Bleeding Flashcards
(30 cards)
During circulation check in the P-MARCH-P algorithm how does TQ application differ?
Apply directly to skin 2-3 inches above wound
What is the CoTCCC hemostatic dressing of choice for compressible hemorrhage not amenable to limb TQ use?
Combat gauze
What are the alternate hemostatic adjucnts?
Celox (Sell-ox)
Chitogauze (kite-o gauze)
XSTAT
What type of wounds is XSTAT best for?
deep narrow tract-junctional wounds
How long must you hold pressure with hemostatic dressings?
at least 3 minutes
What three criteria must be met before converting a TQ to a hemostatic or pressure dressing?
Casualty is not in shock
It is possible to monitor the wound closely
TQ is not controlling bleeding from an ambutation
What are the steps for TQ conversion?
Apply combat gauze and pressure dressing
Gradually loosen high and tight TQ and move it down to just above pressure dressing
Monitor
If the transition to combat gauze at 2 hours failed when should you try again?
at 6 hours
Can you transition a TQ after six hours?
no, unless you have lab support for metabolic complications
Do not convert TQ if:
Casualty is in shock You cannot monitor Traumatic amputation TQ on longer than 6 hours Casualty will arrive at MTF within 2 hours Tactical consideration
What is the active ingredient of chito gauze?
chitosan (mucoadhesive) (Kite-O)
What is combat gauze impregnated with?
Kaolin (material that cause the blood to clot)
XSTAT is contraindicated in what areas?
thorax, pleural cavity, mediastinum, abdomen, retroperitoneal, sacral above the inguinal ligament or tissues above the clavicle
What are the XSTAT 30 coated with?
chitosan
How many XSTAT 30 applicators are recommended to have on hand at the point of injury?
three
What are the three CoTCCC recommended junctional TQs?
Combat ready Clamp (CRoC)
The Junctional Emergency Treatment Tool (JETT)
The SAM Junctional TQ (SJT)
What are the contraindications to using EZ-IO in the sternum?
Fx of manubrium Previous surgical procedure IO within last 24-48 hrs Infection at site Inability to locate landmarks
What can be used to reduce blood loss from internal hemorrhage?
Tranexamic Acid (TXA)
What is the dose of tranexamic acid?
1 gram in 100 cc of NS or LR
Begin second dose after Hextend or fluid treament
When is the survival benefit the greatest with tranexamic acid use?
given within 1 hour
What is the trade name of TXA?
Cyklokapron
What are possible side effects of TXA?
Nausea, vomiting, diarrhea,
Visual disturbances
Possible increase injury blood clots
Hypotension if given bolus
What is the recommended temperature range of TXA?
59-89 degrees F
at what rate should you infuse TXA?
over 10 minutes
