rems trauma
TRANSCRIPT
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Trauma Equipment In-Service
Rotterdam Emergency Medical ServicesDouglas Hexel, AEMT-P, NYS CLI
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Reasoning
• REMS has recently developed a new trauma bag for the purpose of controlling massive hemorrhages in the field.
• The bags and items within the bag are based on military technologies, aimed at rapidly stopping life-threatening hemorrhages.
• They will be maintained separately in the bag for the purpose of rapidly locating and implementing.
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Agenda
• New Bag
• Contents
• Quikclot
• Combat Application Tourniquet (C-A-T)
• Emergency Trauma Dressing (ETD)
• Hy-Fin Chest Seal
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New Bag
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New Bag
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New Bag
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New Bag
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Contents
• (1) 10” x 30” Trauma Dressing
• (4) 8” x 10” Trauma Dressings
• (1) Quikclot Z-Rolled Gauze
• (2) Combat Application Tourniquets (CATs)
• (1) Emergency Trauma Dressing (ETD)
• (2) Hy-Fin Chest Seal Occlusive Dressings
• (1) EMS Shears
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Contents
• Quikclot: For use on arterial bleeding or deep, profusely bleeding venous bleed that cannot be controlled with a tourniquet (i.e. to torso, pelvis, or neck.) DO NOT USE ON HEAD WOUNDS.
• C-A-T: For use with severe extremity bleeds that cannot be stopped with traditional dressings.
• ETD: Best used with venous bleeds to quickly control.
• Hy-Fin: For use as occlusive dressing.
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Quikclot
• 3” x 4yd Z-rolled, soft, white, sterile, nonwoven gauze impregnated with kaolin, an inert mineral that does not contain animal or human proteins or botanicals.
• It is safe for use on those with allergies unlike previous generations of hemostatic agents containing shellfish derivatives.
• It does NOT cause exothermic reactions like previous generations.
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Quikclot Directions
1. If the location of the wound allows, apply a tourniquet.
Tourniquet
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Quikclot Directions
2. If needed, wipe or suction away any pooled blood.
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Quikclot Directions
3. Begin packing gauze into source of bleeding. Simply placing the gauze over the wound will NOT work. The gauze must make contact with the bleeding vessel(s).
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Quikclot Directions
4. Continue packing gauze into wound until all gauze has been used. Firmly apply pressure for 2-3 minutes until all bleeding has stopped.
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Quikclot Directions
5. Cover wound with standard gauze and write ON the dressing that quikclot has been used.
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Quikclot Directions
6. Ensure that all ED staff are aware of quikclotplacement. Quikclot requires surgical removal.
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Combat Application Tourniquet
• Developed for the United States Army, it has been their standard issue tourniquet since 2005.
• Proven 100% effective in occluding blood flow in both upper & lower extremities by the U.S. Army’s Institute of Surgical Research.
• Expands up to 37.5” to fit nearly any extremity.
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C-A-T Directions
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C-A-T Directions
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C-A-T Directions
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Emergency Trauma Dressing
• Sterile, non-adherent gauze attached to an elastic bandage.
• Suitable for application to limbs or torso when tourniquet cannot be used.
• Applies immediate pressure to wounds, helping to stop bleeding.
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ETD Directions
1. Place sterile pad side down on wound
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ETD Directions
2. Begin wrapping with tension on bandage to create tight dressing.
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ETD Directions
3. If necessary to apply more pressure, twist the bandage over like with old pressure dressings.
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ETD Directions
4. Continue wrapping tightly and secure with built-in C-clips.
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Hy-Fin Occlusive Dressing
• Advanced adhesive technology to create a superior seal.
• Transparent backing allows placement directly over the wound and easily conforms to the patient’s chest.
• Red elliptical tab for single step peel-and-apply. application that can also facilitate burping of the wound.
• As there is no one-way valve, the seal is to used in conjunction with needle decompression, but can be “burped to relieve air pressure in wound.
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Hy-Fin Directions
1. Wipe blood/dirt from around wound
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Hy-Fin Directions
2. Grip red tab (not pictured) and peel backing from dressing
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Hy-Fin Directions
3. Place dressing with adhesive side down, centered on the wound
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Hy-Fin Directions
4. Firmly press dressing onto wound, assuring it adheres on all sides
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Hy-Fin Directions
5. Monitor for tension pneumothorax and perform needle decompression as needed.
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Conclusion
The presentation provides a quick in-service for the new major trauma kits that will be placed in each ambulance.
Remember that these are designed for massive hemorrhages and not suitable for easy to control bleeding.