Junctional wound packing for groin, neck and armpit gunshot wounds

Key points: Junctional wound packing groin

• Tourniquets only work on arms and legs; the three junctions where two body areas meet — neck, armpit and groin — need a different answer, and that is the entire subject of the video.
• The sequence is identify, expose, then direct pressure through wound exploration: put your fingers into the wound, feel for the pulsating vessel, and press on it rather than around it.
• Arteries pump away from the heart, so pack toward the heart — Paul removes a badly packed wound on camera to show that gauze stacked at the surface does nothing no matter how much you add.
• Do not panic pack: keep the gauze in your palm, take a power-ball-sized amount, and pack finger over finger like a sewing machine until roughly a golf ball of gauze sits proud of the wound.
• Hemostatic gauze stimulates clotting rather than burning like the early granular agents, and the doctrinal hold times he cites run about 60 seconds for one product and three minutes for another against roughly ten for plain gauze — which he treats as filler behind the hemostatic.
• Bandaging changes with the site: belt line toward the toes and intersecting lines for the groin, a figure-eight anchored across the opposite side for the armpit, and an arm-over-the-head wrap for the neck that never circles the throat.
• Closing considerations are hypothermia, pelvic stabilisation before a carry, and the recovery position for an unconscious casualty — with roughly two litres of estimated blood loss still described as survivable with the right skill set.

About this Tactics and Training video

Junctional wound packing for groin, neck and armpit gunshot wounds — the bleeds a tourniquet cannot reach. Dirty Civilian brings Paul of Bear Solutions back to work three high-fidelity moulage injuries in real time: find the vessel with your fingers, replace your hand with hemostatic gauze packed toward the heart, build a golf-ball mound of pressure, then seal it under a pressure bandage that survives being moved. Covers hemostatic versus plain gauze, why a tourniquet cannot work on a junction, the packing error that wastes blood, and the recovery position.

Transcript: Junctional wound packing