While responding as an advanced life support (ALS) first-response engine company to an industrial accident, you remember the last time you went to this factory. On that run a 1,500-pound billet of steel fell on an operator, fracturing and lacerating his leg from just below his knee to his ankle. The plant’s rapid response team was on-scene and attempting to stop the bleeding with towels and trauma dressings.
This current response is not much different; the dispatch message is “a laceration with uncontrolled bleeding.” As the chauffer pulls into the parking lot, several people are frantically signaling you to the back building of a large metal milling auto parts plant. The safety supervisor tells your officer that an operator was using a metal lathe when the spindle broke, sending the part and shrapnel through the guard, causing a large and deep laceration to his right hip/groin area. You find a 50-year-old male with a four-inch-long by three-inch-wide laceration directly over the right femoral artery/vein area with heavy bleeding. The response team had been holding direct pressure with a towel for about four to five minutes and reported that there was spurting blood. The patient’s pants were soaked with blood; you estimate a pool of about 300 to 400 ml of blood surrounding him.
在最近的一次在职,你的医学主任rolled out the newest in bleeding controla hemostatic dressing designed to stop arterial bleeding in only a few minutes of applied direct pressure. As your patient’s heart rate increases and the level of consciousness declines, you press this new dressing into the wound and apply pressure. As the bleeding slows and IVs are started, you are grateful to have this new technology.
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