Tampons vs Gauze for Blood Loss

[Ben]

I was reading a tactical medicine discussion on why some people continue to recommend tampons for things like gunshot wounds. The below video was a really good visual about why tampons shouldn't be used for anything but their intended purpose and maybe nosebleeds. The video uses rolled gauze, which is a good illustration about using z-fold gauze (JMO from taking a class where I could try both). The video uses fake blood, but if you get queasy about blood, it's not for you.

https://youtu.be/6h6Tuart1-o

[K Frame]

What bullshit!

Spit on it, rub some dirt on it, and get your ass back on the line!

[WLJ]

Plenty of free tampons in the men's restroom

[Hawkmoon]

Plenty of free tampons in the men's restroom

How DARE you presume the gender of a toilet facility?!?!

[dogmush]

Much like anyone thinking a  Serpa is a good holster, I encourage anyone that believes a Tampon is good for blood loss to use one if they are injured.

The two behaviors may end up linked.

[WLJ]

Much like anyone thinking a  Serpa is a good holster, I encourage anyone that believes a Tampon is good for blood loss to use one if they are injured.

The two behaviors may end up linked.

I always thought of it as a in an emergency it's better than nothing and can be found in many homes and in many women's purses.

[dogmush]

I always thought of it as a in an emergency it's better than nothing and can be found in many homes and in many women's purses.

Nope.

In a penetrating deep bleed, you need to stop the blood leaving the blood vessel, not the body.  This is why, on extremities, TQ's are highly recommended.  In a joint area, or somewhere you can't get a TQ, you switch to wound packing (rolled or Z-gauze).  The idea there is you jam your finger down in the wound, find the severed blood vessel, and pack gauze tightly right on the vessel, creating an internal pressure dressing, that molds to the wound channel, and slows blood loss enough for a clot to form on the vessel.

A tampon, being a compressed cylinder that expands circumferentially, does not put pressure on the blood vessel that is leaking, but rather on the sides of the wound channel. This doesn't stop the bleed, just converts it to an internal bleed.  It may make you think you stopped the bleed, but home boy is still bleeding out.

If you have a bleed that requires packing, and you don't have gauze, you are better off either attempting to hold pressure on the artery upstream or sticking your fingers in there and holding that MFer closed till EMS gets there.

[WLJ]

I'm not a doctor nor do I play one on TV but there seems to be some wildly different opinions on their usefulness.

or sticking your fingers in there and holding that MFer closed till EMS gets there.

Or your thumb 

[Ben]

I'm not a doctor nor do I play one on TV but there seems to be some wildly different opinions on their usefulness.

Perhaps in the general population, but not in the professional community. I think you would be hard-pressed to find any credentialed EMS instructor who would recommend a tampon for arterial or serious puncture wound bleeding. As Dogmush mentioned, your fingers would be better for pressure. Likely even stuffing a shirt or rag into the wound. Obviously the best course is a stop the bleed kit (and training). Cheap to put together and compact. I keep one velcroed to the back of the driver's seat in both my vehicles.

[French G.]

I found it interesting reading Lone Survivor that Luttrell packed his own leg with dirt, his med bags long since having parted company.  Seems like an extremely less than ideal method but one that may get you a day more of fighting or if you are really lucky get your walking infection to advanced care.  Worked in that case.

[dogmush]

I'm not a doctor nor do I play one on TV but there seems to be some wildly different opinions on their usefulness.

Or your thumb 

I'm just telling you what my multiple TCCC instructors have said over multiple classes.  Like Ben, I haven't seen anyone with real training recommend a tampon for bad bleeding.

On the thumb, tellingly, had he tried tampon, he'd almost certainly be dead now.


With the first world EMS system we have these days, about the only thing that doesn't kill you DRT, but will before you get to real care is a bad bleed.  IMNSHO stop the bleed supplies should be EDC for everyone.  Certainly, if I had to choose between medical and a gun, the medical is more important, and statistically more likely to be used. YMMV

[WLJ]

Not my area of expertise so I'm learning here
What if in cases of when a main artery is not hit and in terms of having on hand I'm more thinking of Joe blow on the street. Most people aren't going to be carrying EDC kit around. Would they be of use then? or is simple pressure still preferred?

[Ben]

Most people aren't going to be carrying EDC kit around. Would they be of use then? or is simple pressure still preferred?

Certainly "How much to EDC?" is a valid point for how much stuff someone wants to have on their person. There are ways to prioritize medical without having bulging cargo pocket pants. Most holster manufacturers that make the appendix sidecar style holsters now offer the ability to make the sidecar a TQ holder instead of a mag holder. Vacuum packed z-fold gauze is actually pretty compact - not much bigger than a matchbook.

Coincidentally to this thread, last week I was watching a video put out by Dogmush's buddies at Barrel and Hatchet and ended up ordering the Snakestaff Systems EDC tourniquet, which is about 60% the size of a CAT5. It just arrived in the mail this morning and easily fits in my offhand front jeans pocket. Quality is comparable to a NAR CAT5. Obviously if I have a choice, I'll grab the bigger TQ, but if it's a situation like coming up on an auto accident when I'm in downtown Boise walking from the brewpub back to where my vehicle (and IFAK) is parked blocks away, the little one in my pocket will be good to go between application and when EMS arrives.

https://www.snakestaffsystems.com/

[dogmush]

Not my area of expertise so I'm learning here
What if in cases of when a main artery is not hit and in terms of having on hand I'm more thinking of Joe blow on the street. Most people aren't going to be carrying EDC kit around. Would they be of use then? or is simple pressure still preferred?

It kinda depends on what you want to carry, just like all EDC.  I carry compressed gauze, a set of gloves, and a RATS TQ in a little fabric cover in my back pocket.  It's smaller than most wallets.  Not the best TQ, but workable, and it'll get me back to my truck where the big kit is at.  When I took grounded and Wounded from Vigr Training, he gave us a commercial equivalent.  I'll see if I can find my notes when I get home and look that up for you.  I have a SnakeStaff too.  It's a better product but I haven't fit it into my system yet.

To answer your question, in the US, if they aren't spurting blood and you have no gear or training, your best bet is direct pressure with a compress (like a whole ass t-shirt wadded up over the wound and held tight) while someone else activates EMS.  But EDC Med gear or a decent IFAK in every one of your vehicles and the training to use it should be a priority for everyone.  You are very likely to see a car crash in your life, and having good Traumatic First Aid can be a life saver there.

If your everyday activities take you outside of the normal 15ish min EMS response time in the US, you should consider your risks and gear more carefully.

[Ben]

It kinda depends on what you want to carry, just like all EDC.  I carry compressed gauze, a set of gloves, and a RATS TQ

Have you done any training with the RATS, like on a bleeding dummy? I've never seen one in person, but see them pop up occasionally in the "what's your EDC?" videos. IIRC, they're actually supposed to be pretty good pet tourniquets in case you have to save your dog.

[dogmush]

Yes, I've trained with it.  It works, but it's skinny, so it hurts like a solid mother *expletive deleted*er (Significantly worse than a Gen5 CAT).  Also takes a couple wraps to get good blood shutoff.

The dual use on pets is why I have a couple.  They are in my hiking pack too.