Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do They Compare? John B. Luck, MD, Danielle Campagne, MD, Roberto Falcón Banchs,

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Presentation transcript:

Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do They Compare? John B. Luck, MD, Danielle Campagne, MD, Roberto Falcón Banchs, BS, Jason Montoya, BS, Susanne J. Spano, MD Wilderness & Environmental Medicine Volume 27, Issue 4, Pages 476-481 (December 2016) DOI: 10.1016/j.wem.2016.09.002 Copyright © 2016 Wilderness Medical Society Terms and Conditions

Figure 1 From left to right, devices tested included commercial 500-mL compressible plastic bottle with splash guard (splash guard), a 10-mL syringe, a 10-mL syringe with a 14-ga catheter (10-mL syringe + 14-ga catheter), a 50-mL Sawyer water filtration cleaning syringe (50-mL Sawyer syringe), plastic bag punctured with a 14-ga needle (Ziploc + 14-ga holes), a water bottle cap punctured with holes from a 14-ga angiocatheter (water bottle + 14-ga holes), a sports-top water bottle, and an Osprey 3-L bladder hydration system (bladder hydration system). Wilderness & Environmental Medicine 2016 27, 476-481DOI: (10.1016/j.wem.2016.09.002) Copyright © 2016 Wilderness Medical Society Terms and Conditions

Figure 2 Using a ruler for reference and still images captured from the VLC Media Player, the stream impact was measured. Wilderness & Environmental Medicine 2016 27, 476-481DOI: (10.1016/j.wem.2016.09.002) Copyright © 2016 Wilderness Medical Society Terms and Conditions

Figure 3 Experimental setup with Y0 representing the height of the support of the irrigation device. X represents the distance between the support and the glass barrier, and Y1 marks the height of the irrigant stream striking the glass as recorded by the high speed digital camera. ΔY is the calculated difference between Y0 and Y1 to be used in data analysis described in the methods. Wilderness & Environmental Medicine 2016 27, 476-481DOI: (10.1016/j.wem.2016.09.002) Copyright © 2016 Wilderness Medical Society Terms and Conditions

Figure 4 Pressure ranges from the maximum and minimum pressures for each device tested are shown in light gray. Black lines are pressures measured by Stevenson et al4 on a benchtop model of a 12-mL syringe + 19-ga needle (20 psi) and a 50-mL asepto bulb syringe (0.05 psi). Dark gray lines reflect pressures measured by flowmeter by Singer et al using a pierced 250 mL intravenous fluid bag + 19-ga needle (4 psi), and a water bottle +19-ga holes (2.3 psi). The dashed line is the benchmark: the minimum pressure measured by a commercial device used in a level 1 trauma center (a compressible 500-mL normal saline bottle with splash guard). Wilderness & Environmental Medicine 2016 27, 476-481DOI: (10.1016/j.wem.2016.09.002) Copyright © 2016 Wilderness Medical Society Terms and Conditions