HellsBells Posted October 4, 2011 Share Posted October 4, 2011 I agree with the above, in my experience these type of wounds are usually easily controlled. However, if you simply can't control the bleeding with any other method, then obviously a tourinquet is in order. This reminds me of a pt we had a couple years back. While working at a gravel quarry, a production worker got his arm pulled into a conveyer belt used to seperate rocks. They managed to stop the machine and get his arm out before our arrival. His arm had been bandaged by first aid before our arrival, it was actually quite skillfully done. He was not bleeding through the banage and had good distal CMS. The first aid attendent mentioned that there was a lac over his tricep, but he didn't seem overly excited about it. On further examination in the ambulance, we noticed that his humerus was obviously fractured, so we put him in a sling/swathe, but elected not to remove the bandage, since as mentioned the circulation was present and the environment was dirty/dusty. During transport his pain level becomes very severe, alomst screaming in pain, we maxed out our pain meds, and he is still in considerable discomfort, seemingly out of line with a simple fracture. Anyway, arrival at the hospital, the resident removes his bandage, only to reveal that his entire tricep has been severed from his arm, and the bone from his humerus visable and actually broken in at least three different places. From that point on I've typically removed bangages put on by first aiders prior to my arrival. Link to comment Share on other sites More sharing options...
Kiwiology Posted October 4, 2011 Share Posted October 4, 2011 (edited) Combat application tourniquet and fast transport to the ho'biddle to see the chiurgeons (Kiwi for go to hospital with much fastness) Edited October 4, 2011 by kiwimedic Link to comment Share on other sites More sharing options...
DFIB Posted October 5, 2011 Share Posted October 5, 2011 Direct pressure, tourniquet only to be removed in the presence of the Dr. Link to comment Share on other sites More sharing options...
brentoli Posted October 5, 2011 Share Posted October 5, 2011 Our current protocol calls for a quick clot dressing followed by tourniquet for a major amputation. Our current doc is huge on tourniquets and QC. Very agressive beeding managagement in the protocols. Our current protocol calls for a quick clot dressing followed by tourniquet for a major amputation. Our current doc is huge on tourniquets and QC. Very agressive beeding managagement in the protocols. Link to comment Share on other sites More sharing options...
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