One thing though .....and this is a SERIOUS risk..... you have to understand that if you’re going to pack a wound (with gauze or XSTAT), you have a high likelihood of introducing bacteria into the wound - which WILL ultimately result in a septic wound. So unless you’re either doing it in sterile conditions, or can first scrub/wash the area with betadine and then create a sterile field around the wound to work in, you wouldn’t want to do this to someone who was more than a few hours away from a trauma room with IV antibiotics.flechero wrote:Maybe so, we took it a few weeks ago. They also talked at length about the sponge packed syringes and the trauma surgeons were big fans of them... thinking they must be a newer version/model than what your class talked about. They said they had the clay base clotting agents and also the markers for scan/x-ray.The Annoyed Man wrote: Interesting. If your class was more recent than mine (3 years ago), maybe the protocols have changed.
And I probably don’t need to tell you this, your having had a class in this stuff, but other people read these pages. So it goes without saying that nobody ought to pack a wound without wearing surgical gloves - both to protect the patient, and to protect you from whatever they might already be carrying. You just never know these days what somebody might be carrying.
Typically though, a gunshot wound has probably already had a fair amount of bacteria dragged into it from the patient’s clothing and skin by the passage of the bullet. A local cop friend of mine back in CA accidentally/negligently/whatever shot himself in the thigh one night with his duty weapon while reholstering his gun after having had to draw it. The bullet entered the lateral side near his hip, and exited just above his knee on the medial side. I was on duty when the paramedics brought him into our ER. The bullet hit no major blood vessels or bone; it just punched a hole through the muscles of his anterior thigh. But the bullet did drag fragments of his holster and uniform pants along the wound path, thoroughly “salting” it with bacteria. My friend ended up with a heck of a wound infection. Instead of being admitted overnight for observation and sent home the next day - which is what would have happened had there been no infection - he spent several days in the hospital getting some pretty stout IV antibiotics to knock the infection down.
Even so, that is not an argument in favor of packing a wound without exercising sterile technique if at all possible. This is where the “first, do no harm” rubber meets the road, and it’s why I was arguing above against the practice of wound packing by anyone not trained and certified in the techniques. If you don’t know what you don’t know, you can cause great harm......harm which a badly injured person cannot afford.
So XSTAT might be a godsend in the right hands - as you previously posted - but not such a good thing in the hands of someone who hasn’t been trained it its use, who saw and ad for it, had the $300/unit available, and bought some online.