For all the AIWB carriers.

[breakingtime91]

What wound, the dick or the femoral artery?

Dick. Just stuff with gauze?

[Josh Runkle]

On a serious note how would you treat that wound? I am being 100% serious as I am at a loss even though being to multiple combat life saver courses and civilian equivalent

Being serious...my limited understanding, and that is to say, I have never treated this situation...loosely pack with dry, sterile gauze. If inside organs are exposed...IE: you have half a nut sticking out, loosely pack with wet sterile gauze. A genital injury is treated as life threatening and highly emergent. Self-inflicted genital mutilation is actually not as uncommon as one would think. The last case I heard about, the person "accidentally" removed their penis with shears. They were fine for a couple of days. They had put a tourniquet around any remaining parts. Infection from the wound traveling up the urethra into the bladder to the ureters to the kidneys made the wound life-threatening from severe sepsis.

We had a class on genital injuries during trauma sections of paramedic school. For some reason, my study partner found a phrase from that section to be either funny or important: "never pack the vagina"...and I remember him writing that on the board during the next study session.

Being that not all people who carry AIWB are male, if you are sincere in learning to treat this potentially life threatening injury for a female as well, loosely pack the outside with gauze. IE: don't perform any wound packing like you would with a gunshot wound somewhere else (not for a male to the groin area). NEVER pack the vagina. It sounds silly to phrase it like that, but in a life threatening emergency, where people are severely bleeding, people often fall back on their training, which might be something like wound packing. Do not use any sort of hemostatic agent or combat gauze either.

Luckily, we have emergency physicians here who can probably pass on better information than mine. Hopefully one of them can chime in.

ETA: I would not advise packing tight. Remember that as the patient is given drugs for pain, the groin/genital muscles, currently under contraction, will relax and expand...like when you are in REM sleep. The expansion process will pull against the tight packing, which will cause further damage. Or, if they pass out from pain, even if they don't receive drugs, they may undergo the same expansion process.

[YVK]

Well, I would not try to put on a tourniquet .

Yep, I'd just pack it. There is no way to effectively compress any proximal artery for hemostasis. I'd probably put something cold around, to promote arterial spasm and tissue contraction.

[breakingtime91]

Awesome tips, thanks.

[okie john]

Awesome tips, thanks.

I see what you did there.


Okie John

[baddean]

Well, I would not try to put on a tourniquet .

From a strictly Darwinian standpoint, I would think that a tourniquet strategically placed, say in the neck area, would prevent blood loss from the alleged "big" head through where the "small" head used to be. Blood flow would eventually cease, thus preventing further contamination of the gene pool.

[23JAZ]

On a serious note how would you treat that wound? I am being 100% serious as I am at a loss even though being to multiple combat life saver courses and civilian equivalent

Tourniquet?

[23JAZ]

Being serious...my limited understanding, and that is to say, I have never treated this situation...loosely pack with dry, sterile gauze. If inside organs are exposed...IE: you have half a nut sticking out, loosely pack with wet sterile gauze. A genital injury is treated as life threatening and highly emergent. Self-inflicted genital mutilation is actually not as uncommon as one would think. The last case I heard about, the person "accidentally" removed their penis with shears. They were fine for a couple of days. They had put a tourniquet around any remaining parts. Infection from the wound traveling up the urethra into the bladder to the ureters to the kidneys made the wound life-threatening from severe sepsis.

We had a class on genital injuries during trauma sections of paramedic school. For some reason, my study partner found a phrase from that section to be either funny or important: "never pack the vagina"...and I remember him writing that on the board during the next study session.

Being that not all people who carry AIWB are male, if you are sincere in learning to treat this potentially life threatening injury for a female as well, loosely pack the outside with gauze. IE: don't perform any wound packing like you would with a gunshot wound somewhere else (not for a male to the groin area). NEVER pack the vagina. It sounds silly to phrase it like that, but in a life threatening emergency, where people are severely bleeding, people often fall back on their training, which might be something like wound packing. Do not use any sort of hemostatic agent or combat gauze either.

Luckily, we have emergency physicians here who can probably pass on better information than mine. Hopefully one of them can chime in.

ETA: I would not advise packing tight. Remember that as the patient is given drugs for pain, the groin/genital muscles, currently under contraction, will relax and expand...like when you are in REM sleep. The expansion process will pull against the tight packing, which will cause further damage. Or, if they pass out from pain, even if they don't receive drugs, they may undergo the same expansion process.

So no quick clot?

[RoyGBiv]

Awesome tips, thanks.

Ida fallen out of my chair if I wasn't already laying down on the couch.

[breakingtime91]

Ida fallen out of my chair if I wasn't already laying down on the couch.

I see what you did with my user name there.. well played sir