A Warning Re Quikclot

[FlyingHaggis]

I have CELOX in my medical bergin which i use on events , but I keep meaning to transfer some over to my personal medical kit i take into the field

I get my celox from spservices.co.uk

I use this company all the time for my medical supplies

 

[Redwall]

I noticed today RVOps are selling a quikclot pad (not powder).

Might have already been said in this extensive thread but here it is

 

[Martyn]

I give up.

 

[rik_uk3]

I give up.

The words, "peeing, wind, save, breath, your and into" spring to mind Martyn with this thread. Just give up and enjoy the weekend mate.

 

[Genty]

SP Services are also selling the FAST 1 Intraosseous Infusion device as well as a pocket emergency cricothyrodotomy kit. I've seen them both used on the telly so might buy one of each for my FAK. Just in case ;-)

 

[PeterH]

There must be loads of surplus equipment coming up for sale as there will be fewer "operators", perhaps we could club together and get a few yellow Sea Kings like they have on the telly :rofl

 

[cave_dweller]

SP Services are also selling the FAST 1 Intraosseous Infusion device as well as a pocket emergency cricothyrodotomy kit. I've seen them both used on the telly so might buy one of each for my FAK. Just in case ;-)

Stop it, they'll think you're serious...

 

[rik_uk3]

Don't forget
http://www.nxstage.com/chronic_renal_care/products/

 

[BoonDoc]

SP Services are also selling the FAST 1 Intraosseous Infusion device

It all boils down to training and experience. As someone who has used this FAST 1 device before as well as the Quick Clot/ Hemcon, please don't expect this to work as you see them on YouTube or the tele. Quick Clot worked well for a couple of years before being replaced by Celox Gauze. It took me a few times doing this on an actual bleeder before I got the hang of it. There was no time at the moment to read the directions or rely on the internet for proper applications.

Sure, it is nice to have all of the latest medical toys in your FAK. They are only as good as the operator. I can do miracles with a cut up T-Shirt without any medical supplies due to some good training.

Look lads (and ladies) get some training first.....THEN start thinking about all of the cool-guy toys out there.

 

[Graveworm]

I think the best advice is go with what you have been trained to do and you can't use what you don't have so train for having everything and nothing. No point in arguing really they all work very well at what they are supposed to do some are slightly better than others. They are only going to be used to treat a life threatening injury if they are used properly, so they can hardly make matters worse so long as you know what life threatening really looks like hence the training.

We get issued with Quikclot Z fold gauze now over Celox gauze as it's less bulky and easier to use. We also still get the powder as it works best in a few circumstances but I hear it's being phased out; they are all for extremity catastrophic bleeds where you can't use a tourniquet, which, incidentally, are no longer the anti christ and in fact the preferred treatment for cat bleeds (so long as you are trained) Direct pressure and elevation is very hard to maintain and not that effective where haemostatics would be indicated, indirect pressure is even harder. Self administering is where TQs and haemostatics are a big step up which I would assume is a consideration for the users of this forum I know it is for me. All field dressings do in those circumstances is soak the blood up to save it making a mess on the floor. The FAST is much quicker and easier than an IV especially with a limited number of responders and with a remote or trapped casualty. If you can't maintain your own airway and I can't maintain it for you, then I'll still stick a safety pin or 2 through your tongue (never heard of the suture thing before though) if it's all I've got.

 

[Ronnie]

If you can't maintain your own airway and I can't maintain it for you, then I'll still stick a safety pin or 2 through your tongue (never heard of the suture thing before though) if it's all I've got.

I do hope you'd try the recovery position first...

 

[Graveworm]

I do hope you'd try the recovery position first...

I'd definitely consider it though I'd consider that you being able to maintain your own airway at that point. It largely depends on the method of injury, if I know the method of injury and whether I liked you or not

In all seriousness the recovery position is often over emphasisised, as, in the real world, the contre indications are far too often present in an unconscious casualty especially in a rural setting. It worked really well for stereotypical swooning females in the 1950's (where most of the training diagrams seem to come from as well) and flat out drunks on a Friday night. It is useful after a tonic clonic seizure. It can of course, as a last resort, be a necessary evil with vomitus.

 

[Ronnie]

In the course of my career I have cared for many multi-trauma victims in the critical phase. I have only once come across a lad with a safety-pin through his tongue - and we were all deeply unimpressed by the technique. I would consider this an intervention of last resort at best.

 

[Graveworm]

In the course of my career I have cared for many multi-trauma victims in the critical phase. I have only once come across a lad with a safety-pin through his tongue - and we were all deeply unimpressed by the technique. I would consider this an intervention of last resort at best.

You need to get out more I've met some very interesting types with all sorts through their tongues

However as a way of maintaining an airway I agree, I've never done it in anger. But as I said if I can't and you can't and I've nothing else then it's probably better than dying, it's still taught.

 

[Genty]

8-| The safety pin method was openly published in Peter Steele's Medical Handbook for Walkers and Climbers, which was, for a long time my favoured remote medical handbook, but times move on.

To degrade to efficacy of the recovery position on an open, public forum or lay-people is not just laughable, it is irresponsible.

What are the contra-indications of the recovery position? Spinal injury? Airway always comes first whether you are an A&E consultant or have just been on a 4hr first aid course.

What has the 'rural setting' got to do with anything? Seriously. I don't know your background but if you want to go sticking pins in people, you crack on mate. Basic first aid taught basically to basic people will always save lives. Don't knock it.

 

[Graveworm]

I wasn't degrading the efficacy of the recovery postion it works great where it's indicated and I've used it often enough. It's not contra indicated if there is a spinal injury, it's where one is suspected so that's most trauma serious enough to render someone unconscious and it's suspected whenever someone is unconscious until I know the method of injury.

I wasn't knocking basic first aid either it does save lives, I was elsewhere saying it should be taught in schools. I was saying that other training might be useful in a bushcraft setting. Rural matters because unconscious but breathing is probaby more likely to be the result of a fall and therefore C spine considerations will effect things. Also you might not have a 6 foot by 6 foot space to kneel alongside someone and roll them over. I might also in some circumstances suggest off road driving lessons as an addition to BSM in no way would that be knocking BSM.

I agree airway does come before any spinal considerations (It no longer comes first) and since I have never used the safety pin clearly I have always used an alternative. But I am sorry if I really suspected spinal injury, and I had no alternative (and by god I'd look for one) then I would use a safety pin because then I could try to do both and if the injury is superior to C4 then airway or not they are likely not breathing on their own if I roll them over on my own.

 

[Genty]

Fair comment. Apologies.

 

[Martyn]

The problem when you get professionals talking about EMT, is that the conversation ramps up to advanced techniques. Best practice for an experienced professional isnt the same as best practice for a layman. While the kit itself isn't difficult to use, the hard part is knowing when it's right to use it and that isnt just a question of training, it requires experience too. Whether it's CAT keys, intra-osseous devices or haemostatic agents, they are all simple to use and require little skill to apply, but knowing when to use them requires assessment skills that are far outside the remit of the layman and even trained first aiders. It takes years of exposure to real world scenarios to gain the experience for assessments to become instinctive. You cant teach experience and you cant read experience. You only get it by doing it - a lot. It's the inappropriate use of such things as CAT keys and QC that cause problems. They have their place and are useful tools for the experienced technician, but for the inexperienced and untrained - which means most of the people on this forum, they can be and often are just a liability. We should be advocating simple techniques and basic first aid every time.

 

[Graveworm]

Martyn I think you make some excellent points but you did lump three disparate things together there and some techniques require more training/experience than others. I know it is perfectly possible to teach appropriate use of a tourniquet to the inexperienced as part of a 2 day or longer course and more and more courses do, fortunately now, include this. I think this is an excellent idea and real progress eg the off duty Police officer who saved the passenger on the July 7th tube train by use of a tourniquet.

Haemostatics is a small step up and has more training challenges I accept, but it can be taught to the inexperienced within realistic training but (this is only a personal view) I'd prioritise quite a few other things first especially for those in a civilian environment.

IO/IV access is, of course in a whole different arena and in isolation would not be much use unless as part of a whole IV therapy package which is definitely a different target audience. There is an ongoing debate around early provision of saline locks within PHTLS but that's another can of worms best left closed.

I will always promote training (including keeping up to date), only doing what you have been trained and basic first aid as definitley being the best bang for buck. In light of that my view differs slightly from you, that responsible discussion even of more advanced techniques with the appropriate caveats regarding training could encourage others to undertake training and highlight what they might look for in a training course.

 

[EdS]

Advanced techniques are all fine and dandy if the A&E, parapmedic can get to the casualty.

For example most of them would have seriously struggle to get down more than a grade 2 cave - and then be at a loss as to a) what to do to with their waterlogged and mud caked kit and b) evacuate the casualty. Not that an uncommon happening.Some situations require simple as possible with doig minimum additional damage. If that means a casualty with a broken femur and possible internal bleedin crawl or being dragged as even teh underground stretch wont get around hte twists so be it. Pain relief and bset monitoring posssible.