Bonjour à tous, je vien de tomber sur une poudre magique nommé Celox qui serait utilisé en cas de coupures importantes voir hémorragiques, quelqu'un aurait-il une idée de l'éfficacité de se truc...
Oui, clairement c'est bien pour des théâtres d'opération très exposés et où l'aide médicale n'est pas disponible immédiatement MAIS surtout où les toubibs ontdes protocoles detraitements adapté à ce produits, ici lorsque la samu va arrivé, ils te diront : "c'est quoi cette m*rde que vous avez foutu sur la plaie ?"Je confirme... Loll
Fred
Oui, clairement c'est bien pour des théâtres d'opération très exposés et où l'aide médicale n'est pas disponible immédiatement MAIS surtout où les toubibs ont des protocoles de traitements adaptés à ce produit, ici lorsque le SAMU va arrivé, ils te diront : "c'est quoi cette m*rde que vous avez foutu sur la plaie ?"
Je confirme aussi ( salut pics :lol:)
Et surtout n'oublions pas que dans pratiquement 99% des cas, toutes circonstances confondues une Hémorragie se stop avec une simple compression manuelle qui peut être remplacée par un pansement compressif de fortune et qu'il est extrêmement rare d'avoir recours à un point de compression à distance ( en 13 ans de Sapeurs Pompiers je ne l'ai jamais vu ! Ça ne veut pas dire que cela n'arrive jamais mais bon !) c'est pourquoi aujourd'hui en France il n'est plus enseigné ces techniques dans les formations de secourisme PSC (ancien afps ) ou SST, mais simplement la bonne vielle compression manuelle et le garrot qui reste l'ultime solution en cas de nombreuses victimes ou d'inefficacité de la compression manuelle ( inaccessible, plaie trop grande ...etc)
Pics, et en Belgique les points de compression sont-ils toujours enseignés ?
Salut Ibis, es-tu Pompier avec Pics à Mons ? Si oui est-ce toi qui étais au stage de survie le 1 et 2 décembre dernier ?
AbstractLe document complet:
Objectives: Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury.
Methods: A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.
Results: CX reduced rebleeding to 0% (p < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD.
Conclusions: In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.
OBJECTIVE
Despite advances in medical intervention and protective equipment, fatal traumatic hemorrhage remains one of the most challenging problems for both military and civilian medicine. Uncontrolled hemorrhage currently accounts for almost 50% of battlefield deaths before evacuation in Iraq and Afghanistan.1 Additionally, civilian trauma death from exsanguination approaches 80% in the United States, accounting for the second leading cause of trauma death overall.2 The continued military emphasis on remote operations in austere environments and increasing threat to civilian tactical law enforcement will require advances that improve the field treatment of hemorrhage in both settings.
As a result, much attention has been focused on the development of alternative methods of controlling hemorrhage, including topical hemostatic dressings. While several agents have been developed, the two most commonly utilized on the battlefield include the chitosan standard dressing (HemCon [HC], HemCon Inc., Portland OR) and zeolite powder dressing
(QuikClot [QC], Z-Medica, Wallingford, CT).3-5 The chitosan dressing is a fairly rigid wafer that
forms a mucoadhesive physical barrier at the site of injury. Zeolite is a hard granule that quickly adsorbs water from blood to concentrate native elements of coagulation at the site of bleeding. However, mixed results with regard to the success of each agent have been reported in individual studies utilizing a variety of preclinical models.6-10 There have also been concerns related to side effects, specifically, thermal injury from the exothermic reaction associated with use of zeolite,7-11 although documented occurrences are relatively infrequent.12 Field use of these agents has reported some success in treating human wounds.5 Overall, recent reviews of the existing literature suggest that there is no single perfect hemostatic dressing; each has its drawbacks and benefits.3,4
A new chitosan granular dressing (CELOX [CX], SAM Medical Products, Newport, OR) reports success in controlling hemorrhage while continuing to possess many of the ancillary characteristics of an ideal hemostatic dressing. This agent is a fine granular product that works by interacting directly with red blood cells and platelets to form a cross-linked barrier clot, independent of native factors. According to the manufacturers, it is reportedly nonallergenic, nonexothermic, able to function in a hypothermic environment, and low in cost.
The purpose of this study is to compare the CX, HC, and QC dressings to standard gauze dressing (SD) in an accepted swine groin injury model. We hypothesize that CX, HC, and QC will improve hemorrhage control and survival compared with SD, HC, and QC.
RESULTS
All four dressings were able to control the initial hemorrhage in 100% of cases. However, as the subjects were resuscitated, 10 of 12 SD animals rebled, and 6 of 12 of those cases did not reach a secondary hemostasis. At necropsy, surrounding hematoma was apparent in all SD animals that rebled. There were no hematomas apparent in rebleeding animals from other groups. Statistical analysis revealed that each of the three hemostatic agents proved superior to SD with respect to rebleed. Rebleeding occurred in no CX subjects, 4 of 12 HC subjects, and 1 of 12 QC subjects. Among the three hemostatic agents, there were significant differences in rebleeding. HC instances of rebleed were associated with an application of the dressing that adhered tightly to the soft tissue surrounding the vessels but did not seal the actual vascular injury. In HC applications that successfully prevented rebleeding, the dressing was also tightly adhered to the vessels on necropsy.
Survival was determined by a subject's ability to maintain vital signs for 180 minutes after infliction of the injury. Only CX improved survival significantly compared to SD in this study. Survival was achieved in 100% of CX subjects, compared to 50% in the SD group. Eight of 12 HC subjects survived, and 11 of 12 QC subjects survived. Each death in the HC group was associated with rebleed and failure of the dressing to adhere to the vasculature.
CONCLUSION
It is widely recognized and accepted that early control of hemorrhage can improve immediate and delayed mortality through the prevention of massive blood loss, hypotension, coagulopathy, metabolic derangements, and infection.21-23 The results of this study demonstrate that, in a porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CX is a viable option for the treatment of severe hemorrhage.
BASICS member & Mountain Rescue team doctor Steve Rowe used an innovative medical treatment to help save the life of a climber at the weekend.http://www.basics.org.uk/press_area/battlefield_invention_saves_injured_climber
Edale Mountain Rescue Team was called to Stanage Edge where a 25-year-old from Lincoln had suffered life-threatening injuries in a fall while abseiling on the popular climbing edge near Hathersage in the Peak District. The man had substantial, life-threatening bleeding after falling 8m (26ft) on the Saturday of the Easter weekend.
The rescue team used Celox to stem the blood flow from the climber’s wounds. The treatment, which contains a natural polymer derived from shrimp shells, coagulates blood in about 30 seconds and has been developed for battlefield wounds. The Edale team believes it is the first time the treatment has been used in mountain rescue in this country.
A spokesperson for the team said: “Having been stabilised on scene, the patient was evacuated to the top of the crag before being taken to the Northern General Hospital by the Nottinghamshire and Lincolnshire Air Ambulance.
“The injured climber is now in a stable condition in hospital following emergency surgery on his pelvis and wrist.”
The team also put new techniques into practice the previous day, Good Friday, when a new type of pelvic splint was used on a climber who fell from the Valkyrie route on Froggatt Edge, 8km (5 miles) south of Stanage, near Grindleford.
He was placed on a spinal board and carried to the crag top before being flown to hospital in Sheffield by the Derbyshire, Leicestershire and Rutland Air Ambulance.
The two rescues came as members of the Edale MRT were out fundraising in Hathersage, Edale and Bakewell.
The team spokesperson said: “The successful outcome of both rescues was the result of excellent teamwork between Edale MRT, the East Midlands Ambulance Service and our local air ambulance charities.
Si vous avez pas de pansement à portée pour les petites coupures ,je vous conseille la sève d'arbre,au yukon ,vers l'alaska ont prend le spruce tree quand ont se coupe avec un couteau,ça cicatrise bien! Mais voilà je me demande si certaines sèves d'arbres ne seraient pas toxiques,donc en attendant ... je vous l'indique pour cet arbre là,je vais me renseigner
Pas bien compris, là! Si je saigne et que je n'ai pas de pansement hémostatique, je vais au Yukon, chercher la sève d'un arbre pour arrêter mon hémorragie? :D :down:
"je vais me renseigner": pas la peine :). !
Le résumé qui suit est issu des recommandations militaires, les recommandations civiles n'envisageant pas d'hémorragie résistant à une compression bien menée ou au pire un garrot:
Lorsqu'on parle de recommandations militaires, on parle de situations de combat, et de gestes à appliquer en situation où les dangers sont encore présents et les secours pas accessibles dans l'immédiat.