Wound Packing

Tom RaderStaff - June 8, 2021

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This is where it seems very useful to have gloves in your IFAK.

Great demonstration of how much gauze is used for a wound.

 

Question on this lesson: a. Is it a datum in packing a wound that you always want to pack towards the heart – ie push pressure mainly up (in this case)? b. If I have some, would I use anti coagulation gauze first?

 

Good question.

You want to start packing or applying that “power ball” directly at the precise site of the bleeding vein/artery.  So focus more on that exact source of bleeding more so than using the direction of heart as a guide.  

Yes, use your hemostatic agent first.  Never use “anticoagulant” products when trying to control any bleeding.  “Anticoagulant” means basically not clotting or prolongs clotting; which in this case, we DO want clotting to take place.  

 

In really austere scenarios, how would one eventually remove this wound pack without restarting the bleeding? Is it just a matter of timing?

 

Assuming the original packing did it’s job of putting well-aimed direct pressure on the bleed site, then yeah, it’s basically a matter of timing — has enough time passed for the injury to clot.

Removing the packaging isn’t that different between austere and normal, because in both cases you’re essentially using clean hands / tweezers / whatever to carefully pull the packing material out, reversing what you did when packing. Similar to undoing a tourniquet, the key is to be ready to “clamp back down” if the bleeding restarts — that’s really all that matters during the unpacking process, since it means the wound still needs that packing pressure. So you might have a fresh gauze roll nearby, ready to use a finger or two to put pressure back down in the wound while re-packing the cavity. 

 

Loaded question.  😉  

The problems with removing packed material from a wound are extensive.  Several variables will come into play.  

I would recommend reviewing wound management techniques and concepts first.  

 

Are these the types of wounds that Quikclot is sometimes recommend for?  And, if so, how is Quikclot different from standard run-of-the-mill Z-fold gauze?