JEMS Medical Editor Ed Dickinson shares his approach to external hemorrhage control based on his many years of clinical experience in the field and in the ED, evaluation of the medical literature and use of common sense.
Despite major advances in trauma care and medical devices, massive hemorrhage continues to have significant morbidity and mortality. Adequate hemorrhage control must take place in the prehospital environment, and EMS systems must keep pace with changing protocols.
Controlling compressible hemorrhage is the highest medical priority for improving survival in trauma cases. Now there is a new, simple and effective tool that will transform the way bleeding, particularly difficult-to-control bleeding, is managed in the field: the iTClamp50.
The iTClamp is a new hemorrhage-control device that converts an open bleeding wound into a closed wound, which then allows a stable clot to form in the contained space, ultimately tamponading the bleeding vessel. Dr. Joe Holley explains how it works.
Tourniquets are a valuable, life-saving tool, and providers should be well-versed in their use to control bleeding and prevent hypoxia. However, they do prevent blood flow to areas distal to the tourniquet application, which can in turn induce stagnant hypoxia. Jason Clark reports on the first in-the-field use of the iTClamp, a new device designed to control bleeding but still allow blood flow to distal areas.
Uncontrolled hemorrhage also results in the death of a large number of civilian trauma fatalities each year. Recent military conflicts have led to many new and novel approaches, as well as clarified the appropriate application of current tools.
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