Bleed control - personal program

[roadrunner]

What does the injury list look like that would call for the use of a tourniquet?

How many of y’all carry around AED’s?

Severed femoral artery and that's only if you can get the tourni applied within 30 secs...

 

[roadrunner]

Okay @Marbles. Please explain what made you giggle like a little girl...

 

[Marbles]

Okay @Marbles. Please explain what made you giggle like a little girl...

Average blood flow through the femoral artery is 650 ml/minute +/- 250 ml/minute. A 200 pound adult male will have about 6 liters of blood volume.

Up to 15% volume loss produces few symptoms, so at least one minute of a completely severed femoral will give only a slight elevation in heart rate.

15-30% results in elevated heart rate and respiratory rate and narrowed pulse pressure, but at most a slight decrease in BP. So at least 2 minutes of normal function with a completely severed femoral artery.

30-40% starts to generate a marked drop in blood pressure and changes in mental status. Above 40%hypotension becomes worse, pulse pressure becomes significantly narrowed, and altered mental status becomes worse.

The absolute worst case is probably 3 minutes of function, throw in compression from surrounding tissue and from the likely hematoma, as well as arterial spasm and the slow in bleeding from dropping blood pressure, and that a nicked artery can result in bleeding out and in most cases there will be more time.

Arteries are muscular structures and tend to spasm when severed, the more traumatic the injury, the more likely they are to spasm. It is not unheard of for limbs that are initially ripped off by machinery to produce very little bleeding at first.

Beyond that, injuries to smaller arteries can sometimes best be managed by a torniquet, which compounds the impression of fatalism that you only chose to list the femoral.

 

[roadrunner]

Average blood flow through the femoral artery is 650 ml/minute +/- 250 ml/minute. A 200 pound adult male will have about 6 liters of blood volume.

Up to 15% volume loss produces few symptoms, so at least one minute of a completely severed femoral will give only a slight elevation in heart rate.

15-30% results in elevated heart rate and respiratory rate and narrowed pulse pressure, but at most a slight decrease in BP. So at least 2 minutes of normal function with a completely severed femoral artery.

30-40% starts to generate a marked drop in blood pressure and changes in mental status. Above 40%hypotension becomes worse, pulse pressure becomes significantly narrowed, and altered mental status becomes worse.

The absolute worst case is probably 3 minutes of function, throw in compression from surrounding tissue and from the likely hematoma, as well as arterial spasm and the slow in bleeding from dropping blood pressure, and that a nicked artery can result in bleeding out and in most cases there will be more time.

Arteries are muscular structures and tend to spasm when severed, the more traumatic the injury, the more likely they are to spasm. It is not unheard of for limbs that are initially ripped off by machinery to produce very little bleeding at first.

Beyond that, injuries to smaller arteries can sometimes best be managed by a torniquet, which compounds the impression of fatalism that you only chose to list the femoral.

You forgot to mention how quickly shock can and will take affect on a person self treating a wound all the while digging out their compression bandages and tourniquet to stop or at least slow the bleeding.

Once the mishap occurs, there will be a moment of surprise realizing what happened and that you need to take immediate action.

There will be a time delay that will add on to the total time for volume loss. Your heart rate will be elevated, no matter what. A higher heart rate at the start will exacerbate the issue.

No where did I say the 30 sec was most crucial. You assumed. You assumed that bleed out would occur in that timeframe.

That's the true reality of it. Your response is nothing more than academic and juvenile at best.



And, just for reference for others, this is a copy and paste from a simple internet search on femoral artery damage:

If severed or severely lacerated, the femoral artery can dump enough blood quickly enough to immobilize most people from loss of blood pressure and volume in about 30 seconds.

Modern Suvival - Knife Strikes

 

[Marbles]

You forgot to mention how quickly shock can and will take affect on a person self treating a wound all the while digging out their compression bandages and tourniquet to stop or at least slow the bleeding.

Please define "shock?"

Once the mishap occurs, there will be a moment of surprise realizing what happened and that you need to take immediate action.

I've seen enough people in crappy situation to know that there is a large variance in individual reactions, talk like that is what makes people fall to the ground from non-lethal gunshots.

There will be a time delay that will add on to the total time for volume loss. Your heart rate will be elevated, no matter what. A higher heart rate at the start will exacerbate the issue.

As elevated heart rate in such a situation is a function of catecholamines, please define their effect on peripheral circulation and arterial tone? Have you ever personally seen how strong an effect endogenous catechols can have on a person in circulatory collapse? Ever held your fingers jammed up against an injured artery until your hands and forearms cramp?

 

[Marbles]

And the 2nd gen antihistamines we should carry. Please

Sorry I though I answered that.

Zyrtec (cetirizine). As an Rx (so this is a statement, not a recommendation) it can be used safely at 4x the normal daily dose (two 20 mg doses) for hives.

Zyrtec is available over the counter, the dosing discussed is Rx as it is not in accordance with the label.

 

[fngTony]

Let’s not ruin a good topic with being disrespectful.

 

[fwafwow]

Sorry I though I answered that.

Zyrtec is available over the counter, the dosing discussed is Rx as it is not in accordance with the label.

You did. I’m sorry. I totally spaced and overlooked your first post on the topic. I used to carry an epi pen, but it expired. I may get another but will also swap out the Benadryl for Zyrtec.

I think I saw the post by @Maverick1 and just got sidetracked. Still waiting on that elucidation