Stocking supplies for a TEMS bag

[stopmedic]

I'm a paramedic with our county based ems. The county sheriff's office asked myself and 2 other medics to join their tac team. We've been training with them for about 9 months now. The sheriff finally has some money to spend on us and we are putting our packs together. We need some suggestion on what to fill them with and what type of packs we should go with. Is a vest type pack better than carrying a back pack or do we need both. All suggestions greatly appreciated.

[Doczilla]

PM sent.

'zilla

[tniuqs]

PM sent.

'zilla

Soldiers in war zones to be given new bandages

By Jeff Schogol, Stars and Stripes

Pacific edition, Wednesday, October 17, 2008

ARLINGTON, Va. — All soldiers in Iraq and Afghanistan will get new

bandages to treat life-threatening bleeding, replacing the "hemcon"

bandages they use now.

The Army has ordered more than 270,000 packages of Quik-Clot Combat

Gauze and 17,700 packages of WoundStat, said Lt. Col. Sean Morgan of

the Office of the Surgeon General of the Army.

Combat Gauze, made by Z-Medica Corp. in Wallingford, Conn, is gauze

with a hemostatic agent while WoundStat, made by TraumaCure in

Bethesda, Md., is a granular substance meant to mix with blood to form

a seal over wounds.

The Army plans for every soldier to have a package of Combat Gauze

while every combat lifesaver issued a combat lifesaver bag will have

three packages of Combat Gauze, and all combat medics will have three

packages of Combat Gauze and two of WoundStat, Army officials said.

Morgan said the hemostatic agents would be in Qatar by Nov. 30, but he

could not say when all troops in Iraq and Afghanistan would have them.

About 60,000 packages of Combat Gauze and all of the packages of

WoundStat are in Qatar, waiting to be shipped to soldiers in Iraq and

Afghanistan, officials said.

The products are intended to be used in cases of life-threatening

bleeding where tourniquets cannot be applied, said Col. Paul Cordts of

the Army surgeon general's office.

Tests have shown that the two products do much better at stopping

bleeding than the hemostatic agents that soldiers have now, said Dr.

Bijan Kheirabadi, a physiologist with the Army Institute for Surgical

Research.

The products were tested on live animals, of which 100 percent treated

with WoundStat survived compared with 80 percent of those treated with

Combat Gauze.

Ten percent of those treated with hemcon bandages survived, and none

of the animals treated with QuikClot — not to be confused with Combat

Gauze — survived, Kheirabadi said.

The reason Combat Gauze will be used as the first line of treatment is

that medics prefer using gauze products to pack wounds, while

WoundStat is harder to get into deep wounds, harder to clean off, and

it might lead to blood clots — blocked blood vessels that can result

in strokes, officials said.

Devinder Bawa of TraumaCure said the Army Institute for Surgical

Research found the risk of WoundStat causing blood clots is

"theoretical," and said all wounds must be cleaned out thoroughly

prior to surgery.

"We are concerned about assumptions and decisions being made that

real-world experiences don't support," he said.

Zilla Whats your Take on this ?

[chbare]

I know I was not asked, but allow me to throw in my thoughts? We have flow a few patients where various hemostatic agents were used with varied degrees of success. In fact, my medical director took a flight today where the new Quick Clot was used without any success. I find many people have incorrect assumptions regarding these agents. One of the biggest is that they are a silver bullet in the hemostasis department. In fact, they suffer one of the pitfalls that any conventional treatment suffers. You have to get the treatment to the source of the bleed or it may not work. Much easier said than done when considering IED's and blast trauma.

I think these agents are tools; however, we need to have a realistic understanding of how they work and their pitfalls.

Take care,

chbare.

[tniuqs]

I think I have to agree, chbare and do appreciate the input.

I was given a "sample" pack I think its the exact same deal that the troops will recieve, in it is the "quick clot foil wrapped dressing" but in addition to rolls of gauze with a pressure dressing incorporating a Tourniquet called the "H bandage"of all things interesting.

cheers

[Doczilla]

The USAISR conducted studies on the hemostatic agents, and the Wound Stat and Combat Gauze came out on top. Slightly better than Hemcon (which is far more expensive). The granulated Quikclot didn't fare so well (6 consecutive failures, and therefore dropped from the study). The TCCC committee recommended the change after evaluating the ISR study and a Navy study.

'zilla

[tniuqs]

I can't find the literature but does it not generate a exothermic reaction ... moreover a chemical cauterize, I hear a story about a field medic using the powder in the wind and it got in his eyes, dont know if this was the reason they put it in bags ?

Is not Hemcon a shell fish by product ? ... hey its all about recycling these days .... just saying. Oh yes there is the shell fish challenged folks too .

OH crap I think I was given the cheap stuff ... argh !

[Richard B the EMT]

OK, I am thinking as someone not tactically trained, but has used to a degree a vest.

The vest is close to you, you can reach whatever stock you need quickly, and if you have to flee one area after a treatment is started, it goes with you to restart at the safe(er) area.

A backpack has to be removed, unless your partner has a duplicate pack, and you work out of theirs while not removing it. If removed from the wearer for articles to be taken out and used, if the conditions say "run for the hills", understandably, you are going to move, and the hell with the bag for now. However, you and (hopefully) the patient are in a safe zone, but the supplies are useless to you, as they are in the danger zone and unavailable.

For back pack, also say hand carried kit. Under the same scenario, the same end result can happen.

As for stocking said vest, backpack, or carry bag, I'd go heavy on bulky dressings, triangle bandages, 30 inch "arm boards", and a couple of 1" and 2" tape rolls. (Remember that I am BLS, and think as a BLS, too. ALS providers would probably have more stuff.)

Also, I'd be going in with a long back board with the local specification number of straps, multi size adjustable "C" collar (with a head bed or equivalent, if local protocols use them), a "D" cylinder with attached regulator, at least one non-re-breather mask (NRB), and possibly a Bag Valve Mask (BVM).

[tniuqs]

Richard ... I bought a "Cloaking Device" its pricey but very effective ... 8)

Sorry man some days I just have no control over me fingers :oops:

The only thing in your hand's should be firepower, IMHO Tactical EMS and unarmed is just stupid man, like taking a knife to a gun fight. ALS kit no way no O2 either your not going to get fancy ass in a hot zone "may be a Trach and MS... just saying extract to safe zone and DON'T look different from the other team members, cause when you take out the medic the bad guys have the upper hand.

http://www.medekit.com/controller/Catalogu...?clksrc=catlist

cheers

[Doczilla]

I can't find the literature but does it not generate a exothermic reaction ... moreover a chemical cauterize, I hear a story about a field medic using the powder in the wind and it got in his eyes, dont know if this was the reason they put it in bags ?

Is not Hemcon a shell fish by product ? ... hey its all about recycling these days .... just saying. Oh yes there is the shell fish challenged folks too .

The granulated QC generates an impressive exothermic reaction. The QC Advanced Clotting Sponge was developed because of issues getting small granules to stay in place in a briskly bleeding wound. It has less of an exothermic reaction than the original QC. The QC combat gauze lacks the exothermic reaction of previous editions of QC. The exothermic reaction does not cauterize wounds, and is in fact an undesirable effect.

Hemcon, like Celox, contains chitosan, which is obtained from shrimp shells. It has been purified of other proteins and therefore will not cause an allergic reaction in those allergic to shellfish.

The only thing in your hand's should be firepower, IMHO Tactical EMS and unarmed is just stupid man, like taking a knife to a gun fight. ALS kit no way no O2 either your not going to get fancy ass in a hot zone "may be a Trach and MS... just saying extract to safe zone and DON'T look different from the other team members, cause when you take out the medic the bad guys have the upper hand.

This statement demonstrates lack of awareness of most elements of tactical medicine.

'zilla