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The "Tactical Tampon" in Treating Gunshot Wounds

Marauder06

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#1
I know there are a lot of "medical-smart" people on this board. How do you feel about the field-expedient use of tampons to great GSWs?

It seems that every other week a post on social media touts the amazing effects of tampons as a life-saving intervention (LSI). After all, there are anecdotes from Iraq, Afghanistan, and the veteran favorite “back in my day” story.
 

Devildoc

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#3
There has been anecdotal evidence ("I did it and it saved my buddy's life) but I have yet to see them actually, you know, help.
 

x SF med

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#4
Gotta use the 'plain jane' variety, and get the ones in plastic outer wrappers and sleeves. Outer wrapper because they protect better, sleeves because they are easier to place in the wound channel. All other wound care protocols stay in place, and if you'll pardon the medical pun, the tampon acts as an agent for tamponade for grossly misaligned structures.
 

policemedic

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#5
Using a tampon seems intuitive, and I suppose if nothing else was available would be worth it as a last ditch hail Mary. Otherwise, I tend to think it's not worth the effort.

They are too short, composed of too little fluffy stuff, and generally incapable (in my view) of occluding a bleeding vessel which is the point of stuffing fluffy white stuff into a wound channel.

I think this falls into the same category as MAST pants, 15LPM O2 for everyone, KEDs, and the like.
 

SpitfireV

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#6
I suppose if you're ever in a situation where enough people have been shot that you've run out of everything else and need to use tampons, you should probably concentrate on shooting the guys shooting your guys.
 

Ocoka

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#7
Gauze.

I can't envision many scenarios where you'd encounter both a GSW and a box of tampons. I mean there'd be no reason for a Medic/Corpsman/Paramedic to pack tampons when he can just pack more gauze.

Likewise I think we had a thread about urine as an antiseptic in an emergency. How often is that gonna happen?
 

256

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#10
Gauze.

I can't envision many scenarios where you'd encounter both a GSW and a box of tampons. I mean there'd be no reason for a Medic/Corpsman/Paramedic to pack tampons when he can just pack more gauze.

Likewise I think we had a thread about urine as an antiseptic in an emergency. How often is that gonna happen?
Ocoka,

Short story about tampon availability. During a deployment to Iraq (06-07) we had a dude in our platoon named Jamie Christi. We would also get care packages sent to us from random churches or the US community in general. Jamie would regularly get tampons sent to him in the mail because of his name. haha! Needless to say, we had tampons in our med kits, I never used them to treat GSW tho.
 

FisherAD1

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#13
Seems everyone agrees, tampons are useless in life-threatening GSWs or to control hemorrhage. Glad everyone enjoyed the article.
 

256

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#15

Figured this was a good thread to post, since it's penetrating trauma. Pericardial tamponade relieved.
Thank you for sharing, not 100% sure what I’m watching. The medical field is so interesting. What I see in the video: The Doctors make cuts to something red which is near a white cord then blood (I’m assuming it’s blood, assuming not being the best word in this type of field) comes from something red. Now “all we have to do it fix it” they say to one another. I’m still scratching my head going, “I knew I should have at least given blood this month..slacker!”

Kudos to the men and women of this field from the Doctors to the EMT rookie, thanks for what you do!
 

Muppet

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#16
Thank you for sharing, not 100% sure what I’m watching. The medical field is so interesting. What I see in the video: The Doctors make cuts to something red which is near a white cord then blood (I’m assuming it’s blood, assuming not being the best word in this type of field) comes from something red. Now “all we have to do it fix it” they say to one another. I’m still scratching my head going, “I knew I should have at least given blood this month..slacker!”

Kudos to the men and women of this field from the Doctors to the EMT rookie, thanks for what you do!
Hey bro. Pericardial tamponade is a life threatening malady that occurs with trauma and some non trauma events. It results in the pericardium or outter sack around the heart becoming compromised resulting in blood filling that space, squeezing the heart, preventing inflow/outflow of blood to/from body, resulting in rapid death. This unlucky soul on the video had a gun shot wound, resulting in the injury. Trauma docs made a pericardial window, open the sack and did the work that bright lights and cold steel requires (there was a caption but apparently, it did not copy over with video).
 

ZFino

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#17
I was always taught that tampons are insufficient in treating GSWs. Paramedicine changes constantly so correct me if I was taught wrongly. Hell, using normal saline to treat hemorrhagic shock is still a SoC.

Gunshot wounds are not always linear, especially if a rifle was used. The geometry is not conducive to providing direct pressure to affected vessels. To control massive hemorrhage, you want direct pressure on lacerated vessels and a stable environment for coagulation. They are designed to absorb and wick blood not form stable clots or stop it from exiting circulation, although perhaps the blood will be drawn into the tampon and begin clotting there... You want the blood to adhere to your packing material at the site of the ruptured vessel and begin clotting in this location. Absorption does little but keep the work area clean, and tampons don't even hold much blood. If you have ever packed a wound, you know that when done properly and aggressively, you will be inserting WAY more material into the wound than a tampon contains. You are trying to fill the entire void for the best chance of providing strong and consistent direct pressure on the affected vessel. This is hard to do when you can't get your fingers directly over the artery, which is why you pack until it is full and then you pack some more. You want your material to provide an adequate medium for direct pressure with a large surface area at the site of the ruptured vessel. You would be much better off using your shirt.

If I was ass naked, alone with a bleeding patient and the only material near me was a crate full of tampons, I would be breaking their shape and shoving as many of them as I could inside his body. I'm sure there are a thousand other effective uses for them though.