Another week, another #traumatuesday! This series we are providing #coderedtips on how to optimise casualty management. Last week we covered pelvic binder application using a road traffic collision scenario as an example. Today we are switching things up and looking at penetrating trauma and external haemorrhage – so let’s start with the basic skill of applying direct pressure using the ‘stiletto effect’.
When asked to demonstrate direct pressure, many of our course candidates naturally place the palms of their hands over the top of a wound – just like the movies! Why not try it now on your thigh – one hand over the other, pressing down. Effective? Not really.
Instead, use focused pressure by pressing down with your thumbs or fingers over the top of a wound – this is known as the ‘stiletto effect’. Try it now and see how using a reduced surface area can massively increase the pressure exerted.
For casualties with massive external haemorrhage; expose the bleeding point, find the ruptured vessel and press your (ideally gloved) fingers or thumbs directly against it.
90% OF EXTERNAL HAEMORRHAGES CAN BE CONTROLLED WITH WELL PERFORMED DIRECT PRESSURE (Forrest, 2020).
*If the casualty has large or multiple wounds where the ‘stiletto effect’ won’t work, apply firm direct pressure using the heel of the hand over an absorbent sterile pressure dressing. If bleeding continues, consider a tourniquet if on a limb or haemostatic gauze on junctional wounds (neck/armpit/groin) or deep cavity wounds. Do not blindly insert gauze into the thorax or abdomen if the point of bleeding (ruptured vessel) cannot be visualised.
Our mission is to make a difference by #empoweringothers to have the knowledge, skills and confidence to alleviate suffering and save lives. Access further CPD and learn more about the courses we teach at www.coderedtraining.co.uk
You can also check out our free CPD video on direct pressure application here: Free CPD | Code Red Training | Bristol
Reference:
Forrest, M., 2020. Rescue Trauma and Casualty Care Manual. V1.2 Lancashire: The ATACC Group