Medical Poll #1

[Patriotic Sheepdog]

I will be posting a few polls over the next few weeks. These are for all of us to think about our medical gear/equipment/training.

This is a private post, so no one will know what you answer. Don't be shy. Ask questions if you want if you answer "I don't". There are several here that can help.

[qrprat77]

I've always heard a credit card can stop the lung from collapsing in a fix, but I bet there's a little more to it than that!

[610Alpha]

Needs a third option..."I think so but its been a while since my training"

I believe you can use Cling wrap to seal the hole but not 100% sure.

[TyrannyUnleashed]

I don't have training for this. But on the bright side if I have this happen to me, I'll be fine as long as my wife is around (she's a medical provider). But it would stink for her if she get's in that position ;-).

Seriously, we are just starting to work on medical emergencies and procedures. Funny that this is something she is willing to help me prep for along with water. Other important items, not so much. But I guess something is better then nothing.

Any help on this and any other subjects will always be much appreciated. I have really been learning a lot since joining here Thanks to all of you!

[Grand58742]

Like elittle, it's been a while so to speak.

But the question is, I have the training and the tools. But which chest seal would work best?

[monkeybird]

http://www.amazon.com/Rusch-Asherman.../dp/B0015TE9N4

While you can use any air tight material, this seal is used by the Navy Seals and is rated one of the best. It's only $12.90.

[jmsneorrcom]

Asherman chest seal is what we use on the fire department. any thing that will seal the hole against air entering will work -saran wrap or a cigarette wrapper will work in a pinch. you need to seal it on three sides, leaving the fourth open so that air can escape but not enter again. then you need to lay the victim on their injured side, to let gravity help you keep the pressure down. the problem is long term care to reinflate and heal the wounded lung.

[Patriotic Sheepdog]

Thanks for the replies thus far...
There are several "devices" on the market for sucking chest wounds. I have heard the Asherman is one of the best, and have heard good things about the HALO chest seal as well. If I remember correctly the HALO comes with two seals in the kit. I have seen the HALO's for about $15-20.

Bottom line, know how to use whatever you stock, but also know how to improvise. Hopefully you won't run out of whichever one you stock, but you need to have a backup. Vaseline gauze can work, but you need to know how and when to use whatever you have.

[Matt In Oklahoma]

Coming back to this, i know its an old thread but when i was first trained in the old days to seal the wound with plastic. Now with changes it's seal but make a valve. I have trained on using field expedeant stuff like the plastic wrapper on the bandage but i needed to catch up with technology and get more realistic IMO.
I finally got to a tactical team medic who sacrificed an Ashermans to let me see and try it. Its pretty simple just clean the area, stick it with the valve over the wound and it should start working. At $12 - $15 its a worthy investment to have in a kit or maybe all the kits - once you learn how to use it. I got mine in today and its my small addition without crunching the budget.



This video is not a subsitute for real training but its a learning tool and its hard to get volunteers to take one for the team for weekend stuff

[Grand58742]

This video is not a subsitute for real training but its a learning tool and its hard to get volunteers to take one for the team for weekend stuff

I wondered why you were so pushy about getting me to come along lol

"Just stand still, this will only hurt for a second..."

The Bolin as well as the Asherman work great. Just another option in case your particular medical supply dealer doesn't carry one or the other.

[goatlady]

the problem is long term care to reinflate and heal the wounded lung.

so the next step is???? Those devices are a temporary fix to a really severe problem. Seems to me if there is not a thoracic surgeon handy and immediately available, some triage may be in order in a SHTF situation.

[Grand58742]

Very good point. Perhaps Survival Doc can shed some light on this.

[Matt In Oklahoma]

the problem is long term care to reinflate and heal the wounded lung.
so the next step is???? Those devices are a temporary fix to a really severe problem. Seems to me if there is not a thoracic surgeon handy and immediately available, some triage may be in order in a SHTF situation.

True and like alot of other medical issues the same could be said like cutting major arteries, cancer, alzehimers etc. SHTF your hosed with me and what I can do but I prepare for today and I cant control what happens tomorrow. I train hard, hunt, shoot, work in a sometimes rough environment and just in life a whole lot happens that could cause this so IMO this is a critical area above and beyond the bandaid to prepare for. Who knows SHTF maybe at some point a Dr might be located or join. Gotta try, thats all i know

[Patriotic Sheepdog]

Remember, the chest is normally a sealed system. When you have a wound that causes an opening in the chest wall there will be air drawn into the chest cavity when the patient breathes. You will likely see frothy, bubbling bloody liquid at the injury site. Sealing with a chest seal ASAP is the treatment to help prevent a tension pneumothorax. This is where the air continues to get drawn into the chest cavity and continue to build up pressure. When this happens the pressure will start compressing the large vessels, think aorta and vena cava, and also progress to collapse the contralateral lung.

Okay, you have sealed the lung quickly without letting it progress to a tension pneumothorax, what to do next? This is where it gets touchy, as a chest tube needs to be inserted to allow the air trapped inside the chest cavity to escape to the outside where it belongs. Here is a description on how to insert a chest tube. For those that are visual learners, here is a YouTube video showing how to insert a chest tube.

Look how they inserted this tube under sterile conditions. Sterile surgical gloves, sterile drapes, sterile equipment...you get the point. In a PAW how many of us will have this available? Are you stocking the medical supplies you need? I'm not saying that it cannot be done, but it will be more difficult for your medical team. What wasn't told is that patients will need antibiotics as well.

Now, be sure you are dealing with a pneumothorax. You don't need to be inserting anything into the chest unnecessarily. We have talked about a pneumothorax, but what about a hemopneumothorax? The same thing except now there is not only air in the chest cavity, but blood as well. As you can imagine, this is more concerning. What has caused the blood? And how are you going to stop it? Without someone experienced in chest surgery, you can only hope that when the B/P drops that the wound will seal itself and your patient will survive.

Some aspects of medicine in a PAW will not be pretty. We will lose many people to things that today would be taken care of with a simple med, simple procedure or early recognition with a modern day imaging study.

[goatlady]

Thank you, PS, exactly my point. We MUST develop the proper mind set for these potentially severe and "ethical" situation. The mind set that serves us well now just will not hack it later, I don't think, and that in itself can cause some severe emotional trauma for the "caretaker."