First Aid

[Mr Monkey Nuts]

what is the current thinking on how to use tourniquets?

Same as it always has been, if you haven't been trained in it don't use it! That same thinking also extends to quick-clot and vascular surgery!

 

[Deek]

There is a newer version of QuikClot that doesn't produce heat when applied. The complication with QuikClot is that it is mineral based, so it does need cleaning out of the wound when used. The other big name is Celox - this works on a similar principle, but it is made from chitosan, a natural product. Chitosan is broken down by the body into natural sugars, so left over Celox doesn't need to be cleaned out of the wound, making it safer to use.

 

[Ian_Gere]

So Mr MM, would you suggest that a person should not make the best of their limited knowledge, when applying pressure to a wound is not preventing arterial blood from leaking and the ambulance is at least 15mins away?

 

[Mr Monkey Nuts]

Yes, yes I would. Blindly applying a tourniquet or hacking into someone's leg is only going to cause significant problems further down the line. And it's not just the motor skill of applying the physical tools, it's the overall patient management and incident management that can't be taught over the internet. How can you tell that this is life threatening bleed and not just a bad bleed? How much blood loss are you looking for how are you judging it? Can you tell the difference between 1 litre of blood and 3 litres of blood once it's on the ground? Because it's significantly harder than you can imagine it is.

We have left the realms of first aid and moved into a different game altogether. It's not as simple as just applying a bandage.

I would much prefer you get the appropriate training if you feel compelled that this level of major haemorrhage is something that concerns you.

 

[Mike636]

I heard an little rhyme once from a medic about arterial bleeds "If it goes further than a foot you're fucked"

 

[Ian_Gere]

Well Mr MN, I find you quite patronising and lacking imagination. Just because accidents and violence which result in heavy blood loss are not common events, that doesn't mean that I, or anybody else reading this, hasn't seen it happen, or been involved. Certainly blood has a way of seeming like more than it actually is and, if someone turns up when it is already on the ground (in the clothes, covering the hands, spattering faces, on the foliage, etc), it may indeed be difficult to tell 3L from 1L, however if even the dopiest person to ever wield an AEG came across somebody with bright red blood spurting out of a wound around the fingers of the desperate casualty, they would very quickly be able to tell that if blood is not prevented from spurting out quite soon, the casualty will die.

It doesn't matter how much is already out, it's the rate at which it keeps coming out and the state of the casualty. If s/he has blue lips and grey skin, is out cold, and the blood is losing power in how far it sprays, it is clearly because no matter how much has come out, it is too much. At which point the urgency of the situation has gone from "Shit, I need to do whatever I fully understand to try to stabilise him/her until paramedics arrive," to "Shit, unless someone can tell me for sure that paramedics will be here in 3mins or less, we need to do whatever we can, because otherwise it won't matter."

Of course it helps if you have picked up tips from healthcare professionals, like if you pinch the skin immediately above the biceps hard and there is no change in pallor nor slight reddening around the imprint when you let go, the casualty has dangerously low blood pressure (and that works on people with any skin colour), or if someone is unconscious you can find out if that is because they have passed out due to fear (erroneously referred to as 'passing out from shock'), or whether it has resulted from damage caused by the injury, by rubbing your knuckles hard up and down the breastbone - it hurts enough to bring you round if you can come round. If you can't get at the breastbone, you can stick your fingers into the armpit and squeeze the pectoral muscle with your thumb to get the same wakeup pain effect. Or my personal favourite for when performing CPR, "If you don't break at least one rib, you're not doing it properly!"

 

[NickM]

My original question and statements regarding tourniquets revolves around the fact I had been taught about them years ago, and haven't heard much about them since other than first aiders were discouraged from using them and they were no longer part of the any first aid training.

Notice MMN that we haven't asked how to apply them, just about current thinking about their use and it appears they are regaining ground. They are still not part of the average first aid qualification. You may also have noticed in my previous post I mentioned my other pass times, kayaking, canoeing and hiking. In these are environments help won't necessarily be minutes away but potentially hours and the potential for severe traumatic injuries are ever present. Now I have found out from this thread there are additional steps I could take in the event that I ever encounter a life threatening bleed I will endeavour to look for someone to provide training that would allow me to use it confidently should the need ever arise.

In no way are Ian and I suggesting we would rush out and buy a tourniquet set today and start applying them to people with a minor graze using information we have gained from an internet forum.

 

[Ian_Gere]

Actually I need to rephrase what I said above. What I meant was that, in this thread, I find what Mr Monkey Nuts has written patronising and lacking in imagination, not that he is either of those in general. As far as I'm aware he is a decent enough bloke and is without doubt a valuable member here, in that he has opinions and states them. Whether I agree with them in this instance or not, the forum thrives on discussion and we often learn something from disagreements, so long as, like here, they remain civil.

 

[Unrustle_Thine_Jimmies]

I'm not trained in anything but I do carry basic antiseptic stuff like Zelenka and Perekis (Don't know the english for them,sorry) Zelenka is a strong antiseptic that gets it's name from leaving a green stain on skin for a long time. Perekis is a mix between some sort of quick clotting thing and an antiseptic,helps reduce bleeding,it's mostly used for nosebleeds but works excellently for smaller cuts,like a nick of a knife or a thorn. Also have some bandages in my pack. Staff on site are all medically trained,I just carry this for bad scenarios,the site I play it is 400 acres large so I'm bound to be hiking along and some bugger of a thorn could cut my arm or something,it's happened before.

 

[Deek]

An interesting thing I have noticed recently is that the manufacturers of QuikClot and Celox are both now aiming products at domestic / first aid users - QuikClot for instance have developed a range of dressings for sports use and Celox have been promoting their products for work place use.

You still can't walk into somewhere like Boots and buy these products over the counter yet, but they are available to buy if you know the right places.

 

[bornleverpuller]

Bit of spit is all you need for the majority of wounds

 

[Ian_Gere]

Bit of spit is all you need for the majority of wounds

Yeah, that way you don't even have to go to hospital...

...to get MRSA, C. dificile, E. coli, the lurgy, Z1, etc.

 

[Mr Monkey Nuts]

I apologise if my statements have caused an offence and seem patronising, they are not aimed an any individuals in particular.

However my point still stands that this is a step above and beyond "first aid", if you are going to be carrying this equipment, you need to be trained and prepared to manage this level of patient and injury.

I have no doubts that as adults who display a level of maturity, both Ian and Nick may be capable of managing these patients with appropriate training, however I am very aware that not all Airsoft players are mature and adult enough to know the difference, I just don't want this thread dramatising and idealising the advanced "gucci" stuff to the younger generation and the less medically experienced, players who may read this and assume that a CAT is a standard level of first aid intervention required on the field.

 

[Ian_Gere]

You may be right to be concerned, Mr. MN, but I honestly don't think anyone, no matter how young or inexperienced, could mistake serious uncontrollable arterial bleeding for anything else. I mean, blood pumping out which does not stop when you apply pressure to the wound itself, or you can't because something is stuck into the casualty... it's not an ambiguous situation.

Yeah, there are branches off the main arteries which could be damaged creating a wound which pumps blood but does not require a tourniquet, but a squirt a couple/three millimetres wide, even going a couple of feet, is not 'uncontrollable' and i seriously doubt anyone could think it was.