Several people have attempted to refute it, but the myth of the tactical tampon stopping a life-threatening hemorrhage just refuses to die. And if you try to ever so gently school a Tampon Truther with facts, you’re labeled as the village idiot while the Truthers smugly work the room with their superior knowledge. Actually, they just shout down every voice of reason. I’ve even seen (self-proclaimed—not sure I believe they’re licensed or certified) nurses and nursing students do it.
So let’s look at some facts and the math to accompany the information.
First off, the tampon is almost always asserted to be an effective expedient method for stopping bleeding due to a gunshot wound. After all, it’s about the right size to plug that hole. However, while the entrance wound may be small, there’s this thing called cavitation. Basically, the energy from the bullet creates a larger cavity inside. This energy not only damages the soft tissue, it may also perforate arteries. Arterial bleeding is a primary cause of death. A tampon inserted into such a wound may prevent blood from exiting through the tampon, but it does nothing to stop the bleeding. The blood will just find another way out.
Oh, and how long is that tampon? 3-4” if it’s a big one? Most bullets also leave exit wounds. Most people are much more than 3-4” deep. In other words, there’s no way the tampon is reaching down to all the tissue damage from the bullet.
Now, let’s consider the math of the tampon. The average tampon will absorb 2 teaspoons of blood. Life-threatening hemorrhage involves somewhere around 1 pint of blood or more. There are 96 teaspoons in 1 pint. A tampon isn’t going to cut it. Next, let’s consider surface area. A tampon boasts a surface area of about 4 square inches. Hemostatic gauze, much preferred in a situation like this, has about 400 square inches. Even regular gauze, without the hemostatic agent, would be a much better choice for stopping bleeding. The fact that the tampon cotton is ¼” thick is irrelevant. It still only holds 2 teaspoons.
1000 mL. About 2 pints of blood. That’s the amount pumped out of an injured artery in three minutes. Two teaspoons—about 9 ml of blood—is all that the average tampon holds. There’s no way it’s stopping an arterial bleed.
0. This gem from Bioprepper asserts that tampons were used to plug bullet holes during WWI. There is no proof. Zero substantiation of this claim. Because it doesn’t exist.[1] Yes, cotton wadding was used as bandaging material, and nurses did decide to try it as a tampon. However, tampons were never used (at least, not successfully) to stop life-threatening hemorrhaging from bullet wounds.
0. That’s also the number of peer-reviewed studies on the utility of tampons in stopping bleeding. And this is in an age when we can research any topic within mere minutes on the internet. Nothing about a tampon working as well as gauze. Or even not working as well, but still working a little. Nothing at all. Zero.
30,000. Of the approximately 150,000 trauma deaths in the US in 2014, about 20% (or 30,000) were potentially survivable. Many were due to bleeding from an extremity. In other words, a tampon wouldn’t have worked, but gauze and pressure may have.
Two 2x4" pieces of cotton gauze in a tampon or 3.6x4.1" by 12 yards of Kerlix gauze. It would take 36 tampons to exert the same amount of pressure (156 mmHg) exerted by 1 roll of Kerlix gauze.[2]
One source on Snopes.com doesn’t count.[3] There is no documentation anywhere to support the claims made about tampon use in the military to stop bleeding.
Never. The time when you would want to use a tampon instead of anything else to stop bleeding. What if you are totally out of supplies? Would you use a tampon then? No, the answer is still never. Would you ever choose to pack tampons instead of proven medical equipment? No, never. And that is because clothing—any clothing—would be far superior to using a tampon. Preferably clean clothing, but even sweaty clothing would be better than a tampon. That’s supposedly according to the American College of Surgeons, quoted all over the internet on this topic. I can’t find any legitimate source to document that.
Finally, if the above isn’t sufficient to convince you, here is Dr. Joseph Alton, author of The Survival Medicine Handbook. He’s an off-grid medicine doctor sharing his thoughts on the tactical tampon:
Why wouldn't a tampon work? After all, it might be the right size to plug a bullet hole. When soft tissue is struck by a projectile at high speed, however, it creates a channel through which that projectile travels. As a matter of fact, it causes two channels: A permanent one caused by the actual path (not to mention any fragments) and a larger one caused by the energy being released into the body by the round. Vessels and organs not in the direct line of the permanent cavity may still be damaged and bleed due to the secondary shock wave. Bullets traveling at high speeds go deeper into the body than a tampon can reach. Plugging a hole, even one that looks like it could fit a tampon, doesn't stop the bleeding inside. It just pools internally or finds an exit wound. The tampon is just concealing the bleeding, not stopping it. Just because you can't see it doesn't mean it isn't happening. "Successes" in the field were, probably, nightmares for the surgical team after evacuation.[4]
References:
https://www.mayoclinichealthsystem.org/-/media/local-files/eau-claire/documents/medical-services/ed-trauma/stop-the-bleed-booklet.pdf?sc_lang=en&hash=BF6F26E7E5A0F683278C61EB53DEF57F
https://www.doomandbloom.net/the-tactical-tampon/
https://pracmednz.com/the-myth-of-the-tactical-tampon-for-gun-shot-wounds/
https://www.crisis-medicine.com/tampons-not-for-bullet-wounds/
Links to related posts:
DIY QuikClot (coming tomorrow)
As a note the FBI consider a round suitable for stopping a target if it can penetrate 11in of ballistic gel (or about 11 in of flesh). Most people are not like a dutch dyke, you can't just stick a finger into the hole (or a tampon) and call it good
ReplyDeleteExile1981
Thank you, thank you, thank you! Finally a voice of reason with proof explaining why some things don't work the way they are intended!
ReplyDeleteirontomflint
About how stopping external bleeding does not necessarily stop internal bleeding, I personally witnessed a gunshot victim who lost, at most, a tablespoon of blood externally from the chest wound and exit wound by the time the ambulance arrived, he was stabilized, and was rushed to a hospital. From the moment he was shot until he arrived at a hospital took perhaps a half-hour. I forget how many pints of blood he lost internally by the time he got to the hospital, but the loss was borderline fatal. I heard from his relative that the doctor said that he had he lost so much blood internally that he was lucky to live.
ReplyDeleteTampons don't really work. But logic will not convince those that believe they are "perfect bullet plugs". Battlefield bandages can slow the OUTSIDE bleeding, hopefully giving time for transport to Surgery.
ReplyDelete1st a bullet that tears, punctures or otherwise opens an artery is going to be a fatal wound unless you have EMS and surgery easily available. You can bandage the outside bleeding, but they will bleed out internally.
2nd A bullet that seriously damages the central nervous system is also fatal (think brain or spine shot) unless you have EMS and surgery immediately available and really your still pretty much toast even if your capped outside of Johns Hopkins Trama Center.
Wounds in the torso are generally fatal in a SHTF scenario. Oddly a lung shot is reasonably treatable, but intestines and internal organs respond very poorly to non-EMS stabilization and surgical intervention.
Shattered bones are likely to be major crippling even with a "saved life" from tourniquet.
Low velocity bullets (mostly pistols or spent rifle rounds) don't create much of a secondary cavitation channel. High velocity does create serious cavitation wounds, often destroying blood vessels.
People need to begin thinking of post SHTF medicine as civil war level care hopefully with a better grasp on sanitation and wound care.
Sorry incomplete thought add groin wounds to torso above.
ReplyDeleteFor those of us who take blood thinning medications (Coumadin - Warfarin - Jantovan, etc.), an external cut often has a few minutes of persistent blood oozing from the wound. Pressure on wound and down time waiting for blood flow to slow can be required. A tampon, cut open and pressed across the wound is welcome for its assistance in helping stem the flow.
ReplyDeleteThe original OP made some great points about penetrating wounds and I completely agree with the evidence presented.
If you're carrying around a tampon to split open, why not just carry a packet of sterile gauze? Let's start with the right shape and start blood containment earlier.
DeleteYes!
Delete