Although anecdotal stories of tampons being used in military settings for hemorrhage control may exist, using a tampon as a bandage or “blood sponge” is very different than trying to stop massive hemorrhage with one. The military has a long history of one generation handing down unofficial lessons learned to the next generation. It seems possible some military medic somewhere was told, “it was the way to go,” but it doesn’t mean it works. One member of a medic team I talked with remembers specifically being told the instructors had tried tampons for hemorrhage control, but they were never effective.
Named arteries (generally the larger ones such as the axilla, brachial, radial, etc) can bleed several hundred milliliters of blood per minute when perforated. (200 milliliters is about 40 teaspoons for those metric-adverse, or 4 shot glasses if that’s your preferred unit of measure). Prehospital hemorrhage control options for this kind of bleeding are tourniquets, if the bleeding source is amenable to circumferential pressure, for instance, a limb, or wound-packing if the bleeding is in “junctional areas” like the neck, axilla, and groin.
To control life-threatening hemorrhage anywhere in the body, the goal is to stop the bleeding. That is generally accomplished by encouraging the blood to clot and essentially “seal the hole” in the bleeding blood vessel. With wound packing, this is done by tightly packing gauze directly at the point of bleeding. When enough gauze is packed into the wound, the pressure exerted by the packing will be more than the bleeding blood vessel’s bleeding pressure. This slows or stops the bleeding and allows for clotting to occur. In a ballistic gel wound model, measuring a volume of 53 ml, a Kerlix–like gauze exerted 156 mmHg pressure in the wound when packed by well-trained combat medics.
Still inclined to keep tampons in your IFAK or first aid kit? The average tampon contains approximately 2 – 2×4 inch pieces of gauze. Kerlix gauze is between 3.6-4.1 yards long. From a cost perspective, tampons also make no sense to stock in an IFAK. If a tampon costs $0.24 each (at bulk Amazon pricing) and is approximately 4” of gauze, it would take $8.64 worth of tampons to equal the length of packing material in one $1.99 roll of Kerlix (at non-bulk pricing). If someone is bleeding to death from a junctional wound, shoving a 4×4 in the wound is not going to accomplish the same thing as 156mmHg pressure from 12 feet of gauze.
Hemostatic gauzes help with clotting by providing pro-coagulant materials or mucoadhesive, thus making it easier for blood to clot. The goal of the packed gauze isn’t to absorb blood, but to encourage clotting. That is exactly how direct pressure works. Provide so much pressure on the bleeding site that blood can’t come out, which allows the clot to form. With no pressure, the blood keeps washing the body’s efforts to form a clot out with the blood. If you need to improvise to pack a wound, there are much better and readily available choices than a tampon, including strips of fabric.
Tampons are not designed to stop bleeding, but rather simply absorb it. “The function of the internal tampon is to absorb menstrual blood inside the vagina after it has left the uterus, preventing it from leaking out, and thus providing suitable protection with total discretion.”
How much blood does a woman even lose during menses? “Most women will lose less than 80 ml (16 teaspoons) of blood during their period, with the average being around 6 to 8 teaspoons. Heavy menstrual bleeding is defined as losing more than 80 ml with each period.” Remember a shot glass is 50 ml. Though inconvenient, this is not a lot of bleeding.
How much blood is the most absorbent tampon made to soak up? The most absorbent tampons manufactured are “Ultra-absorbency Tampons” which absorb up to 17 ml of menstrual blood.
FUN FACT!
For a little history on the tampon, there are different accounts of its first use. Women have been fashioning solutions to absorb menstrual flow since the Egyptian era, including intravaginally. The first commercial applicator tampon was created by Dr. Earle Cleveland Hass. Dr. Haas obtained a patent for this tampon in 1933. He combined the terms “tampon” and “vaginal packs” to create “Tampax”.8
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First Aid kits and First Aid courses, as commonly thought of, deal with topics more akin to Band-Aids than tourniquets and life-threatening injuries. STB (Stop The Bleed) is more used for stopping the bleeding and providing lifesaving techniques to that end.
We keep IFAKs in our vehicles and co-locate them in the house with fire extinguishers and flashlights. If you’re planning to be prepared in an emergency, like a fire, then you may need medical equipment, and more light is never a bad thing.
Our IFAKS are stocked to provide lifesaving intervention. We prepare for massive hemorrhage, impaired airways, and tension pneumothoraxes. A first aid kit, more appropriately called a boo-boo kit (or snivel kit, as some call it) and is a convenience: no one ever died of a scrape or a splinter. Massive hemorrhage can kill a casualty in minutes. Lives may depend on knowing what is in your kit, where it is, and how to use those items. You can never have too much training and practice makes perfect.
Band-Aids, antiseptic wipes, rolled gauze, and moleskin may be part of your first aid kit. However, we recommend your basic first aid kit be kept separate from your IFAK (or should we call it your ITK?). The reason is this: much like scissors are never where you expect them to be because someone has “borrowed them” (and neglected to put them back), if there are every-day items in your IFAK/ITK that someone may need to get into, like Band-Aids they will likely trot off with your IFAK/ITK. It will never be where you expect it to be in an emergency.
That is also a separate kit. Many people advise being prepared with essentials including sun/rain protection, fire starters, whistles, navigation tools including a map and compass, etc. This would be known as a “GO BAG” or “72 Hour Kit”. The possible exception would be adding a light to your IFAK/ITK.
Whether you buy generic Band-Aids or Johnson & Johnson doesn’t matter. A Band-Aid’s job is largely to keep small cuts from getting blood on your clothing and to keep them clean. For buying the supplies for your IFAK/ITK, quality matters because having proven life-saving supplies in an emergency where someone’s life depends on your equipment matters. And training in using those items matters just as much as what you carry.
]]>It’s an expression that goes without saying: when you are prepared for a crisis, you are less likely to panic. But how many of us have taken it to heart?
There are some fairly significant ways to be prepared for all the unexpected things that happen in life—like saving the life of a person with a massive bleed.
A person who is bleeding from an injury can die within five minutes. Chances are, the ‘first responder’ on the scene of a traumatic situation will be a private citizen. Do you have an individual first aid kit (IFAK), Trauma Kit or First Aid Kit, and if you do, do you know what’s in it or how to use it?
Here’s a hint. You’ll need more than the basic equipment that takes care of minor cuts, bruises, and burns. Bleeding injuries are in a whole other realm. Here are 8 things you should have in your Trauma/First Aid Kit or IFAK if you find yourself on the scene of a massive bleeding event.
Gloves keep your hands clean and help protect you from exposure to blood-borne viruses and bodily fluids. These gloves are meant to be disposable. Never wash or reuse them; discard them immediately after tending to the injured person. That means, do not get in your car and drive away with them still on your hands! Other tips for gloves:
To get to a person’s injury, you may need to cut away clothing or a seatbelt. Your trauma shears should be rugged with a blunt tip so you can safely get between the skin and the clothing. Time is of the essence, so the fastest way to cut and remove clothing is to rip through the seams and hems.
Remember this: studies show that when a tourniquet is properly used to slow blood flow, odds of survival increase over 500%! If you’ve tried direct pressure and the spurting injury hasn’t stopped, use a tourniquet. Tourniquets are placed on the bleeding limb several inches above the part of the injury that is closest to the heart. Because not all limbs are created equal in size and shape, make sure you stock a variety of tourniquet options and sizes. Here’s a tip: Some tourniquets are more intuitive than others, but all require practice.
A deep or bloody wound that doesn’t respond to pressure needs to be packed—immediately, deeply, and tightly! Pack gauze into the wound with your finger while at the same time applying pressure. Putting your fingers into a wound probably won’t happen without some hesitation, but just remember, you aren’t going to hurt the injured.
These blood stoppers, like QuikClot, contain active ingredients that when put in contact with the wound, speed up the clotting process and help stabilize the injured person. Blood stoppers are especially useful when it’s difficult to apply the right force of direct pressure to the wound. Here’s a tip: Save the packaging for medical personnel so they’ll know what you used.
Compression is the ultimate response for a bleeding injury. Once you’ve packed a wound, apply a pressure dressing to maintain pressure and keep the wound packing in place. The Elite and Elite Pro both come with a 4”ETD.
Chest and abdominal wounds like a gunshot or a stab are the most difficult to stop outside of a hospital setting. Chest seals or dressings placed directly over the hole in the open cavity allows air and blood to escape while preventing the re-entry of either. The Just In Case Rescue Elite Pro comes standard with DUAL CHEST SEALS.
Yes, the permanent marker may not seem like something you would need in your IFAK, but it is, in fact, an important tool to have in case of a massive bleeding event. Use it to write down the time you applied a tourniquet, what you packed the wound with, and what type of antiseptic was used. All these things are important for EMS or the incoming medical facility personnel to know.
With so many proven products to stop and control severe bleeding injuries available, make sure you purchase an IFAK, Trauma/First Aid Kit based on your budget, your purpose, and your training level. We invite you to explore our complete kit solutions at www.JustInCaseRescue.com
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Instruction is lead by former Green Berets Don Deyo and Joel Gupton of D-Dey Response Group. D-Dey Response Group instructors are the most experienced in the public safety industry with both Special Forces instructors and highly trained Paramedics.
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When it comes to emergency medical equipment, most of us know better than to price-shop, yet thousands of fake “CAT” tourniquets are sold on Amazon, eBay, and similar sites. The genuine C-A-T (Combat Application Tourniquet) made by North American Rescue, is favored and proven by Combat Medics, used in Stop The Bleed kits, and is deemed 100% effective by the U.S. Army Institute of Research. Special Operations Forces, many Federal Law Enforcement agencies, and countless Police Departments and State Patrols carry a CAT Tourniquet with them every day. You can get yours at Just In Case Rescue along with a nice Trauma Kit.
Many of the fake CAT Tourniquets appear legitimate and could pass a casual inspection. But they are not reliable due to the quality of materials used and the methods of production and assembly. Counterfeit tourniquets are known to fail — the windlass may break off in your hand or bend so that it cannot be secured, the buckle may fail, and internal stitching can come apart. If the tourniquet fails, severe bleeding will resume, endangering the injured person and decreasing their chance of survival.
These fakes were more prevalent a few years ago, when the Generation 6 Combat Application Tourniquet was the latest version. Even Law Enforcement and First Responders were getting fooled by them. In 2013, New Hampshire first responders experienced a “catastrophic failure” when two counterfeit tourniquets failed at the scene of a motorcycle accident. Similar stories were alarmingly common at the time, and these things still happen, though not as frequently.
When the CAT Generation 7 appeared, it made the counterfeiters’ jobs somewhat harder. The Gen 7 windlass is more robust and has deeper ribbing. There is a distinctive single-feed routing buckle with raised “CAT” lettering, which few, if any, fakes have been able to mimic very well. The same raised lettering appears on each end of the windlass, just below the ribbing. Perhaps the biggest “tell” is the sonic welding that binds the buckle to the strap. The majority of fakes are sewn, instead of having the sonic welds shown in the picture below.
Someone’s life may hang in the balance, so if you have a CAT Tourniquet in your IFAK or Trauma Kit, please spend a few minutes to assure yourself that it is the real item. If you are shopping or planning to shop for a tourniquet or a kit containing a CAT tourniquet, use a reputable, authorized dealer of North American Rescue products and avoid the discount resellers who populate Amazon, eBay, and other “bargain” websites.
Expect to pay $27 - $39 for the genuine product. If you are paying less than $20, it is a near certainty that you are purchasing a counterfeit. With so much at stake, this is not the time to try to save a few dollars.
These kits are designed to be used by anyone present at an emergency, much like an AED (automated external defibrillator). The kits are usually small, single-purpose bleeding control (B-CON) kits which contain items selected to enable untrained or minimally trained laypersons to stop or significantly slow loss of blood at the point of injury. These are often referred to as “Stop the Bleed” kits, because the Stop the Bleed initiative has been a leader in promoting their presence and use.
Prior to the STB initiative, preventable deaths due to bleeding injuries from industrial, and farming accidents, car crashes, gunshot wounds, terrorist violence and even recreational mishaps, were alarmingly common. The fact that many of these fatalities are preventable with immediate treatment became apparent during the wars in Iraq and Afghanistan when tourniquets were adopted by all combat personnel. It took several years of tourniquet use in combat zones to compile sufficient data, but once done, the case for educating and equipping the public was too compelling to ignore. The Stop the Bleed initiative is now administered by the Department of Homeland Security (DHS), which has created a website to promote awareness and education:
“Stop the Bleed is intended to cultivate grassroots efforts that encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.”
WHERE are Stop the Bleed kits?
The short answer is “they’re almost everywhere, if you know where to look”. The STB initiative can be credited for at least some of the dramatic rise in the number of STB kits now found in public places, as well as for the hundreds of thousands of non-medical professionals who have taken very brief but very effective Stop the Bleed trainings that are now widely available. Many who have received such training have taken it upon themselves to buy or build their own kits for their homes, shops, Jeep, cars, RV, Side x Side, ATV, UTV, packs, four wheelers, boats, range bags, or even for every-day-carry (EDC) in their pockets.
In addition to cabinets shared with AEDs, dedicated STB Cabinets containing multiple single-treatment STB kits are becoming more common in industrial settings, recreational facilities and public places where the sheer density of human numbers increases the possibility of multiple injuries.
In facilities such as schools where lockdowns are probable in the event of an active shooter incident, single kits are placed in safe corners of classrooms, out of the line of sight from the doorway. Multi-treatment kits are also commonly placed in central locations in the building such as near the main office, library, cafeteria, and even out on ball-fields (central locations might become inaccessible in a lockdown situation).
AEDs and CPR training—a true game changer
According to the American Heart Association, each year in the U.S., there are approximately 359,400 Emergency Medical Services (EMS)-assessed cardiac arrests outside of a hospital setting and on average, less than 10% of victims survive. But communities that have advanced comprehensive AED programs including CPR and AED training for first responders, have achieved survival rates of nearly 40% for cardiac arrest victims! It is therefore little wonder that AED cabinets have become ubiquitous, now found in every location from airplanes to zoos.
It makes sense that those cabinets should also house bleeding control kits. They are already well placed in high population-density, high visibility/accessibility areas. Adding the STB kits to existing AED cabinets saves the expense of installing additional alarm locks (AED cabinets are usually alarm-rigged so that responders are automatically notified of an emergency when the cabinets are opened).
WHAT DIFFERENCE can Stop the Bleed Kits make?
According to the Journal of Emergency Medical Services (JEMS), around 5 million people die every year worldwide from trauma, and exsanguination (bleeding out) accounts for approximately one-third of these deaths. Data from the wars in Iraq and Afghanistan shows a reduction in battlefield deaths caused by traumatic bleeding from extremity injuries by up to 85%.
This statistic alone would indicate a tremendous upside to training and providing public access Stop the Bleed equipment for civilians to deal with hemorrhagic bleeding. The principles are so basic that only a few hours are required for most people to gain a lifetime of ability—and perhaps more importantly—the confidence that they can intervene to save a life in an emergency.
WHAT IS IN a Stop the Bleed kit?
STB kits contents are not rigorously defined, though kits bearing the official Stop the Bleed logo are required to be submitted to and approved by the Department of Homeland Security.
STB kits typically contain tourniquets for stopping extremity bleeds, plus gauze and pressure dressings for dealing with thoracic and groin wounds and sometimes chest seals. Just In Case Rescue has everything you need for STB and much more.
The tourniquets are often windlass-driven types such as a C.A.T., the SOFTT-W or the XT by SAM Medical. Some STB kits contain the elastic SWAT-T tourniquet, which can also serve as a pressure dressing cover, and may be less intimidating to the untrained civilian responder.
Gauze and pressure dressings can be extremely effective in the hands of someone trained in the wound packing techniques taught in bleeding control classes. Hemostatic gauze such as Celox, Quickclot or Chito-SAM, used in conjunction with wound packing, can greatly reduce time required to stop blood loss. This can save lives in the case of a mass casualty incident, or any situation where time for treatment is limited.
Other usual STB components include gloves (to protect the responder from possible blood-borne pathogens) and shears, which can rapidly remove clothing from a wound site to enable treatment.
More elaborate kits designed for use by trained responders are sometimes loosely referred to as Stop the Bleed kits. Such kits can contain items unrelated to bleeding control, such as decompression needles and nasopharyngeal or oral airways. Public access STB kits rarely contain such materials, as their misuse can endanger patients.
Your Part in the Stop the Bleed Effort
Public access Stop the Bleed kits have already proven their worth, and are credited with numerous lives saved. Despite their simplicity, their basic components enable most people to effectively address life-threats at the scene of injury, so nobody should be afraid to use them when needed. Many law enforcement and EMS agencies have expressed their hope that STB kits become as prevalent in public places as AEDs.
“You are the help until help arrives” is the maxim that should apply to all of us, should we find ourselves with an injured person who is bleeding profusely. It is up to each individual citizen to make mental notes of where we have seen them, familiarize ourselves with the components of the kits, and gain the minimal knowledge required to employ them effectively, and to accept our role as first responders.
If you need a kit, Just In Case Rescue has your back! Remember, "Don't be a victim, BE PREPARED!"
]]>First aid kits include a variety of items that will help treat cuts, scrapes, and injuries including sprains, burns, and supplies for a variety of ailments that are common. Also make sure the first aid kit is easy for everyone to open so when an emergency occurs it is not about where the kit is but that it can be used for the situation. With a JUST IN CASE RESCUE kit, it comes in an easy rip away pouch and is easily opened with two zippers.
JUST IN CASE RESCUE kits contain gauze to cover open wounds. Includes medical tape that can be used to keep a wrap or gauze on the skin. Another important item is Band-Aids that can be used in case of minor scrapes and cuts. Also include rubbing alcohol to clean out some open wounds. Hand sanitizer can be used to wash the hands of the person that will be treating the injury. Antibiotic cream is also good for cuts and scrapes. Those are just some of the important items included in our kit.
First aid kits are necessary for every household no matter the age of who lives in the home. Injuries can happen anytime and anywhere. When you have a first aid kit within easy access of wherever you are you will ensure the safety of everyone. First aid can reduce infections from open wounds and injuries. It can also reduce the severity of an injury. You cannot always keep your family from getting hurt but you can protect them when they get injured with a first aid kit.
]]>Whether you are thinking about a small JUST IN CASE RESCUE kit for your car or something more substantial for work, we have what you need and can customize for your particular wants and needs. Whatever you decide, always have a JUST IN CASE RESCUE kit nearby. You’ll feel better knowing you can help somebody in need. Maybe even yourself!
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