Forums / Strategies, Tactics & Training / Treating wounds, pt 7 Control bleeding (Basic dressings and tourniquets)

5 years 3 weeks ago, 11:01 AM

runawaygun762

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Opening an airway and restoring breathing actually comes before controlling bleeding, but maintaing airways and rescue breathing are very difficult to explain well in print and are more easily demonstrated face to face. For airway training, you should enroll in a Red Cross class, as that information is exactly the same as the info I can give you. i think. I don't know if the RC teaches the jaw thrust method or not, but even if it doesn't, the basic head tilt, chin lift method works for most situations. So, on to controlling bleeding.

I'll break them down by steps first, and explain as needed.

1-Expose the wound. Cut or remove clothing to fully expose the wound so you can see exactly what you are working with. If the clothing is stuck to the wound, do not remove that. Cut around it and leave the clothing there.

2- If there is an object protruding from the wound (knife, shrapnel, debris, etc), do not attempt to remove the object. Use padding around the object to immobilize it, then bandage as well as you can.

3- Apply a dressing. Using as sterile material as possible, apply the dressing to the wound. Hold the dressing in place and secure the dressing using any available material. When tying the dressing in place, be careful not to use any narrow item that may cause further tissue damage. Yes, Greasy, this means you shouldn't use zip ties or soldering wire to hold an oil rag onto a gunshot wound. Hah hah hah. Tie the knot on the outside edge of the dressing. It should be a nonslip knot with enough room to slip two finger under. This will prevent the bandage from becoming a tourniquet should the area begin to swell. Apply manual pressure to the wound and elevate the wound above the heart unless the wound is on an extremity with an unsplinted fracture.

4- Apply a pressure dressing. If the serious bleeding has not stopped with a dressing and manual pressure, you will need to apply a pressure dressing. A pressure dressing helps to control bleeding by compressing open blood vessels and aids in clotting. For a pressure dressing, you will need a piece of wadded up material that you can place on top of the first dressing, right over the wound. Then take another piece of material and secure the wadding. Tie a nonslip knot directly over the wound, with just enough room to slip one finger under it.

4- Apply a tourniquet. If a pressure dressing has failed to stop the serious bleeding, you need to go with a tourniquet. A tourniquet is also the first step if a limb has been amputated. This does not include the head. If the head has been amputated, you probably don't have to do any first aid on that one. To apply a tourniquet, you will need a piece of material the same width as three or four fingers and a sturdy object to twist the tourniquet. A pen or pencil is the right length, but unless it's a nice metal pen, they typically aren't strong enough. Tools such as a ratchet or wrench work very well. For maximum effectiveness, the tourniquet should be applied to the upper arm or leg. Wrap the material around the limb, several times if possible. Tie a half knot (Like the first knot when tying your shoe). Place the stick on top of the knot, then tie a full knot (granny knot) on top of the stick. Then twist the stick until the major bleeding has stopped. Secure the stick to the limb with the tails of the tourniquet of another pice of material to keep it from loosening. Once a tourniquet is applied, do not loosen it. Onluy medical personnel at the hosptial should loosen or remove it.

There are some belts designed to be used as tourniquets, the web belt types like shooting instructors wear. These can be used, but a pad needs to be placed under the buckle or it will pinch the limb, potentially causing nerve or tissue damage.

"I have always been a soldier. I have known no other life. The calling of arms, I have followed from boyhood. I have never sought another." From The Virtues of War, by Steven Pressfield.

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