Bleeding ControlBleeding ControlOBJECTIVESOBJECTIVES

-Discuss need for aggressive bleeding Discuss need for aggressive bleeding managementmanagement

-Discuss and Demonstrate MethodsDiscuss and Demonstrate Methods-Discuss use of the Chitosan Dressing Discuss use of the Chitosan Dressing

in CLS bagin CLS bag-Discuss when to apply a TourniquetDiscuss when to apply a Tourniquet-Demonstrate alternate tourniquet Demonstrate alternate tourniquet

methodsmethods

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

The leading cause of Death on the The leading cause of Death on the battlefield is uncontrolled extremity battlefield is uncontrolled extremity bleeding.bleeding.

In most situations a pressure dressing is In most situations a pressure dressing is adequate to control bleeding—but in “care adequate to control bleeding—but in “care under fire” you don’t have the luxury of under fire” you don’t have the luxury of time.time.

In combat, under fire, a Tourniquet can be In combat, under fire, a Tourniquet can be applied quickly, and once you have time to applied quickly, and once you have time to properly evaluate the wound, a pressure properly evaluate the wound, a pressure dressing may replace the tourniquet. dressing may replace the tourniquet.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Our body organs need oxygen. Blood Our body organs need oxygen. Blood carries oxygen from our lungs to these carries oxygen from our lungs to these organs. Major blood loss results in organs. Major blood loss results in these organs not getting enough these organs not getting enough oxygen.oxygen.

The clotting factors we need are also The clotting factors we need are also found in blood. Major blood loss found in blood. Major blood loss results in longer time for the body to, results in longer time for the body to, if even able, begin to clot from a bleed.if even able, begin to clot from a bleed.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

The Point is to jump on blood loss The Point is to jump on blood loss quickly and aggressively! quickly and aggressively!

Especially under fire. Especially under fire.

2500 soldiers died in Vietnam 2500 soldiers died in Vietnam alone from blood loss secondary alone from blood loss secondary

to a wound suffered.to a wound suffered.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Expose the wound (Exception Expose the wound (Exception CBRNE)CBRNE)

Don’t clean itDon’t clean it Don’t poke it or probe it ( to Don’t poke it or probe it ( to

remove an object embedded in it). remove an object embedded in it). Don’t remove any impaled object Don’t remove any impaled object

in a wound site (Exception: In the in a wound site (Exception: In the cheek or impeding the airway)cheek or impeding the airway)

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Types of DressingsTypes of Dressings Emergency trauma bandage ( also Emergency trauma bandage ( also

known as the Israeli Pressure known as the Israeli Pressure Dressing) Dressing)

CLS have 2 in their CLS bagsCLS have 2 in their CLS bags Every soldier has one in their IFAK kitsEvery soldier has one in their IFAK kits It applies continuous pressure to the wound.It applies continuous pressure to the wound. The Field First Aid dressing is still in the The Field First Aid dressing is still in the

system as well.system as well.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Demonstration of the Israeli Pressure Demonstration of the Israeli Pressure dressingdressing

Demonstration of the Field First Aid Demonstration of the Field First Aid DressingDressing

Demonstration of pressure dressing Demonstration of pressure dressing placed over Field First Aid Dressingplaced over Field First Aid Dressing

ISRAELI PRESSURE DRESSINGISRAELI PRESSURE DRESSING

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Chitosan® DressingChitosan® DressingThe Chitosan® dressing is used for The Chitosan® dressing is used for

Serious Arterial bleeding.Serious Arterial bleeding.

DO NOT USE IT ON MINIMAL TO DO NOT USE IT ON MINIMAL TO MODERATE BLEEDING! MODERATE BLEEDING!

It releases Chemicals that “plug” the It releases Chemicals that “plug” the tears in blood vesselstears in blood vessels

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Demonstration of the Chitosan® Demonstration of the Chitosan® Dressing.Dressing.

Key points:Key points: Only touch the green backingOnly touch the green backing Don’t let moisture come into contact with Don’t let moisture come into contact with

chemicalschemicals Apply light colored portion over wound Apply light colored portion over wound

and push it in– Apply DIGITAL PRESSURE and push it in– Apply DIGITAL PRESSURE for 4 Minutesfor 4 Minutes

Digital Pressure on Pressure points, and Digital Pressure on Pressure points, and elevation are other tools to use.elevation are other tools to use.

Re-evaluate ( If dressing has adhered, Re-evaluate ( If dressing has adhered, apply a new one over it. If it has not apply a new one over it. If it has not adhered, remove and replace.). adhered, remove and replace.).

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

WARNING!WARNING! Due to cost and availability, the Due to cost and availability, the

CLS is advised not to allow other CLS is advised not to allow other soldiers to ‘play’ or experiment soldiers to ‘play’ or experiment

with this dressing while in the field, with this dressing while in the field, or to even use it for a training aid. or to even use it for a training aid.

You may be the person who needs it You may be the person who needs it out there– so safeguard this item, out there– so safeguard this item,

and protect the package’s integrity. and protect the package’s integrity.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

You are going to be familiarized You are going to be familiarized next with the QuikClot ® next with the QuikClot ® Hemostatic dry powder. While the Hemostatic dry powder. While the official Hemostatic dressing is the official Hemostatic dressing is the HemCon®, You will see both types HemCon®, You will see both types in Theater. Avoid skin, mucosal in Theater. Avoid skin, mucosal ( eyes, mouth) contact with this ( eyes, mouth) contact with this material as it causes burning ( You material as it causes burning ( You are advised to use goggles if able are advised to use goggles if able to)to)

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Bleeding Control Bleeding Control (Cont’d)(Cont’d) Tourniquet Myths:Tourniquet Myths:

If I put on a Tourniquet, everything from that If I put on a Tourniquet, everything from that point downward is lostpoint downward is lost

Only a Doc can remove itOnly a Doc can remove it

All Tourniquets are created equalAll Tourniquets are created equal

Loosen every 15 minutesLoosen every 15 minutes

Tourniquets vs. ‘constricting bands’Tourniquets vs. ‘constricting bands’

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Indications for use of a tourniquetIndications for use of a tourniquet

Under fire when there isn’t time to Under fire when there isn’t time to control bleeding, and when your control bleeding, and when your weapon could be used to help suppress weapon could be used to help suppress the enemythe enemy

When other methods of bleeding When other methods of bleeding control have failedcontrol have failed

When there is an amputation of the When there is an amputation of the arm, forearm, thigh, or lower leg.arm, forearm, thigh, or lower leg.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Every Soldier in Theater has an Every Soldier in Theater has an IFAK® pack which has a C-A-T IFAK® pack which has a C-A-T Tourniquet inside. If you are the Tourniquet inside. If you are the CLS– Use theirs! Next we will CLS– Use theirs! Next we will watch two videos demonstrating watch two videos demonstrating both One Handed and Two both One Handed and Two Handed application of this Handed application of this device.device.

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Bleeding Control Bleeding Control (Cont’d)(Cont’d)

Demonstration of the application Demonstration of the application of the CAT Tourniquet of the CAT Tourniquet

Demonstration of other Demonstration of other improvised tourniquets. improvised tourniquets.

QUESTIONS?QUESTIONS?