“So here is the story: I am an emergency medicine resident and I am currently rotating in the ICU. There was a patient I was taking care of that (sparing unnecessary details), had an arm that was opened up and left open (fasciotomy). All of a sudden the nurse comes get me and says that we are going up on pressors (medication to keep blood pressure up) and so I go and evaluate him. Turns out his bed sheet was soaked in blood, 500cc to a liter. Undoing his dressings, it looked like he was having a spontaneous arterial bleed from the radial artery. Multiple attempts at direct pressure to control bleeding fail due to the way his arm is laid open and due to the way the dressing is done. I call for a tourniquet but apparently they don’t carry them on the floor.
I call for a bedsheet next, and using an old EMS trick, I cut a strip off, wrap it around his bicep, and then tie an overhand knot. Then I place the Gerber Impromptu over the overhand knot and tie another one going in opposite direction (square knot). Then I used the Impromptu as a steel winch to increase the pressure applied and within 3 turns the bleeding stopped. Kept it up until the surgeons could come and locally explore and tie off the artery. I have done this before back when I was an EMT before tourniquets were back in vogue, so there were no commercial options, and I can tell you that a plain Bic pen is not gonna hold up, so I was glad to have my Impromptu that day!” – Richard, Emergency Medicine
Photo courtesy of Gerber Gear Facebook Page
