgery thing covered” box. She disabused me of that notion though and said pretty much what you did. The IFAK and most of the GSW care stuff that us ordinary people would carry are just to keep a lid on things until you can get them to some higher medical care who can fix things. Post TEOTWAWKI there probably isn’t going to be anywhere to take someone for surgery after you stabilize them. Many GSWs are going to be the end of the road in that environment. I’ll still keep all that stuff just in case, but it’s something to think about that I hadn’t considered before.

                      • #82568
                        DuaneH
                        Participant

                          This is probably the 5th time I have made this reply to a similar post on a similar board:

                          Case studies from WWI are plentiful in which people were shot through and through in the chest and were back at the front fighting in a few months. This is without advanced medical care. All they did was keep the wound sealed to avoid pneumothorax and allowed the body to heal itself. As long as no major blood vessels are hit, it isn’t always fatal.
                          Alot of times people are thinking about TEOTWAWKI and they are thinking MadMax. Reality is that scenario is actually low and there are many scenarios out there in which SOME medical care will be available.
                          .
                          .
                          So DON’T be a fatalist.

                        • #82569
                          Joe (G.W.N.S.)
                          Moderator

                            So DON’T be a fatalist.

                            Amen, the human body is quite resilient on its own and many times the most basic treatment goes a long way.

                            Another thing to consider, you might just have to provide your best treatment with the most qualified person available, even if it means stepping way beyond your true qualifications.

                            It’s the difference between First Aid and Survival Aid.

                            First Aid you are stabilizing patient until qualified personnel can treat them.

                            Survival Aid is when qualified personnel are not expected.

                            Here are a few stories to think about.

                            Deborah Sampson
                            1760 – 1827

                            Surgical Procedure: Extraction of Musket Ball

                            Deborah Sampson was actually mentioned in the “Top 10 Men Who Were Really Women” list as a notable omission. In 1782 Deborah Sampson was enlisted in the Fourth Massachusetts Regiment of the Continental Army. Going by the name of Robert Shutleff she was strong and tall enough to look like a man and it was thought she didn’t have to shave because she was a very young man. When her unit was sent to West Point, New York she was wounded in a battle nearby. She was taken to a hospital to be treated but snuck out so that she would not be discovered to be a woman. She operated on herself and removed one of the musket balls out of her thigh with a penknife and sewing needle. When she recovered from her wound she went back to her regiment. The next time Sampson was wounded her doctor found out she was a woman and in 1783 he arranged for her to be discharged from the Continental Army.

                            Sampson Parker
                            Born circa 1960

                            Surgical Procedure: Amputation of Right Arm

                            In September of 2007 Parker a Farmer from South Carolina was harvesting corn when some stalks got stuck in a set of rollers that shuck the cut corn. He reached in the still-running machine to pull the stalks out and the rollers grabbed first his glove and then his hand. Parker tried yelling for help, but there was no one near the isolated field in Kershaw County. For more than an hour, he tried to pull his hand free, only to have it pulled ever further into the machinery. He was able to reach an iron bar and jam it into a chain-and-sprocket that drove the rollers, and, with his fingers growing numb he pulled out a small pocketknife and started to cut his own fingers off to free himself. Before he could do that the sprocket grinding against the rod he’d jammed in it threw off sparks and set the ground litter on fire. Parker then knew he had to cut his arm off or die right there. Parker credits the fire with keeping him from passing out from the shock of cutting through his arm. When he got down to the bone, he dropped onto the ground, using the force of his own weight to break the bone and free him from the machine. When he was finally loose he got in his pickup truck and started driving his truck into the middle of the road to force a car to stop. Finally a motorist stopped and a rescue helicopter was called in to take him to a hospital. Parker spent three weeks in a burn center before going home.

                            Dr Leonid Rogozov
                            Born 1937

                            Surgical Procedure: Appendectomy

                            At the age of 27 Soviet Doctor Leonid Rogozovwas was stationed at the Novolazarevskaya base in the Antarctic. The doctor recognized his own acute appendicitis and worsening condition. Because of the absence of a support aircraft and inclement weather along with the danger of a burst appendix the doctor decided he would have to perform surgery on himself. With the team’s meteorologist holding the retractors, a driver to hold the mirror and other scientists passing surgical implements, he sat in a reclined position and cut out his own appendix under local anesthetic. During the operation he passed out, but was able to continue and complete the procedure in little less than two hours.

                            These demonstrate over coming obstacles!

                            As DuaneH points out the quality of medical care and Surgeons WW1 and prior were quite rudimentary by today’s standards yet people still survived.

                            My better half is a veterinarian…

                            If a Vet can treat trauma injury on a K9, they can treat one on a person.

                            There are all kinds of animal meds that work just fine on people too.

                            …isn’t going to be anywhere to take someone for surgery…

                            Are all the Doc’s going to vanish during a SHTF Event? :-)

                            Befriend some Doc’s, Nurses, etc…

                            There are likely to be some living in your AO, they just might be willing to do some trading.

                            Sure there will be many limits to what can be done, but it’s not that bad.

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