The effectiveness of the manual pressure points technique for hemorrhage control—The 2022 THOR pre‐conference meeting experience

Author:

Thompson Patrick1,Glassberg Elon1234,Alon Yuval2ORCID,Bjerkvig Christopher K.56ORCID,Eliassen Hakon S.16,Radomislensky Irina27,Strandenes Geir18ORCID,Talmy Tomer29ORCID,Almog Ofer29ORCID

Affiliation:

1. The Hemostasis and Oxygenation Research Network (THOR) Steering Committee Bergen Norway

2. Israel Defense Forces Medical Corps Ramat Gan Israel

3. Azrieli Faculty of Medicine Bar‐Ilan University Safed Israel

4. Uniformed Services University of the Health Sciences Bethesda Maryland USA

5. Department of Anesthesia and Intensive Care Haukeland University Hospital Bergen Norway

6. Norwegian Navy Special Operations Commando Norwegian Armed Forces Bergen Norway

7. The National Center for Trauma and Emergency Medicine Research The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center Ramat Gan Israel

8. Department of Immunology and Transfusion Medicine Haukeland University Hospital Bergen Norway

9. Department of Military Medicine, Faculty of Medicine The Hebrew University of Jerusalem Jerusalem Israel

Abstract

AbstractIntroductionLimb and junctional hemorrhage are leading causes of potentially preventable death among trauma casualties. Hemorrhage control for these regions could be achieved by direct or indirect pressure. The manual pressure points (MPP) involves applying manual pressure on the arterial supply to occlude distal blood flow without the need for specialized equipment.Study Design and MethodsProspective, non‐randomized, human volunteer, controlled environment study involving 38 healthy military caregivers, with 26 participants attending a short instructional session. During a medical exercise, participants were requested to apply pressure on the supraclavicular and femoral points aiming to stop regional blood flow, measured by distal pulse palpation. The measures recorded included achievement of distal pulse cessation, success in achieving cessation for a full minute, and subjects' pain scores reported after each attempt.ResultsAll participants succeeded in achieving distal pulse cessation for both the supraclavicular and femoral points for a full minute. The median time to initial success was 3.0 (interquartile range 2.0–5.0) seconds in the supraclavicular point and 4.5 (interquartile range 3.0–6.0) seconds in the femoral point. Pain scores ranging between 0 and 3 were reported by most subjects during supraclavicular (68.4%) and femoral occlusion (84.2%).ConclusionThe MPP technique was highly effective in occluding distal palpable pulses in healthy volunteers when applied to the supraclavicular and femoral arteries. Brief instruction on the technique can potentially improve the chances of achieving hemorrhage control within 5 s. Further research is required to determine efficacy among different populations and providers with varying experience levels.

Publisher

Wiley

Subject

Hematology,Immunology,Immunology and Allergy

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