So I’m sitting here watching Battlestar Galactica. In this particular episode, Apollo gets shot in the upper right chest. This girl says, “someone get me some shirts.” So as far as I can tell, the reasoning behind this is that somehow, pushing some kind of cloth against an open wound helps to clot up the blot to stop it from flowing further.
However, what would be wrong with creating an airtight seal around a wound? Let’s imagine someone gets shot in a way that is basically a flesh wound. This could obviously be a problem under certain circumstances, but why not just create some kind of air-tight seal over the wound? The pressure exerted on the seal wouldn’t be higher than blood-pressure. How has this not been done already? Let’s imagine someone has a leg that has been blown off in war. Why not place the aputated leg in a mini barometric chamber?
Does anyone here have any idea why blood loss can’t be dealt with in terms of blood pressure?
If someone is shot in the chest, the proper treatment is an airtight seal around the wound. But this is to keep the chest an airtight chamber so the lung works, not to stop blood.
If you put an airtight seal around a massive leg wound, you’ll keep the blood inside the body, but you wont be keeping it inside the viens and capillaries where it belongs. There would be no way to seal each vessel individually.
Aside from the novelty of your suggestion, maybe I’m missing something. I mean, why bother with something as sophisticated and potentially complex as a "mini baromteric chamber? Isn’t easier just to place a tourniquet around the wound and thereby prevent blood from entering the site and/or leaking from the site, (depending on where the tourniquet is placed, and how tightly it’s tied)?
In any case, did you mean to say, “The pressure exerted on the seal wouldn’t be higher than blood-pressure”? (emphasis added) If it wasn’t higher, wouldn’t blood just continue to enter the wound area and then leak out from the body. It would seem to me that if the seal was higher than blood pressure, it’d be more sucessful to stem the bleeding.
It’s usually better not to create airtight seals for chest wounds. For wounds that penetrate the chest it’s a better idea to create a flap valve that lets air out but not in. You can do this by taping a dressing on three sides, for instance. If a lung is punctured along with the chest wall, air escaping from the lung can get trapped between the lung and the chest wall (a pneumothorax). If the opening in the chest is completely obstructed (a closed pneumothorax) the trapped air can make things worse.
My wife got shot in the forearem without striking a major artery. The treatment was to let it bleed. It was stitched up along the sides but the main pathway was left open. The point, I think, was to let shrapel escape.
IANAD, just Red Cross certified, but my understanding was always that direct pressure on the wound tends to compress the veins and arteries, slowing down the flow to help clotting. Seems like an air-tight seal would let the wound fill with blood and leave the veins and arteries open, slowing clotting. Also, you’d end up with a massive clot in the wound, don’t think that would be good.
Your bloods ability to clot and seal the wound off is enhanced by providing a matrix of sorts for it to adhere to via a bandage. The larger and deeper the injury, the less generally effective this is but it can still be helpful in slowing blood loss. In emergency situations sometimes all you need to do is keep them alive for a few more minutes for more advanced measures to be brought to bear. IF your patient will bleed out in 10 min without bandage and pressure or 17 with it, thats 7 more minutes to get them to a hospital were they can be transfused with blood products to keep them going.
With deep penetrating trauma the bleeding is going to continue internally but sometimes just denying the blood an easy escape will help slow the blood loss.
Its amazing how much damage our bodies can take and how we have mechanisms to deal with more than a few major shocks to our system.
I was just an EMT so I am less familiar with the longer term treatment but I was more under the impression you want it to heal from the inside out so as not to create pockets of infection and such within the arm during healing