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Posted: 6/5/2002 11:05:03 PM EDT
Anybody carry/use these? I have some in my personal jump bag. I always thought they are probably easier to use than something improvised or a NIFA unit. (You have to strap the NIFA around the torso of the victim.) An Asherman can be slapped on with NO rolling or moving of the victim, except as needed to access the wound site.... Scott
Link Posted: 6/5/2002 11:18:29 PM EDT
Help us out... What are these. It sounds like something for a sucking chest wound, where can I see one, and how much are they? I have a fair amount of medical training, but I've never heard of these. (I have found that regionally there are huge differences in what people consider standard, and even system to system there are big differences.) dp
Link Posted: 6/5/2002 11:37:17 PM EDT
Well, it is a circular doohicky (Pardon the Southron technical jargon) that is used for sucking chest wounds. It was designed by a corpsman named Asherman who was on one of the SEAL teams. It has an adhesive back (supposed to be SUPERsticky) and a "burp valve" in the center. Just slap it on and go to work on the other problems the patient has.... They retail for around ten bucks. Usually can find ads in the various EMS magazines..... Scott
Link Posted: 6/6/2002 12:38:27 AM EDT
Hmm... I was taught the take a piece of plastic, tape it on three sides technique for sucking chest wounds. The Asherman sounds faster, and more to the point. Fortunatly, I can say I've never encountered an actual sucking chest wound. (But EMS is no longer my full time job, either.) Of course, the problem with any field treatment for this, is its just field treatment, they need a doc and a hospital. But, it does sound like the fast and easy way to patch it. dp
Link Posted: 6/6/2002 3:21:29 AM EDT
The ACS is great on gaping holes or where the open chest trauma is allowing air to enter and exit the thorax freely or where blood freely flows out. It'll definitely help prevent a pneumo. The one way valve DOES work. However, if you do have a tension pneumothorax, you're gonna have to spike or tap the chest anyway, so the ACS is limited in it's deployment in that respect. My agency doesn't use them, although I have been eyeballing a couple for my personal ohshit bag. P3[pyro][^][heavy]
Link Posted: 6/6/2002 4:18:28 AM EDT
dpcop, Here's a pic fot you. [url]http://www.life-assist.com/at290.jpg[/url]
Link Posted: 6/6/2002 3:13:54 PM EDT
Thanks Chris for the pics. Does look like a good idea, but I'm fairly sure there's no one around here using them. I think I will try to pick up one for my personal kit, though. dp
Link Posted: 6/6/2002 3:32:45 PM EDT
dpcop, Sent you an IM
Link Posted: 6/6/2002 5:32:30 PM EDT
I was told they are ok with a clean wound. If there is lots of blood and sweat they don't stick that good. I have seen them but never used it. I do like the valve idea, it saves some time.
Link Posted: 6/6/2002 9:26:18 PM EDT
They have a 4x4 packaged with them, to wipe off blood and sweat before application. Now, how much that would help with a person who was REALLY slick, I do not know.... Scott
Link Posted: 6/8/2002 5:59:35 PM EDT
Sounds like a slick thing in need of a problem, I was taught stabilize and seal the wound with a gloved hand (helper) until done the primary and then deal with the problem after you have the patient assessed. sucking chest wound is a major but easily fixed problem, A-B-C's come first.
Link Posted: 6/8/2002 6:07:39 PM EDT
Originally Posted By Westicle: Sounds like a slick thing in need of a problem, I was taught stabilize and seal the wound with a gloved hand (helper) until done the primary and then deal with the problem after you have the patient assessed. sucking chest wound is a major but easily fixed problem, A-B-C's come first.
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You are correct in the sense that ABC's come first but, while conducting your ABC's, you treat life threatening emergencies as you go along. A sucking chest would would be identified under 'B-Breathing'. It is a true life threatening emergency that, if untreated, can manifest into a tension pneumo, can prevent proper O2 exchange, etc...The Asherman Chest Seal can correct the problem in a manner of seconds and allow you to progress in your assesment of the patient much quicker as opposed to having to stop and take the time to apply an occlusive dressing. I've used it on a number of occasions and swear by it....The Ascerman is a quick, efficient, and definitive solution to a life threatening emergency.
Link Posted: 6/8/2002 8:33:42 PM EDT
[Last Edit: 6/8/2002 8:35:22 PM EDT by ParaPyroPig]
Originally Posted By Westicle: I was taught stabilize and seal the wound with a gloved hand (helper) until done the primary and then deal with the problem after you have the patient assessed.
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Trudat, but "Let the situation dictate the tactics." Example: I'm gonna have my partner do the glove-over thing while I clamp that femoral that's pumping like a lawn sprinkler... [xx(] The ACS DOES have it's place in the prehospital, even moreso, the battlefield enviroment: it's phucking [i]quick[/i] and simple! Hell, you can even throw it to the nearest gloved bystander, cop, grunt, or even an EMT-Basic(D'oh!!), point, and say: "Wipe off the blood and put this on that!" -This means I can spend more time fixing the patient's other problems - or move on to treat the next patient(s), rather than putz around with the goddam vasilene gauze or plasticwrap & tape. P3[pyro][^][heavy]
Link Posted: 6/9/2002 12:10:46 AM EDT
Originally Posted By Westicle: Sounds like a slick thing in need of a problem, I was taught stabilize and seal the wound with a gloved hand (helper) until done the primary and then deal with the problem after you have the patient assessed. sucking chest wound is a major but easily fixed problem, A-B-C's come first.
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Howdy, Westicle. Just sign up, or not posting often? Scott
Link Posted: 6/9/2002 6:13:34 AM EDT
[Last Edit: 6/9/2002 6:23:12 AM EDT by Westicle]
Yes I agree that it is handy to have a prepackaged dressing, BUT your partners gloved hand is alot easier/Faster to apply to a Sucking Chest during the primary, after the primary now the asherman is worth it's weight in gold due to the prepacked nature of it. My main concern with it is the ease of application and possible complications of a tension happening, also when something is quick and easy and the injury is either a GSW or penetrating object we always have to check the back and the speed of this thing either makes it easier or harder because then you start missing steps. I am just a worry wart and haven't been trained in its use and am falling back on Protocals eh.... ;) Mostly am a Bystander at this board, been registered for awhile and then they did that upgrade and lost all the registrations... took me a while to reregister.
Link Posted: 6/10/2002 7:33:13 AM EDT
I use the ACS both on the ambulance and as part of my TEMS equipment. They are quick and easy, can be used by a single provider,and in the tactical environment allow for the rapid treatment of a life threatening problem which allows me to extricate my patient to a safer area that much quicker. Sean
Link Posted: 6/10/2002 7:42:42 AM EDT
Originally Posted By swatmedic: I use the ACS both on the ambulance and as part of my TEMS equipment. They are quick and easy, can be used by a single provider,and in the tactical environment allow for the rapid treatment of a life threatening problem which allows me to extricate my patient to a safer area that much quicker. Sean
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Sean, My point exactly. When the lead's flying theres no time for farting around with gloved hands in wounds, occlusive dressings, etc. Slap on the Ascherman, remove your patient (and yourself) from the threat, and continue treatment in a less hostile environment....
Link Posted: 6/10/2002 10:03:50 PM EDT
Originally Posted By ChrisLe:
Originally Posted By swatmedic: I use the ACS both on the ambulance and as part of my TEMS equipment. They are quick and easy, can be used by a single provider,and in the tactical environment allow for the rapid treatment of a life threatening problem which allows me to extricate my patient to a safer area that much quicker. Sean
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Sean, My point exactly. When the lead's flying theres no time for farting around with gloved hands in wounds, occlusive dressings, etc. Slap on the Ascherman, remove your patient (and yourself) from the threat, and continue treatment in a less hostile environment....
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Not sure if I mentioned this.... but they were designed by a Navy corpsman working with a SEAL team... Scott
Link Posted: 6/11/2002 12:06:11 PM EDT
[Last Edit: 6/11/2002 12:07:46 PM EDT by GSG9]
[b][red]Two problems:[/b][/red]
Originally Posted By Westicle: Sounds like a slick thing in need of a problem, I was taught stabilize and seal the wound with a gloved hand (helper) until done the primary and then deal with the problem after you have the patient assessed. sucking chest wound is a major but easily fixed problem, A-B-C's come first.
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[red] A sucking chest wound is a life threatening injury and should be assessed and treated during your primary survey (ABCs as you called them), it should immediately follow checking/ securing the airway while doing the LLF for breathing, however the gloved hand will be utilized until the Asherman is unpackaged.[/red]
Originally Posted By Westicle: Yes I agree that it is handy to have a prepackaged dressing, BUT your partners gloved hand is alot easier/Faster to apply to a Sucking Chest during the primary, after the primary now the asherman is worth it's weight in gold due to the prepacked nature of it. My main concern with it is the ease of application and possible complications of a tension happening, also when something is quick and easy and the injury is either a GSW or penetrating object we always have to check the back and the speed of this thing either makes it easier or harder because then you start missing steps. I am just a worry wart and haven't been trained in its use and am falling back on Protocals eh.... ;)
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[red]Most crews are gonna only have two members and when you compromise one of the by "tying his hands to the patients chest" you only have a one man lifesaving crew until the chest wound is treated properly, the Asherman makes it slap and go for the crew. Also I remember from my training EMTA - EMTP - APHTLS that if the patient is on his back then in most cases if he has a sucking chest wound there it will remain sealed untill he is rolled anyway due to the pressure of his body weight on whatever he is laying on. So your routine should ASSESS and TREAT [blue]ABCDE[/blue] roll patient ASSESS and TREAT[blue] BC[/blue] while continuing to treat [blue]A[/blue] insert backboard, roll REASSESS [blue]ABCDE[/blue].[/red] But to each his own treatment method, within protocol. Jake
Link Posted: 6/12/2002 6:06:56 PM EDT
FWIW, 3/75 Ranger Regt (and possibly the other Batts) have been using the asherman system since 1999 (or possibly earlier).. The asherman was recently discussed by a couple of TEMS medics and ex-military guys at www.legionconsulting.com (in the forums section)... heres a links to another "interesting" new bandage idea (although not an occlusive type).. http://www.narescue.com/bandagessplints/israelibandage.htm MDWest www.legionconsulting.com
Link Posted: 6/12/2002 6:45:21 PM EDT
mdwest, Can you post the link to the forum topic on legion.com. I was unable to find the discussion. Thks
Link Posted: 6/12/2002 7:07:12 PM EDT
I've used saran wrap taped on three sides with success while waiting on the correct treatment. So what does this offer that the simple and cheap temporary fix does not? Lebrew
Link Posted: 6/12/2002 8:31:43 PM EDT
Originally Posted By lebrew: I've used saran wrap taped on three sides with success while waiting on the correct treatment. So what does this offer that the simple and cheap temporary fix does not? Lebrew
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Speed. You don't need to tape down three sides of the seal. It has an adhesive back and a burp valve.... BTW, IIRC, ACS is used by USN, Army, and British navy medics now... Scott
Link Posted: 6/13/2002 5:16:23 AM EDT
[Last Edit: 6/13/2002 5:16:59 AM EDT by ChrisLe]
Originally Posted By lebrew: I've used saran wrap taped on three sides with success while waiting on the correct treatment. So what does this offer that the simple and cheap temporary fix does not? Lebrew
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It offers a number of advantages. 1. Speed, for one thing. If you're under fire or in a similar precarious situation, you can apply the seal in a matter of seconds and remove your patient and yourself from the threat. 2. The seal has a one-way valve already incorporated into its design. No need to use the old 'tape down three sides' to make a valve dressing that takes precious time to complete. 3. Exceptional adhesion qualities. Once you quickly wipe the site of gross blood contamination the seal will stick tenaciously and not peel off. You and I both know that the standard tape carried on most ambulances will not adhere to skin that is anything other than bone dry. I've never been much for 'hi speed' gear in the EMS world. I've always been the type to go with the tried and true equipment. But, in this case, this is one of those 'hi speed' items that works very well. I have yet to find a drawback to using this device. Safe tour, Chris
Link Posted: 7/6/2002 12:53:07 PM EDT
dpcop, Ever get the Asherman I sent you? Tried to IM you but your mailbox is full...... Safe tour, Chris
Link Posted: 7/6/2002 5:24:49 PM EDT
I haven't used the Asherman yet, but I have used a defib / pacer pad as an occlusive dressing. Works pretty well, as long as you reassess for developing tension frequently.
Link Posted: 7/7/2002 4:35:14 PM EDT
ChrisLe, I did get the Asherman, thanks! It looks like it would work well. It's been added to my personal jump kit. Let me know if you need anything! Any reason for me not be getting IM's when I only had one IM in my inbox? Thanks again, Chris! dp
Link Posted: 7/9/2002 10:02:06 AM EDT
Link Posted: 7/9/2002 11:53:10 PM EDT
Originally Posted By medicmandan: Where can I get a few of these? I'd like to try them and pass one on to my boss.
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If you have a subscription to any of the EMS mags, look for an Asherman ad. Got many of mine free by circling numbers on the reader response cards.... Scott
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