Critical Haemorrhage

I’ve mentioned before that our ‘Primary Survey’ (i.e your initial assessment of a patient to decide if there’s anything immediately life threatening that needs correcting) differs from that of a first aider, who’s primary survey will be:

D – Danger

R – Response

A- Airway

B – Breathing

and maybe C – Circulation

Our primary survey is:

D – Danger

C – Catastrophic Haemorrhage

R – Response

A – Airway

c (deliberately small) – Cervical Spine injury

B – Breathing

C – Circulation

D – Disability or Neurological signs

E – Everything else

F – Family/Friends for history taking

G – Glucose levels.

So, as you’d expect, it’s a bit different.

When it comes to managing Catastrophic/Critical Haemorrhage (by which I mean an arterial bleed which will bleed a patient dry in mere moments), we don’t piss around. As you can see, we control Catastrophic Bleeding before we even try to get a response from our patient, let alone try managing an airway etc etc.

Most if not all of our critical haemorrhage kits have been developed by the Military. Their ‘bread & butter’ work is dealing with traumatic amputations and massive trauma to the abdomen and chest.

They’ve developed very efficient tourniquets and dressings known as ‘blast dressings’, or to give them their proper name, ‘haemostatic dressings’. These have a chemical in them which promotes clotting to stop bleeding quickly. These dressings are idiot proof, very large and very expensive. They save lives.

I’ve never been unfortunate enough to have to apply a tourniquet, though my regular crew mate was – he was sent to a lady who was trapped under the wheel of a bus!

I have, however, applied a blast dressing to a lady with a catastrophic bleed from the chest. It works very well indeed.

We have a special bag which is a cool, special op’s style black bag with red writing which says ‘Critical Haemorrhage Kit, Trained Personnel Only”. In there we carry tourniquets, various sized blast dressings and haemostatatic gauze.

On my last day shift, we answered a 999 call for a man who’d cut himself shaving, so the bag was left on the Ambulance that day……*sigh*.

Needless to say, we recommended some basic first aid and left him to it. Another life saved šŸ™‚

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