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(M) Massive Hemorrhage

Home - Articles - MARCH - (M) Massive Hemorrhage - Page 6
Showing 31-36 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.

Mike Shertz MD/18D

XSTAT 12 Trainer on a Hog Thigh

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

🕖 Reading Time, 1 minutes Used the X-Stat trainers in class today on a hog thigh with a simulated femoral artery laceration. This narrow wound track is a challenge to pack with Kerlix Gauze, the X-Stat 12 applicator worked awesomely.

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A bar napkin, sitting next to a beer, listing the hateful eight signs to look for before administering prehospital blood in a trauma patient
Mike Shertz MD/18D

Prehospital Blood Administration and the Hateful Eight

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

🕖 Reading Time, 3 minutes One of the best parts of the Special Operations Medical Association annual meeting is connecting with your peers and discussing issues we all deal with.  One evening, while having a bar napkin discussion about prehospital …

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A collage of photos showing Mike's technique for creating an improvised tourniquet from the casualty's own pants: cut up each leg strips 2-4" wide that include the seam (for strength), wrap the upper thigh, and use a windlass to tighten the tourniquet.
Mike Shertz MD/18D

Improvised Pant-leg Tourniquets

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

🕖 Reading Time, 2 minutes Our first plan to manage massive extremity hemorrhage is to use a proven commercially available tourniquet. Barring that, create an improvised tourniquet using a cravat, or a strip of fabric, with a windlass for leverage. …

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Photos demonstrating using a casualty's pants as an improvised pelvic binder by cutting the pants up the front, winging the legs out, wrapping them tightly and tying around the casualty's pelvis
Mike Shertz MD/18D

Improvised Pant-leg Pelvic Binder

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

Pelvic fractures occur in 8% of major trauma patients. You can improvise a pelvic binder. 🕖 Reading Time, 3 minutes IED induced injuries resulting in traumatic lower limb amputation are associated with a 22% rate of pelvic fracture; half of …

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A photo showing the small time savings of using a single routed 7th gen CAT vs a 6th generation double eyelet routing.
Mike Shertz MD/18D

Single vs Double Routing of the Eyelet on the CAT Tourniquet

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

Change in CAT tourniquets from 6th to 7th generation 🕖 Reading Time, 4 minutes In October 2015, the 6th generation Combat Application Tourniquet, or CAT, with its double-eyelet buckle was discontinued, in favor of the 7th generation CAT which has …

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A green striped t-shirt lays on the ground covered in blood. But is it? How much blood is it actually?
Mike Shertz MD/18D

Visual Estimation of Blood Loss

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

Knowing the quantity of blood loss helps estimate the likelihood of shock 🕖 Reading Time, 5 minutes Having a sense of how much blood a trauma patient “spilled” on the ground can be very helpful for understanding and estimating the …

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