As first responders, we know that bleeding is one of the leading causes of preventable death in trauma patients. While tourniquets are effective for extremity bleeding, what do we do when faced with wounds that aren't amenable to tourniquet use or large cavity wounds? The answer lies in a simple yet crucial skill: wound packing.

Why Wound Packing Matters

Wound packing is a fundamental technique that can mean the difference between life and death. It's been a staple in military medicine for years, but it's time we bring this life-saving skill to the forefront of civilian emergency response.

When to Use Wound Packing

• Heavily bleeding junctional wounds (e.g., neck, armpit, groin)
• Large wounds with deep cavities
• As a follow-up to tourniquet application

When to Avoid Wound Packing

• Chest and abdominal wounds (these require immediate surgical intervention)
• Wounds with minimal bleeding
• Caution: When packing neck wounds, be careful not to compromise the airway

Choosing the Right Packing Material

1. Hemostatic gauze (e.g., QuikClot): Accelerates clotting process
2. Standard gauze bandage: Effective, but requires unrolling during packing
3. S-Rolled Gauze: Designed specifically for efficient wound packing

DITCH THE MYTH! Avoid using tampons for wound packing. They're designed for absorption, not compression, and are ineffective for controlling severe hemorrhage.

Proper Wound Packing Technique

1. Ensure scene safety and use appropriate PPE
2. Expose the wound fully
3. Remove excess blood with gauze 
4. Locate the source of bleeding
5. Pack tightly, starting at the source of bleeding
6. Fill the entire wound cavity
7. Apply direct pressure for at least 3 minutes
8. Secure with a pressure bandage

Remember: The goal is pressure, not absorption. Large dressings or towels alone won't effectively control bleeding.

How to Pack:

Wound packing is a critical skill that every first responder should master. It's simple, effective, and can save lives in situations where other methods fall short. Stay prepared, stay trained, and be ready to make a difference when it matters most.