# Using Tegaderms for sucking chest wounds.



## Waterborne

Any penetrating wound above the navel and below the clavicles should be covered with an occlusive dressing. Any type of waterproof, airtight material can be used as an occlusive dressing but they also require the use of tape. On the ambulance we carry Petroleum gauze and tape for this purpose but there are some drawbacks. They require 2 hands because you have to tear the tape to secure it. Over the years there have been multiple commercial options on the market over the years. Asherman chest seal, the hyfin, Halo, and bolin chest seals and all of these have the advantage of being self adherent. I particularly like the hyfin and Halo seals because they come in 2 packs, one for the exit and one for the entrance wound. The only drawback to these items is the price, and when someone is stocking up multiple IFAKS, medic bags, and stockpiling medical supplies this all adds up quick.

Tegaderms normally come in 2 3/8" x 2 3/4" and are used for securing IV sites IV hub at the angiocath and to protect the site from infection. Tegaderms also come in larger sizes for covering surgical sites for bathing. A box of 50 4" by 4 3/4" tegaderms can be bought for under 30$ on ebay and amazon. These are large enough for 95% of penetrating traumas, they are self adherent and very thin to stash away in a IFAK or the airway part of your medic bag. While most chest seals come with a valve or a flap to release air, PHTLS no longer recommends the old way of taping on 3 sides because if a tension pneumothorax does occur adipose and muscular tissue may be causing the blockage and mere burping the dressing will not alleviate the problem. Just stick on the dressings and if a tension pnuemo does occur just perform a needle decompression. 
http://www.amazon.com/Tegaderm-Tran...pebp=1433732140000&perid=1DBH1W2XE79E0HBSBZEV


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## Medic33

you do know the purpose of dressing a sucking chest wound right?
to keep the other lung from collapsing.


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## Medic33

once this is established even with a candy bar wrapper the person usually goes stable enough for transport.


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## Waterborne

I'm very aware of the purpose an occlusive dressing. I offered a cheap and viable alternative to commercially available chest seals, so what exactly are you asking? I never said a pt. couldn't be transported after dressing a chest wound. Yes you could use a candy wrapper as an occlusive dressing, but then again you could use a sharpened turkey flavor needle, latex tubing, and a wine bottle for an IV but there are better options. The occlusive dressing prevents air exchange to the outside of the body through the hole in the thorasic cavity. This facilitates effective respirations via gas exchange to the aveoli and helps prevent lung collapse.


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## Denton

Thanks for the heads up!

I have a question about the item. It says it is breathable. That doesn't matter, does it?


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## Jakthesoldier

Literally any flexible plastic can work. Cigarette cellophane is great. MRE wrappers, plastic bags, etc. The upside of NOT buying specialized devices like the ones mentioned in the OP include being multi use. The more you specialize the more you limit, and the more you ha e to cary. 

Seriously, skip them all, a roll of ceranwrap (sp?) Can cover SO many more uses.


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## Jakthesoldier

Denton said:


> Thanks for the heads up!
> 
> I have a question about the item. It says it is breathable. That doesn't matter, does it?


YES! the purpose is to create a valve to release pressure that builds up around the lungs causing them to colapse. You don't want it to "breathe", you want it to seal. Similar concept to the exit port on a gas mask. Air/fluid gets out, nothing gets in


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## Denton

Jakthesoldier said:


> YES! the purpose is to create a valve to release pressure that builds up around the lungs causing them to colapse. You don't want it to "breathe", you want it to seal. Similar concept to the exit port on a gas mask. Air/fluid gets out, nothing gets in


Back in the days of caissons, we were taught to use the gauze's packaging as the seal for the sucking chest wound.

We were also taught that a sucking chest wound was nature's way of suggesting the soldier take it easy for a while. :armata_PDT_04:


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## Waterborne

Tegaderms don't breath enough to matter when used for an occlusive dressing. Jakthesoldier are you just going to carry a roll of plastic wrap or an MRE wrapper in your IFAK? Don't forget to pack the tape to tape your improvised dressing down. It's hard to cover a dish with saran wrap without it sticking to itself without throwing it away, but you're gonna do it with bloody hands and under stress. Pre packaged and self adherent takes the stress out of it. it's easier to do, just open peel and stick.


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## Still Resist

Uggggh. This is why I avoid internet forums. The excess of opinion with no experience to shoot down useful information which can save someone's life. The original poster was 100% correct in his post and obviously knows the purpose of an occlusive dressing by his suggestion of using tegaderms to seal a wound.

You cover a chest wound with an occlusive dressing to prevent air from entering on the inured side, becoming a tension pneumothorax and collapsing the injured lung, not to keep the uninjured side from being affected.

You could use a candy bar wrapper if you are carrying one AND a roll of duct tape but why wouldn't you just use a dressing purpose made for this as was the purpose of the post? A candy bar wrapper would only be effective if the wound is small enough to be covered with the wrapper. MAYBE an entrance but probably not an exit wound.

What other uses does a decompression needle have? Nasal Airway? If you are carrying multi-use items to be used under stress for immediate life threats are you carrying them where they can be found in the dark? Under stress? In the same place as everyone else? You could use a cigarette wrapper but I'm not sure what its other purpose will be? 

A tegaderm may breath but it is minuscule. A window screen prevents 50% of air movement. A tegaderm will allow microscopic drops of fluid and air to pass through. No where even close to it not being occlusive and providing a good seal. You will have more air leak from using improvised items and not having a good seal around the dressing.

If anyone has spent 5 minutes training in this they would see the value of prepackaged solutions. Your brother has a penetrating chest wound and is in respiratory distress. You can either use an improvised method to seal the wound with bloody hands and the clock ticking, maybe under fire, or you can use the prepackaged version which weighs nothing, costs next to nothing and can be slapped on in seconds. 

Thanks to the OP for taking the time to give good information which can save someone's life.


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## Still Resist

This is what you're improvising on except you won't be in a clean, safe hospital or ambulance. It will be in austere conditions with your loved one crying for help. You may be tired, hungry and in the dark. If you were just involved in a fire fight you could be injured, have tunnel vision and shaking hands to say the least.


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## Kauboy

I'd like to thank the OP, and what looks to be our newest member, for their insight on this product as a solution to a very real problem.

The product, while not specifically designed for a sucking chest wound, does look to have more use than improvising something from random materials.
Like Denton, I was concerned about the "breathing" description of this covering, but from Water and Still, that looks to be a non-issue.
I don't think any of us expect something like this to be a permanent solution. It just needs to work long enough to get out of the danger zone and on to proper medical care.
The price is certainly right, and I like that it's diverse enough to be used in many scenarios.

Thanks again!


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## Denton

Kauboy nailed it. The whole notion of a discussion board is to discuss and clarify.

Clarification was given and we appreciate it.

Can I use the packaging of the gauze? Why, sure! Can I use a candy bar wrapper? Yeah, but not what I would prefer. Would I prefer something that is sterile and made for such situations? That would be the better solution.

If I am carrying gauze, I can carry the item in question, too. Now that I know about it and also know that "breathable" doesn't mean not effective, I am happy.


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## Seneca

Well now I'm confused. 
If you had both the prepackaged seals and tegaderm, available to you which would you use? I know the field expedient methods are for when you have neither, so that moot.


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## Kauboy

Seneca said:


> Well now I'm confused.
> If you had both the prepackaged seals and tegaderm, available to you which would you use? I know the field expedient methods are for when you have neither, so that moot.


Either is a good option.
It seemed like the primary reason that the OP brought these up is their drastically reduced cost when compared to seals marketed specifically for chest wounds.


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## Medic33

no dude - thank the OP and welcome here ,and thank you kuaboy for reminding me.
the problem I have is a sucking chest wound will need professional medical attention in shtf there might be none period.
just a point. Otherwise all your tring to do is keep the wound sealed on the breath in and soak up a minimal amount of fluid on the exhale -so just about anything that will seal it is good as jack pointed out cellophane is a kind of cool I never thought of.


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## paraquack

So let me be the first to
welcome to the group from Arizona. 
Land of Sun, Surf, and Sand. 
Ok, I lied, no surf, but enough sand 
to make all the dang sand bags I’ll ever need!
Grab a stump and sit a spell. I’d offer you a beer,
but I don’t know if you’re of legal drinking age.
So why don’t you tell us a bit about yourself, like what
state your from and anything else you might like to share.


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## jimb1972

I seem to remember being trained to treat a sucking chest wound by using something flexible and plastic like a gauze wrapper and tapeing three sides of it, leaving the side untaped that will face down when the patient is laid with the wounded side lower. Wound on left chest, left side left untaped and patient laid on left side, but it was a long time ago.


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## paraquack

You remember correctly. The untapped side of the seal is in case the victim has a pneumothorax going on. It is usually caused by a penetrating chest wound that has damaged the lung and is leaking air into the chest. If untreated, the lungs collapse and the victim dies. With out proper training, sealing off a chest wound can be as bad as the sucking chest wound. Way too complicated to go into details. Find a good first aid class, and go.


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## Slippy

Very interesting thread. 

But who's the dude who said "Ughhh, this is why I avoid internet forums?" This is precisely why I like this forum!


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## Waterborne

Medic33 said:


> no dude - thank the OP and welcome here ,and thank you kuaboy for reminding me.
> the problem I have is a sucking chest wound will need professional medical attention in shtf there might be none period.
> just a point. Otherwise all your tring to do is keep the wound sealed on the breath in and soak up a minimal amount of fluid on the exhale -so just about anything that will seal it is good as jack pointed out cellophane is a kind of cool I never thought of.


Not all penetrating wounds to the chest will require surgery. The thoracic cavity is pretty good at closing up on it's on with palliative care.


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## Waterborne

paraquack said:


> You remember correctly. The untapped side of the seal is in case the victim has a pneumothorax going on. It is usually caused by a penetrating chest wound that has damaged the lung and is leaking air into the chest. If untreated, the lungs collapse and the victim dies. With out proper training, sealing off a chest wound can be as bad as the sucking chest wound. Way too complicated to go into details. Find a good first aid class, and go.


PHTLS (Just took the newest version) no longer recommends taping only 3 sides, they advocate taping all 4 sides and if a tension pneumo occurs then perform a needle decompression to alleviate the pressure. I took First aid merit badge in the boy scouts, also took my EMT-Basic, EMT-Intermediate, and Paramedic, that's over 2 years of schooling, also have over 7 years of EMS experience in a rural EMS service.

I'm sure some will say just stick with the old ways. but the old ways also said never use a tourniquet to stop bleeding and now it's first line treatment for major extremity bleeds.


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## Waterborne

Well I'm 27 so I'm of the legal drinking age. (no believe it or not I'm not a know it all teenager) but I prefer white Russians to beer. I also have an post in the introduce yourself forum.


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## PaulS

First aid classes do not cover chest penetrated wounds, or how to treat them. If you are faced with a wound of that type you call 911. If you have an object that is penetrating you do what you can to immobilize the object and the patient and call 911.
You need more than first aid training to deal with "battle field" wounds. If you are faced with this kind of wound in a SHTF scenario then the person who is wounded is likely to die. If the would does not kill them it is likely a secondary infection or incorrect action will. If you can afford the time and money to get battlefield medic training then it will improve the odds on the survival of your team - you might even be able to teach the others enough to save you if you are hit.
I have been through a series of first aid classes in the last year. A couple were put on by the Red Cross folks, and one was put on by a local fire department. The EMT that put on the fire department training made it plain that you have to have training to back up what ever you do. Granted that once the SHTF you are not going to be worried about being sued but you still need to have training before you apply lifesaving efforts when you have no way to tell what the internal injury is. If you don't have training then anything you do will likely make things worse.


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## Kauboy

PaulS said:


> First aid classes do not cover chest penetrated wounds, or how to treat them. If you are faced with a wound of that type you call 911. If you have an object that is penetrating you do what you can to immobilize the object and the patient and call 911.
> You need more than first aid training to deal with "battle field" wounds. If you are faced with this kind of wound in a SHTF scenario then the person who is wounded is likely to die. If the would does not kill them it is likely a secondary infection or incorrect action will. If you can afford the time and money to get battlefield medic training then it will improve the odds on the survival of your team - you might even be able to teach the others enough to save you if you are hit.
> I have been through a series of first aid classes in the last year. A couple were put on by the Red Cross folks, and one was put on by a local fire department. The EMT that put on the fire department training made it plain that you have to have training to back up what ever you do. Granted that once the SHTF you are not going to be worried about being sued but you still need to have training before you apply lifesaving efforts when you have no way to tell what the internal injury is. If you don't have training then anything you do will likely make things worse.


That said, and entirely true, if I'm bleeding out, you damn well better not be standing there doing nothing.


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## Still Resist

Between all choices store bought is the best but how many can one person buy? The Bolin, Hyfin and Halo chest seals will be superior to any improvised item (MRE or gauze wrapper) or expedient (tegaderm) but you are looking at a much larger cost. My personal BOK contains these because if I need them I want the best and want it to be as easy for a someone who is not a medic to apply under stress. 

I have different medic bags set up depending on the mission and in different locations (home, vehicle, cached). It wouldn't be practical unless one was rich to buy Halo seals for every kit. If someone is injured you would use their supplies on them before digging into your medic bag (which is why making sure people have the right stuff on them and in an easily identifiable and accessible location is so important) then move onto your bag. Sometimes you drop stuff in mud, wind blows it away or it sticks to itself. Stuff happens. Having tegaderms as a back up would be great then. 

Training can reflect this. Having water poured on you, rocks thrown at you, loud noises, strobes, screaming at you and equipment "failures" can be set up to make the medic think and progress through the problem. 

You can use the tegaderms to set up spare blow out kits in Ziplocs (containing them, chest needles, NPA/lube, battle dressings) which can be passed out before a mission etc. A medic can hand these kits out to people acting as a combat life savers with a little direction and then move onto the next patient so the medic isn't tied up.

Immediate treatment of the chest injury can prevent a tension pneumothorax so it never becomes a problem. 

Someone mentioned sealing on 3 sides to allow it to burp. That has been changed over the last few years and the TCCC and civilian standard is to seal all 4 sides and decompress if it develops into a tension pneumo. 

If a lung is "deflated" you should seal the injury site and "reinflate" with a bag valve mask or mouth to mouth. A person can get by pretty well with only one lung but you want to limit damage as much and as fast as you can. 

If you're looking at austere conditions or SHTF scenario there may not be higher level of care available but a person can still live with a chest injury and recover. A Vietnam War medic once told me that your job is to patch them up well enough so they can get on their feet and die the right way. Some people will die no matter what but interventions might keep them alive long enough to finish the mission or protect you while you escape, evade or whatever.


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## PaulS

If a person is dying or dead then your efforts to help are always better than letting them bleed out.

Kauboy, it you had a wound with an arterial bleed, I would try a restrictive compress first and if that didn't slow the bleeding I would use a tourniquet. Blood loss will kill you faster than a secondary infection. I might even apply some powdered alum to a non-arterial bleed before I bound it with a pressure compress. It all depends on the wound and available care. 

I would not attempt to dig a bullet out of you with active bleeding. There is plenty of time to go digging for a bullet after the bleeding is controlled.


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## Waterborne

You're right paulS first aid doesn't cover things like this. However being a prepper you of course realize that 911 might not always be available. Take your time now to utilize all the information available in print and on youtube. Channels like Dr. bones and nurse amy, Patriot nurse, skinny medic, and tac med solutions.


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## Seneca

Nothing like a discussion about sucking chest wounds to spark an interest in acquiring body armor.
Sounds like tegaderm may be a pretty good item to have in a blowout kit.


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## Kauboy

PaulS said:


> If a person is dying or dead then your efforts to help are always better than letting them bleed out.
> 
> Kauboy, it you had a wound with an arterial bleed, I would try a restrictive compress first and if that didn't slow the bleeding I would use a tourniquet. Blood loss will kill you faster than a secondary infection. I might even apply some powdered alum to a non-arterial bleed before I bound it with a pressure compress. It all depends on the wound and available care.
> 
> I would not attempt to dig a bullet out of you with active bleeding. There is plenty of time to go digging for a bullet after the bleeding is controlled.


I feel better now knowing you'll help me.


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## Kauboy

Still Resist said:


> Someone mentioned sealing on 3 sides to allow it to burp. That has been changed over the last few years and the TCCC and civilian standard is to seal all 4 sides and decompress if it develops into a tension pneumo.


You mentioned "civilian standard", so I have to ask... is a civilian expected to know how to perform a needle decompression from a simple first aid class? I don't remember being taught that during mine. Given the risks involved, is it even something we, as prepared individuals, should chance doing? I've read the procedure, and seen it done in videos, but should I really try it without proper training?
If the answer is no, should I then default to only a 3-side taping?


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## PaulS

As long as you use a needle about the worst you could do is hit an artery. You can relieve the pressure putting the needle into the wound through the dressing or below it. Expect a stream of blood (not pulsing) or air and blood mixed. Take appropriate precautions for fluid exposure or use a needle and tube from an IV bag to direct the fluid in a safe direction.

Yes I have several IV and blood draw bag kits in my disaster medical kit.


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## Kauboy

A proper decompression is done at the top of the chest, above the third rib, and outside of the nipple-to-clavicle line. (yeah, that probably has a medical term)
Doing it wrong can range from serious damage to just having to do it over again because you missed the pleural area.


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## Medic33

Kauboy said:


> You mentioned "civilian standard", so I have to ask... is a civilian expected to know how to perform a needle decompression from a simple first aid class? I don't remember being taught that during mine. Given the risks involved, is it even something we, as prepared individuals, should chance doing? I've read the procedure, and seen it done in videos, but should I really try it without proper training?
> If the answer is no, should I then default to only a 3-side taping?


DO NOT EVEN THINK ABOUT DOING SHIT LIKE THAT EVER. Don't even mention it cause some jackazz will think they know what they are doing and F it up and the person they are treating-no no just don't go there.


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## Medic33

I have had to step in and physically correct a couple field trakes that some thought they knew what they were doing almost killed the casualties
so again leave the medical to a professional.


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## Kauboy

Medic33 said:


> DO NOT EVEN THINK ABOUT DOING SHIT LIKE THAT EVER. Don't even mention it cause some jackazz will think they know what they are doing and F it up and the person they are treating-no no just don't go there.


That was less than informative...
If the answer is no, would you care to offer your perspective on my second question?


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## Waterborne

When stillresist says civilian standard I think he means the civilian standard in EMS and in the hospital. Needle decompression is performed at the intercostal space between the second and third rib at the mid clavicular line making sure to insert the needle at 90* to the chest wall. A regular IV needle won't work, make sure you get a special made needle like the North American Rescue ARS needle. They are pretty cheap on ebay. I just bought 10 of them on ebay for 50$
PaulS unless you stick your face right in front of the decompression needle you shouldn't get anything onto you. if you hook up a regular IV dripset to the hub of the decompression cath I'd be afraid you would pull it out. You don't leave the needle in you pull that out and leave in the flexible hollow catheter. I'm also kind of confused. you talk about not know much about the treatment of penetrating chest wounds from your first aid classes but you carry IV and blood draw sets? What do you mean by blood draw sets? Butterfly needles and blood tubes? Or do you mean blood bags for collecting blood to give during a trauma?


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## Kauboy

Waterborne said:


> Needle decompression is performed at the intercostal space between the second and third rib at the mid clavicular line making sure to insert the needle at 90* to the chest wall.


See, I knew it had a real name. 
Thanks for the info.

Still, nobody has answered my other question.
If a non-trained civilian knows about needle decomp, but isn't formally trained, should a 3-side taping be done on the chest seal, or still all 4 sides? I assume timing is an issue in determining that?


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## Medic33

I think waterborn covered it for me-thanks waterborn I am starting to like you.
don't have any friends yet maybe I found a first.


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## Medic33

3 sides you have to have something to allow for drainage or as I was trained slap a butload of petroleum jelly on the inside of the dressing to allow a tighter seal in the intake and still be able to drain on the exhale


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## Kauboy

Thanks!


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## Waterborne

If you are in a SHTF scenario and someone just took a round to the chest and after finishing the firefight, finishing the fight is the best initial medicine and why everyone should carry an IFAK so they can start self aide, and the person took a round to the chest cover both any holes with an occlusive dressing. If they experience further breathing difficulty put your hands on their chest. and have them breath in and out. if one side of their chest seems to stick out more than the other side and doesn't go back in when they breath out find their space between the second and third rib. the first rib is under your clavicle so you can't feel it. push hard to find the space between them and go over the third rib at the mid clavicular line. There are other ways like listening for breath sounds, and presence of JVD, but just go with the first test.Using the proper sized needle set line it up at a 90 degree angle to the chest not the ground but the chest. and bury the needle all the way up to the hub. remove the needle and leave the hollow catheter in place. You may or may not feel or hear a pop or a rush of air. If they did need it then you might have saved their life, if they didn't you didn't do that much trauma compared to the bullet that just left a much bigger hole in them. When you pull the catheter out the hole will close up pretty quick with no adverse affects. As far as medical professionals go it's important for everyone in a group to know how to use everything in their IFAKS; NPAs, decomp needles, occlusive dressings, Israeli bandages, ect. You should have a Paramedic or similar In your group that knows a lot of pathophysiology to back up the basic skills every member in the group should know. but... if it's SHTF and I take a round in the chest and you think I need a decompression you bury that F'n needle in my chest. Will go from there.


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## Kauboy

You're gonna fit in just fine here.


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## Still Resist

By civilian standard I meant non-military EMS. Sorry, should of clarified that.

A basic first aid class won't show you needle decompression but it also won't have you packing wounds, using Quikclot or using a tourniquet either. Most basic first-aid by its name is very basic and meant to be used till higher trained individuals show up. Most of the people who attend those courses aren't planning on there not being higher medical care available, getting shot or SHTF. Take basic first aid then as much additional training as you can get. Medical isn't as cool as guns and Multicam but it will save your life. 

If you don't have the equipment or knowledge to decompress, you could either tape 3 sides or in my opinion the better option is to still tape 4 sides and if the condition worsens to "burp" the dressing by lifting a corner off then reapplying it. Even advanced techniques like needle decompression can fail or become clogged so you have to monitor the patient and treat accordingly no matter what you use.

SHTF, a big killer will be infections unless you are having to fight. TCCC puts tension pneumothorax at 33% of all combat preventable deaths, which is a huge amount. 

+1 on what Waterborne said about the ARS needles. The chest wall is surprisingly thick and you need a long needle to reach the area. During our gross anatomy class we got to mess with corpses cut up in all kinds of different ways. The instructor put a 1.5" 20g angiocath into the removed chest wall of a cadaver and it didn't even come close to being deep enough. The ARS needles come in a container shaped like a pen which makes it easy to find in low light and protects the needle.


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## PaulS

I have a lot of gear in my extensive med kit that is there for a professional - not for me to use.
Looks like I need to get to know my new doctor better...


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## Jakthesoldier

For those of you who think carrying all kinds of specialized crap is super cool, and have giant first aid kits, let me give you this: I carry a kit in my car capable of fixing any medical situation up to and including field surgery. The entire kit could fit in a medium sized woman's purse. I have 2 specialized items in my kit, both are needles, and neither will be used for their intended purpose.

If you are set on staying in one location, and want all kinds of super cool high speed medical supplies, then absolutely go for it.

If you want to be able to carry your kit, skip it. 

The ifak does NOT contain a specific solution for a Sucking chest wound. It contains a repurposed solution to a Sucking chest wound, the plastic from the gauze.

As for shaking, bloody hands, I've enough experience to know better than get all jittery when fine motor skills are needed, but I forget that I have experiences many others do not.

As for the idea that anything you use in the field is sterile, just forget it. By the time you put on a bandaid, it's already infected. Persons suffering from something as severe as a sucking chest wound either need trained and supplied medical personnel (in which case sterile won't matter since they will clean the wound out anyway) or fixing them is probably just delaying the inevitable long enough to suffer a lot.

I'll leave it with this, just remember these key things
the wound stays as close to the person's ground side as possible, and tape only THREE sides of the lower wound, all four if there is an exit wound. (This let's fluid, and built up air drain out, but stops the outside air and nasty from getting in, and most people don't really know how to recognize or don't realize the solutions to what happens when you don't, especially under stress)


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## Jakthesoldier

PaulS said:


> As long as you use a needle about the worst you could do is hit an artery. You can relieve the pressure putting the needle into the wound through the dressing or below it. Expect a stream of blood (not pulsing) or air and blood mixed. Take appropriate precautions for fluid exposure or use a needle and tube from an IV bag to direct the fluid in a safe direction.
> 
> Yes I have several IV and blood draw bag kits in my disaster medical kit.


It was mentioned, but you need bigger needles for that.

Also needle decompression is performed by placing the needle in between the first and second ribs, not into the wound.


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## Jakthesoldier

Waterborne said:


> Not all penetrating wounds to the chest will require surgery. The thoracic cavity is pretty good at closing up on it's on with palliative care.


Unless... you penetrate anything that's inside the cavity, in which case you need surgery.


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## Prepared One

I have several medical kits. However, beyond rudimentary first aid I am lost. This is a big concern to me. I have the stuff but without the knowledge...and being alone, I fear it will end badly. Good thread. Has started me thinking. Thanks


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## PaulS

Like I said, beyond first aid, I have no training. I have learned a lot from this thread but nothing that I would feel comfortable doing without professional help. I'll keep my med kit stocked in case there is a professional that can use it.
Let's face it, even a veterinarian could help in a medical crisis as long as the tools are available.


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## Kauboy

PaulS said:


> Let's face it, even a veterinarian could help in a medical crisis as long as the tools are available.


For the medics on the board, is that really true? I'd like to think it is.
Hollywood likes to tell us this, but is vet training transferable to humans?
Yes, better than nothing, for sure.


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## Waterborne

Jakthesoldier said:


> Unless... you penetrate anything that's inside the cavity, in which case you need surgery.


I guess that's why put "not all". I don't know your experience but if you choose to limit yourself to being cool by being able to improvise everything you want to do feel free too. If you want everyone in your group to carry a piece of MRE wrapper and tape in their IFAK that's fine, but hopefully they all have the nerves of steel like you do, does your wife? your 15 year old son. I carry dedicated items in my IFAKs and my medical bags. I'd love to know how you're gonna improvise an NPA with surgilube, let me guess you're gonna use a safety pin through their tongue onto their shirt collar? How are you going to ventilate the person then? Are you going to stab a hollowed out ink pin to relieve a tension pneumo? I'd love to know how you are going to administer fluids without specialized equipment . Medical professionals carry specialized equipment from civilian EMS to SF super medics. Can I improvise all sorts of things? Yes I can. Do I choose to be fool hardy by limiting myself to junk I may or may not have? No I'm a prepper, thus I buy the things I might need one day.


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## Medic33

to follow up on jack's advise -splinting a fracture is about as far as most first aid types are going to go-gunshot wounds knife and perforated objects stuck in someone like pieces of 2x4's or something a first aid person is not going to really help except make it worse and before you say anything is better than nothing remember this; that person needs help not feel good advice most first responders are trained to stabilize and transport -if shit hits the fan were you going to transport? every medical facility in 100 miles is going to be over flowing with people who think they need emergency treatment. basic wound dressings like roller gauze maybe field dressings ect some antibiotic ointment maybe a compact burn kit 2x2's and 4x4s several rolls of clothe medical tape and a cpr mask is about all your going to need many times if you get a wrap on a laceration(cut) fast enough and snug(not freaking tight) enough, sutures may not even be needed. like jack has stated keep it simple and cover the basics IFAC are oneshot use and that blood stopper shit doesn't work I have had it just clog then blow out in one large clump then I was back to square one with profuse bleeding. also if there in internal bleeding then you just plugged a hole and now the person is filling up on their own fluids = not good. use your head keep your head and just fix what you can if it isn't enough well live with it. it sounds harsh and sometimes life can be.


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## Waterborne

Medic33 when is the last time you saw quikclot come in powder form? It has come in sponges and impregnated in gauze for years so that argument is gone. JAksoldier, you said decompress over the second rib, where? into the shoulder through the clavicle? Ya'll keep harping on first aid trained people, most soldiers aren't trained as medics yet they learn how to initially treat a GSW. I keep hearing outdated advice, cliché's, defeatist attitudes, and strawman arguments from people who want to be argumentative, it's asanine. In a SHTF situation with a good understanding of pathophysiology, skills, and stockpiling necessary equipment and meds then it' won't be treat, transport and then treat at your retreat to the best of your medical personals abilities.


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## RNprepper

And the fact of the matter is that a lot of people will simply die from stuff that we don't even think much about now a days. - appendicitis, compound fractures, pneumonia, asthma, childbirth. Traumatic injuries involving body cavities and bones are much more likely to die than survive. It will be very hard, but it will be important to triage who can be saved and who will just receive comfort measures. The day may come when limited resources will have to be reserved for those who can be saved.


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## Still Resist

Hershel patched up several gunshot wounds, made IV antibiotics, sutured people up but didn't get involved with sick pigs LOL.

A vet can be a great asset especially if they are aggressive and willing to make the jump from animals to people. They can suture, remove bullets, extract teeth, treat infections etc. I don't know much about working on animals to give it a good comparison but have used human interventions on my chickens and helped them. Farmers have taken vet items for themselves before it became cool in prepping circles. My father thought everything could be fixed with turpentine and bag balm. I think it was an old Ragnar Benson book where he listed unlikely occupations which can help with medical issues such as a mechanic being able to visualize and set bones from his mechanic experience. 

My girlfriend is some kind of vet helper/technician or something. I really should pay more attention when she tells me stuff. When we talk medical stuff there is a lot of similarities. She is able to start IVs, mix and give meds, assists in surgery,dress wounds, suturing and tooth extraction. While not credentialed to do some skills on her own she has acquired knowledge from watching and helping that I don't have. 

This might sound stupid but I think my cat has a UTI. I bought test strips to use on people when SHTF and there is no ER but never thought of using it on my cat. Even at her level she can interpret the strips and analyze the urine under a microscope and know what treatment to give. The antibiotics they would use are similar to identical to the ones for people. You would just need to make sure you're using the correct drug and dose (Physician's Desk Reference and Nurse's Drug handbook) for the problem. 

Even if the vet cannot do open heart surgery they should be able to reset bones and do most of what people would need post SHTF. Lots of people have antibiotics but if you don't use the right one on the right strain it won't work. The vet will know which to use. 

If I had to pick between different Drs I would probably choose an ER Dr first (broad knowledge and skills), Vet second and a toss up between a trauma surgeon and a general practitioner. A trauma Dr is great but specialized where we're more likely going to need someone to help us treat lice, ringworm, bladder infections, and STDs than remove shrapnel.


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## Still Resist

Absolutely agree, RN Prepper!!!! 

I don't carry a BVM or much advanced airway stuff because long term without a ventilator it won't make a difference anyways. Without secure, long term care even those who can be saved with emergency interventions will die. That is where nursing really shines. I can treat and dress wounds in emergent situations but some injuries will require weeks or months to properly heal. That is a lot of dressings to change and looking at the wound to prevent infection, hydrate with the proper fluids etc.

Infections will be a big killer. I have nurse boxes set up in totes for this (guerrilla warfare scenario) containing Laundry, hand, dish soap. Tons of sterile dressings and gloves. Beta-dine. Bed sheets, wash clothes, towels, bug nets, pool shock, etc. They can be dropped off into an area and make a cave or building a long term care station.


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## Jakthesoldier

This is one of the reasons I started the skills thread. Training skills, developing the calm mind under fire, and maintaining the creative and adaptive mind are far more valuable than the supplies themselves. 

Maybe I can do a few "advanced" first aid posts on there. Medic, I appreciate your input there as well.


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## Medic33

well water - it has been a while, but I have no doubt on my ability I was around before all that fancy stuff was out -so to you how many doctors or professional medical people such as myself (A PA in pediatrics) are going to be around to give a helping hand in a shtf I bet they are so bogged down they won't see the light of day for weeks* if* they don't bail to their families first. And those that are I bet will be keeping their mouths shut and walking on after a while. that I took an oath will lst only so long they are people too.
*joke* what is the difference between a doctor and God ---you never heard God say he was a doctor.


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## Waterborne

Well I'm out, I think my time would be better used convincing liberals that gun control is bad, they seem to use more logic. I'll leave ya'll in the capable hands of one who admits he hasn't done this kinda stuff in awhile and hasn't kept up with current research and practices in austere medicine or TCCC and one who is going to teach you how to remain calm under fire ...... Over the internet and other gems like specialized equipment like tourniquets , chest seals, and IVs can all be improvised from the purse sized bag he has full of Popsicle sticks, 550 cord and other multi purpose items. I.'my sure I'll get flamed but oh well. Is improvising important? Yes. But I'll leave with this.., I can start a fire with a 9V battery and steel wool, hell I even did it with a bamboo saw once but a bic is a lot easier to carry, even if it is too specialized for some.


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## paraquack

Bye Waterborne, I have learned one thing from you, and thank you for sharing. I hope you've learned a few things from us. Bye.


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## Kauboy

Stick around. You have to have a thicker skin around these guys. Some of them take things personally.(a fatal flaw on the internet)
Your information is just as valuable to us as anyone's.


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## Jakthesoldier

Waterborne said:


> Well I'm out, I think my time would be better used convincing liberals that gun control is bad, they seem to use more logic. I'll leave ya'll in the capable hands of one who admits he hasn't done this kinda stuff in awhile and hasn't kept up with current research and practices in austere medicine or TCCC and one who is going to teach you how to remain calm under fire ...... Over the internet and other gems like specialized equipment like tourniquets , chest seals, and IVs can all be improvised from the purse sized bag he has full of Popsicle sticks, 550 cord and other multi purpose items. I.'my sure I'll get flamed but oh well. Is improvising important? Yes. But I'll leave with this.., I can start a fire with a 9V battery and steel wool, hell I even did it with a bamboo saw once but a bic is a lot easier to carry, even if it is too specialized for some.


I wonder if you consider a surgical research technician who specializes in damage control and resescitation, a medical laboratory technician, a first aid trainer, or a combat veteran as "capable"?


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## Medic33

well if that was all it took then good bye - lastly why don't medical pro's give advice and how to's on the internet or forums -simple -it is called liability one assjerker tries something you said and BOOM your in a lawsuit with copies of what you said in a court -can you say bye bye license-can you say malpractice -can you say possible jail time. now do you get the point. and there are people waiting out there that make their living doing exactly that. also good Samaritan laws do not apply in these situations, and you will have to prove it wasn't you who typed it not them proving you did.
And jack bud, he was rapping on me -I particularly could care less about someone who can't even hang for a couple days with a little negative criticism makes you wonder how they even function in everyday life especially in a crisis when lives may be on the line.


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## Jakthesoldier

I know, but jesus. Some people buy a box of bandaids and watch a youtube video on an NPA, then suddenly become experts and think they know how to do brain surgery. 

I'll say again, I'm all for stockpiling medical supplies, provided you know how to use them, and provided you are staying put. As for the staying put part, that applies to all supplies you can't carry.

Having dedicated and specialized equipment doesn't help if 1. You don't know how to use it, and 2. you have to move and can't carry it.

But if you take the time to learn the skills, it can be a huge help. 

But I still see this, a roll of tape has 1000 uses, ceranwrap too. But a patch designed to seal a sucking chest wound has two, stopping a sucking chest wound, and pissing you off when your bloody fingers can't grip the little adhesive cover edges and get the dang thing operational.


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## Medic33

petroleum jelly jack works wonders for sticking stuff temporarily
kuaboy a veterinarian I don't see why they couldn't help in a pinch -they do have medical knowledge and aren't afraid to use it even if the anatomy is different.
in a real teorwawki the biggest issues medically are going to be infection and disease - the human body is a wondrous healing machine it just takes time - but today people pop antibiotics like they are tic tacs that alone is the one reason superbugs are so damn aggressive.
learn wound management cleaning and bandaging as well as keeping it clean, also learn bedside care the ones to really watch are the young the old and the immune compromised


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## Jakthesoldier

Hmmm. Yea I guess on a non porous surface petroleum jelly would work. Couldn't bump it or anything, but it'd hold something in place for a bit.


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## MisterMills357

*I Would Use Saran Wrap*

View attachment 11498

In the Army I was taught to use the plastic from a bandage, to cover the hole. Then tie wrap the bandage around the chest, to seal of the hole.
Then to hold pressure if needed.
Now-a-days, I figure that a roll of Saran Wrap would work as well as anything. Just wrap it around the chest tightly and hope for the best.
Saran Wrap can be stretched tightly and is tougher than you think.
Anyone with this wound is in deep doo-doo, until they get surgery. So anything that you can do would be considered life-saving and Good Samaritan.

Pneumothorax (sucking chest wound). - Biology Forums Gallery


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## RNprepper

Kauboy said:


> For the medics on the board, is that really true? I'd like to think it is.
> Hollywood likes to tell us this, but is vet training transferable to humans?
> Yes, better than nothing, for sure.


Yes, a vet can be a big help. The anatomy of mammals is pretty similar between species, with variation of course. But lungs are lungs and kidney are kidneys. Vets can stitch, extract teeth (you've never seen anything until you've seen a vet hammer out a horse molar!), give IV fluids, administer antibiotics, and deliver a baby. I'd let a vet take out my appendix if there was no other choice post SHTF. Dentists are also pretty handy, and they can perform minor surgery and stitch you up as well. The thing about any medical professional is that they know how to maintain aseptic technique, handle surgical instruments, perform resuscitation, and keep calm in an emergency. They aren't going to put on sterile gloves and then accidentally contaminate their field by touching their nose. (And they actually know HOW to put on sterile gloves without contaminating the gloves in the process.) Medical training, no matter what the specialty, will be in high demand post SHTF.


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## Medic33

Jakthesoldier said:


> I know, but jesus. Some people buy a box of bandaids and watch a youtube video on an NPA, then suddenly become experts and think they know how to do brain surgery.
> 
> I'll say again, I'm all for stockpiling medical supplies, provided you know how to use them, and provided you are staying put. As for the staying put part, that applies to all supplies you can't carry.
> 
> Having dedicated and specialized equipment doesn't help if 1. You don't know how to use it, and 2. you have to move and can't carry it.
> 
> But if you take the time to learn the skills, it can be a huge help.
> 
> But I still see this, a roll of tape has 1000 uses, ceranwrap too. But a patch designed to seal a sucking chest wound has two, stopping a sucking chest wound, and pissing you off when your bloody fingers can't grip the little adhesive cover edges and get the dang thing operational.


or worse they watch *greys anatomy *or *house* and think they learned something? like a big WOWser


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## paraquack

Can I give a double like?


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## Urinal Cake

The best thing for Sucking Chest wounds....
HALO XL CHEST SEAL TRAUMA DRESSING


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## Jakthesoldier

Urinal Cake said:


> The best thing for Sucking Chest wounds....
> HALO XL CHEST SEAL TRAUMA DRESSING


You have any first hand experience using these? Run across the issues of not sticking and sealing over hair? Blood? Tearing wounds when burping? Not resealing when burped more than twice?


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## Medic33

the best thing for sucking chest wounds is just don't get one.


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## warrior4

Sitting here in my ambulance I can't help but think of a few things reading this thread. There's been some very good information shared. Right now today if anyone who wasn't at least a licensed paramedic tried to do anything invasive like decompress a chest wound, start a needle or surgical cric airway, start an IV or anything like that even if they were successful they're opening themselves wide open to a lawsuit. I'm a licensed Paramedic and the only time I would even consider doing something like that is when I'm in uniform, on duty, and called to the scene of a patient that requires it. Off-duty it's a nasty grey world to consider. So off duty I'll stick to basic first aid and do my best to stabilize the pt as in most urban and sub-urban areas medical help is a phone call and maybe 4-8 min away.

By all means for those who are not medical professionals take first aid and CPR classes. Basic interventions by bystanders such as holding direct pressure on a bleeding wound or performing high quality CPR can and do make the difference between life and death before an ambulance can arrive on scene. I'd rather have a calm collected bystander on scene who can do basic things when I show up than someone who is panicking or not doing anything any day of the week. 

Yes it's also good to be able know how to use non-medical equipment for medical purposes. Give me some duck tape and a long strong stick and I can splint just about anything. Post SHTF or when "real" medical equipment isn't available it can and will work. However there's also nothing wrong with having the right equipment for the job at hand, provided you also know how and when to use it.


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