Working as a Corpsman and EMT, I wasn’t given the choice of what medical gear I used. People with much more experience, training and education decided ahead of time what was acceptable and what wasn’t.
As a result, I only used gear that was issued and available to me and I never thought about if there might be a better option because it wouldn’t matter if there was. It would go against SOPs (Standard Operating Procedures) and that was always strictly forbidden.
Now that I’m free to explore and look into other life saving equipment, I’m given the opportunity to search out the answers for myself and question my reasons for doing what I do.
An emergency usually means you have little or no resources available to recover from a bad situation. Being able to extend the life of precious resources like trauma gear might become an essential skill set, and it happens to be one that medics pride themselves in.
Unless you're heading out to do errands in a fully stocked ambulance, you aren’t going to be able to carry all the things you might need for trauma control. And the situation only gets worse for multiple casualties.
Some things you just can’t get around, like carrying tourniquets for life threatening bleeds or seals for chest wall punctures. But if possible, carrying items that can be used for more then one type of injury is good for extending the number, and different kinds of emergency trauma you might encounter.
Here’s a list of items that can handle more than one job:
Full disclosure: I’m the one that decides what gear should go in our kits. And if it isn’t obvious already, I receive a financial kick back for talking about the MMM kits.
But I’m also confident this is an excellent trauma kit full of top-of-the-line gear and priced better than any comparable kit on the market. I take a lot of pride in the value we offer, and it’s my hope that more trauma gear is placed where it can save more lives.
One of my favorite jobs during my career in the medical field has been teaching trauma classes to organizations looking to be proactive in preparing for a disaster, either natural or manmade.
A few weeks ago, I made a video on the Mountain Man Medical YouTube channel about an Officer who was stabbed in the neck while attempting to apprehend a suspect.
After the altercation is complete, the body cam footage ends with the officer walking away to pack gauze into his own neck wound.
If you’ve been reading this blog in the past few weeks, you’ll already know why junctional wounds are uniquely dangerous, and why bleeding control is so difficult.
If you haven’t read these articles, I highly recommend that you do so you’ll better understand what I’m talking about here. They’re short reads, and I try to make them entertaining and educational.
After completing the video review of the injured Officer, I kept thinking about how important it is that everyone know how to pack a junctional wound. As I’ve said repeatedly in the last few posts, tourniquets, while important and effective, don’t fix everything.
I hear all the time from instructors about how important it is everyone to learns to self-apply a TQ to save your own life, but never anything about a technique for packing your own junctional wounds and/or improvising effective pressure dressings.
This is an unusual and potentially deadly blind spot in the normal training of medical skills for personal preparedness and protection.
I worry for the person who carries around a trauma kit for their own personal safety, confident they can control bleeding with their TQ, only to bleed out from a junction wound because they don’t know what to do.
Learning how to control your own junctional bleed is equally important as learning how to self-apply a tourniquet.
I started thinking of a way where an injured person suffering from a knife wound to the neck, might go about controlling bleeding until help arrives.
How to Improvise a Pressure Dressing with a Flannel Shirt
This method, like all improvised equipment, has its flaws. Improvised medical gear will never be better than commercially produced gear, and whenever possible I recommend you maintain your own supplies of pressure dressings like the Israeli Style or OLAES, so you don’t have to do any of this.
But the reality of emergencies is that they can occur when you are least prepared and knowing how to fix this problem might be handy when you need it most.
Here is a demonstration so you understand what I’m talking about here, but come back after you watch it and I’ll add some tips that might make the process easier.
Tip #1
This technique won’t work well if your shirt doesn’t have long enough sleeves. I wear a lot flannel (yeah, yeah, make your jokes) so this isn’t really an issue for me, since I’m usually wearing a long sleeve shirt. But if you don’t, this won’t be quite as simple.
That said, learning this technique means the material doesn’t have to be a shirt. Look around for something suitable to replace the shirt and you’re still accomplishing the goal. This is your shining opportunity to think outside the box.
Tip #2
You must practice. Self-application of a tourniquet must be practiced, and so must pressure dressings. Play around with it until you can do it without stumbling. It will probably take a few tries so don’t give up.
And if you happen to figure out a better way to do it, please don’t hesitate to share with the rest of the community so we can all benefit!
Tip #3
Yes, the shirt must be flannel. Flannel shirts are naturally imbued with the powers of Mountain Men, which is why it works so well as an improvised pressure dressing…
Tourniquets (TQ) have an especially big flaw: They only work on your arms and legs. What if you’re cut somewhere else? What’s your plan for that?
Carrying a CAT for emergencies is great until you trip into a pine tree branch and punch a hole in your neck.
People seem to gravitate to the tourniquet as the only thing they need for bleeding control, but while the TQ is important and effective, you can’t use it to treat other injuries. (Unless we’re talking about the SWAT-T. But I’m staying off that soapbox, for now.)
Here are two good reasons why learning to wound pack is just as important as tourniquet application:
I am frequently told stories about coming up on the scene of a car accident.
These stories are almost always told in a way that describes a feeling of helplessness and uncertainty.
Most people go about their day completely unaware that on their way home from work, they’ll come across a bad car crash, and when they are presented with the unexpected, they realize how unprepared they are to handle it.
This adds to the stress of the situation greatly because they’re don’t know what to do. In this article we’ll explore a few topics so you’re better prepared to help someone who needs it.
It’s impossible to be prepared at all times and knowing what to do when you don’t have any medical gear can be the literal difference between life and death.
Even a paramedic with a fully stocked ambulance has finite supplies, and if the situation is bad enough, anyone could easily run out.
If you haven’t already read what to do for bleeding, make sure you check that out before you continue with this article so everything makes sense.
Sucking chest wounds are treated quickly and effectively with the quick application of a chest seal. Penetrating trauma to the chest can cause a Tension Pneumothorax (TPT), a potentially life-threatening condition, but how can you treat it with no medical gear?
This article will focus on what other steps can be taken to reduce blood loss when you are caught in a bad situation without gear. Now that we understand how to apply direct pressure and why it’s probably better then trying to make a tourniquet, we can look at methods for increasing our effectiveness.
This week will continue along with the theme of how to save a life without medical gear.
Wound Packing
If you have our Yellowstone Trauma Kit you’ll feel comforted to know it contains a roll of QuikClot, a hemostatic agent (makes blood clot quicker).
This is a handy item to have in a pinch, but if you don’t have any, what else can be done?
Research shows packing wounds with gauze, any gauze, is an effective way to control bleeding. All you need to do is make some.
It’s impossible to be prepared at all times. We’re likely to be caught off guard and without important gear when an emergency happens. This is why training skills is so important.
Skills are weightless and with us all the time if an edge is honed every now and then. Skills sharpen or dull depending on how often they are used. Gear is great, but you also need to know what to do if you don’t have any, or, you use up everything you have.
This will be a multiple article discussion about what to do in the event you don’t have any gear with you. All you have is your mind, a bad situation, and an injured person in danger.
Severe Bleeding
This is first because blood loss is the injury that will kill your casualty the quickest, but the simplest to prevent. If you’ve been following the Mountain Man Medical YouTube channel or reading any of the articles on this web site, then you already know a tourniquet (TQ) is the first choice for treating life-threatening wounds to arms and legs.
TQs are easy to use and fast to apply with very little training, and are clearly the optimal choice. But what if you don’t have one… or there are more casualties and/or wounds then you have tourniquets for?
Emergency Professionals like Fire Fighters are widely respected for being able to stay calm when things get hairy. It's not impossible for you to do the same.
In Part 1 of Handling Emergencies Like a Pro, we talked about how to make a quick plan on the way to the casualty. Professionals do this all the time and it’s a great way to get past a lot of the indecision. But, to come up with a workable plan, you need to be trained.
Any high-level professional will tell you they are constantly training. Developing and maintaining skills takes a big stress load off your shoulders by allowing you to focus on the bigger, more dynamic picture. Since you have applied a Tourniquet (TQ)so many times in training, you aren’t thinking about each and every step when you do. Instead you’re thinking ahead about the next problem.
