Mini-Trauma Systainer Tip Of The Day

[wow]

Disclaimer: I am trained as an EMT, but am in no way 'the definitive source' on anything medical. I believe that I am better than average at explaining things, so I am posting these tips in the hopes that they will help someone to be better informed or more prepared. They are not intended to be a substitute for appropriate medical training, and you should ONLY attempt first aid that you feel comfortable providing and are trained for. There - that oughta satisfy the lawyers!
;D
By the way, I will update this post to add more tips, correct any errors, or to clarify something. Check back often!

We're getting closer to having the Mini-Trauma / First Aid Systainer ready to ship. Since not everyone here is trained as an ER Doctor - including me - I thought I'd offer up some help in "bite-sized' chunks. These tips are relevant whether you ordered a kit, made your own, or are just thinking about getting one.

*** Thursday May 15th - When should I use Quikclot?

Quikclot is a great product when used properly, and a PITA for the ER folks if used incorrectly. While misuse typically isn't fatal, it can seriously complicate the cleaning and final treatment of the wound. So, when should you use it?

Only use QuikClot if:

• Direct pressure over several minutes isn’t stopping the bleeding.
• The compress/trauma pad becomes saturated with blood quickly and repeatedly.
• You are many miles from any medical assistance.

Also, Once QuikClot has been applied, NEVER attempt to remove it or expose it to water. Doing so will also remove the clot, which puts you back to square one - or worse. It should only be removed in the ER where they can deal with rapid blood loss.

Do not use QuickClot:

• As a first resort to stop bleeding. Always apply direct pressure to the wound FIRST.
• To delay treatment. If you need to use QuikClot, you need treatment NOW.
• If an ambulance or rescue can reach you in minutes. This means that you will typically NEVER need to use QuikClot in a metro area.

*** Friday May 16th - Why give heart patients aspirin before they get to the hospital?

Aspirin is one of the most important medications we have for treating heart attacks. Unlike when you're just taking it daily to reduce your risk, this is an emergency. In this emergency setting, taking an aspirin can reduce your risk of dying from the heart attack by about 20 to 30 percent. It's one of the most powerful and most important medications for the treatment of a heart attack. By the way, be sure you CHEW the aspirin to get it into your system faster. Yes, it will taste bad.

So why do paramedics give patients aspirin before they get to the hospital? They do that so it can be provided early, and they also do it so it's not forgotten. If the patient ends up getting an extra aspirin in the emergency department, that's okay - it won't hurt them.  

While there's no strong evidence that you need to take it within seconds of the heart attack's onset, there's likewise no evidence that you shouldn't. It's important to administer within hours - certainly within 24 hours of the onset of a heart attack -  and it's probably true that the earlier the better.

The important thing is that someone who's having a heart attack does get an aspirin. If you want to take an aspirin the moment that you believe that you might be having a heart attack, it's not a bad idea.

As far as dosage, Bayer says: "Taking at least one half (160 to 162.5 mg) of a Genuine Bayer Aspirin during a suspected heart attack can help save your life. And, if you've survived a heart attack, a doctor-directed aspirin regimen can reduce your risk of a second attack by 30%."

Most Paramedics and ER's will simply give you ONE adult strength aspirin, as a little extra won't hurt.

Credit: Harlan Krumholz, M.D., S.M., Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health, Yale University School of Medicine. Edited 5-19-14 to add Bayer information.


*** Monday May 19th - Blood is good - cuts and scrapes 101

Blood helps clean wounds, so a little bleeding is good. Most small cuts and scrapes stop bleeding pretty quickly, but you can help by applying firm, gentle pressure with gauze. If blood soaks through, put another piece of gauze on top. Don't remove the old one or you may start the bleeding again.

• Clean Cuts and Scrapes Gently
Soothe and clean the wound with cool water. Then remove any pebbles or splinters with sterile tweezers. Gently wash around the wound with mild soap and a washcloth or gauze. You usually do not need to use harsh soap, iodine, alcohol, or hydrogen peroxide -- fresh, clean water should be all you need.

• Apply Antibiotic Cream
Antibiotic creams and ointments not only keep wounds moist, but they can reduce the risks of infection. Apply a thin layer on the wound. Certain antibiotic ingredients can trigger a rash in some people. If you get a rash, stop using that ointment.

• Apply a Bandage
An uncovered scab or scrape is at risk of reopening or infection. Cover it up with an adhesive bandage to keep out the bacteria (and your prying fingers). Change the bandage daily.

• Signs of Healing
Almost as soon as you get a cut or scrape, your body begins healing your injury. White blood cells attack infection-causing bacteria. Platelets, red blood cells, and fibrin create a jelly-like clot over the wound and soon a protective scab forms. If your wound gets itchy, be gentle -- you want that scab to stay where it is.

• Signs of Infection
If there's skin redness that spreads out from your injury, swelling, green or yellow fluid, or increased warmth or tenderness around your wound, you may have an infection. Other signs include swollen lymph nodes at your neck, armpit, or groin, as well as body aches, chills, or fever. If you have any of these signs, give your doctor a call.

*** Tuesday May 20th - Dealing with Diabetes

Diabetes is a potential emergency, and *MAY* require immediate action.

Reaching a 'sugar high' condition takes a long time, and can usually be dealt with as a non-emergency. If the patient can't self-correct using their insulin, get them to an urgent care center or ER.

A low-sugar condition, however, is a real emergency requiring action within minutes. If the person is failing but conscious, you can simply allow them to drink regular soda, juice or energy drink. But you should never give food or drink to an unconscious person.

If they are unconscious, first call 911. If you have glutose, creamy peanut butter, frosting or something similar - and have been trained to do this - place some of it on the end of a tongue depressor (conveniently included in your Systainer Kit !!!) and slip it between their teeth and their cheek with the sugary stuff toward their cheek. This will allow them to absorb the sugar needed to deal with their condition, while minimizing the risk of choking.

When in doubt - If you aren't sure whether their sugars have gone low or high - but they are still conscious - give them a sugary drink like regular soda, juice or energy drink. The small amount of sugar they will receive will help them if they are 'low', and won't be enough to be a serious problem if they are high. Obviously after an episode like this they SHOULDN'T drive, and they SHOULD be seen by a doctor.

Simple and effective - and you can always cancel the first responders if the patient comes around. But if the treatment doesn't have a positive effect within a few minutes, you already have the right help on the way!

***

I'll have another TOTD tomorrow. Let me know if this helps and/or is of interest to you?

 

[RKA]

Keep 'em coming!  If not for this I would have used it on the first paper cut!  Thanks for all the work!

 

[wow]

WOW - 200 views and only one comment? What's up with that?

 

[3PedalMINI]

Probably because fog has a ton of lurkers/non members that look. Fog has also seemed a bit quiet lately too.

Fascinating read so far, I too would have used quick clot on my first paper cut  [scared]

Thanks again for all your hard work, I truly appreciate it...I look forward to more of your medical posts

 

[Sparktrician]

Great tip, WOW!!!  More, please. 

 

[SittingElf]

My wife (Senior Military Critical Care Nurse) told me a few months ago that the military has stopped using Quick-Clot for some reason.

I will ask her later today when she gets home to find out what the story is, but as I recall, there is a problem with it. More later in an update.

Frank

 

[SittingElf]

OK, so here's the deal....

The military in tests have found that Quick-clot can burn derma (Skin and muscle). It also has had additional negative issues with after effects to the injury and health as a whole.

The military has found that old methods, including tourniquet and whole blood transfusions, FFP, cryo, and platelets are more effective than Quick-Clot without the problems caused by the Quick-Clot formulation...and as a result, no longer uses the product for traumatic injuries. It was tested extensively in Afghanistan and Iraq, and as a result of those tests, was discontinued as a treatment for traumatic injury.

Not saying it's not an emergency method in a SHTF situation, where trauma care is not readily available, but I AM saying that it should not be the first choice for traumatic injury if help is close at hand.

Cheers,

Frank

 

[wow]

OK, so here's the deal....

The military in tests have found that Quick-clot can burn derma (Skin and muscle). It also has had additional negative issues with after effects to the injury and health as a whole.

The military has found that old methods, including tourniquet and whole blood transfusions, FFP, cryo, and platelets are more effective than Quick-Clot without the problems caused by the Quick-Clot formulation...and as a result, no longer uses the product for traumatic injuries. It was tested extensively in Afghanistan and Iraq, and as a result of those tests, was discontinued as a treatment for traumatic injury.

Not saying it's not an emergency method in a SHTF situation, where trauma care is not readily available, but I AM saying that it should not be the first choice for traumatic injury if help is close at hand.

Cheers,

Frank

A couple of clarifying points to your post, since it may have created some additional confusion:

1. There was an older (original) version of QuikClot that did indeed burn. The newer versions are a different formulation, and burning is much less likely. It is still possible that burns will occur in sensitive areas. I suspect that the military had access to whatever version they wanted for testing, so this is only provided as additional information and not intended to be 'dismissive' of your comments.

2. The military has the 'luxury' of having well-trained medical personnel around at most times, and I am VERY happy that they do!! In civilian life, though, there will be times when a trained 'medic' is not close at hand, and for those situations you want all the help you can get - whether that's a technical advantage like QuickClot or a personnel advantage like a trained first responder.

3. I clearly indicate - and QuikClot advises - that the product is ONLY for use in life-threatening situations. Nothing either of us has said changes that advice.

So where would *I* use QuikClot?

I can give you a PERFECT example. Say someone has sustained a traumatic injury that has torn or severed their femoral artery. (For those new to this stuff, that's the big artery in the leg that runs through the groin area.) If the injury is close to (or in) the groin there is no way to apply a tourniquet, so your options are:

1. QuikClot and
2. Direct Pressure.

I would immediately - without hesitation - use both. I'd stuff a QuikClot bandage into the wound as close to the artery as possible, then grab every trauma pad I had and start applying direct pressure.

Actually, I'd call 911 before/while beginning the above. This is truly a "minutes save lives" situation, and I'd welcome all the help I could get - as fast as I could get it!!

[eek]

 

[wow]

Frank:

I forgot to mention that I sincerely hope that *IF* I am ever in a trauma situation like we are discussing, your wife or someone like her would care for me. Our military has the world's BEST at treating trauma. Of course I'd expect nothing less for our soldiers.

Be sure to thank her for her service from me! And if I can ever buy her or you a drink or meal to express my thanks, consider it an open invitation.

 

[hullbert]

Excellent tips--keep them coming!!  I hope I never have to use this information, but I definitely NEED to know it.

  I've been thinking about adding one other item to the kit once it arrives.  We have several diabetics on our crew, and I thought it might be a good idea to put in a small tube of gel cake icing (green of course) in case someone has a sugar crash.  The "tip" that I've always heard regarding this is:  Cold and clammy--need some candy, hot and dry--sugar's high.

 

[wow]

Excellent tips--keep them coming!!  I hope I never have to use this information, but I definitely NEED to know it.

 I've been thinking about adding one other item to the kit once it arrives.  We have several diabetics on our crew, and I thought it might be a good idea to put in a small tube of gel cake icing (green of course) in case someone has a sugar crash.  The "tip" that I've always heard regarding this is:  Cold and clammy--need some candy, hot and dry--sugar's high.

Diabetes is a potential emergency, and will be dealt with in a future TOTD. But your 'tip' is accurate.

Reaching a 'sugar high' condition takes a long time, and can usually be dealt with as a non-emergency. If the patient can't self-correct using their insulin, get them to an urgent care center or ER.

A low sugar condition, however, is a real emergency requiring action within minutes. If the person is failing but conscious, you can simply allow them to snack on the icing. But you should never give food or drink to an unconscious person.

If they are unconscious, call 911. Then place some of the icing on the end of a tongue depressor (conveniently included in your Systainer Kit !!!) and slip it between their teeth and their cheek with the icing toward their cheek. This will allow them to absorb the sugar needed to deal with their condition, while minimizing the risk of choking.

Simple and effective - and you can always cancel the first responders if the patient comes around. But if the treatment doesn't have a positive effect within a few minutes, you already have the right help on the way!

 

[gkaiseril]

Not to put a damper on helpful tips, but there is a reason doctors, nurses, EMTs, and attorneys are licensed and now have continuing education requirements. Good Samaritan laws provide some protection to trained volunteers who remain within the limits and instructions of their training.

I have seen artificial necessitation instructions go from back pressure only to back pressure arm lift, mouth to mouth with chest compressions, and now to mouth to mouth for non-breathing and chest pressure only for no pulse.

From within my own family, I know of physician that responded to a "doctor" call on an airplane flight from Australia to the US and came upon a heart attack victim and an Automatic Electronic Defibrillator and could not help because the doctor was not trained in its use. Fortunately there was another physician on the flight that was trained on the use of the AED. So he took on the role of clearing the area and keeping other calm during the crisis. His specialty did not include direct patient care and the use of AEDs did not exist when he attended medical school and completed his internship and residency training. He has since obtained the training through a program at a nature center. Now the flight attendants should have been trained in AED use but they are also trained to defer to the more experienced and trained medical professionals.

I think the best approach is to encourage all wood workers to obtain some first aid training on a regular basis. On my day job, I get first aid training every 2 years that include use of the AED whether it is part of on site equipment or not. There are many public buildings, office buildings, and transportation vehicles that are now equipped with AEDs.