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yellowfin
06-02-11, 08:17
I'm preparing my first aid kits and have run into a detail I don't know a lot about simply because I've had the fortune thus far of not having had to use one or observe one being used. What's to know about the different kinds of chest seals? I see three types so far, the Asherman, the Hyfin, and the Bolin. Anyone here have a preference or relevant experience on how well one or more of them work? I don't expect to have to use one often and ideally never at all, but heaven forbid should I need to it seems that it's something I should absolutely want to get right. I'm thankful to know that we have such a tool available to us to solve such a serious situation with reasonable expectation of success.

Danny Boy
06-04-11, 17:20
I keep Hyfins in my aid bag as that's what that the Army gives me. I've never had to use one apart from training lanes and teaching CLS classes. The Hyfins are real easy to apply, stick like shit to a blanket which was a shortcoming of at least the older version of the Asherman especially when blood and sweat were present. They pack down well into pouches and bags. I've never used a Bolin.

As with anything medical, get trained on the how, where, when and why you should use it if it's going in your kit by someone who truly knows what they're doing. Also remember that duct tape and some plastic wrap make a good substitute if push comes to shove. There's obviously the complications of tension pneumothorax from an open chest wound but that's another story.

chuckman
06-05-11, 08:24
My response is often not very popular. If you are stocking a personal first aid kit, my advice: don't get one (chest seal). I stock my kits based on probability, and in my AO and for my needs the probability of needing one is essentially nill. If your AO or needs say you 'might' need one, then go ahead. And even then the probability of using one is basically zero, so any of the brands will do.

yellowfin
06-05-11, 13:36
It isn't so much the odds as it is the stakes. I'm an insurance broker: minimizing impact of uncertain but potentially catastrophic loss at comparatively smaller cost of prevention is the entire basis of my profession. $20 and just a little extra space to have something on hand to fix a problem that can cost everything is a pretty good deal to me. Same reason I carry a sidearm everywhere I can.

chuckman
06-05-11, 14:45
It isn't so much the odds as it is the stakes. I'm an insurance broker: minimizing impact of uncertain but potentially catastrophic loss at comparatively smaller cost of prevention is the entire basis of my profession. $20 and just a little extra space to have something on hand to fix a problem that can cost everything is a pretty good deal to me. Same reason I carry a sidearm everywhere I can.

I get that. When I was a brand-new corpsman, my LPO (Leading Petty Officer) told me to get everything I needed for the platoon for an extended op. I get everything. He says, "take half of everything you think you need, throw it to the side. Take half of the pile that's left, split it in half. The remainder is what you will actually need."

I have developed and stocked kits from individual and family kits to expedition kits, after the people and organizations for whom I have built kits tell me their requirements (i.e., how many people, in a pack or in a vehicle, for household use or on the Amazon, etc), and invariably something has to get left out, so I base those decisions on probability. Will a chest seal/NPA/14 ga dart/whatever save a life? You bet. But if it means sacrificing room for, say, two extra 4"x4" gauze (which gets used all the time), out it goes, cause almost nobody aside from the .mil will have a need to use that stuff.

I do understand your point, and I appreciate the different perspective. I am certainly not arguing against carrying one type of widget (or any particular item). If you want one, the Hyfin works as well and most and better than some. Just don't sacrifice room for band-aids or 4"x4" gauze.

ryanschmidt65
06-07-11, 20:36
Chest seals have their advantage in a home pack or a place where you are not concerned about room. In my BoB FAK, I do not carry a chest seal. If I have to use the FAK in my BoB, I'm going to assume hospitals are not available or safe and therefore having a chest seal only prolongs suffering.

If you get shot in the chest when SHTF, your screwed.

Chest seals work wonders if you have hospitals available.

Iraq Ninja
06-07-11, 23:45
My response is often not very popular. If you are stocking a personal first aid kit, my advice: don't get one (chest seal). I stock my kits based on probability, and in my AO and for my needs the probability of needing one is essentially nill. If your AO or needs say you 'might' need one, then go ahead. And even then the probability of using one is basically zero, so any of the brands will do.

Well, I must respectfully suggest that a Hyfin takes up very little space, and weighs a lot less than a dead buddy. Mine is based on probability too- of dying from something that can easily be prevented.

There are three things I don't like to run out of

1. ammo
2. med supplies
3. team mates because I didn't have the first two.

Asherman and Bolins can be a bit bulky. Hyfin is my choice. Honestly, Ashermans need to be retired from consideration. I would rather use one of those glue rat traps than fight an Asherman on a hairy, bloody, and sweaty chest.

Training is essential, and weighs nothing.

Dave L.
06-08-11, 06:38
Honestly, Ashermans need to be retired from consideration.

Exactly how I feel.

MIKE G
06-08-11, 09:18
HALO or other non-venting design if you carry a decompression needle. CoTCCC says the HALO is what they recommend but it can not burp itself and requires you to break seal to burp or simply drop a needle.

Bolin or other venting design if you dont carry a decomp needle because that small amount of loss of contact isnt going to kill the function of the seal and reduces your chances of needing to burp (reduces, not eliminates, valve may still clog although the bolin has three for redundancy).

As to carrying or not that is an individual decision but do you really want to be kicking yourself for cheaping out on a $10-20 item while you or your buddy makes funny noises from the fresh hole in his chest?

chuckman
06-08-11, 11:52
To clarify my comments: if you are in a positon whereby adding a seal, or any specific item, will likely save a life, then by all means do so. I did carry chest seals (and other stuff) downrange that I do not and will not carry in the US, unless it is my little range kit. The range kit is for the range, where gunplay is the norm.

If you are putting together a little kit for your glove compartment or the back of your vehicle or for under the bathroom sink, why waste the $$?

chuckman
06-08-11, 12:02
Well, I must respectfully suggest that a Hyfin takes up very little space, and weighs a lot less than a dead buddy. Mine is based on probability too- of dying from something that can easily be prevented.


Agreed, if the OP is in Iraq or any other place booger-eaters are looking to pop you. But I would be curious as to how many people who carry chest seals in their personal kits in the US has ever had to use a chest seal. To go out a bit further on a limb, I would be curious as to how many paramedics in the back of a bus have used a chest seal. My guess is not very many, and think very likely statistically insignificant. I would say the folks here are a tad of an outlier because we are cut from different cloth from the vast, vast majority of people who carry/use personal kits.

I have used kling, 4"x4", ABD pads, QC Combat Gauze, on the side of the road assisting injured morotists, but in 20 years have never seen a poor schmuck requiring a chest seal. My soapbox, but one I am fine to speak from.

MIKE G
06-08-11, 12:02
If you are putting together a little kit for your glove compartment or the back of your vehicle or for under the bathroom sink, why waste the $$?

Why carry a gun except at the range? They are expensive, heavy, and most people that don't go into harms way for a living will rarely have to actually use one.

I seem to remember that there is a member here who was in his car and was shot secondary to an ND by another passenger in his vehicle. I believe he was hit in the arm. A couple of inches and that would have been in his chest. Just a thought.

Is there no chance that you would be injured in a home defense shooting? I guess it isnt worth it to have a trauma kit near places where you would use your gun in defense of your life i.e. vehicles or home.

My comments are not really posed at you but more so the general forum. It is up to the individual to decide whether it is appropriate for them to spend money on such an item.

MIKE G
06-08-11, 12:07
To go out a bit further on a limb, I would be curious as to how many paramedics in the back of a bus have used a chest seal. My guess is not very many, and think very likely statistically insignificant.


When I was riding a unit I used quite a few, however I was working in a city that at the time was getting a lot of penetrating trauma (gun shot wounds, stabbings, impaled objects removed by patient prior to arrival, etc). We had Ashermans because that was what my agency provided and they sucked. This was before the current generation of seals now available.

chuckman
06-08-11, 12:13
Mike, I hear you, and I agree (and have said) that people can carry/use whatever they want, and whatever brand; and I agree that people should decide what is appropriate for thier use and their hard-earned money. I understand your logic, but there has to be a line drawn for mere mortals (said tongue-in-cheek, about people who do not frequent this forum).

What I choose to carry is based on probability and the liklihood of use. Sure, I carry a pistol for CCW. But should I carry a shotty in the trunk? I carry a dart for needling a chest, but should I carry a chest tube (yes, I have the training)? I have a well-stocked first aid kit, I have several as I have 6 kids and they get stupid, so should I have a c-collar in case one falls down the stairs? The likelihood of needing these things are pretty low so I choose to not have them.

If someone wants to spend money for a widget, any widget, please have at; I just want people to be educated on the liklihood of actually using a specific item.

drsal
06-08-11, 12:43
Halo chest seals....have two each of my med bags.

Iraq Ninja
06-08-11, 12:54
Chuckman,

I understand your point of view. But, I can see events such as vehicular accidents, or outdoor activities in which a chest seal may be of use.

I don't depend on the police for my protection, nor the emergency medical units for my health in trauma based situations. If they show up, then they can do their job. Till then, it is up to me.

Likewise, I feel that if someone is involved in outdoor activities with guns, knives, and especially axes, a tourniquet should be part of their kit.

My views are probably not mainstream, but seven years OCONUS has changed how I view my CONUS medical preparations.

BTW, duct tape is a wonderful thing. Just today I read about it being more effective at removing warts than the OTC chemical means...lol.

yellowfin
06-08-11, 20:59
On the lighter side, has anyone noticed how Hyfin seals in the packaging look like a very large condom? I suppose that's one to show to the ladies and say you're big on safety gear. :jester:

Decon
06-08-11, 22:21
I like the HALOs and the Sentinels. The only problem I have with them is they don't fit where I use to have the Ashermans. If you do get a Asherman, do not get the civilian ones get the "combat" ones with "improved" stickiness

chuckman
06-09-11, 06:32
On the lighter side, has anyone noticed how Hyfin seals in the packaging look like a very large condom? I suppose that's one to show to the ladies and say you're big on safety gear. :jester:

"Very large?" I'd say a small! HA! :)



edited to add: I am sure my wife and any previous girlfriends would disagree with my assessment.....

ctvega
06-20-11, 10:17
I'm a ER physician and SWAT team medic. I carry an asherman in my kit, but to tell the truth probably would use the wrapper from one of the dressings as an occlusive seal. Take the wrapper from an Isreali dressing and put it over the wound and duct tape it to the chest on 3 sides and it works just as well as anything else.

starlight_cdn
06-26-11, 12:01
Halo Seals, two in a pack, entrance and exit, recommended by the CoTCCC in USA and the CCCWG in Canada. They are very effective. Cut a hole in the center and you can use them to anchor your Asherman should you need a one way valve. 'Burping' is effective too.

l3mon
07-17-11, 15:16
My response is often not very popular. If you are stocking a personal first aid kit, my advice: don't get one (chest seal). I stock my kits based on probability, and in my AO and for my needs the probability of needing one is essentially nill. If your AO or needs say you 'might' need one, then go ahead. And even then the probability of using one is basically zero, so any of the brands will do.

eh..

I have to disagree entirely with you.. respectfully of course.. everyone is always taught/trained center mass right? even IPSC target focus you to center mass.. realistically I think you have a greater need for chest seals than you think..

as I said this is based on personal opinion

cslone
07-18-11, 16:03
Halo Seals, two in a pack, entrance and exit, recommended by the CoTCCC in USA and the CCCWG in Canada. They are very effective. Cut a hole in the center and you can use them to anchor your Asherman should you need a one way valve. 'Burping' is effective too.

Exactly.

I carry 4 sets in my kit. So simple I can even teach my guys to use them. ;)

chuckman
07-19-11, 08:50
eh..

I have to disagree entirely with you.. respectfully of course.. everyone is always taught/trained center mass right? even IPSC target focus you to center mass.. realistically I think you have a greater need for chest seals than you think..

as I said this is based on personal opinion

That's cool. I encourage debate. As I said, it depends on your AO and what you see. Where I work we average 5 GSWs a week. Out of those, maybe one is thoracic. Gang-gangers here don't shoot IPSC; if they did, we would be in trouble. EMS here does not use them, I have not spoken to the med director about this one way or the other (but I will. The med director is a former EMTP and is also a Army Res EM doc). When I was a paramedic, we had them, but rarely used them, even with penetrating trauma to the chest.

In MY experience, where I have been and what I have done, chest seals are not a priority, especially with a personal med kit. If you think you have a need, then go for it.

yellowfin
07-19-11, 10:02
5 a week? Sheesh, where is that so I can avoid accidentally moving near there?! :fie:

chuckman
07-19-11, 10:42
5 a week? Sheesh, where is that so I can avoid accidentally moving near there?! :fie:

Durham, NC. Not a bad place, really....98% of GSWs are within a 8-block area.

MessedUpMike
07-19-11, 14:23
I doubt you'll see chest seals in EMS. They're to expensive especially considering we can do the same thing with some tape and the wrapper off of a trauma pad/OB kit/burn sheet. You get the idea.

In 20 years I can only immediately recall seeing on candidate who needed to be sealed off, and at the point it was pretty much a done deal anyway.

Out of curiosity, why the obsession with chest seals & cavity punching but nothing about IV fluids? Rob's numbers in the other thread seem to indicate, correctly in my experience, that bleeding out of the main killer. Are IV kits to complicated (in which case why are we decompressing somebody) or are they just not sexy enough?

MIKE G
07-19-11, 14:39
I doubt you'll see chest seals in EMS. They're to expensive especially considering we can do the same thing with some tape and the wrapper off of a trauma pad/OB kit/burn sheet. You get the idea.

In 20 years I can only immediately recall seeing on candidate who needed to be sealed off, and at the point it was pretty much a done deal anyway.

Out of curiosity, why the obsession with chest seals & cavity punching but nothing about IV fluids? Rob's numbers in the other thread seem to indicate, correctly in my experience, that bleeding out of the main killer. Are IV kits to complicated (in which case why are we decompressing somebody) or are they just not sexy enough?

Take a TCCC course (or any modern trauma course ITLS/PHTLS, EMT CE) and you can update your knowledge and find out why IVs are not so focused anymore for penetrating trauma. Why dilute clotting factor with a substance that can not carry oxygen? As well permissive hypotension has saved many trauma patients. It is old school thinking to dump tons of fluid (3 liters crystalloid for every 1 liter estimated blood loss) on someone who has a potentially uncontrolled bleed i.e. thoracic and abdominal wounds or joint injuries that do not respond to hemostatics or basic packing.

Some agencies do use chest seals, my last agency started carrying Ashermans in '05, while not my first choice of brand they do carry them and use them quite a bit.

MIKE G
07-19-11, 14:40
Durham, NC. Not a bad place, really....98% of GSWs are within a 8-block area.

I did a good portion of my EMT ride time out of Lincoln Base. The beginning of my trauma training.

chuckman
07-19-11, 14:50
I did a good portion of my EMT ride time out of Lincoln Base. The beginning of my trauma training.

Lincoln. I know it well...small world, good times. :)

BTW you should see Duke's ED now...about 3 times the previous size.

l3mon
07-20-11, 05:50
I doubt you'll see chest seals in EMS. They're to expensive especially considering we can do the same thing with some tape and the wrapper off of a trauma pad/OB kit/burn sheet. You get the idea.

In 20 years I can only immediately recall seeing on candidate who needed to be sealed off, and at the point it was pretty much a done deal anyway.

Out of curiosity, why the obsession with chest seals & cavity punching but nothing about IV fluids? Rob's numbers in the other thread seem to indicate, correctly in my experience, that bleeding out of the main killer. Are IV kits to complicated (in which case why are we decompressing somebody) or are they just not sexy enough?

the issue with that is training.. i have all the supplies needed just none of the know how, (which is why when this deployment is over i'm taking a training course, or getting an EMT cert cant decide) then i'll know how to use 99% of what i have medically.. just gotta tackle sutures next :)

chuckman
07-20-11, 06:11
the issue with that is training.. i have all the supplies needed just none of the know how, (which is why when this deployment is over i'm taking a training course, or getting an EMT cert cant decide) then i'll know how to use 99% of what i have medically.. just gotta tackle sutures next :)

Thank you. You made part of my point on why they should not be top priority in an personal kit. 99% of first aid kit owners do not know how to use 75% of the items in the kits. And suturing has very little out-of-hospital practicality...and is a perishable skill.

yellowfin
07-20-11, 09:36
Which items in particular would you say that the majority of people who don't know how to use first aid items most commonly, and most to their detriment, are most particularly deficient in knowledge thereof?

chuckman
07-20-11, 14:51
Which items in particular would you say that the majority of people who don't know how to use first aid items most commonly, and most to their detriment, are most particularly deficient in knowledge thereof?

That is a great, and prescient, question. Most items in a first aid kit are hard to use to the detriment of patient care; chest seals, hemostatic agents, etc., the stuff that most of the folks on this forum understand, are not common to 99% of people who own a general first aid kit (moms, dudes who have a kit in their trunk, a kit under the kitchen sink, etc.), as they are not found in 99% of kits.

It's hard to misuse basic bandage supplies, but beyond that, the 'bad' stuff is rarely seen (syrup of ipecac, charcoal, etc.). Chest seals are not hard to use, but do require a level of training, as do hemostatic agents, and any airway adjuncts. A basic first aid class as offered through ARC or any similar groups do not train the latter, but are great classes for someone who wants rudimentary knowledge of basic first aid. Like has been said before, it isn't always how to use the tool that it hard, but when to properly use the tool that often gets people in trouble.

Pax
07-20-11, 20:30
Question. So you can cut a HALO and use it with an Asherman, can the same be done with a Bolin? Should the larger HALO be used for this application? Thanks.

MIKE G
07-20-11, 21:00
Pax,

There is no need to. The bolin has three valves already in the center. You would be cutting three valves out to replace it with one. No net gain. The three valves design came out of concern of a single valve potentially clogging with blood/tissue.

Pax
07-20-11, 21:14
Pax,

There is no need to. The bolin has three valves already in the center. You would be cutting three valves out to replace it with one. No net gain. The three valves design came out of concern of a single valve potentially clogging with blood/tissue.

Right right, I mean can I anchor it with the cut HALO and leave the valves on the Bolin intact? Place the Bolin, cut the XL HALO and place it over the Bolin to secure. Any issues with this setup?

MIKE G
07-20-11, 21:19
No real need to as the Bolin has a high strength adhesive very similar to the HALO. I wouldnt see any advantage to using the HALO with a hole cut into it with the Bolin.

Pax
07-20-11, 22:26
Okay, thanks.

SuperiorDG
07-28-11, 09:44
Another reason for chest seal. Although it appears a garbage bag works too.


http://www.cnn.com/video/#/video/us/2011/07/28/bts.bear.attack.survivor.cnn?&hpt=hp_c2

hwkeye1911
07-30-11, 00:07
I second what ctvega said. Lots of plastic in our ifak, combined with a good 14 ga needle and i'm good to go. I did now medics who would go to homedepot or lowes and get the rolls of cellophane for wrapping boxes, they'd leave them in their mounted kits and supposedly swore by it.