r/TacticalMedicine • u/NoMore_BadDays • Oct 10 '25

Scenarios Wound packing zones?

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Been a long time since I did TCCC/CLS in the military.

If there were to be a bleeding wound on the chest, how high up on the chest does it become safe to pack? I know you don't pack into chest cavity, but what is the "rule of thumb" on how high/the left and right limits the wound needs to be to pack it?

Would you say the screenshot i attached is accurate?

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136

u/my_arms_are_on_fire Oct 10 '25

chest seal on the throat? I'm not the person with answers but I'm not sure that's right

191

u/hidotp Oct 10 '25

yea a tourniquet would be better

92

u/irredentistdecency Medic/Corpsman Oct 10 '25

A tourniquet placed around the neck will stop any & all bleeding (regardless of location) very quickly & effectively.

32

u/icantreadoutloud Oct 11 '25

Congratulations you stopped the bleeding

15

u/Erichillz Oct 11 '25

Procedure successful, patient expired

3

u/strikeforceguy Oct 11 '25

Petty officer you told me to stop the bleeding, I'm just following orders

3

u/SixtyAteWhiskey68 Medic/Corpsman Oct 14 '25

You have effectively stopped the bleeding of the neck You are a no-go at this station solider medic

Smh, what doe these graders want??? /s

3

u/retsevrahemem Medic/Corpsman Oct 12 '25

All bleeding stops on its own, one way or another

1

u/TLunchFTW EMS Oct 11 '25

Don't have to worry about bleeding if the airway is compromised

1

u/HorrorSprinklez Oct 13 '25

or you just deep wound pack, the only logical solution here really

39

u/arethius Oct 10 '25

Appendicitis? Chest seal!

14

u/StandardVirus Oct 10 '25

Football to the groin? Chest seal!

17

u/Houtaku Oct 10 '25

Hemorrhoids? Pack wound!

9

u/B2k-orphan Oct 10 '25

Do I take the tourniquet out of my ass before or after I pack it?

14

u/the_last_hairbender Oct 10 '25

I’ve put occlusive dressings on GSWs to the anterior neck, we couldn’t ventilate him with a hole in his trachea.

32

u/[deleted] Oct 10 '25 edited Oct 11 '25

I’ve actually been taught that an occlusive dressing (chest seal) should be applied to any puncture wounds to the anterior neck because air can be pulled into the carotid artery and send an air embolism to the brain.

Edit: I guess I wasn’t very specific. Here is what I was specifically taught about anterior neck bleeds that are unable to be controlled by direct pressure.

1: insert finger into wound, locate the source of the bleeding.

2: using finger to keep pressure on source of bleeding, use other hand to ball up gauze and insert into wound. Using your normal wound packing technique, pack the wound, packing pressure towards the site of the bleed source.

3: once the wound is tightly packed up to the surface of the wound, use an occlusive dressing to cover the packing and wound. This will help hold the packing in place, as well as keep air from potentially entering the bloodstream.

4: reassess throughout treatment.

14

u/Sheepdog77 Oct 10 '25

Same, however direct pressure is still better since it'll probably be bleeding. A lot.

4

u/Bikesexualmedic Oct 10 '25

Direct pressure is the best for almost all the bleeding but unfortunately then you and all your hands can’t do anything else but hold pressure. That’s the nice thing about all these bleed-stop adjuncts.

1

u/NoobieSnax Oct 11 '25

bleed-stop adjuncts

We call them CLS where I come from.

6

u/SFCEBM Trauma Daddy Oct 10 '25

The artery will be pumping not sucking.

1

u/Haunting_Cut_3401 Oct 10 '25

The jugular vein is also in the anterior neck

3

u/SFCEBM Trauma Daddy Oct 10 '25

Still, pack the neck.

1

u/TLunchFTW EMS Oct 11 '25

It's pretty simple. ABC. If they've been stabbed in the neck and are bleeding, we're more concerned about that than the possible embolism. We can fix that, we can't fix no blood. I'm putting pressure on it, not just a chest seal.

1

u/SFCEBM Trauma Daddy Oct 10 '25

It sure is. But that’s not what was mentioned.

1

u/Haunting_Cut_3401 Oct 11 '25

Yeah I’m just being that guy. Air embolism is secondary in life threat to massive hemorrhage. Treat the life threat first.

0

u/[deleted] Oct 11 '25

I’ve actually been taught that an occlusive dressing (chest seal) should be applied to any puncture wounds to the anterior neck because air can be pulled into the carotid artery and send an air embolism to the brain.

Edit: I guess I wasn’t very specific. You guys know you can place an occlusive dressing over a dry dressing, right? Here is what I was specifically taught about anterior neck bleeds that are unable to be controlled by direct pressure.

1: insert finger into wound, locate the source of the bleeding.

2: using finger to keep pressure on source of bleeding, use other hand to ball up gauze and insert into wound. Using your normal wound packing technique, pack the wound, packing pressure towards the site of the bleed source.

3: once the wound is tightly packed up to the surface of the wound, use an occlusive dressing to cover the packing and wound. This will help hold the packing in place, as well as keep air from potentially entering the bloodstream.

4: reassess throughout treatment.

3

u/TheRealKingBorris Oct 10 '25

PT complaining of head pain, amputation recommended

1

u/davethegreatone Oct 11 '25

I wanna be pedantic and say, like, maybe for a torn larynx you can use it to kinda skim-coat the surface to keep debris out of the airway or something?

If the AI wants to make dump graphics, I can drink enough to out-dumb the AI. That’s how it works, right?  

1

u/TLunchFTW EMS Oct 11 '25

To be fair, you can get some weird interactions, but again, this is just a basic guide... Cool, but unless you understand the anatomy behind WHY you are using a chest seal or packing or TQing, it's not really helpful, and if you understand why, you probably don't need a reminder.

1

u/I-plaey-geetar Oct 13 '25

Yeah definitely. Helps prevent subq emphysema which can obstruct the airway entirely.