- Life threatening hemorrhage that cannot be controlled by other means.
- Serious or life threatening extremity or junctional hemorrhage and tactical considerations prevent the use of standard hemorrhage control techniques.
- Chest or Abdominal wounds.
- Expose the wound site by removing clothing in proximity to the injury.
- Removes excess blood from the wound while preserving any clots that may have formed. The provider identifies the source of the most active bleeding.
- Removes the hemostatic agent or plain gauze from its package and packs it tightly into the wound directly over the site of the most active bleeding. More than one gauze roll may be required to control the hemorrhage.
- Apply direct pressure over the wound and packing with enough force to stop the bleeding. The provider holds direct pressure for a minimum of 3 minutes (if using a hemostatic agent) or 10 minutes if using plain gauze.
- After the required amount of time for application of direct pressure has elapsed, the provider reassesses for bleeding control. Additional packing may be placed as necessary to stop any continued bleeding.
- Leave the wound packing in place and secure it in place with a pressure dressing or additional Kling.
- Document the procedure, time and result (success) on/with the PCR.
- Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by medical control.