Application of the iTClamp™ in the clinical management of haemorrhage: a case study

A case studyA male patient was stabbed below the jaw line to the left side of the face/neck. The initial call suggested a catastrophic haemorrhage. On scene, the male patient had an obvious and considerable haemorrhage, with his friend applying direct pressure with his thumbs to the wound, stating it was a ‘spurter’. On examination the wound/haemorrhage did not appear to be arterial but was free flowing and considerable. Direct pressure was applied with gauze and the area around the wound cleaned to expose what was thought to be potentially other wounds but were actually clots forming on the patients chin stubble. No foreign bodies were visible in the wound and the iTClamp™ was prepared. The patient was warned that it may cause pain but on application the patient did not appear to be in any discomfort though was heavily intoxicated. Minor bleeding did continue and the device was reapplied without further complication and controlled the haemorrhage well. On arrival at hospital the device was easily removed and the wound easily managed with no visible additional tissue damage from the device. Figures 1 and 2 represent the pictures taken immediately before device applied (extensive wound cleaning and exploration) and after application. The patient's distinguishing features have been hidden to maintain anonymity.Figure 1.Extensive wound cleaning and exploration of the patientFigure 2.Patient after application of iTClamp™Figure 3.iTClamp™The ED consultant was impressed by the device and its application but did have concerns about being used in more vascular areas of the neck (I gather the clamp has since been used in several severe neck wounds in the UK with success and without incident).

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