Page 20 - JSOM Winter 2025

FIGURE 3 Securing a bowel evisceration. FIGURE 5 Creation of endotracheal tube tie and improvised
pressure infuser.

it can hold the head in a fixed position, particularly if cervical
spine immobilization blocks or an improvised equivalent (e.g.,
FIGURE 4 Securing a casualty card to the patient.
rolled up blankets) are used.

Advantages in Field Care
The advantages of using plastic packaging wrap in austere
medical settings are many and are described in this section.

Dimensions and Weight
A typical mini plastic packaging wrap, as illustrated in Fig-
ure 6, is 5 inches (12.7cm) wide and 1,000 feet (305m) long,
whereas a standard emergency care bandage (ECB) is approx-
imately 6 inches wide (15cm) and 67 inches (1.7m) long. A
standard mini plastic packaging wrap with dispenser handle
weighs approximately 1 pound, 2 ounces (500g), while a stan-
dard ECB with packaging weighs approximately 3.5 ounces
(100g). In length alone, the plastic packaging wrap is equiva-
lent to 179 standard ECBs. These would weigh approximately
39 pounds, 7 ounces (17.9kg).
FIGURE 6 Plastic packaging wrap with standard emergency care
bandage.

Improvised Pressure Infuser
Packaging wrap can be used to secure a blood pressure
cuff to a bag of intravenous fluid to create an improvised
pressure infuser. The inelastic nature of the packaging wrap
when applied in multiple layers around the cuff and fluid
bag ensures that the increasing pressure from cuff inflation
is transmitted to the fluid bag to act as an improvised pres-
sure infuser.

Improvised Pneumatic Tourniquet
Similarly, packaging wrap can be used to create an impro-
vised pneumatic tourniquet by applying a blood pressure cuff
around a limb, then covering it with multiple layers of pack-
aging wrap. Inflation of the cuff will transmit pressure to the
limb in a similar manner to commercially available pneumatic Cost
tourniquet devices such as the Delfi EMT (Delfi Medical Inno- A typical single mini plastic packaging wrap roll costs ap-
vations, Vancouver, BC, Canada). proximately US$7. By comparison a single 6-inch ECB usually
costs approximately US$10.
Head Immobilizer
If customized, commercially available head immobilization de- Visualization of Underlying Packing or Wounds
vices are unavailable, the head can be immobilized to a litter The transparency of plastic packaging wrap allows for the vi-
or spinal immobilization scoop device using plastic packaging sualization of underlying wound packing materials (Figure 7).
wrap passed around the forehead and around the litter. Thus, Rebleeding can be rapidly identified if the packing material

18 | JSOM Volume 25, Edition 4 / Winter 2025