Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 I like to use a Tegaderm if it's a small GSW. You can see through it and if it starts to bulge, you can vent it then. Of course, the ideal thing is an Asherman Chest Seal. I don't know why more services don't carry them. They're not that expensive. GG > Â > What is the current standard of care for BLS treatment of a sucking > chest wound? I was always taught to use an occlusive dressings, and > seal three sides, leaving one open. But one of my instructors came up > with this from a colleague (I'm not 100% sure of its original source): > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > Curriculum is now recommending taping chest seals on all 4 sides. The > goal is to seal the hole completely and quickly. The concept of a > one-way valve from a dressing taped on 3 sides doesn't seem to work in > the real world. Let's teach to seal the chest hole completely and > quickly with a 4 sided dressing. If a tension pneumothorax develops, > then release the dressing " . > > Steve > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 I like to use a Tegaderm if it's a small GSW. You can see through it and if it starts to bulge, you can vent it then. Of course, the ideal thing is an Asherman Chest Seal. I don't know why more services don't carry them. They're not that expensive. GG > Â > What is the current standard of care for BLS treatment of a sucking > chest wound? I was always taught to use an occlusive dressings, and > seal three sides, leaving one open. But one of my instructors came up > with this from a colleague (I'm not 100% sure of its original source): > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > Curriculum is now recommending taping chest seals on all 4 sides. The > goal is to seal the hole completely and quickly. The concept of a > one-way valve from a dressing taped on 3 sides doesn't seem to work in > the real world. Let's teach to seal the chest hole completely and > quickly with a 4 sided dressing. If a tension pneumothorax develops, > then release the dressing " . > > Steve > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I've been at it for over twice as long, and while I've seen more than a few tension pneumos, I can still only count the number of sucking chest wounds on one hand. Most of the pneumos have been either spontaneous due to smoking/anatomical factors or from blunt trauma... ck In a message dated 10/29/2009 05:49:50 Central Standard Time, Grayson902@... writes: I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, _paramedic1@..._ (mailto:paramedic1@...) > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed] > > -- Grayson www.kellygrayson.www Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I've been at it for over twice as long, and while I've seen more than a few tension pneumos, I can still only count the number of sucking chest wounds on one hand. Most of the pneumos have been either spontaneous due to smoking/anatomical factors or from blunt trauma... ck In a message dated 10/29/2009 05:49:50 Central Standard Time, Grayson902@... writes: I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, _paramedic1@..._ (mailto:paramedic1@...) > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed] > > -- Grayson www.kellygrayson.www Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I've been at it for over twice as long, and while I've seen more than a few tension pneumos, I can still only count the number of sucking chest wounds on one hand. Most of the pneumos have been either spontaneous due to smoking/anatomical factors or from blunt trauma... ck In a message dated 10/29/2009 05:49:50 Central Standard Time, Grayson902@... writes: I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, _paramedic1@..._ (mailto:paramedic1@...) > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed] > > -- Grayson www.kellygrayson.www Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Gene, an Asherman works great for a little while, but the adhesive wil come off after awhile due to moisture especially if the wound is bloody. A better choice, and even less expensive, is to use an expired defib pad. They stick very well, are usually discarded, and are easily placed, even on bloddy wounds. McGee, EMT-P, EMT-T Re: Sucking Chest Wound I like to use a Tegaderm if it's a small GSW. You can see through it and if it starts to bulge, you can vent it then. Of course, the ideal thing is an Asherman Chest Seal. I don't know why more services don't carry them. They're not that expensive. GG > Â > What is the current standard of care for BLS treatment of a sucking > chest wound? I was always taught to use an occlusive dressings, and > seal three sides, leaving one open. But one of my instructors came up > with this from a colleague (I'm not 100% sure of its original source): > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > Curriculum is now recommending taping chest seals on all 4 sides. The > goal is to seal the hole completely and quickly. The concept of a > one-way valve from a dressing taped on 3 sides doesn't seem to work in > the real world. Let's teach to seal the chest hole completely and > quickly with a 4 sided dressing. If a tension pneumothorax develops, > then release the dressing " . > > Steve > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Gene, an Asherman works great for a little while, but the adhesive wil come off after awhile due to moisture especially if the wound is bloody. A better choice, and even less expensive, is to use an expired defib pad. They stick very well, are usually discarded, and are easily placed, even on bloddy wounds. McGee, EMT-P, EMT-T Re: Sucking Chest Wound I like to use a Tegaderm if it's a small GSW. You can see through it and if it starts to bulge, you can vent it then. Of course, the ideal thing is an Asherman Chest Seal. I don't know why more services don't carry them. They're not that expensive. GG > Â > What is the current standard of care for BLS treatment of a sucking > chest wound? I was always taught to use an occlusive dressings, and > seal three sides, leaving one open. But one of my instructors came up > with this from a colleague (I'm not 100% sure of its original source): > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > Curriculum is now recommending taping chest seals on all 4 sides. The > goal is to seal the hole completely and quickly. The concept of a > one-way valve from a dressing taped on 3 sides doesn't seem to work in > the real world. Let's teach to seal the chest hole completely and > quickly with a 4 sided dressing. If a tension pneumothorax develops, > then release the dressing " . > > Steve > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Gene, an Asherman works great for a little while, but the adhesive wil come off after awhile due to moisture especially if the wound is bloody. A better choice, and even less expensive, is to use an expired defib pad. They stick very well, are usually discarded, and are easily placed, even on bloddy wounds. McGee, EMT-P, EMT-T Re: Sucking Chest Wound I like to use a Tegaderm if it's a small GSW. You can see through it and if it starts to bulge, you can vent it then. Of course, the ideal thing is an Asherman Chest Seal. I don't know why more services don't carry them. They're not that expensive. GG > Â > What is the current standard of care for BLS treatment of a sucking > chest wound? I was always taught to use an occlusive dressings, and > seal three sides, leaving one open. But one of my instructors came up > with this from a colleague (I'm not 100% sure of its original source): > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > Curriculum is now recommending taping chest seals on all 4 sides. The > goal is to seal the hole completely and quickly. The concept of a > one-way valve from a dressing taped on 3 sides doesn't seem to work in > the real world. Let's teach to seal the chest hole completely and > quickly with a 4 sided dressing. If a tension pneumothorax develops, > then release the dressing " . > > Steve > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I'm curious. Just how many of you have seen an actual *sucking* chest wound? Could they accurately be described as 1/100 of penetrating chest wounds? 1/1000? One in ten thousand? I've been a medic for fifteen years and I can count the number of sucking chest wounds I've seen on the fingers of one hand, and two of those were *deer* I have shot with high-velocity rifle rounds. Just doesn't seem to be that common an injury amongst the homeys bustin' caps at each other with they nines... .... or for that matter, a Glock fohty or fohty-five. McGee wrote: > > > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is > bloody. A better choice, and even less expensive, is to use an expired > defib pad. They stick very well, are usually discarded, and are easily > placed, even on bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > writes: > > > > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 based on the feedback I've gotten back from some of my contacts, if the body armor is worn properly, then the chance of a sucking chest wound from an aimed gunshot is pretty small...among other things, it seems that most of the bad guys over there often don't practice any more marksmanship than the gang bangers do here in the states ( " spray and pray " apparently takes on a whole new meaning for most of the jihadists). That's not to say that *all* of the bad guys don't know how to use the sights, nor is it saying that a piece of shrapnel with " to whom it may concern " on it won't slip around the edges of the BA when a big IED goes off...but I know of several cases where an Ami or Brit grunt took a round to center mass, and then got back up to rejoin the fight...including one where the grunt was really the corpsman, who ended up taking care of the would be sniper who shot him....much to the jihadist's surprise. And the problem of 'where did all the bullets go' when there are civilians around still holds true. ck In a message dated 10/29/2009 10:05:59 Central Standard Time, abaustin+yahoogroups@... writes: You're forgetting 'marksmanship'You're forgetting 'marksmanship' . I'm the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 based on the feedback I've gotten back from some of my contacts, if the body armor is worn properly, then the chance of a sucking chest wound from an aimed gunshot is pretty small...among other things, it seems that most of the bad guys over there often don't practice any more marksmanship than the gang bangers do here in the states ( " spray and pray " apparently takes on a whole new meaning for most of the jihadists). That's not to say that *all* of the bad guys don't know how to use the sights, nor is it saying that a piece of shrapnel with " to whom it may concern " on it won't slip around the edges of the BA when a big IED goes off...but I know of several cases where an Ami or Brit grunt took a round to center mass, and then got back up to rejoin the fight...including one where the grunt was really the corpsman, who ended up taking care of the would be sniper who shot him....much to the jihadist's surprise. And the problem of 'where did all the bullets go' when there are civilians around still holds true. ck In a message dated 10/29/2009 10:05:59 Central Standard Time, abaustin+yahoogroups@... writes: You're forgetting 'marksmanship'You're forgetting 'marksmanship' . I'm the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 based on the feedback I've gotten back from some of my contacts, if the body armor is worn properly, then the chance of a sucking chest wound from an aimed gunshot is pretty small...among other things, it seems that most of the bad guys over there often don't practice any more marksmanship than the gang bangers do here in the states ( " spray and pray " apparently takes on a whole new meaning for most of the jihadists). That's not to say that *all* of the bad guys don't know how to use the sights, nor is it saying that a piece of shrapnel with " to whom it may concern " on it won't slip around the edges of the BA when a big IED goes off...but I know of several cases where an Ami or Brit grunt took a round to center mass, and then got back up to rejoin the fight...including one where the grunt was really the corpsman, who ended up taking care of the would be sniper who shot him....much to the jihadist's surprise. And the problem of 'where did all the bullets go' when there are civilians around still holds true. ck In a message dated 10/29/2009 10:05:59 Central Standard Time, abaustin+yahoogroups@... writes: You're forgetting 'marksmanship'You're forgetting 'marksmanship' . I'm the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 You're forgetting 'marksmanship'. I'm sure the deer would rather have the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some areas. As far as the inner-cities go, I'm less worried about the people the bangers are shooting at and more worried about where the bullet actually ends up. Austin > I'm curious. Just how many of you have seen an actual *sucking* chest > wound? Could they accurately be described as 1/100 of penetrating > chest > wounds? 1/1000? One in ten thousand? > > I've been a medic for fifteen years and I can count the number of > sucking chest wounds I've seen on the fingers of one hand, and two of > those were *deer* I have shot with high-velocity rifle rounds. Just > doesn't seem to be that common an injury amongst the homeys bustin' > caps > at each other with they nines... > > ... or for that matter, a Glock fohty or fohty-five. > > McGee wrote: >> >> >> Gene, an Asherman works great for a little while, but the adhesive >> wil >> come off after awhile due to moisture especially if the wound is >> bloody. A better choice, and even less expensive, is to use an >> expired >> defib pad. They stick very well, are usually discarded, and are >> easily >> placed, even on bloddy wounds. >> >> McGee, EMT-P, EMT-T >> >> Re: Sucking Chest Wound >> >> I like to use a Tegaderm if it's a small GSW. You can see through >> it and >> if it starts to bulge, you can vent it then. Of course, the ideal >> thing is >> an Asherman Chest Seal. I don't know why more services don't carry >> them. >> They're not that expensive. >> >> GG >> In a message dated 10/28/09 7:23:38 PM, paramedic1@... >> writes: >> >>> >>> What is the current standard of care for BLS treatment of a sucking >>> chest wound? I was always taught to use an occlusive dressings, and >>> seal three sides, leaving one open. But one of my instructors came >>> up >>> with this from a colleague (I'm not 100% sure of its original >>> source): >>> >>> " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty >>> Curriculum is now recommending taping chest seals on all 4 sides. >>> The >>> goal is to seal the hole completely and quickly. The concept of a >>> one-way valve from a dressing taped on 3 sides doesn't seem to >>> work in >>> the real world. Let's teach to seal the chest hole completely and >>> quickly with a 4 sided dressing. If a tension pneumothorax develops, >>> then release the dressing " . >>> >>> Steve >>> >>> >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 You're forgetting 'marksmanship'. I'm sure the deer would rather have the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some areas. As far as the inner-cities go, I'm less worried about the people the bangers are shooting at and more worried about where the bullet actually ends up. Austin > I'm curious. Just how many of you have seen an actual *sucking* chest > wound? Could they accurately be described as 1/100 of penetrating > chest > wounds? 1/1000? One in ten thousand? > > I've been a medic for fifteen years and I can count the number of > sucking chest wounds I've seen on the fingers of one hand, and two of > those were *deer* I have shot with high-velocity rifle rounds. Just > doesn't seem to be that common an injury amongst the homeys bustin' > caps > at each other with they nines... > > ... or for that matter, a Glock fohty or fohty-five. > > McGee wrote: >> >> >> Gene, an Asherman works great for a little while, but the adhesive >> wil >> come off after awhile due to moisture especially if the wound is >> bloody. A better choice, and even less expensive, is to use an >> expired >> defib pad. They stick very well, are usually discarded, and are >> easily >> placed, even on bloddy wounds. >> >> McGee, EMT-P, EMT-T >> >> Re: Sucking Chest Wound >> >> I like to use a Tegaderm if it's a small GSW. You can see through >> it and >> if it starts to bulge, you can vent it then. Of course, the ideal >> thing is >> an Asherman Chest Seal. I don't know why more services don't carry >> them. >> They're not that expensive. >> >> GG >> In a message dated 10/28/09 7:23:38 PM, paramedic1@... >> writes: >> >>> >>> What is the current standard of care for BLS treatment of a sucking >>> chest wound? I was always taught to use an occlusive dressings, and >>> seal three sides, leaving one open. But one of my instructors came >>> up >>> with this from a colleague (I'm not 100% sure of its original >>> source): >>> >>> " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty >>> Curriculum is now recommending taping chest seals on all 4 sides. >>> The >>> goal is to seal the hole completely and quickly. The concept of a >>> one-way valve from a dressing taped on 3 sides doesn't seem to >>> work in >>> the real world. Let's teach to seal the chest hole completely and >>> quickly with a 4 sided dressing. If a tension pneumothorax develops, >>> then release the dressing " . >>> >>> Steve >>> >>> >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 You're forgetting 'marksmanship'. I'm sure the deer would rather have the gang-bangers shooting at them rather then y'know, someone who can actually hit the broad sign of a barn. Now, if we required all the homies to get associate degrees, then they may be able to gang-bang more effectively ... I think the incidence of that particular injury would change significantly depending on the venue of the provider. As far as I know, most of my friends in the sandbox carry a kit that includes an Asherman, so obviously it happens enough to still be a problem in some areas. As far as the inner-cities go, I'm less worried about the people the bangers are shooting at and more worried about where the bullet actually ends up. Austin > I'm curious. Just how many of you have seen an actual *sucking* chest > wound? Could they accurately be described as 1/100 of penetrating > chest > wounds? 1/1000? One in ten thousand? > > I've been a medic for fifteen years and I can count the number of > sucking chest wounds I've seen on the fingers of one hand, and two of > those were *deer* I have shot with high-velocity rifle rounds. Just > doesn't seem to be that common an injury amongst the homeys bustin' > caps > at each other with they nines... > > ... or for that matter, a Glock fohty or fohty-five. > > McGee wrote: >> >> >> Gene, an Asherman works great for a little while, but the adhesive >> wil >> come off after awhile due to moisture especially if the wound is >> bloody. A better choice, and even less expensive, is to use an >> expired >> defib pad. They stick very well, are usually discarded, and are >> easily >> placed, even on bloddy wounds. >> >> McGee, EMT-P, EMT-T >> >> Re: Sucking Chest Wound >> >> I like to use a Tegaderm if it's a small GSW. You can see through >> it and >> if it starts to bulge, you can vent it then. Of course, the ideal >> thing is >> an Asherman Chest Seal. I don't know why more services don't carry >> them. >> They're not that expensive. >> >> GG >> In a message dated 10/28/09 7:23:38 PM, paramedic1@... >> writes: >> >>> >>> What is the current standard of care for BLS treatment of a sucking >>> chest wound? I was always taught to use an occlusive dressings, and >>> seal three sides, leaving one open. But one of my instructors came >>> up >>> with this from a colleague (I'm not 100% sure of its original >>> source): >>> >>> " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty >>> Curriculum is now recommending taping chest seals on all 4 sides. >>> The >>> goal is to seal the hole completely and quickly. The concept of a >>> one-way valve from a dressing taped on 3 sides doesn't seem to >>> work in >>> the real world. Let's teach to seal the chest hole completely and >>> quickly with a 4 sided dressing. If a tension pneumothorax develops, >>> then release the dressing " . >>> >>> Steve >>> >>> >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Well that would stand to reason. Soldiers are dealing with high-velocity rifle rounds, albeit not quite as deadly in regards to bullet construction as hunting rounds. Just isn't that common an injury from pistol calibers, though. A Austin wrote: > > > You're forgetting 'marksmanship'. I'm sure the deer would rather have > the gang-bangers shooting at them rather then y'know, someone who can > actually hit the broad sign of a barn. Now, if we required all the > homies to get associate degrees, then they may be able to gang-bang > more effectively ... > > I think the incidence of that particular injury would change > significantly depending on the venue of the provider. As far as I > know, most of my friends in the sandbox carry a kit that includes an > Asherman, so obviously it happens enough to still be a problem in some > areas. As far as the inner-cities go, I'm less worried about the > people the bangers are shooting at and more worried about where the > bullet actually ends up. > > Austin > > > > > I'm curious. Just how many of you have seen an actual *sucking* chest > > wound? Could they accurately be described as 1/100 of penetrating > > chest > > wounds? 1/1000? One in ten thousand? > > > > I've been a medic for fifteen years and I can count the number of > > sucking chest wounds I've seen on the fingers of one hand, and two of > > those were *deer* I have shot with high-velocity rifle rounds. Just > > doesn't seem to be that common an injury amongst the homeys bustin' > > caps > > at each other with they nines... > > > > ... or for that matter, a Glock fohty or fohty-five. > > > > McGee wrote: > >> > >> > >> Gene, an Asherman works great for a little while, but the adhesive > >> wil > >> come off after awhile due to moisture especially if the wound is > >> bloody. A better choice, and even less expensive, is to use an > >> expired > >> defib pad. They stick very well, are usually discarded, and are > >> easily > >> placed, even on bloddy wounds. > >> > >> McGee, EMT-P, EMT-T > >> > >> Re: Sucking Chest Wound > >> > >> I like to use a Tegaderm if it's a small GSW. You can see through > >> it and > >> if it starts to bulge, you can vent it then. Of course, the ideal > >> thing is > >> an Asherman Chest Seal. I don't know why more services don't carry > >> them. > >> They're not that expensive. > >> > >> GG > >> In a message dated 10/28/09 7:23:38 PM, paramedic1@... > > >> writes: > >> > >>> > >>> What is the current standard of care for BLS treatment of a sucking > >>> chest wound? I was always taught to use an occlusive dressings, and > >>> seal three sides, leaving one open. But one of my instructors came > >>> up > >>> with this from a colleague (I'm not 100% sure of its original > >>> source): > >>> > >>> " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > >>> Curriculum is now recommending taping chest seals on all 4 sides. > >>> The > >>> goal is to seal the hole completely and quickly. The concept of a > >>> one-way valve from a dressing taped on 3 sides doesn't seem to > >>> work in > >>> the real world. Let's teach to seal the chest hole completely and > >>> quickly with a 4 sided dressing. If a tension pneumothorax develops, > >>> then release the dressing " . > >>> > >>> Steve > >>> > >>> > >>> > >>> > >> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Agreed. I have done that also. I've not had that much experience with the Ashermans. They look good. But perhaps simple is better. Occam's Razor. GG > Â > Gene, an Asherman works great for a little while, but the adhesive wil > come off after awhile due to moisture especially if the wound is bloody. A > better choice, and even less expensive, is to use an expired defib pad. They > stick very well, are usually discarded, and are easily placed, even on > bloddy wounds. > > McGee, EMT-P, EMT-T > > Re: Sucking Chest Wound > > I like to use a Tegaderm if it's a small GSW. You can see through it and > if it starts to bulge, you can vent it then. Of course, the ideal thing is > an Asherman Chest Seal. I don't know why more services don't carry them. > They're not that expensive. > > GG > > > > Â > > What is the current standard of care for BLS treatment of a sucking > > chest wound? I was always taught to use an occlusive dressings, and > > seal three sides, leaving one open. But one of my instructors came up > > with this from a colleague (I'm not 100% sure of its original source): > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > Curriculum is now recommending taping chest seals on all 4 sides. The > > goal is to seal the hole completely and quickly. The concept of a > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > the real world. Let's teach to seal the chest hole completely and > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > then release the dressing " . > > > > Steve > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 I assume that all chest wounds are potentially " sucking " and treat them accordingly. The last one I saw was actually caused when a pedestrian walking down the highway stepped out just as a little old lady with blue hair driving a big Chrysler came along doing 65. The right rearview mirror struck him and the stem imbedded in his left chest wall about ribs 8-10. The force picked him up and threw him up on the hood and into the windshield, which he broke. She, of course, slammed on the brakes, and he got propelled about 40 feet. I happened to be driving by. Found him in the middle of the road being fanned (no I'm not kidding) by a woman who identified herself as a nurse. I found the chest wound and it was actually sucking air and making bubbles. I covered it with a trauma dressing still in the package that I happened to have and held it till EMS got there. They intubated and then decompressed a tension. Air came and hauled him away. In spite of it all he survived. GG > Â > I'm curious. Just how many of you have seen an actual *sucking* chest > wound? Could they accurately be described as 1/100 of penetrating chest > wounds? 1/1000? One in ten thousand? > > I've been a medic for fifteen years and I can count the number of > sucking chest wounds I've seen on the fingers of one hand, and two of > those were *deer* I have shot with high-velocity rifle rounds. Just > doesn't seem to be that common an injury amongst the homeys bustin' caps > at each other with they nines... > > ... or for that matter, a Glock fohty or fohty-five. > > McGee wrote: > > > > > > Gene, an Asherman works great for a little while, but the adhesive wil > > come off after awhile due to moisture especially if the wound is > > bloody. A better choice, and even less expensive, is to use an expired > > defib pad. They stick very well, are usually discarded, and are easily > > placed, even on bloddy wounds. > > > > McGee, EMT-P, EMT-T > > > > Re: Sucking Chest Wound > > > > I like to use a Tegaderm if it's a small GSW. You can see through it and > > if it starts to bulge, you can vent it then. Of course, the ideal thing > is > > an Asherman Chest Seal. I don't know why more services don't carry them. > > They're not that expensive. > > > > GG > > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > > writes: > > > > > > > > What is the current standard of care for BLS treatment of a sucking > > > chest wound? I was always taught to use an occlusive dressings, and > > > seal three sides, leaving one open. But one of my instructors came up > > > with this from a colleague (I'm not 100% sure of its original source): > > > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat Casualty > > > Curriculum is now recommending taping chest seals on all 4 sides. The > > > goal is to seal the hole completely and quickly. The concept of a > > > one-way valve from a dressing taped on 3 sides doesn't seem to work in > > > the real world. Let's teach to seal the chest hole completely and > > > quickly with a 4 sided dressing. If a tension pneumothorax develops, > > > then release the dressing " . > > > > > > Steve > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Maybe I'm getting soft in my old age. LOL. G > Â > Why would we think you were kidding about the nurse? > > If I had a dime for every " stupid nurse/doctor trick " I've seen since > 1981 I'd be a he'll of a lot richer than I am poor now. > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/ FF/ > Typed by my fingers on my iPhone. > Please excuse any typos > (Cell) > LNMolino@... > > > > > I assume that all chest wounds are potentially " sucking " and treat > > them > > accordingly. The last one I saw was actually caused when a > > pedestrian walking > > down the highway stepped out just as a little old lady with blue hair > > driving a big Chrysler came along doing 65. The right rearview > > mirror struck > > him and the stem imbedded in his left chest wall about ribs 8-10. > > The force > > picked him up and threw him up on the hood and into the windshield, > > which he > > broke. She, of course, slammed on the brakes, and he got propelled > > about 40 > > feet. I happened to be driving by. Found him in the middle of the road > > being fanned (no I'm not kidding) by a woman who identified herself > > as a > > nurse. I found the chest wound and it was actually sucking air and > > making > > bubbles. I covered it with a trauma dressing still in the package > > that I > > happened to have and held it till EMS got there. They intubated and > > then > > decompressed a tension. Air came and hauled him away. In spite of it > > all he > > survived. > > > > GG > > > > > > > > > > I'm curious. Just how many of you have seen an actual *sucking* > > chest > > > wound? Could they accurately be described as 1/100 of penetrating > > chest > > > wounds? 1/1000? One in ten thousand? > > > > > > I've been a medic for fifteen years and I can count the number of > > > sucking chest wounds I've seen on the fingers of one hand, and two > > of > > > those were *deer* I have shot with high-velocity rifle rounds. Just > > > doesn't seem to be that common an injury amongst the homeys > > bustin' caps > > > at each other with they nines... > > > > > > ... or for that matter, a Glock fohty or fohty-five. > > > > > > McGee wrote: > > > > > > > > > > > > Gene, an Asherman works great for a little while, but the > > adhesive wil > > > > come off after awhile due to moisture especially if the wound is > > > > bloody. A better choice, and even less expensive, is to use an > > expired > > > > defib pad. They stick very well, are usually discarded, and are > > easily > > > > placed, even on bloddy wounds. > > > > > > > > McGee, EMT-P, EMT-T > > > > > > > > Re: Sucking Chest Wound > > > > > > > > I like to use a Tegaderm if it's a small GSW. You can see > > through it and > > > > if it starts to bulge, you can vent it then. Of course, the > > ideal thing > > > is > > > > an Asherman Chest Seal. I don't know why more services don't > > carry them. > > > > They're not that expensive. > > > > > > > > GG > > > > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > > > > writes: > > > > > > > > > > > > > > What is the current standard of care for BLS treatment of a > > sucking > > > > > chest wound? I was always taught to use an occlusive > > dressings, and > > > > > seal three sides, leaving one open. But one of my instructors > > came up > > > > > with this from a colleague (I'm not 100% sure of its original > > source): > > > > > > > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat > > Casualty > > > > > Curriculum is now recommending taping chest seals on all 4 > > sides. The > > > > > goal is to seal the hole completely and quickly. The concept > > of a > > > > > one-way valve from a dressing taped on 3 sides doesn't seem to > > work in > > > > > the real world. Let's teach to seal the chest hole completely > > and > > > > > quickly with a 4 sided dressing. If a tension pneumothorax > > develops, > > > > > then release the dressing " . > > > > > > > > > > Steve > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 Why would we think you were kidding about the nurse? If I had a dime for every " stupid nurse/doctor trick " I've seen since 1981 I'd be a he'll of a lot richer than I am poor now. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos (Cell) LNMolino@... > I assume that all chest wounds are potentially " sucking " and treat > them > accordingly. The last one I saw was actually caused when a > pedestrian walking > down the highway stepped out just as a little old lady with blue hair > driving a big Chrysler came along doing 65. The right rearview > mirror struck > him and the stem imbedded in his left chest wall about ribs 8-10. > The force > picked him up and threw him up on the hood and into the windshield, > which he > broke. She, of course, slammed on the brakes, and he got propelled > about 40 > feet. I happened to be driving by. Found him in the middle of the road > being fanned (no I'm not kidding) by a woman who identified herself > as a > nurse. I found the chest wound and it was actually sucking air and > making > bubbles. I covered it with a trauma dressing still in the package > that I > happened to have and held it till EMS got there. They intubated and > then > decompressed a tension. Air came and hauled him away. In spite of it > all he > survived. > > GG > > > > > > I'm curious. Just how many of you have seen an actual *sucking* > chest > > wound? Could they accurately be described as 1/100 of penetrating > chest > > wounds? 1/1000? One in ten thousand? > > > > I've been a medic for fifteen years and I can count the number of > > sucking chest wounds I've seen on the fingers of one hand, and two > of > > those were *deer* I have shot with high-velocity rifle rounds. Just > > doesn't seem to be that common an injury amongst the homeys > bustin' caps > > at each other with they nines... > > > > ... or for that matter, a Glock fohty or fohty-five. > > > > McGee wrote: > > > > > > > > > Gene, an Asherman works great for a little while, but the > adhesive wil > > > come off after awhile due to moisture especially if the wound is > > > bloody. A better choice, and even less expensive, is to use an > expired > > > defib pad. They stick very well, are usually discarded, and are > easily > > > placed, even on bloddy wounds. > > > > > > McGee, EMT-P, EMT-T > > > > > > Re: Sucking Chest Wound > > > > > > I like to use a Tegaderm if it's a small GSW. You can see > through it and > > > if it starts to bulge, you can vent it then. Of course, the > ideal thing > > is > > > an Asherman Chest Seal. I don't know why more services don't > carry them. > > > They're not that expensive. > > > > > > GG > > > In a message dated 10/28/09 7:23:38 PM, paramedic1@... > > > writes: > > > > > > > > > > > What is the current standard of care for BLS treatment of a > sucking > > > > chest wound? I was always taught to use an occlusive > dressings, and > > > > seal three sides, leaving one open. But one of my instructors > came up > > > > with this from a colleague (I'm not 100% sure of its original > source): > > > > > > > > " The Pre-Hospital Trauma Life Support and Tactical Combat > Casualty > > > > Curriculum is now recommending taping chest seals on all 4 > sides. The > > > > goal is to seal the hole completely and quickly. The concept > of a > > > > one-way valve from a dressing taped on 3 sides doesn't seem to > work in > > > > the real world. Let's teach to seal the chest hole completely > and > > > > quickly with a 4 sided dressing. If a tension pneumothorax > develops, > > > > then release the dressing " . > > > > > > > > Steve > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2009 Report Share Posted October 30, 2009 Intermittent Positive Pressure Ventilation… Sorry… couldn’t resist From: texasems-l [mailto:texasems-l ] On Behalf Of wegandy1938@... Sent: Thursday, October 29, 2009 8:33 PM To: texasems-l Subject: Re: Sucking Chest Wound Found him in the middle of the road being fanned (no I'm not kidding) by a woman who identified herself as a nurse. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2009 Report Share Posted October 30, 2009 Now that's funny!!! GG >  > Intermittent Positive Pressure Ventilation… > > Sorry… couldn’t resist > > From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On > Behalf Of wegandy1938@wegandy > Sent: Thursday, October 29, 2009 8:33 PM > To: texasems-l@yahoogrotexasem > Subject: Re: Sucking Chest Wound > > Found him in the middle of the road > being fanned (no I'm not kidding) by a woman who identified herself as a > nurse. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2009 Report Share Posted November 2, 2009 My son starts nursing in January. I will let him finish and get a job before I start the re-training process.The key here is get a job. Henry Re: Sucking Chest Wound > > Found him in the middle of the road > being fanned (no I'm not kidding) by a woman who identified herself as a > nurse. > > Quote Link to comment Share on other sites More sharing options...
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