Abdominal wounds...interesting concept

[MAJK]

So....it's impossible that this thing will work, huh?

While we're on the subject of...er...questionable concepts, tell me more about pumping the peritoneal cavity full of Celox, especially the part about how it won't make the abdominal cavity into a cement brick.

at the concept of paramedics squirting Celox into the peritoneal cavity. Good one. Assuming you're joking, of course.

I'd have to test it and see it first hand but I don't think it will work. I don't want to say without trying it but seems like a bad idea for the above reasons. An injectable hemostatic agent would be better at the role one CCP.

Not much else you can do...just get him to the surgeon (NOT ER DOC) ASAP. An ER Doc will not do anything different than a good medic/PJ/18D in the field. I know a few 18Ds also and they are very good at what they do. However, I did have a 3rd group 18D get sick while doing a BKA

[Hmac]

I'd have to test it and see it first hand but I don't think it will work. I don't want to say without trying it but seems like a bad idea for the above reasons. An injectable hemostatic agent would be better at the role one CCP.

Not much else you can do...just get him to the surgeon (NOT ER DOC) ASAP. An ER Doc will not do anything different than a good medic/PJ/18D in the field. I know a few 18Ds also and they are very good at what they do. However, I did have a 3rd group 18D get sick while doing a BKA

I'm not sure you have a complete grasp of the anatomy and physiology of the peritoneal cavity, nor of whats actually happening in intraabdominal hemorrhage. You keep talking about an "injectable hemostatic agent" as a means of controlling shock from intraabdominal hemorrhage. What are you talking about? Injecting what into what? How do you propose that's going to work exactly?

Compression is always the first line of controlling arterial hemorrhage, and, as a trauma surgeon, compressing the aorta is the first thing I do when entering the abdominal cavity for shock. If hemorrhagic shock can be identified pre-hospital ddand if this device can be applied pre-hospital before the patient gets to the trauma surgeon, it might save lives from penetrating trauma. Your concerns about not being able to ventilate with abdominal compression are likely unwarranted in normal BMI folks, maybe unwarranted in everyone. I'd have to see the data.

[MAJK]

I'm not sure you have a complete grasp of the anatomy and physiology of the peritoneal cavity, nor of whats actually happening in intraabdominal hemorrhage. You keep talking about an "injectable hemostatic agent" as a means of controlling shock from intraabdominal hemorrhage. What are you talking about? Injecting what into what? How do you propose that's going to work exactly?

Compression is always the first line of controlling arterial hemorrhage, and, as a trauma surgeon, compressing the aorta is the first thing I do when entering the abdominal cavity for shock. If hemorrhagic shock can be identified pre-hospital ddand if this device can be applied pre-hospital before the patient gets to the trauma surgeon, it might save lives from penetrating trauma. Your concerns about not being able to ventilate with abdominal compression are likely unwarranted in normal BMI folks, maybe unwarranted in everyone. I'd have to see the data.

you must know ... your the trauma surgeon

[Hmac]

I'd have to see it applied but putting pressure on the abdomen is going to be very hard to do. I guess its worth a try but I dont think its going to work. Creating an abdominal compartment syndrome might not be the best thing to do. However, as stated above I'd have to test it myself.

As far as injectable hemostatic agents ... I dont think there is one out good enough yet. I would think that would be the way to go.

Trust me I have a very good understanding or thoracic and abdominal anatomy. And I have seen tons of GSWs CONUS and OCONUS.

Your concepts regarding "injectable hemostatic agents" are impractical. Treating a groin wound with Celox or Quikclot doesn't translate to treating a penetrating injury to the aorta or iliac vessels. I'm not sure how practical an external aortic compressor is, but the concept is at least viable while "injectable hemostatic agents" blindly placed in the peritoneal cavity is not.

[MAJK]

as I try it myself with my hand it might work as long as its not compressing your entire abdomen. I guess I'd have to see it work in the field and the data.