alternative chest seal?

[Von Rheydt]

Of course, we had just stopped using leeches to drain evil spirits, too. It was that long ago.

Go on, it was that long ago Marines were transported in Roman galleys and you had a chariot licence.

Other than that we used to use the wrapper from first field dressings for chest wounds. I saw an improv on a course one time when a guy had an instructor screaming down his neck, he cut a piece of butyl laminate off his gasmask case and used that.


Slightly off topic apologies:

...The amazing thing about being old and in the medical field for a long time is how many things come full circle.

Not just in medicine. Last week I was talking with a friend at the European Defence Agency who is involved in infantry clothing design. He told me he was looking for a friendly cotton like fabric for multi environment use. It had to be warm in the cold, waterproof in the rain and cool in the summer. I told him about ventile that was used around 20 + years ago and still is in a couple of quiet military uits. He is from the new goretex age and had never heard of it. However, next week he is presenting it as a possibility.

[SeriousStudent]

Go on, it was that long ago Marines were transported in Roman galleys and you had a chariot licence.

......

Negative. As a Centurian, I had a Legionnaire do that for me.

Junior troops drive the chariot, us NCO's toss the spears.

[igoswoop]

Hyfin...

[500grains]

Not just in medicine.

Correct! I keep hearing about "caseless ammunition". Sounds like muzzle loaders to me.

[Hmac]

Is there in alternative chest seal to the asherman or Bolin?

I remember in my EMT class and WEMT class, the even told us heavy duty plastic wrap with tape would do in a pinch.

I'm looking for something that is more compact and even less expensive than the asherman and bolin for 3rd, 4th and 5th kits (third and fourth car, plane flights, etc)

Any occlusive dressing is fine, including the plastic wrap from you various bandages. Don't forget to leave one side untaped, or at least burp the dressing every so often. A penetrating injury means there's likely a visceral injury in addition to the chest wall. Just occluding the chest wound and forgetting about it means you may create and miss a tension pneumothorax, especially if using positive pressure ventilation. That will kill a patient faster than paradoxical respirations from a sucking chest wound alone.

[NinjaMedic]

Defibrillation pads expire requiring agencies to dispose of them, and they happen to make one of the best non-commercial chest seals and have the benefit of being readily available at your local EMS agency. The old ways of taping an occlusive dressing to create a one way valve are proving to be unnecessary, sucking chest wounds cause collapsed lungs secondary to inflow of ambient air through the chest wall opening itself when you create negative intrathoracic pressure upon inspiration. Most tension pneumo's will be seen as a result of blunt trauma to the thorax rather than penetrating. Positive pressure ventilation worsens tension pneumo's however it has less effect on pneumo's resulting from an opening in the chest wall.

[mkmckinley]

I'm kind of shocked that nobody has mentioned the Halo seal. I've used the Halo, Asherman and Bolin on real world, blood and guts casualties and I'm only carrying Halos at this point. They're the the best thing going right now. They stick like a mofo and you get two seals per package. Some might balk at them because they skip the valve but the valves on other designs don't work anyway. Lacking the valve they pack better than designs with valves. Furthermore the valve is moot if you needle decompress like you're supposed to.

http://www.progressivemed.com/halo_seal/index.html

[BattleDrill3]

I echo Mckinley's thoughts. ACS was the standard a few years ago, but sticking in place is pretty essential, and they weren't amazing at it. When in the wild blue yonder, I keep an SOE Gear medical insert tray on me for the shitty times (random pontification: "IFAK" really gets overused these days); the only things in it are gauze, a 14 gauge needle (for tension pneumo), NPA, Quickclot, and two Halo seals. (Ratchet tourniquet rubber-banded to the vest.) For real life, nothing better, practical, and available than a Halo seal.

Worst comes to worse, plastic and medical tape works, but with multiple casualties, you don't always have the luxury of time.

Ratchet tourniquet:
http://www.chinookmed.com/cgi-bin/it...--------------

Medical insert tray:
http://www.originalsoegear.com/medtray.html

Be safe.

[tracker722]

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[rob_s]

I am not a medical professional, and I have never bandaged a GSW.

I took a one-day GSW class yesterday and the instructor appeared to be extremely knowledgeable. One of the best parts of the class was his extensive knowledge and understanding of the TCCC as well as the history and current condition of various supplies available on the market today (hemostatics, tourniquets, trauma dressings, and chest seals were all covered in detail). Evidently the TCCC is going, or has gone, from the tape-three-sides solution to suggesting purpose-built commercial products. Additionally, what was said above about the likelihood of a tension pneumo from a GSW vs. a blunt trauma was mentioned, as well as the fact that a chest seal with no valve can be "burped" periodically as the patient is monitored for signs (and the signs were covered as well).

Pretty much every chest seal I've ever even heard of was passed around both in and out of the package, and the Halo definitely impressed this layman the most, both because there are two and because we were able to peel off the edge of the backings and get a feel for the amount of adhesive.

FWIW, the Asherman has evidently gone through two adhesive improvements, one last year and one this, so those that liked them but felt they didn't stick well enough might revisit them if your experience is prior to that.

Not claiming any expertise here, just relaying what I was told yesterday as it's all fresh in my mind.