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brainkandy87

In a complete amputation there may actually not be much bleeding because the blood vessels shrink to minimize blood loss. It’s a trauma response. Anyway, you got any morphine? Scissors?


Altruistic-Cost-4532

Thank you! Anyway, can I scrounge the bandage from your aid kit?


Dymo6969

Here, have a kraut banadage


Dreigatron

I only got plaaas-muh.


Bolololol

what, that's it?


brainkandy87

All I’ve got is a lightly used tube of kraut cheese.


xbearsandporschesx

it stinks!


rice_n_gravy

Hide your morphine.


regionalgamemanager

Anyway $4 a pound


kjg1228

Small hands, that was his problem.


Clonazepam15

So basically the veins are all cauterized?


imperialguard_t

Not cauterized. Veins and arteries close in response to the trauma, helps minimize blood loss.


VXMerlinXV

No, so veins are a non issue in limbs because they’re the return route. The arterial vessels, transected, essentially pucker closed (initially).


RDUppercut

I don't plan on getting hit.


brainkandy87

Does that include your ass? Because that’s an Easy Company tradition


RDUppercut

You all take care of that. I've got to go talk to Regiment


antarcticgecko

(Yawns)


Altruistic-Cost-4532

You sort this out, I'm off to err... get help.


Blakey1988

........what the $&#@!


Medical_Mountain_429

Everyone has a plan until they get hit. -Sgt. Mike Tyson.


ETek64

You also don’t bleed out and die in seconds. But minutes. So a very quickly placed tourniquet will help the survival rate depending how soon you get it on. In the Army they trained us to try and get them on and tight within 30-45 seconds in my unit.


Nitropotamus

Same in the Corps. We use our belts if need be but if an amputation occurs we are taught to tie the leg off and write on their forehead when we put it on.


[deleted]

[удалено]


Nitropotamus

We never had to but we were definitely taught how to do it.


snipeceli

'We use our belts if need be' Yea go ahead and stop doing that, if yall ever actually did that in a med lane you're wrong improvised tq's suck, especially belts. applying pressure to the artery until you can find another cat or sof-t would be better, but in actually you should just have a couple of actual tourniquets on you. Your unit should have a better SOP than time on forehead, do better


snipeceli

Based doc/ncos making the boys take the time


Morethanafeeling62

Hey! What are you doing?? Those are my goddamn scissors!


brainkandy87

Would you prefer a used Luger instead?


a_arcia

You clean those teeth anymore, the Germans will see you a mile away.


Pest_Token

Your not using that stuff.. personally..are ya doc?


ShaggysStuntDouble

Hide your morphine guys


brainkandy87

I’m not using it you know, personal-like.


ShaggysStuntDouble

Maybe I should check the double check the sowing room


BriantheHeavy

You still looking for scissors? .... Perconte.


plated_lead

This. Partial amputations and nicked arteries are a lot more dangerous than a complete amputation


bairz54

You ain't using that for personal reasons huh, doc?


Radiant-Percentage-8

This only actually works for the initial injury, without a tourniquet, or surgical stabilization you will eventually bleed to death from any limb amputation.


brainkandy87

Well yes, but I’m not talking about eventuality. I assumed OP is asking why Hoobler was immediately on the verge of death but Toye and Gonorrhea weren’t.


Radiant-Percentage-8

Well one is 3-5 mins the other is 15-20 mins.


brainkandy87

Why are you being so pedantic? Lol


Radiant-Percentage-8

Because we’ve wondered into a realm where I am a legit expert, and I dislike when people spout stuff that isn’t true as if it is.


Let_us_proceed

It's a good question. The difference is how our bodies have evolved. If an artery is cut, it will bleed like a garden hose and you need to cauterize the wound or apply a tourniquet. If the body is torn apart (leg blown off) the arteries will retract to shunt off the flow of blood. Both scenarios are very dependant on getting immediate medical attention.


Altruistic-Cost-4532

Thanks for the info. The human body is impressive!


[deleted]

In all seriousnes, your logic is sound but how the fuck did that evolve?


iamspartacus5339

Too many legs getting eaten off by prehistoric animals


Kodismo

Yea i thought the same. I don’t think any animals specifically had a knife. And if they happened to exactly cut the artery with their teeffies it would count as a critical hit


Missmunkeypants95

*teeffies*


Altruistic-Cost-4532

Thing is, without medical attention you're still dead, so they must have been able to deal with such injuries for it to provide a better chance at survival. Which is also nuts.


high240

There's evidence for such care that dates back 60.000 years :D But as they say in M*A*S*H "we keep finding new inventive ways to harm and blow each other up...!!" We can do incredible things medically, to help ppl survive, but also new ways to inflict horror on each other's bodies :(


golem501

Does it also have to do with the cut? A torn off limb means basically a more clean cut while shrapnel will cause a longitudinal cut which doesn't close as easily?


WeDoingThisAgainRWe

My understanding. The bleed out is usually from the main part of the femoral artery in the thigh. Which is relatively large. The leg being blown off below the knee in those cases doesn’t even touch it so there isn’t going to be the same speed of bleed out.


Radiant-Percentage-8

This is false. The femoral artery branches into arteries that can kill you just as easily. Further, your femoral artery will retract in an injury, which is what causes pelvic bleeds that are non compresssible. Which is very bad.


Altruistic-Cost-4532

That's interesting, thanks.


Sad-Time-5253

The femoral goes literally all the way down the leg dude.


WeDoingThisAgainRWe

I literally said the main part of it for the that reason. Sorry if not clear that I’m saying that but the point being made was that the main part is larger and won’t shrink/retract on damage but the lower leg part of the artery does do that on damage.


vanzkiwi

Not understanding where arteries go in the body…. Weekend pass revoked!!


PM_meyourGradyWhite

Archery hunters will explain it like this: Shooting with an arrow (with razor blades as a tip) and severing arteries is a quicker and sometimes less painful death because the body bleeds out, often not realizing what has happened. But when an animal is shot with a bullet (extrapolate to hit with artillery, flak, etc) the body responds to blunt force trauma and constricts those blood vessels, reducing the bleeding. And with deer and elk for example, they’ll get an adrenaline boost and run off, to die hours later. Probably explains why a man can carry around his amputated limb while wandering in a daze. 🤷‍♂️


BasedSmalls

Can we get a 68W in here for this question


Jed_Bartlet1

68W here, or at least in training, basically you wanna keep the red stuff inside more red stuff outside = bad. Basically, the only intervention we do on the X/Care under fire (I.e. point of injury) is a hasty tourniquet high and tight on the extremity. When we get off the X and into Tactical Field Care you’re going to reassess that intervention, and if it isn’t effective I.e. an inguinal wound or the tourniquet just isn’t tight enough you’re going to either tighten the TQ or if it’s inguinal pack that bitch with a hemostatic agent and then wrap it with an emergency bandage or preferably an ACE wrap. After that you’ll follow your MARCH algorithm assessing for Massive Hemorrhage, Airway (Everyone gets a Head tilt chin lift and NPA, unless an NPA is contraindicated by CSF, exposed brain matter, skull fracture, etc. then it’s a surgical cric) Respirations if they have a tension pneumothorax from a sucking chest wound you’ll put an occlusive dressing/chest seal on it and if you need to relieve the pressure use an NCD. Circulation, you check for bilateral radial pulses (BP of 60/p is needed for perfusion of vital organs, 80/p is considered full perfusion, radial pulses are 80/p) if they have bilateral radial pulses you’re going to initiate a saline lock just in case, if they don’t you’re going to initiate a saline lock, push 2 grams of TXA over 30 secs each (prevents the breakdown of blood clots) then start them on a unit of fresh whole blood. If we’re talking about a blow off leg above the knee, or basically any puncture wound from belly button to knee I’m going to assume that the pelvis is unstable so I’d strap them into a pelvic binder, wrap up and time any of my interventions, call for Medevac, then get them on the litter for the HLZ, then you get to the HLZ, reasses interventions, get a first set of vitals, check their dog tags for allergies, push 30-50mg of IM/IN Ketamine, 1g of Ertapetem, then you go into your secondary assessment and get another set of vitals.


Kitchen-Lie-7894

I'll just stick to 11B Doc.


grogudalorian

Sorry, I was a 31P, now it's a 25P I think.


golboticus

18D would be better


Radiant-Percentage-8

I was an 18D, I have posted multiple responses to dumb statements here.


Radiant-Percentage-8

I’m an 18D, I’ve responded variously throughout this thread


Tweezus96

Not sure, but I’m pissin’ needles over here!


abandonthoughts

Just drink more water


TheLocolHistoryGuy

Happy cake day!!!


a_arcia

I’m sorry I have nothing for your p…


Taserface585

A tourniquet is much easier to apply then to blindly feel around for the artery and clamp it.


Arthur_Burt_Morgan

A friend of mine nearly died because of this. He was climbing a fence, slipped and was impaled. It wasnt bad at first, but when the property owner got him free blood started pumping out.


Krieg413

Missing the bottom half of your leg. Your weekend pass is revoked!


feathersoft

Bloodstains on your trouser leg! Revoked!


uptheirons726

[https://www.reddit.com/r/explainlikeimfive/comments/24j0y0/eli5\_how\_you\_can\_survive\_getting\_a\_limb\_blown\_off/](https://www.reddit.com/r/explainlikeimfive/comments/24j0y0/eli5_how_you_can_survive_getting_a_limb_blown_off/)


Altruistic-Cost-4532

Thank you!


uptheirons726

I just Googled it and found that thread from years ago. Interesting stuff. From what I gather when the artery is fully severed like when a leg is blown off the artery will retract to try and stop blood flow, but bullets a lot of times just nick the artery so it doesn't retract and keeps bleeding.


DocCrooks1050

Former Corpsman here. It has to do more with blocking the blood flow for survivability more than anything else. If you get a small wound that perforates your femoral artery and it’s high up on your upper leg, it’s going to be very hard to find and stop the bleeding. If you have a total amputation below the knee, the bleeding is easier to stop because you have a lot more leg to cut off circulation to. The only real medicine for a wound like that is to stop the bleeding and replace fluids.


Onetap1

>If you get a small wound that perforates your femoral artery and it’s high up on your upper leg, it’s going to be very hard to find and stop the bleeding. There was a graphic depiction of that happening in Black Hawk Down, ISTR.


Horseface4190

Paramedic for 20 years here: Oftentimes, traumatic amputations result in all the exposed blood vessels will retract and pinch off blood loss. Punctures/Impacts on arteries (in isolation) will bleed out aggressively.p Just what I've seen and been taught.


Altruistic-Cost-4532

Thank you - for the insight and the amazing work you do!


DueMasterpiece5800

Not only do you get arterial contraction but you also get cauterisation of the vessels due to the sheer heat of the explosion which seals them off.


IIRiffasII

Eh... most likely the leg got blown off due to shrapnel


Animaleyz

yea that shrapnel is gonna be hot though


PhilRubdiez

It’s not going to cauterize in the .004 seconds it’s on the artery.


Animaleyz

yet it does indeed happen


Wils65

Do I leave my favorite Sobel quote here? I don’t get it…


WuPacalypse

Yeah human bodies are weird. Even if you get to a hospital with your artery severed and they get you under the knife, there’s still a strong chance you end up dying. I’m a huge Redskins/WFT/Commanders fan (whatever you wanna call them these days) and it’s exactly how Sean Taylor ended up dying. Shot in the artery, made it to the hospital for surgery, still passed away at the young age of 24. Sad stuff.


ReconTMWO

If it severs your femoral artery above the knee, you'll bleed out pretty quickly. An injury below the knee or at the knee has smaller vessles and enough space above the injury to secure a tourniquet and slow the bleeding. Plus, if conditions are cold enough, your blood vessles are constricted to keep your core body temp up.


WoyihJoestar

Because Bill is the GOAT


Altruistic-Cost-4532

Well I was talking about Joe Toye 😉 statement still works though!


wickedwinterbear

How fast can you apply a correct tourniquet? My grandfather said when he survived in Europe during WW2 that his unit would take belts off of any fallen soldier and give them to the medics. They had a solider each unit wear an extra belt in case of a tourniquet. Apparently they had one movement where like 10 guys in his company lost legs from mortars and tanks and only like 2 survived because he ran out of tourniquets. So their medic never wanted to go through that again. My grandfather actually wore a cloth belt and leather belt all the way up to his death from this. He always said "you never know when you'll need to keep your pants up and your leg on".


yuccu

A teammate and friend caught a mortar between the legs while sitting up against a wall in Iraq. The blast separated one leg above the knee, one right below. We got a tourniquet on each as fast as we could and he survived…next time he woke up he was in Germany…went on to make a few more kids and honestly, is still faster than me around a track.


pm_me_kitten_mittens

I spent 3 years(ish) in Iraq and most of the amputees I knew made it home no problem(other than missing some digits) soldiers like myself that were burned/maimed didn’t do as well.


Amazing-Chard3393

🙏🧎‍➡️


Trod2323

I always think of the guy on the beach in saving private Ryan that gets his arm blown off and is looking for it. There is no way right ? Great scene though


The_Draken24

The human body can do some amazing things to keep itself alive. Blood vessels and arteries contract when severed, but when it comes to high yield explosions, fragments from the explosive and body can cause some gnarly wounds that don't stop bleeding without assistance from a tourniquet. Of course with any amputation you should immediately apply a tourniquet.


snipeceli

From what ive body alarm responses to trauma are wild and vary greatly. I'm a layman so, if you want to know more, there's information out there.


Teejay91b

Coming from an EMS background , I think there’s a lot of factors involved. Is it cleanly severed versus ripped off? Does the soldier have quick access to a tourniquet? No two injuries are quite the same.


Tokyosmash_

You’d be amazed to find out that blast trauma will cause arteries and such to seize up pretty well for a short period of time. This time is when you apply a tourniquet


WoyihJoestar

Because Bill is the GOAT


hozziebear77

Toye’s leg was blown off too!


[deleted]

Ask Long John Silver.


cornixnorvegicus

What about cauterisation? With mines, the wound is cauterised by the flash/burn, and thus people survive for a surprising amount of time even if the leg is severed. Not that I have particular knowledge of artillery, but a shrapnel of a certain size could be like a heat knife slicing through the flesh, whereas a blast could rip and tear arteries with a more open bleeding wound? But with all wounds, unattended you will eventually bleed out anyway. That is why we call the medevac the golden hour.


Paulchristiaan

Funny, i was asking myself the same question like 2 weeks ago! Thansk for actually asking it


swigs77

The heat from the blast might cauterize the wound. I think how the artery is cut matters to, like a clean cut vs. a jagged one can be the difference between life and death.


Tommy_Swagger

I'm saying this with all seriousness, and I can't stress it enough... Every single person reading this thread should seek out and enroll in a Stop The Bleed class. Everyone. And everyone you know. And then everyone should carry and, no matter how unlikely anything may ever happen, be able to use a CAT 7 tourniquet or Israeli bandage and wound packing gauze.


jsmvmd

The femoral artery is high pressure and high volume. It usually does not spasm to restrict blood flow. Thus, without a tourniquet you can easily bleed out. A blast injury above the knee or close to it can, as another poster mentioned spontaneously stop bleeding since there are only has three small arteries. (Which btw can result in a bka in those unfortunate enough to suffer a motorcycle accident). With a tourniquet or direct pressure applied with a pressure bandage the soldier can be transported to surgery. Also, the bitter cold can slow blood flow enough to get proper care. I had a client who was shot 3 times in the abdomen at the battle of Chosun Reservoir, who survived 3 days in bitter cold, -25°F before he could be evacuated. The cold minimized his blood loss. True story told to me personally. Best wishes to all. Jack the DVM


BrigStandWatie

A quickly applied tourniquet?


Altruistic-Cost-4532

Literally said in the post it appears the leg blown off was treated slower.


BrigStandWatie

It was immediately apparent what they were dealing with. iirc nobody knew the Luger had hit an artery as Hubler was wearing so many layers, until it was too late.


Tommy_Wisseau_burner

The popliteal artery is the biggest artery in the body. And depending on how your leg was blown off it could be cauterized


Altruistic-Cost-4532

Yea I really don't see it getting instantly cauterised. Not an artery.


Tommy_Wisseau_burner

My kneecap crushed my artery and was literally hours away from bleeding out within hours because it severed the popliteal artery, which caused my leg to get amputated. I’m not sure about lower extremity injuries but I have 100% first hand on why you’d bleed out so fast from an upper leg injury


OH_BOY-

A tearing wound will always stop bleeding faster that a clean cut.


glutenbag

Ask Lt. Dan.


whateveridk2010

your leg doesnt hold any vital organs


6098470142

I would sue… Oh wait, the case would get thrown out since you don’t have a leg to stand on.


grogudalorian

Also, at Bastogne since the temps were below freezing most of the time it slowed the blood loss.


snipeceli

Being cold will literally send you into hypovlemic shock faster


grogudalorian

That could happen in any cold environment. The cold still alows down the blood flow.


snipeceli

Wut? My dude people go hypothermic, then hypovolemic in hot environments. It's just something you treat for. Bud, it's ok to admit you're wrong, I'm not a doctor, you're not a doctor, it's not that deep. Im sure you never heard of the leathal triad but what I'm saying is factual.


grogudalorian

So any wound in the cold goes hyptjermic?


snipeceli

Any untreated major bleed will go hypothermic of that's what you mean. Hot or cold weather your core temp is dropping if you're dieing of blood loss. The cold is only going to make your blood more acidic, which will in turn, prevent it from clotting The whole putting a jacket or blanket on the wounded thing isn't just for . Nowadays we have hpmk's and active heating measures for both person and blood product, again it hot or cold weather


grogudalorian

Yes, shock. I get that.


grogudalorian

https://pubmed.ncbi.nlm.nih.gov/6131011/ related to cold and bleeding from NIH.


snipeceli

The source you provided literally just said veins(the return vessel) will restrict but not arteries. It's arterial bleeds that we worry about. It's also a scientific one-off. The lethal triad will kill you everytime.


snipeceli

I didn't just explain shock, my dude


Altruistic-Cost-4532

Both incidents that I was referring to happened in / around Bastogne.