1st Aid Tampons and other improvised tools. Do they work or are we not thinking through the science

ComCamGuy

Remote Paramedical pain in the ass
There is a lot of improvised first aid and wound care info out there. Some is science supported, some is antidotal. Recently a blow up in the “Overlooked Preps“ thread got a bit heated on the topic of tampons for deep wounds and maxi-pads to stop bleeding. Well some of us got wrapped around the axle and it was suggested (strongly) we take it to another thread, like in the TIO section by a very kind admin (Summerthyme)
not trying to be too argumentative and wanting to keep medical with medical, I decided to start this thread for us to air out our points and dispel medical miscues we may have developed from various sources.

Some of what might be here might be surprising, some may cripple sacred cows, some may bring new ideas to people and some may explain what we knew so it is more than “we did it , we don’t know why, but it worked”

Some of the topics I was thinking of were things like tampons being bad initial deep wound treatment(my main offense in the original thread), honey and maggots good long term wound care, dental floss not the best choice for sutures and so on and so forth.

Please support assertions with facts or references. I’m hoping to dispel myths and add knowledge.
 
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kyrsyan

Veteran Member
I have had medical personnel, in various positions, absolutely freak about the idea of tampons in deep wounds. So not something I ever planned for.
 

nomifyle

Has No Life - Lives on TB
I have had medical personnel, in various positions, absolutely freak about the idea of tampons in deep wounds. So not something I ever planned for.
IMO I would not use them either, pads yes, but not tampons, not sure why, just a gut opinion.

God is good all the time

judy
 

packyderms_wife

Neither here nor there.
When I was in the eight grade my neighbor was fighting with his brother and hit me instead, as I walked past 5heir dining room. Totally flattened my nose, that would not stop bleeding. Nadine, their mom promptly inserted two of those non suppository brand tampons into my nose and boom. Yeah talk about a PITA not being able to breath, but the blood flow stopped. It did not resolve the shattered sinus cavity though.

As for Kotex, the heavy duty Kotex holds one pint of blood, per the class I took to become an ent back in the eighties. It does not stop the blood flow, it does tell ER staff how much you’ve bled out.
 
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ComCamGuy

Remote Paramedical pain in the ass
A tampon has basically a 4 x 4 of gauze in it and is useless. A roll of kerlex and a simple pencil would be much better

dont take just my word. I will post more from my work computer where I have a ton of files

so, take this guys words
https://havokjournal.com/fitness/medical/your-tactical-tampon-is-useless-for-life-threatening-hemorrhage/

Andrew D. Fisher is now a medical student at Texas A&M College of Medicine after serving many years as a physician assistant with the U.S. Army. He joined the Army in 1993 as a Light Infantryman and spent three years at 1st Battalion, 75th Ranger Regiment before leaving the Army to pursue a college education. He is a 2006 graduate of the Interservice Physician Assistant Program. His previous assignments as a PA include UNCSB-JSA (Republic of Korea) and 1st Battalion, 75th Ranger Regiment. He has deployed seven times in support of the Global War on Terror/OCO. Andrew has taken care of more patients in the 75th Ranger Regiment than any other person since October 2001 and is the 2010 Army PA of the Year. Known as Old Man River, he is always angry, irritable, and cynical; at least it appears that way. He considers himself to be the least talented writer for the Havok Journal, but is very appreciative to have the opportunity. In his spare time he enjoys… who are we kidding, he has no spare time.

Your “Tactical Tampon” is Useless for Life-Threatening Hemorrhage
February 22, 2020 by Andrew Fisher

Your “Tactical Tampon” is Useless for Life-Threatening Hemorrhage
by Andrew Fisher
The myth that tampons can quell life-threatening hemorrhage just won’t die.
ngcb1

“Tactical tampon:” you never know when you might need one!
It seems that every other week a post on social media touts the amazing effects of tampons as a life-saving intervention (LSI). After all, there are anecdotes from Iraq, Afghanistan, and the veteran favorite “back in my day” story.
My favorite tampon evidence comes from the always “unbiased”Snopes.com. Here we have “proof” tampons work as a LSI. Nothing says unbiased evidence like a third-party…maybe even fourth-party letter written to mom from a war zone. Snope’s story is full of unsubstantiated information, yet it is a common reference for the Tampon Truthers. Even Snopes admits this story is “Undetermined.”
Then, one can find the fringe of the Internet who also assert tampon effectiveness. Bioprepper claims tampons are “designed
ngcb1

Sanitary napkin, not a tampon. Courtesy: http://www.period.media/factsf
to be ultra absorbent” and “can be used to plug a bullet hole until…accounts of this use date back to World War I.” However, this should all be thrown out the window of truthfulness with this: “Many items in modern society were first developed as a facet of military research – tampons being a prime example.”
No, no, and no.
Tampons have been around for many thousands of years, for, you’ll never guess—vaginal bleeding. In the age of every bit of information at your fingertips, why rely on conjecture and #fakenews as truth? Some have stated tampons were used during World War I and II. I have yet to find definitive information tampons were used as treatments for life-threatening wounds. However, Kimberly-Clark, which produces Kotex® did make and provide Cellucotton, an absorbent wadding made of wood pulp as bandages—which are bandages, not tampons. During World War 1, field nurses discovered that Cellucotton worked well as a disposable feminine napkin.
After the war
, Kimberly-Clark began making sanitary napkins from
ngcb1
Cellucotton. It was not until 1940s that many companies made tampons. Another tampon story says nurses made their own tampons during World War I. During World War II, “production of cotton bandages and surgical dressings for the U.S. military now took place alongside the tampon assembly lines.” The only information found was the use of tampons in the “1st century” for bullet wounds. I found that interesting because I was not aware of firearms in the 1st Century.
Enough of the background and history. Let’s talk science. There is no evidence to support the use of tampons. There is no study, no data, nothing but Internet anecdotes to support this ongoing heresy. Anecdotes and letters to mom is not science or comes close to evidence to support tampon use.
ngcb1

Tampon meme. Courtesy: Eric Totel
Why don’t tampons work? It’s actually not that difficult. When bullets enter the body, while the entrance is small, they create a larger area inside due to the bullet’s energy. This cavitation can be large, but more devastating that the soft tissue damage from the bullet’s energy, is an arterial injury.
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The synergy between fragmentation and cavitation results in detachment of pieces of muscle and increases the permanent-cavity dimensions. Courtesy: Martin L Fackler, Gunshot Wound Review, Annals of Emergency Medicine, Volume 28, Issue 2, 1996, Pages 194-203
Massive bleeding from an artery in an extremity is a life-threating wound and also a preventable death. This is a significant issue, not only for the US military, but also the citizen of our nation. Of the 147,000 trauma deaths in 2014, 20% or 30,000 were potentially survivable. Many of these were due to bleeding from an extremity.
A tampon cannot provide the surface area or the pressure to control massive bleeding. Tampons absorb blood, not provide any hemostatic assistance. The average tampon can absorb 9 mL of blood, or about two teaspoons. This will not stop life-threatening bleeding. While a hemostatic dressing is preferred to control massive bleeding, regular gauze may be used, but it needs to be in sufficient amount. Based on square inches, a tampon has the surface area about 4 square inches.
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11 tampons in a GSW model. Courtesy: Eric S.
A hemostatic dressing is a gauze type dressing, impregnated with hemostatic agents, z-folded and compressed. It’s surface area is over 400 square inches, this is a significant difference. If you think the ¼ inch depth of the tampon makes a difference, again, it holds 9 mL. Furthermore, the hemostatic dressing actually helps with clotting. Each dressing has a different mechanism.
A search of peer-reviewed medical literature will fail to provide you with any data on tampon use. This is likely, because no physician or researcher worth their $200,000 degree would waste their time studying something that is obviously inferior to tourniquets or hemostatic agents.

What about bullets cauterizing wounds? According to Fackler: “On occasion one still hears the myth that bullets reach such a high temperature in the gun barrel that they are sterilized by being fired. This was proved false by kaGarde in 1892.”
But, the other argument is, what happens when you run out of supplies. In what situation would you either preferentially pack tampons over proven medical equipment or find yourself be naked? The latter being, clothing of any type would be superior to tampons, by the amount of surface area.
Others argue they carry tampons for females. That’s cute, but it is not a medic responsibility on a combat mission. If you are in an aid station and you only have tampons left, you failed to plan properly. You will still be more successful using clothing over tampons. The American College of Surgeons recommends, when you do not have a hemostatic dressing, sterile dressings, or a tourniquet, use clothing to pack wound. This can be a shirt, pants, socks, preferably clean, but your clothing covered in body sweat, provides more than a tampon.
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Tampon vs QuickClot Combat Gauze

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Tampon vs Hemostatic Dressing

It is clear, that the tampon argument is based off passed down unverified anecdotes. The claims of “tampon truthers” are dangerous and need to be dismissed. Honestly, we probably need a study demonstrating their failure to make some headway.
This first appeared in The Havok Journal February 12, 2019 and represents the personal opinion of the author and is not necessarily representative of the views of any other party, and is not intended to serve as medical advice
 

kyrsyan

Veteran Member
Don't depend on menstrual pads for absorbing blood from a bleeding wound unless the wound is small. Old style ones maybe, but not modern ones.
In modern ones, with the gel absorption, the beads cannot absorb over a certain speed. So lots and lots of leakage. A true mess. All you'll do is smear blood everywhere and see very little absorbed. Better to go with bandages meant for that job and quikclot.
 

Marie

Veteran Member
If in a perfect world all folks were enlightened enough to have a full medic kit. None would need to be used.
But I highly doubt society in general has more than maybe a bandaid for those types of emergencies.
So pads and tampons serve a very temporary purpose.
 

ComCamGuy

Remote Paramedical pain in the ass
Don't depend on menstrual pads for absorbing blood from a bleeding wound unless the wound is small. Old style ones maybe, but not modern ones.
In modern ones, with the gel absorption, the beads cannot absorb over a certain speed. So lots and lots of leakage. A true mess. All you'll do is smear blood everywhere and see very little absorbed. Better to go with bandages meant for that job and quikclot.
This is why they work for wound dressings for long term care and poorly for emergency wound application to stop bleeding. The comfort layers work well as a non-stick dressing.
 

ComCamGuy

Remote Paramedical pain in the ass
If in a perfect world all folks were enlightened enough to have a full medic kit. None would need to be used.
But I highly doubt society in general has more than maybe a bandaid for those types of emergencies.
So pads and tampons serve a very temporary purpose.

Faster and more effective to tear a chunk of shirt and cram it in the wound,
 

1911user

Veteran Member
If in a perfect world all folks were enlightened enough to have a full medic kit. None would need to be used.
But I highly doubt society in general has more than maybe a bandaid for those types of emergencies.
So pads and tampons serve a very temporary purpose.
And a folded up t-shirt would serve even better than the pads and tampons.
 

packyderms_wife

Neither here nor there.
Don't depend on menstrual pads for absorbing blood from a bleeding wound unless the wound is small. Old style ones maybe, but not modern ones.
In modern ones, with the gel absorption, the beads cannot absorb over a certain speed. So lots and lots of leakage. A true mess. All you'll do is smear blood everywhere and see very little absorbed. Better to go with bandages meant for that job and quikclot.
And this is an excellent point. When I learned about using a heavy duty pad to catch the blood that was the 1980s and pads have changed a lot since then, as have tampons.
 

Hfcomms

EN66iq
Not a doctor or a medic but have some training and common sense. I would use one to control initial bleeding to get some clotting going and have quick clot available as well. I would not leave one in a wound that is trying to heal as infection is a given and the wound would need a latex drain or be packed open so it can drain any exudate.
 

Kayak

Adrenaline Junkie
I've used a pad once, to keep minor bleeding at bay after a playground injury -- until I could get my drama-queen daughter home and properly clean and bandage it. You use what you have available.

I would never stock a first-aid kit with menstrual supplies, though. Use the proper tools when possible, always.
 

kyrsyan

Veteran Member
Modern menstrual pads can't control initial bleeding. They can't absorb blood fast enough. Absolutely can promise you this. They can't.
As for tampons, they won't absorb enough and they'd be in the way of doing any treatment. And they don't really expand to plug the hole the way people seem to think they will. And from the med side, they leave a nightmare field of debris. Especially if they get dried in place. If it's all you have, it might be better than nothing. But I'd rather shove in a section of shirt than a tampon.
 
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Tex88

Veteran Member
If in a perfect world all folks were enlightened enough to have a full medic kit. None would need to be used.
But I highly doubt society in general has more than maybe a bandaid for those types of emergencies.
So pads and tampons serve a very temporary purpose.
Yes, if all you have is a tampon it /might/be better than nothing. A clean shirt would be better. But since the subject of the other thread was “forgotten preps”, I suggested to stock up on proper bandages and compresses and such, instead of tampons, which are more expensive and less useful for dressing a wound.

And since we’re talking about menstrual supplies, further up in the original thread, I suggested to give “the cup” a thought instead of tampons or pads or little fancy napkins crocheted out of wool. Strictly for logistics reasons. You can rinse out the cups and boil them in water to sterilize them. You don’t have to worry about supplies of tampons and pads, and if you’re gonna wash your crocheted pads, you might as well save yourself a step and boil your cups in water since you’re gonna need hot water anyway to wash and sterilize your little period doilies.
 

kyrsyan

Veteran Member
Yes, if all you have is a tampon it /might/be better than nothing. A clean shirt would be better. But since the subject of the other thread was “forgotten preps”, I suggested to stock up on proper bandages and compresses and such, instead of tampons, which are more expensive and less useful for dressing a wound.

And since we’re talking about menstrual supplies, further up in the original thread, I suggested to give “the cup” a thought instead of tampons or pads or little fancy napkins crocheted out of wool. Strictly for logistics reasons. You can rinse out the cups and boil them in water to sterilize them. You don’t have to worry about supplies of tampons and pads, and if you’re gonna wash your crocheted pads, you might as well save yourself a step and boil your cups in water since you’re gonna need hot water anyway to wash and sterilize your little period doilies.
I use coupons to stock on on bandages whenever there is a good sale. That has save my budget and sanity more than once. And in the beginning of 2020 I found different bandages with quikclot type properties to add to the kit. And some actual quikclot as well. I actually have a pretty impressive med kit for a non-med person now. And over time it might get upgraded enough that if a med person needed to use it, they'd find whatever they need.

Cups are okay. And I loved them while I could use them. But I became one of those people that just could not break the cycle of infections while using them. No reason why. It just happened. Honestly, pissed me off because that was the most amazing solution for me. So they work. But have backup.
 

Tex88

Veteran Member
That sucks and I’ve got no solution for it. It’s one of those “might work great for you, might now work at all” things. Or in this case “might work great for you, but had severe drawbacks”.
 

kyrsyan

Veteran Member
That sucks and I’ve got no solution for it. It’s one of those “might work great for you, might now work at all” things. Or in this case “might work great for you, but had severe drawbacks”.
There wasn't a solution. Tried a whole spectrum of things because I really did not want to stop using it. But it came down to unless I was going to boil it each and every time it exited my body... which is really impractical.
 

Marie

Veteran Member
Faster and more effective to tear a chunk of shirt and cram it in the wound,
I'd more than likely choose a sanitary wrapped item than a shirt that is more than likely covered in germs.
But Then again I have prepped for far more extensive med kit so I wouldn't need either. Just thinking the average woke karen but then again they would probably use a shirt. Good way to grind in a ready made infection
 

Marie

Veteran Member
Had to look up these cups. Never heard of such a thing. But then again haven't had to use such things in decades.
 

ComCamGuy

Remote Paramedical pain in the ass
I'd more than likely choose a sanitary wrapped item than a shirt that is more than likely covered in germs.
But Then again I have prepped for far more extensive med kit so I wouldn't need either. Just thinking the average woke karen but then again they would probably use a shirt. Good way to grind in a ready made infection

makes broad spectrum antibiotics a priority, anytime a major hole is created
 

Marie

Veteran Member
makes broad spectrum antibiotics a priority, anytime a major hole is created
I agree completely but when we are talking shtf ya think jqp is gonna think of that? Temporary is temporary that pad would serve as an emergency damper to keep the wound semi clean and allow some type of pressure to be applied. Until something more suitable can be found. I've used them in the past for a quick 10 min solution when nothing else was attainable and no full med kit was available. Just long enough for paramedics or a nurse to arrive with a full kit. We weren't allowed to carry a full med kit at some of my jobs. But it's faster to grab one of those in a bathroom than your med kit in the car half a football field away. And some of my second jobs. Now way would I use a shirt. Grease, battery. Fluid, solvents. No way :lkick:
 

Faroe

Un-spun
Several years ago, I bought some packs of what were called "bar toweles." Large squares of gausey white cotton. I laundered them, tossed them in hot drier, and packed them into ziplocks immediately out of the drier. Just for wounds. Real medical gause always seems to come in tiny little packages. We have some "Israeli dressings," but I also remember a medic complaining that you can't really pack them into a wound. Figured the bar clothes and vet wrap would be better than nothing. (I have zero experience with trauma or medicine, just reading and some videos.)

Maybe a package of knit white t-shirts would leave less lint behind?
 

ComCamGuy

Remote Paramedical pain in the ass
Several years ago, I bought some packs of what were called "bar toweles." Large squares of gausey white cotton. I laundered them, tossed them in hot drier, and packed them into ziplocks immediately out of the drier. Just for wounds. Real medical gause always seems to come in tiny little packages. We have some "Israeli dressings," but I also remember a medic complaining that you can't really pack them into a wound. Figured the bar clothes and vet wrap would be better than nothing. (I have zero experience with trauma or medicine, just reading and some videos.)

Maybe a package of knit white t-shirts would leave less lint behind?
rhey make compressed rolls of gauze that are vac packed to about the size of a deck of cards for not too much of a wallet hit
 

kyrsyan

Veteran Member
Several years ago, I bought some packs of what were called "bar toweles." Large squares of gausey white cotton. I laundered them, tossed them in hot drier, and packed them into ziplocks immediately out of the drier. Just for wounds. Real medical gause always seems to come in tiny little packages. We have some "Israeli dressings," but I also remember a medic complaining that you can't really pack them into a wound. Figured the bar clothes and vet wrap would be better than nothing. (I have zero experience with trauma or medicine, just reading and some videos.)

Maybe a package of knit white t-shirts would leave less lint behind?
Or white sheets, washed and packed similarly.
 
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