<span>TFTC #19</span> Wound Dressing Protocols

This forces the flow of blood to slow or stop, and allow the body’s natural ability to close the wound. This is known as coagulation. When applying pressure you want to apply light pressure with a wound dressing. Here are the dressing options available:

1. 1. 1. Combination Dressing – a sealed dressing that has lots of absorption capability.
      2. Compression Dressing – very similar to a Combination Dressing but has a fastening system attached. The dressing should be applied with light pressure and is “hands-free” once attached.
      3. Sterile Dressing Pad – several compacted layers of gauze to be applied directly to the wound. These pads are available in various sizes – 2"x 2", 4" x 4", 6" x 6" and many others.
      4. Impregnated Blood Clot Dressing – sponge gauze material that has a chemically infused covering or has a chemical component inside the dressing. When this chemical gets in contact with blood a reaction occurs and the wound is closed through cauterization. You can also get this chemical in granular form that is poured directly onto a wound. Used by the military for rapid clotting, this product is very effective but requires immediate medical attention to remove the chemical agent from the affected area.

This is done to limit the body’s vascular system and reduce blood flow to the wound. This isn’t always feasible to do, but if possible place the wound above the heart. This will greatly reduce blood flow and let clotting occur more easily.

This is a final resort, and should be applied with caution. If a tourniquet is left on the body for a prolonged period of time, irreversible damage could occur.  However, a tourniquet is a “life over limb” situation. You want to apply a tourniquet when severe blood loss is occurring, and where the possibility of losing the affected body part is a better outcome than blood loss resulting in death. The average adult human has 6L of blood in their body, and a laceration to a large blood vessel, such as the femoral or radial artery, could result in complete blood loss in less than 5 minutes. If warranted, the application of a tourniquet needs to be applied quickly and only in “life or death” situations.

So, back to our situation. The blood is flowing and what do you reach for?

Selecting the correct size dressing for the wound is essential. You wouldn’t want to put a beach towel on a 1" cut, or a 2"x 2" gauze pad on a 6" laceration. Also, choosing first aid dressings to carry on your saddle is key, since room and weight are a consideration. I choose to only carry three items that I would use to save my own life while awaiting rescue: I carry a Combination Dressing, a Tourniquet and an Impregnated Blood Clot Dressing. These three items should allow me to stop most large vessel bleeding by using them independently, or together as a blood clotting pressure dressing.

Once the dressing is applied to any wound, avoid the urge to replace it with a fresh dressing. This can pull off any coagulated blood that has worked to seal the wound. If bleeding is still occurring, add dressings on top of the previous dressings.

Lastly, contact emergency services immediately and have them arrive to your location.  Even if upon their arrival you no longer need their assistance, it’s better to have them on the jobsite in the event the situation gets worse or you're unable to control the bleeding. Also – let emergency services know if there has been a large amount of blood lost, so they can bring plasma (blood) and start the infusion at the scene.

All arborists know that a serious cut on the jobsite is inevitably going to happen. It’s a “when”, not an “if” situation. When these accidents occur, make sure to address to wound immediately and have the proper wound management and first aid supplies on hand. This will not only reduce blood loss, but make the healing process go faster. Finally, if you’re not sure about calling emergency services, do it! As the old saying goes…… better safe than sorry.

Climb safe. Cut Safe.