Clinical Case Summary
A 50-year-old male presented in hemorrhagic shock from an accidental inguinal gunshot wound — a location where no standard tourniquet could be placed. Robeson County EMS applied the AAJT-S to the abdomen on scene. He survived.
Location: Robeson County, North Carolina
Provider: Robeson County EMS
Setting: EMS · Pre-hospital
Application site: Abdomen
Synopsis
- Inguinal GSW
- Accidental firearm discharge
- Pale, diaphoretic, tachycardic
- Signs consistent with hemorrhagic shock
- AAJT-S applied to abdomen
- One unit of whole blood administered
- TXA & calcium per protocol
- Stabilized for transport
- Hemorrhage control achieved
- Vital signs improved
- Stabilized with minimal intervention
- Discharged with no complications
“The AAJT-S has proven to be an outstanding product. In real-world applications, it has performed exactly as intended and has been a valuable tool in managing critical patients.”
— Deputy Chief Nestor Rivera · Robeson County EMS
A 50-year-old male sustained an accidental gunshot wound (GSW) to the inguinal region, resulting in severe junctional hemorrhage and hemorrhagic shock. When Robeson County EMS arrived, the patient was pale, diaphoretic, and tachycardic — classic signs of life-threatening blood loss requiring immediate intervention.
The inguinal region presents a unique challenge for hemorrhage control because it is located at the junction of the leg and abdomen, too high for a standard extremity tourniquet to effectively stop bleeding. Without rapid control, junctional hemorrhage can quickly become fatal.
Recognizing that conventional methods would be ineffective, Advanced Practice Paramedic Jonathan Valenzuela, Paramedic Trishan Barfield, and EMT Dean Foggan applied the AAJT-S to the patient’s abdomen, providing external aortic compression to immediately control the hemorrhage.
Following successful hemorrhage control, the patient received one unit of O-positive whole blood, tranexamic acid (TXA), and calcium as part of his resuscitation. His vital signs improved rapidly, and he was stabilized with minimal additional intervention before transport to a local hospital. He was subsequently airlifted to a Level I trauma center for definitive surgical care.
The patient survived to hospital discharge.
Clinical Significance: This case demonstrates the critical role of abdominal aortic compression in managing non-compressible junctional hemorrhage when a standard tourniquet cannot be applied. By rapidly controlling bleeding at the scene, the AAJT-S provided EMS clinicians with a lifesaving option for a casualty who otherwise had limited prehospital treatment alternatives.
