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(M) Massive Hemorrhage

Home - Articles - MARCH - (M) Massive Hemorrhage - Page 3
Showing 13-18 of 38 results

Massive hemorrhage is the leading cause of preventable death from injuries.

How much blood loss is too much?

In December 1970, the US military published data on 7,800 soldier and Marine casualties from the conflict in Vietnam. In that data, specifically 10% of combat fatalities were from extremity hemorrhage. This dataset would later form the first TCCC guidelines in 1996. With the widespread adoption of tourniquets by the US. Military in the early 21st Century, death from massive extremity hemorrhage is now unusual in combat. This improvement has lead to greater awareness of massive hemorrhage from “junctional areas” like the neck, axilla/armpit, and groin, areas not amenable to circumferential tourniquet placement. To be facile at controlling massive hemorrhage, wound packing is a needed but often neglected skill set.

A photo of the burly chest of an operator with an American flag and CAT tourniquet staged on the exterior of his gear, center line
Mike Shertz MD/18D

Tourniquet environmental wear: is time of the essence?

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, Equipment

CAT Environmental Breakage 🕖 Reading Time, 3 minutes We receive frequent questions about shelf-life and environmental degradation of tourniquets. There has been some discussion in the US Department of Defense about declaring a five-year self-life for new, unused commercial tourniquets …

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A diagram showing how the landmine umbrella wounding pattern occurs
Mike Shertz MD/18D

Landmine Umbrella: Not for a day at the beach

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, MARCH

🕖 Reading Time, 9 minutes When a casualty steps on a blast mine or is very close to an explosive charge, the explosive force travels up the leg/limb of the casualty stripping skin, fascia, and muscle off the bone. This …

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Neck wound qualifies as junctional hemorrhage
Mike Shertz MD/18D

Junctional Hemorrhage: The next frontier for hemorrhage control

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage

The term “junctional hemorrhage” refers to injuries and bleeding occurring at the transition zones between the extremities and the torso. 🕖 Reading Time, 4 minutes The term first appeared in the medical literature in December 2009. Although not an extremity, …

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A CAT tourniquet, Nonin Pulse Ox, and Doppler displayed on a table
Mike Shertz MD/18D

Head to head: Doppler vs. Pulse oximeter as a training tool for tourniquet efficacy. Doppler wins.

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage

🕖 Reading Time, 5 minutes BLUF:* Is there a role for using a fingertip pulse oximeter as a training tool for tourniquet placement? We believe the answer is no. Considering the relative expense of a quality, FDA approved model pulse ox, a …

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Social Media post announcing Deputy Meg Just's OSSA Lifesaving Award after taking Crisis Medicine's TC2 class
Mike Shertz MD/18D

Deputy receives Lifesaver Award one month after online training and credits Crisis Medicine

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, (R) Respiration

🕖 Reading Time, 3 minutes When Deputy Just responded to a call regarding gunfire, she didn’t know there was a victim until she heard the 911 operator giving care instructions to bystanders. She arrived near-simultaneously with four other officers. As …

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Mike Shertz MD/18D

Wound Packing race Gauze vs XSTAT

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage

🕖 Reading Time, 1 minutes Kerlix Gauze packing can generate up to 197 mmHg at the bottom of the wound and 45 mmHg on the sides. Xstat can generate 156 mmHg and 123 mmHg respectively. Although it’s unclear XSTAT is …

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