到院前止血-傷口填塞 Wound Packing Essentials (針對EMT救護員)
2025-07-11 15:45
傷口填塞一般使用於比較深且不容易止血的傷口. 不建議使用於頸部, 胸部, 腹部.
還有一種止血法, 稱為 Preperitoneal pelvic packing, 用於外傷導致骨盆骨折合併嚴重出血, 無法以其他方式有效止血時. 醫師在手術中將紗布填塞於病患骨盆腔(腹膜之外)
Preperitoneal Packing for Pelvic Fracture Bleeding Control:
上圖來自 Thr trauma pro
下面資料來自 uptodate-Control of external hemorrhage in trauma patients
僅節錄傷口填塞這段.
以下中文使用google翻譯
傷口填塞可填充任何死腔區域，並增加對傷口深層血管的直接壓力[ 18 ]。
填塞創傷性傷口時，應將乾淨的布、紗布或含止血劑的敷料深深地、牢固地壓入傷口。在保持直接壓力的同時，應繼續填塞直至傷口填滿。填塞完成後，塗抹敷料覆蓋傷口，並用雙手施加壓力。然後，應保持該壓力直至止血[ 18 ]。
市售的含止血劑敷料包括因子濃縮劑、黏膜黏附劑和促凝血劑。這些敷料可用於施加直接壓力並填塞傷口。放置這些敷料後，應施加至少3分鐘的直接壓力[ 19,20 ]。需要注意的是，某些敷料可能含有不透射線的標記，這可能會導致CT成像出現散射。 (請參閱“局部止血劑和組織黏合劑的概述”，關於‘外用藥物’一節)
Wound packing — Wound packing fills any area of dead space and increases direct pressure on the vessels deep within the wound [18].
To pack a traumatic wound, a clean cloth, gauze, or hemostatic-impregnated dressing is pressed deeply and firmly into the wound. While maintaining direct pressure, packing should be added until the wound is filled. Once packed, the wound should be covered with a dressing, and pressure should be applied using two hands. Then, it should be maintained until hemostasis is achieved [18].
Factor concentrators, mucoadhesives, and procoagulants are options for commercially available hemostatic-impregnated dressings. These dressings can be used to apply direct pressure and pack a wound. At least three minutes of direct pressure should be applied after placing these dressings [19,20]. Note that some dressings may have a radiopaque marker that can cause scatter on computed tomographic (CT) imaging. (See "Overview of topical hemostatic agents and tissue adhesives", section on 'External agents'.)
傷口填塞一般使用於比較深且不容易止血的傷口. 不建議使用於頸部, 胸部, 腹部.
還有一種止血法, 稱為 Preperitoneal pelvic packing, 用於外傷導致骨盆骨折合併嚴重出血, 無法以其他方式有效止血時. 醫師在手術中將紗布填塞於病患骨盆腔(腹膜之外)
Preperitoneal Packing for Pelvic Fracture Bleeding Control:
上圖來自 Thr trauma pro
下面資料來自 uptodate-Control of external hemorrhage in trauma patients
僅節錄傷口填塞這段.
以下中文使用google翻譯
傷口填塞可填充任何死腔區域，並增加對傷口深層血管的直接壓力[ 18 ]。
填塞創傷性傷口時，應將乾淨的布、紗布或含止血劑的敷料深深地、牢固地壓入傷口。在保持直接壓力的同時，應繼續填塞直至傷口填滿。填塞完成後，塗抹敷料覆蓋傷口，並用雙手施加壓力。然後，應保持該壓力直至止血[ 18 ]。
市售的含止血劑敷料包括因子濃縮劑、黏膜黏附劑和促凝血劑。這些敷料可用於施加直接壓力並填塞傷口。放置這些敷料後，應施加至少3分鐘的直接壓力[ 19,20 ]。需要注意的是，某些敷料可能含有不透射線的標記，這可能會導致CT成像出現散射。 (請參閱“局部止血劑和組織黏合劑的概述”，關於‘外用藥物’一節)
Wound packing — Wound packing fills any area of dead space and increases direct pressure on the vessels deep within the wound [18].
To pack a traumatic wound, a clean cloth, gauze, or hemostatic-impregnated dressing is pressed deeply and firmly into the wound. While maintaining direct pressure, packing should be added until the wound is filled. Once packed, the wound should be covered with a dressing, and pressure should be applied using two hands. Then, it should be maintained until hemostasis is achieved [18].
Factor concentrators, mucoadhesives, and procoagulants are options for commercially available hemostatic-impregnated dressings. These dressings can be used to apply direct pressure and pack a wound. At least three minutes of direct pressure should be applied after placing these dressings [19,20]. Note that some dressings may have a radiopaque marker that can cause scatter on computed tomographic (CT) imaging. (See "Overview of topical hemostatic agents and tissue adhesives", section on 'External agents'.)
