Use of tegaderms as chest seals.

[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-Trans...2XE79E0HBSBZEV

 

[Brent S]

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-Trans...2XE79E0HBSBZEV

I was thinking as reading your post that if someone has a penetrating chest wound over two inches during any kind of large scale emergency then your wasting the tegaderm....... Not trying to be morbid here, but triage is deciding who can be helped with limited resources. I am very aware how lucky we are in this country with the extensive emergency medical care system we can take an injured person to. I hope we never see a time without it.

 

[Waterborne]

Brent S I can agree with you on triage of injuries in compatible with life during a SHTF scenario, however 2'' is a really big hole, larger than most rounds will leave in somebody. If it's just a through and through then a tegaderm is pretty cheap to slap on somebody.

 

[Maverick]

Hyfin twin pack with relief vents is all I stock today along with a NAR ARS decompression needles I've kept with my older style chest seals. I'm with Brent, hope the hell we don't ever have to experience a situation were we have to rely on our preps.

 

[Brent S]

Most of my medical preps are for daily life ailments and common or likely things after shtf like direhhea, fever, minor trauma and such. I want to be able to treat likely things before they get life threatening and be able to stitch someone up if needed. I kind of figure though that if you have a chest trauma like a 5.56 through and through, and there's no access to a hospital, then you're already done for. On the battlefield or in just about any place in the US right now you do all you can to keep someone alive until they reach the support of a medical/surgical facility. If, and when, we ever have a real breakdown of our system we will be much more limited with what we could reasonably expect to be recoverable from.

 

[Waterborne]

Most of my medical preps are for daily life ailments and common or likely things after shtf like direhhea, fever, minor trauma and such. I want to be able to treat likely things before they get life threatening and be able to stitch someone up if needed. I kind of figure though that if you have a chest trauma like a 5.56 through and through, and there's no access to a hospital, then you're already done for. On the battlefield or in just about any place in the US right now you do all you can to keep someone alive until they reach the support of a medical/surgical facility. If, and when, we ever have a real breakdown of our system we will be much more limited with what we could reasonably expect to be recoverable from.

So you just don't carry an IFAK because you are pretty sure you will die anyway. What about now during a non SHTF time?

 

[Brent S]

So you just don't carry an IFAK because you are pretty sure you will die anyway. What about now during a non SHTF time?

I guess each one of us has just so many things on our lists and only so much room and budget to work with. We all prioritize what preps we think are the most important to collect. With the medical system as good as it is right now, I would do anything possible to keep someone alive until I could get them to more advanced care. I'm talking in the middle of a large scale disaster or shtf scenario where hospitals are off line or not reachable within a reasonable amount of time.

 

[Maverick]

I have a fairly large first aid kit that will get me through a crises until help arrives or able to get the person to the hospital or medical facility though in a long term SHTF or TEOTWAWKI it would be far more limited thus arterial bleeding or severe chest wound such as gunshot or gut-shot than only the grace of GOD would save the person thus my expanded kits are very much limited in scope. I do have medical bone saws and good irons for slapping heat to cauterize the stub but even then no guarantee of survival. Perspective, in the Civil War 15% or 7 to 1 wound treatment (those number are far better than surviving the war itself were the survival rate was 1 in 4 through direct action) that was a direct result from amputations as was why fatalities were as low as they were of the wounded plus the advent of field surgical doctors though the numbers don't reflect those that died from infections as a result of the wounds. As a comparison the Korean War the percentage was 2 to 1 given at that time surgical doctors were able to treat chest/abdominal wound and prevent infections.

A slight advantage us laymen have today is our awareness of hygiene/sanitation/sterilization and access to medical kits in treating wounds. Though I hate to say it, in a long term SHTF or TEOTWAWKI without a medical facility surviving head/chest and abdominal area severe wounds isn't going to be good and the best we can do is make the person as comfortable as we can, in some cases it may be better to allow them to bleed out than to prolong the suffering. It may be cold-hearted but sometimes we have to think of the wounded and not our emotions and that is a sad situation to be in In the battlefield with no hope of help coming morphine has been used knowing the morphine will accelerate death, just pray to GOD folks don't find themselves in that situation.

 

[Brent S]

All I am sure of is even though I have a decent first aide supply, it is limited and will run out in a shtf situation or prolonged disaster. Knowing when and how to use your limited resources to benefit the most people is a harsh reality. As we've both said, I hope we never see this.

 

[Waterborne]

I have a fairly large first aid kit that will get me through a crises until help arrives or able to get the person to the hospital or medical facility though in a long term SHTF or TEOTWAWKI it would be far more limited thus arterial bleeding or severe chest wound such as gunshot or gut-shot than only the grace of GOD would save the person thus my expanded kits are very much limited in scope. I do have medical bone saws and good irons for slapping heat to cauterize the stub but even then no guarantee of survival. Perspective, in the Civil War 15% or 7 to 1 wound treatment (those number are far better than surviving the war itself were the survival rate was 1 in 4 through direct action) that was a direct result from amputations as was why fatalities were as low as they were of the wounded plus the advent of field surgical doctors though the numbers don't reflect those that died from infections as a result of the wounds. As a comparison the Korean War the percentage was 2 to 1 given at that time surgical doctors were able to treat chest/abdominal wound and prevent infections.

A slight advantage us laymen have today is our awareness of hygiene/sanitation/sterilization and access to medical kits in treating wounds. Though I hate to say it, in a long term SHTF or TEOTWAWKI without a medical facility surviving head/chest and abdominal area severe wounds isn't going to be good and the best we can do is make the person as comfortable as we can, in some cases it may be better to allow them to bleed out than to prolong the suffering. It may be cold-hearted but sometimes we have to think of the wounded and not our emotions and that is a sad situation to be in In the battlefield with no hope of help coming morphine has been used knowing the morphine will accelerate death, just pray to GOD folks don't find themselves in that situation.

The Chest seal is a comfort item, and is fairly cheap, you could improvise as well. You're probably not going to bleed out from a through and through chest wound, You'll just watch them suffocate until the tension pneumo pushes against the heart enough to cause them to die. Its funny that you mention using morphine to quicken death (only if you give them enough to drop their blood pressure enough or drop their resp. drive) but don't want to use a 0.25$ chest seal that might save their lives. I always see a fair amount of defeatism when it comes to medical stuff in prepping. The knowledge is out their for the learning and medical supplies are pretty cheap.

 

[user 6789]

we have plenty of the tegaderm and washerman chest seals if need be. Also the tegaderm is nice for other things too as its waterproof and see thru. Im thinking a bad cut that needs to be sealed so dirt doesn't get in it. I needs to be open to drain or heal on its own (no suturing it up) the tegaderm patch allows you to see the wound and keep an eye on it as well as keeping out the dirt and trash. Im an ex emt-I and we had three nurses now down to two in our group. We have a better medical section than most third world hospitals and could start our own clinic LOL Its one of those things have it and hope we don't need it. But glad we got it kind of things. We plan on doing everything we possibly can to save our groups lives first.

 

[jontte]

for the moment I'm happy to work at a hospital too and get some experience from there,then getting some more from being that combat medic
in my reserve unit,all this have resulted in small changes for my IFAK I carry with me and that first aid back pack I built up.
then on the other hand,more I learn,more I kinda fear as we seem to walk on very narrow path of safety,it only takes so much
to push us over the cliff.