# Effective home-made occlusive dressing ideas



## OnceAnEMT

I am curious if anyone (specifically Wilderness-related) has used a non-brand occlusive dressing. Saran wrap taped down, ziploc baggy taped, basically anything plastic taped down. This is certainly a cheap route, but does anyone know of its effectiveness? Or have an idea of how to test it?

My only worry is that I hear some occlusive dressings have a coating along the adhesives to create a conscious seal. Could rubbing some lube on the edges the taping do the trick?

I may just be over thinking this, but at the same time I'd love to trim down some costs. Anyone know of any cheap brand-made occlusive dressings? Trying to avoid $20 for 3.


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## DesertMedic66

The bags on NRB make a nice occlusive dressing. 

My issue with the lube is that i think it would eventually make the tape no stick to the skin.


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## OnceAnEMT

DesertEMT66 said:


> The bags on NRB make a nice occlusive dressing.
> 
> My issue with the lube is that i think it would eventually make the tape no stick to the skin.



Another good idea. But that brings me back to the point of how to effectively secure it. I only found out about a coating being applied to brand-made occlusive dressings on Wikipedia, so it very well may be false. Anyone have anything to say in regards to this?

If there truly is a coating and lube is an alternative, I was thinking put lube around the inner edge of the adhesive so it remains sticky. So the adhesive part is still porous, but the lube creates the seal before the puncture site, thus providing for an effective occlusive dressing. Totally ball parking this, have not attempted.

 I almost feel that if it was truly medical-grade adhesive, that ought to be enough of a seal.


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## DesertMedic66

I've never had a leak with just a piece of plastic and then transpore tape on the outer edges.


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## OnceAnEMT

Sounds good to me then! Thinking of cutting a ziploc bag up to get 2 large plastic dressings, which could then be trimmed on-scene if needed. Nice cheap way to remain effective. 

Thanks for the help.


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## NomadicMedic

Or, just stick an asherman in your bag?


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## OnceAnEMT

DEmedic said:


> Or, just stick an asherman in your bag?



But that's about $25 for 2, and they have one purpose. I already carry the tape and ziploc bags for other uses, both of which are cheap and multi-functional, but still effective in those functions.


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## NomadicMedic

Grab a pack of expired defib pads. They work great and stick to everything.  and, you can cut em up if you need two. The tape/bag thing is fine, but something SUPER sticky is a better bet.


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## OnceAnEMT

DEmedic said:


> Grab a pack of expired defib pads. They work great and stick to everything.  and, you can cut em up if you need two. The tape/bag thing is fine, but something SUPER sticky is a better bet.



Ah... now this I have heard of, and completely forgot about. I'll have to ask around.


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## STXmedic

Military medics have been taught to just circumferentially wrap the torso with Saran Wrap. It can cover multiple holes (read: entry and exit), no tape needed, and there's no risk of the bandage being sucked into the wound. It can be digitally burped when needed, then easily reoccluded.


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## EMT11KDL

Being someone who has used occlusive dressings, honestly it doesn't matter what the material is, anything is better than nothing. Thick plastic works great and taping all 4 sides. Saran Wrap around the body works also and is daily cheap.  Now remember not all open chest wounds are sucking chest wounds.


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## OnceAnEMT

My worry with saran wrapping circumferentially is that you are obviously applying force to the thoracic cavity of a patient who is probably already deteriorating. I'll have to give it a try on someone, and see if it can't be effectively secured with 1-2 go-arounds versus mummifying the patient.

It does however provide a good alternative for our K9s. Much simpler than shaving a border around the wound and hoping the tape stays.


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## EpiEMS

Duct-tape and heavy-duty trash bags cut into squares?


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## OnceAnEMT

EpiEMS said:


> Duct-tape and heavy-duty trash bags cut into squares?



 Also in my bag. I'm sure it would also do the trick, though for some reason I would prefer to still have eyes on the actual wound, and not have it obscured by the dressing altogether.


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## jboz7089

*Good stuff*

New to the forum.  Some good suggestions on here.  The only time I've had to use a chest seal, I've always had one available (that I didn't have to pay for ^_^ )

I'm looking to build my own personal response bag, and am going to look into carrying the expired AED pads.  Seems like a good idea!


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## greenmountains

A friend with a local service tells me that they use aluminum foil.  Another guy tells me the ambulance stocks plastic wrap.


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## gotbeerz001

jboz7089 said:


> *Good stuff*
> 
> New to the forum.  Some good suggestions on here.  The only time I've had to use a chest seal, I've always had one available (that I didn't have to pay for ^_^ )
> 
> I'm looking to build my own personal response bag, and am going to look into carrying the expired AED pads.  Seems like a good idea!


Just make sure to clarify during TOC 
Could easily earn some funny looks coming in with oddly-placed defib pads


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## mycrofft

Anytime you cut a corner you invite criticism and failure.

Circumferential saran wrap can cause asphyxia because it is too tight (can't expand chest) or it can fail (too loose). And you have to be able to carry and apply it practically. Try peeling off Saran wrap in the dark with your gloves on, sitting-up the pt, then applying it and securing it. And if it gets wet the saran wrap grip is broken.

If you choose not to carry a dedicated product and to improvise, which is a valid decision, it is defendable, versus deciding to carry food wrap or other stuff, which can get sketchy. ("I read about army medics doing this"). Army medics, and Navy corpsmen, _under fire_, have used everything from the paper cover of a 4X4 to bloody socks to seal a sucker.

That said, improv materials fail when they can't be securely taped or otherwise (as in the pt is wet) secured; when they are too small; when they are buried under another dressing. Get a selection and try them out on dry and wet surfaces.


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## EMDispatch

We  were taught in my original EMT class to use tape and plastic wrap and not do a complete body wrap. We were also made them with a spare exam glove and tape, since you really should always an extra glove on hand.


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## irishboxer384

Have 'mummified' people to a backboard in numerous rigorous practise settings with seran wrap around the chest- and it didn't restrict/hinder breathing at all. even rotated them 360 degrees several times- we even found some skinny/fat people from another military branch to practise on and positive results on those body types


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## mycrofft

irishboxer384 said:


> Have 'mummified' people to a backboard in numerous rigorous practise settings with seran wrap around the chest- and it didn't restrict/hinder breathing at all. even rotated them 360 degrees several times- we even found some skinny/fat people from another military branch to practise on and positive results on those body types


Good work. But some people will shut down when you lay them supine without any constriction or injury at all. Yeah, if it is done just right, it is quite occlusive. (PS: left on for long periods, say, overnight, it will also encoutage growth of bacteria, including facultative and strict anaerobes.

Anyone remember the trick of using a glove with a very small hole in the end of one finger as a half-arsed Heimlich valve?

Or rolling the pt onto the affected side?


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## irishboxer384

mycrofft said:


> Good work. But some people will shut down when you lay them supine without any constriction or injury at all. Yeah, if it is done just right, it is quite occlusive. (PS: left on for long periods, say, overnight, it will also encoutage growth of bacteria, including facultative and strict anaerobes.
> 
> Anyone remember the trick of using a glove with a very small hole in the end of one finger as a half-arsed Heimlich valve?
> 
> Or rolling the pt onto the affected side?



For 'normal' situations I definitely agree, it would be a decent option if for some reason there was nothing else available however. Not to thread jack but it would be cool to see what ideas or experiences people have had with improvised medical equipment/treatment people have, not just limited to occlusive dressings?


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## lifeway

I've used the sterile side of the wrapper taped down from iv solution bags for an occlusive dressing.


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