Bandaging Survey

[OnceAnEMT]

@Qulevrius My concern is the overall blood loss. I really don't care that the Israeli Bandage is more absorbent than other commercial products. All that tells me is that it'll take more blood loss for the provider to notice that the bleeding is not under control.

Am I wrong to question why a bandage is being applied before bleeding is controlled? Sure a quick wrap to keep a non-adherent pad or initial 4x4s in place while higher up 4x4s that are saturated get replaced, but I've never found pressure applied from a bandage to be more successful than manual pressure. If manual pressure doesn't work, tourniquet comes next. I agree that all wounds deserve a bandage, and that bandage ought to provide pressure depending on the wound, but that shouldn't be the primary means of stopping the initial bleeding.

That's just wee me from a Level IV trauma center where our only bleeders are walk-ins, so I'm seriously asking.

 

[Qulevrius]

Did you read my post ? There's a rigid pressure bar inside the absorption pad, that's what applies direct pressure. And it's being augmented by the union jack, because the pressure bar is right where the dressing crosses. Then you tighten it up and voila, get the best applied pressure there is (manual pressure included).

If you work for a TC, you have little to no use for it. It's first and foremost, a field dressing that is very easy to apply and stands head and shoulders above regular bandages. As a whole, the entire purpose of any bandage is to severely restrict the blood loss, not to completely stop it. The reason behind it is to allow clotting which, in turn, stops the bleeding. And the extreme scenarios where you have to use a tourniquet, is when there's absolutely no other way to control the hemorrhaging.

 

[OnceAnEMT]

Did you read my post ? There's a rigid pressure bar inside the absorption pad, that's what applies direct pressure. And it's being augmented by the union jack, because the pressure bar is right where the dressing crosses. Then you tighten it up and voila, get the best applied pressure there is (manual pressure included).

But should that be done before bleeding is controlled, as a way to initially control bleeding as opposed to just maintaining it? That's how I've read this thread so far. I totally understand the efficacy of it in a multitrauma or combat scenario where either way its time to start moving, but just because Joe Schmo shot himself in the leg at the range does he just get an Israeli slapped on and transported?

 

[Qulevrius]

But should that be done before bleeding is controlled, as a way to initially control bleeding as opposed to just maintaining it? That's how I've read this thread so far. I totally understand the efficacy of it in a multitrauma or combat scenario where either way its time to start moving, but just because Joe Schmo shot himself in the leg at the range does he just get an Israeli slapped on and transported?

I think your confusion comes from defining 'bleeding control'. It doesn't mean that the RBCs will suddenly do your bidding and stop dripping away; it only means that the bleeding is manageable and consistent with life. The ultimate goal is to stop the hemorrhage altogether, but that hugely depends on the injury site and the blood vessels involved.

If Joe Schmo plugged himself in the leg and there's an Israeli available then Quickclot it, then slap the bandage on. If bleeding is controlled, then transport (hang an IV bag open if ALS). But if Joe was lucky enough to, say, nick an artery, then no matter how much direct pressure or how many bandages are slapped on, he'll keep exsanguinating and just bought himself a TQ. It's always scenario-dependent.

Hope that explains it.