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Wound Care -Bleeding

Direct Pressure / compression
1) real pressure in the wound
2) elevation
3) packing (important skill)

Add DIRECT pressure during wrapping getting to where the bleeding really is, not just where it is coming out of (potential space bleeding)

Indirect Pressure (pressure points)
1) 22 pressure points

Hemostatic (Proper training should be given for successful use)
1) Quik-clot
2) Hemcon
3) Others

Tourniquet
1) placement (on single long bone)
2) up to 2.5 hrs is safe (life over limb)
3) painful to apply (watch skin pinch)
4) release slowly

ATLS- I believe 2 Liters in 1 hour followed by transfusion hextend / heta-starch as volume replacement with proper protocol

In trauma calls: unless bleeding is controlled, IV should be established but no fluids given due to diluting and bleeding out a patients RBC/O2 and causing more damage.

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