Trauma Equipment In-Service

Rotterdam Emergency Medical ServicesDouglas Hexel, AEMT-P, NYS CLI

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.

Agenda

• New Bag

• Contents

• Quikclot

• Combat Application Tourniquet (C-A-T)

• Emergency Trauma Dressing (ETD)

• Hy-Fin Chest Seal

New Bag

New Bag

New Bag

New Bag

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

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.

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.

Quikclot Directions

1. If the location of the wound allows, apply a tourniquet.

Tourniquet

Quikclot Directions

2. If needed, wipe or suction away any pooled blood.

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).

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.

Quikclot Directions

5. Cover wound with standard gauze and write ON the dressing that quikclot has been used.

Quikclot Directions

6. Ensure that all ED staff are aware of quikclotplacement. Quikclot requires surgical removal.

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.

C-A-T Directions

C-A-T Directions

C-A-T Directions

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.

ETD Directions

1. Place sterile pad side down on wound

ETD Directions

2. Begin wrapping with tension on bandage to create tight dressing.

ETD Directions

3. If necessary to apply more pressure, twist the bandage over like with old pressure dressings.

ETD Directions

4. Continue wrapping tightly and secure with built-in C-clips.

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.

Hy-Fin Directions

1. Wipe blood/dirt from around wound

Hy-Fin Directions

2. Grip red tab (not pictured) and peel backing from dressing

Hy-Fin Directions

3. Place dressing with adhesive side down, centered on the wound

Hy-Fin Directions

4. Firmly press dressing onto wound, assuring it adheres on all sides

Hy-Fin Directions

5. Monitor for tension pneumothorax and perform needle decompression as needed.

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.

Questions/Comments

Questions? Comments? Concerns?

Please direct them to me at dhexel@gmail.com