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Thread: Bolin vs Halo chest seals

  1. #1
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    Bolin vs Halo chest seals

    Not being a trained medical professional, is it better to invest in Bolin Chest seals or the Halo chest seals. My uneducated read on this is that if I use a Halo and tension pneumothorax develops I have to use a decompression needle with cath if the injured party can't get to a hospital right away. If I use the Bolin, with the three one way valves in the first place, will the likelihood of tension pneumothorax be lessened?

    I know it's a simplistic statement, but a shove in the right direction is a grand thing. If you have minimal training, what is the better chest seal? And yes, I understand that the training is important and I am seeking out competent training, it's just not happening this week.

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    Cx Seals

    Bolin, Fox, Halo, all three are great. I have carried and trained on all. You cannot go wrong with any of them as far as I am concerned. After 9 years as a medic on a team, 13 as a Paramedic and multiple TCCC and LETTC courses, I have heard many opinions on chest seals. Last year a renowned course instructor told us that "FOX" was the chest seal to use. I have met Chuck Bolin and believe his seal is a good one based on solid ideas.

    The fact is, a chest seal can be as easy as a plastic material and tape or an EKG defib pad placed over the site(s). With solid training and instruction, anyone should be capable of being trained to assess and treat a "sucking chest wound". Addressing your concern of causing a tension by sealing the wound, just remember, the patient already has a hole or two (remember to assess the back for an exit/entrance wound). You can just as easily, "burp" or release the tension pressure by removing the seal temporarily, if that did not work due to clotting or other causes, then the trained and qualified care provider could move on to proper needle decompression.

    Currently I have a mix of Fox and Halo seals in multiple IFAK and Med kits.


    I hope this helps.

    EMT-B, FFI&II 1999
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  3. #3
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    Quote Originally Posted by Clay34 View Post
    Not being a trained medical professional, is it better to invest in Bolin Chest seals or the Halo chest seals. My uneducated read on this is that if I use a Halo and tension pneumothorax develops I have to use a decompression needle with cath if the injured party can't get to a hospital right away. If I use the Bolin, with the three one way valves in the first place, will the likelihood of tension pneumothorax be lessened?

    I know it's a simplistic statement, but a shove in the right direction is a grand thing. If you have minimal training, what is the better chest seal? And yes, I understand that the training is important and I am seeking out competent training, it's just not happening this week.
    Packaged, set-and-forget solution for a lay, modestly trained rescuer: vented seal of your choice. Lots of good options out there. If you know to burp it or can dart the chest, non-vented are GTG. Good news: A tension pneumo is a delayed event, and outside response times for most folks. It can be a moot point.

    Specific to your inquiry, I found this manufacturer reference: "Study reports Bolin Chest Seal superior to non-vented chest seals in treating tension pneumothorax"
    http://gohandh.com/bolin-chest-seal-...n-pneumothorax

    I use a variety of seals, and have no distinct preference for one.
    2012 National Zumba Endurance Champion
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    Thanks for the thoughts and links. I thought I would buy a completed kit but didn't like what I saw in most kits. I will be buying stuff for it piecemeal and choosing exactly which components that I want. Thanks for a shove in the right direction.

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    I liked the Halo chest seal since they already came in a pack of two. Even heard of people cutting the chest seal in half, if the wound size would allow it and making 4 seals out of a single package of Halo chest seals. Then I liked the idea of the vented seals. I thought that I would end up with the Bolin chest seals in my kit. While shopping at North American Rescue, I came across a pair of vented chest seals by HyFin: http://narescue.com/Portal.aspx?CN=77F301F14058 They came in a pair, they were vented, the price was right and the expiration dates were better buying direct than buying something off of Ebay that was expired or about to be expired. I ended up buying the HyFin's.

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    First off I agree 100% with TacMedic556, I also have several different seals in kits that I use and a few back up plans to make seals if needed. Heck even your hand will work as a seal, RIGHT NOW!

    Regardless of when you have someone with a penetrating chest injury, they have a pneumothorax. It may not be a TENSION pneumothorax (TPX) at this moment, but there is air outside of the lung. They need a MD/DO ASAP and it helps to have a real deal 18D or Paramedic (CONUS civi land) to move the patient to said Dr. After that they will most likely need to go to a Level I Trauma Center in a large city.
    It does not matter what you use for a chest seal. Just seal the chest.

    If this person begins to develop the signs and symptoms of a TPX you can remove the chest seal for a breath or two and see is air leaks from the wound, this CAN reduce pressure in the chest and partly and temporarily reduce pressure inside of the chest, making it easier for the person to move air on their own. Even chest seals with vents in them may need to be burped, as sometimes the valves will get blood clots in them and they wont work.

    Sadly in my experience most people ( <51%) who have a TPX need help breathing and their airway managed, before they need their chest decompressed.

    Chest decompression and chest tubes are a big deal. While you can save a life by doing them properly, there is a chance to cause harm by doing these procedures as well. Just because a chest has been decompressed does not make the person better. They can and often do decompensate again. Chest decompression needles (even the 10g versions) will clot off and not allow air to escape. This can even happen (less common) with the huge finger sized chest tubes that are surgically placed.

    In the end have a plan, have a back up plan and a few back ups to the back up plans. And ALWAYS reassess every patient with this level of an injury every 5-10 minutes.

  7. #7
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    Quote Originally Posted by TacMedic556 View Post
    The fact is, a chest seal can be as easy as a plastic material and tape or an EKG defib pad placed over the site(s). With solid training and instruction, anyone should be capable of being trained to assess and treat a "sucking chest wound".
    When I went through Army Combat Lifesaver (CLS) training last year prior to deploying, the medics who taught the course addressed this several times during the week. They were not really big fans of any of the three chest seals we see in the Army - Bolin, Halo, or HyFin - and seemed to consider them to be kind of "gimicky," for lack of a better term. The main issue that they had with them was that the adhesives used to stick the seal to the area around the wound quickly became ineffective when placed over hair, sweat, and blood. Their solution (as with most dressings) was to completely wrap the area with tape and/or Ace bandages to hold the seal in place over the wound. This essentially meant wrapping around the patient's torso to hold the seal securely in place. They were also concerned about the valve getting clogged with fluid or debris and preferred to burp the seal as described earlier. Most of them were advocates of using plastic sheet, an MRE wrapper, etc. instead of a "fancy" seal, since they were going to end up taping and wrapping the whole thing anyway. It wasn't that they wouldn't use the seals if they had them, but they just cautioned us that they weren't as reliable as advertized, so it was more important to use whatever was on hand and focus on properly sealing and wrapping it to hold it in place.

    These guys all had way more trauma experience from Iraq and Afghanistan that I would ever wish on someone, and it seemed like they prefered to simplify what they carried down to TQs, pressure dressings, combat gauze, tape, and Ace wraps so they could work quickly with that basic menu of items. I think their experiences dealing with mass casualty situations would probably differ from when you have the time to focus on a single patient. I fortunately have limited experiencing with real-word TCCC (although I did get to wrap a guy's leg that got sliced by a glass table last week!), so I'm just passing on the feedback I got from our trainers.

    Dave

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    Dave- What you learned is a valid technique and one possible option. Here's a video: https://www.youtube.com/watch?v=7Jh4...ature=youtu.be

    Problems with packaged seals include the things your instructors described. They may not stick, vents may clog, they may be fouled due to storage/environmentals. They may also work splendidly. The most important thing is to understand what the seal does and why you're applying it. If you know that, you can use any of them effectively, or make functional expedients. (See also: trauma dressings)

    This video is a promo for the Russell chest seal, but does a good job of illustrating the principles at work: https://www.youtube.com/watch?v=GBvM...ature=youtu.be

    Peel-and-stick packaged seals are easily taught, have few, easily-executed steps, and are one possible solution for the IFAK.
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    A seal that has been fielded overseas and just got approval for CONUS is the FastBreathe Seal. It was designed and field tested to mitigate some of the above concerns.

    Hope it helps.

  10. #10
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    Quote Originally Posted by 3ACR_Scout View Post
    When I went through Army Combat Lifesaver (CLS) training last year prior to deploying, the medics who taught the course addressed this several times during the week. They were not really big fans of any of the three chest seals we see in the Army - Bolin, Halo, or HyFin - and seemed to consider them to be kind of "gimicky," for lack of a better term. The main issue that they had with them was that the adhesives used to stick the seal to the area around the wound quickly became ineffective when placed over hair, sweat, and blood. Their solution (as with most dressings) was to completely wrap the area with tape and/or Ace bandages to hold the seal in place over the wound. This essentially meant wrapping around the patient's torso to hold the seal securely in place. They were also concerned about the valve getting clogged with fluid or debris and preferred to burp the seal as described earlier. Most of them were advocates of using plastic sheet, an MRE wrapper, etc. instead of a "fancy" seal, since they were going to end up taping and wrapping the whole thing anyway. It wasn't that they wouldn't use the seals if they had them, but they just cautioned us that they weren't as reliable as advertized, so it was more important to use whatever was on hand and focus on properly sealing and wrapping it to hold it in place.

    These guys all had way more trauma experience from Iraq and Afghanistan that I would ever wish on someone, and it seemed like they prefered to simplify what they carried down to TQs, pressure dressings, combat gauze, tape, and Ace wraps so they could work quickly with that basic menu of items. I think their experiences dealing with mass casualty situations would probably differ from when you have the time to focus on a single patient. I fortunately have limited experiencing with real-word TCCC (although I did get to wrap a guy's leg that got sliced by a glass table last week!), so I'm just passing on the feedback I got from our trainers.

    Dave
    The Bolin seal is what started this "wont work on sweaty, hairy, etc..." rumor - When the Bolin went off to a larger manufacturer they used an inferior glue on the seal, and guys were having issues with it, and since then have dismissed these "gimicky" chest seals. As far as I know, this was resolved years ago.

    As for the HALO, which is what I've trained with extensively, they will stick to anything, and are a bitch to get off.

    Also, with the vented seals, remember that you have to place the vent directly over the wound - and - people forget that these holes bleed and more than likely will need some sort of kerlix/gauze placed over the hole with the chest seal over it.

    It's not always "more important" to use whatever is available on hand - use the right tool for the job. Like I said, these holes bleed and need to be wiped/cleaned if possible before the seal goes on, with or without the kerlix/gauze placed over the hole.

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