Recently we posted a video outlining the challenges of using hemostatic granules as compared to gauze. In response, we were surprised by how many people advocated for tactical tampons to control massive hemorrhage in a gunshot wound. “Depending on the bullet hole size, tampon and pads are your best bets…” Or, “A tampon would have done the same thing.” Not true.
It’s not their job and it’s beyond their capability. While many have written on the fallacy of using tampons for hemorrhage control and wound packing in massively bleeding wounds,1, 2 there are still those on the internet who continue to endorse this misguided technique.
I can find no peer-reviewed medical literature describing or testing the use of a tampon on traumatic bleeding wounds.
Although anecdotal stories of tampons being used in military settings for hemorrhage control may exist, using a tampon as a bandage or “blood sponge” is very different than trying to stop massive hemorrhage with one. Even if the often-referenced Snopes.com cite about a Marine being saved by a tampon placed in his wound by his buddy is true, it doesn’t prove the veracity of the technique.3
The military has a long history of one generation handing down unofficial lessons learned to the next generation. It seems possible some military medic somewhere was told, “it was the way to go,” but it doesn’t mean it works. When I was in the Special Forces Medical Sergeant’s course in 1987, we trained extensively on live tissue. I remember specifically being told the instructors had tried tampons for hemorrhage control, but they were never effective.
Named arteries (generally the larger ones such as the axilla, brachial, radial, etc) can bleed several hundred milliliters of blood per minute when perforated. (200 milliliters is about 40 teaspoons for those metric-adverse, or 4 shot glasses if that’s your preferred unit of measure). Prehospital hemorrhage control options for this kind of bleeding are tourniquets, if the bleeding source is amenable to circumferential pressure, for instance, a limb, or wound-packing if the bleeding is in “junctional areas” like the neck, axilla, and groin.
