Massive Hemorrhage Control

In TCCC/TECC, massive hemorrhage is managed through the use of tourniquets, hemostatic dressings, junctional devices, and pressure dressings.

Hemorrhage is the leading cause of preventable death in combat. Researchers have found that 91% of the potentially survivable patients died from hemorrhage.  In Vietnam, massive hemorrhage from extremities comprised over 9% of all deaths, however, of the leading three causes of preventable death, it was about 60%. 

Using the right products to pack a wound, apply pressure to a wound, absorb bleeding, and control blood loss can mean the difference between life and death. We offer the leading products in managing blood loss and wounds with our proven lines of bandages and gauzes ready to use to pack and wrap wounds.

We offer a Hemostatic Agent Comparison Guide below to help with purchasing decisions.

Showing: 1-24 of 39
Combat Application Tourniquet - CAT Gen. 7
North American Rescue
$26.99 Regular price $29.99
SOF-T WIDE Tactical Tourniquet - Gen 4
Tactical Medical Solutions
Regular price $29.99
SOF-T Tactical Tourniquet
Tactical Medical Solutions
Regular price $27.99
Tactical Mechanical Tourniquet (TMT™)
Combat Medical Systems
Regular price $28.00
S.T.A.T. Smart Tourniquet
STAT Medical
$17.99 Regular price $18.99
Junctional Emergency Treatment Tool™ (JETT®)
North American Rescue
Regular price $299.00
SAM® Junctional Tourniquet
SAM Medical
Regular price $399.00
iTClamp Hemorrhage Control Device
Innovative Trauma Care
Regular price $34.00
CELOX Z-Fold Hemostatic Gauze
CELOX
Regular price $44.99
ChitoGAUZE XR PRO Hemostatic Gauze
Tricol Biomed
Regular price $39.99
Quickclot Combat Gauze Hemostatic Dressing
Z-MEDICA
$39.99 Regular price $45.99
Quickclot Combat Gauze XL Hemostatic Dressing
Z-MEDICA
Regular price $99.00
Celox-A High Speed Applicator
CELOX
Regular price $26.99
MARCH™ Battle Bandage
Combat Medical Systems
Regular price $16.00
TACMED Control Wraps
Tactical Medical Solutions
Regular price $2.95
NAR Elastic Wrap Bandages
North American Rescue
$1.50
ESMARK Elastic Bleeding Control Bandage
Esmark
Regular price $6.95
TACMED OLAES Modular Trauma Dressing
Tactical Medical Solutions
$6.95
PerSys Medical Israeli T3 Bandage
PerSys Medical
Regular price $8.99
H&H "H-Bandage" Compression Dressing - STANDARD
H&H Medical
Regular price $10.95
H&H Big Cinch Bandage
H&H Medical
Regular price $10.00
H&H Cinch Tight Compression Dressing
H&H Medical
Regular price $8.99

From an article by Andrew Fisher
 
Massive hemorrhage is strictly about massive hemorrhage, the treatments include tourniquet application, which should be the first treatment applied in true massive hemorrhage. It is not unreasonable to apply a pressure bandage, if you do it should be a hemostatic dressing for compressible hemorrhage not amenable to limb tourniquet use or as an adjunct to tourniquet removal. Junctional tourniquets and the use of XSTAT® is also approved to control massive hemorrhage.
Hemorrhage is the leading cause of preventable death in combat. Bellamy (Figure 1) found that massive hemorrhage from extremities comprised over 9% of the all deaths in Vietnam.  However, of the leading three causes of preventable death, it was about 60%. Similarly, Eastridge et al. (Figure 2) found 91% of the potentially survivable patients died from hemorrhage. This is directly relatable to the civilian sector. Since 2001, there have been over 2,000,000 deaths from trauma.
Over the last 10 years in the United States, there have been over 400,000 potentially survivable deaths, most of which were hemorrhage. Hesitation to immediately address massive hemorrhage is a significant reason to immediately apply a tourniquet. The easiest, quickest, and most efficient method of hemorrhage control is by tourniquet application. If after addressing life threats, it is determined that the hemorrhage did not need a tourniquet, it can be converted.  
Two hours of tourniquet time is safe and they are used on a regular basis in orthopedic surgeries. Finally, there is no discussion of fluid resuscitation during the identification and treatment of massive hemorrhage.

When is bleeding life-threatening?

  • There is pulsatile or steady bleeding from the wound.
  • Blood is pooling on the ground.
  • The overlying clothes are soaked with blood.
  • Bandages or makeshift bandages used to cover the wound are ineffective and steadily becoming soaked with blood.
  • There is a traumatic amputation of the arm or leg.

  • There was prior bleeding, and the patient is now in shock (unconscious, confused, pale).


How long does it take to bleed to death from a complete femoral artery and vein disruption?
  • Casualties with such an injury can bleed to death in as little as 3 minutes
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