Why Israeli Bandages are like Pepperidge Farm Bread

by October 19, 2011 10/19/11
Israeli Bandage

To quote the late comedian Mitch Hedberg, “You know that Pepperidge Farm bread, that stuff is fancy. That stuff is wrapped twice. You open it, and it still ain’t open. That’s why I don’t buy it, I don’t need another step between me and toast.

Well that’s exactly how an Israeli Bandage is wrapped. You may asking yourself why this is important, so allow me to elaborate and to also explain the new changes in the 4″ Israeli Bandages.

History

The Emergency Bandage, AKA Trauma Wound Dressing, AKA Hemorrhage Control Bandage, AKA Israeli Bandage, has quite a few names. It was invented by Bernard Bar-Natan, a Holocaust survivor, who immigrated to Israel in 1979 and was drafted into the military there in 1983. During his service he saw a need for a dressing that didn’t exist.

Israeli Bandage

What he envisioned, was for medics like himself, to not have to create field expedient pressure dressings and for bandages to evolve like everything else in the military had been. With a loan from the government in the 90s, he turned his idea into a reality and The Emergency Bandage was born.

Bar-Natan’s company, First Care, introduced the bandages to the U.S. Military in 2000 at Ft. Sam Houston in San Antonio. It wasn’t much longer after that before elite units quickly adopted them for standard use. They were also know to have played a part in saving lives during the recent Tucson Tragedy in Arizona.

Israeli Bandage

While the technical name is The Emergency Bandage, it’s a bit of a misnomer, as the Israeli is really a pressure dressing. It combines a sterile dressing, elastic bandage and pressure applicator capable of exerting up to 30 lbs. of pressure on a wound. The closure bar, which secures the bandage at the end of wrapping, can also be used to exert additional pressure.

Israeli Bandage

The Israeli is truly a multi-purpose bandage and can be used as a make-shift tourniquet, ACE Wrap, or even a sling to immobilize an appendage. It’s truly a versatile item to include in your trauma kit or first aid kit. It can also be self-applied, even one-handed.

Usage and Application

We’ve always thought highly of Israeli Bandages, which is why they’re included in every ETA Trauma Kit we make. The only downside to them is that they’re wrapped twice like that pesky Pepperidge Farm Bread!

Israeli Bandage Packaging

Truthfully, this isn’t really a downside, as the double packaging ensures their sterility. Although, if you haven’t been trained on using an Israeli and opening it from the package, you can be setting yourself up for failure and wasting precious seconds in a life-threatening situation.

Hopefully you’ve all heard the phrase “seconds count,” this is no joke when you’re talking about stopping a severe hemorrhage and having to open a pressure dressing like the Israeli Bandage twice isn’t practical.

I’ll let the video explain the instructions for applying the bandage and just what the packaging looks like when they’re opened. We’ve also got step-by-step photos below.

Storage

We recommend storing them out of the outer vacuum sealed wrapper (still wrapped in the inner vacuum sealed wrapper).

The outer wrapper is clearly marked on the new Israelis with tear marks, but if you don’t know what you’re looking for on the interior wrapper you may waste precious time. With the added potential of having gloves on and slippery hands, this is no time to be wildly tearing at a plastic wrapper to get to the bandage.

The inner wrapper is clear and has a small pre-cut tear mark on the very top of the bandage, but both the top and bottom of the bandage’s long side look the same. You’ll have to pull on it slightly to loosen up the side with the slack (top) to find the pre-cut tear mark to open it.

Additions

Something new on the Israeli is the addition of a small tied string that runs throughout the bandage called the “Stop and Go Release.” One of the issues with the past version of the Israeli was that if you dropped them while wrapping, the bandage could potentially hit the dirt and lose it’s sterility. You certainly don’t want to be wrapping dirt into an open wound, that’s just asking for an infection.

Israeli Bandage

We’ve also noticed that the entire Israeli is now vacuum packed even smaller in the 4″ size. They’re also available in a 6″ size if desired.

Another thing to note is that you should save the packaging from the dressing. A large piece of plastic can be used as a make-shift occlusive dressing to treat a pneumothorax aka sucking chest wound. For more on this, check out our article on Developing a Blow Out Kit.

Hopefully this article has given you a glimpse of how effective and versatile the Israeli Bandages can be. It’s definitely a must to have in your kits and keep in your vehicle and the office. They’re available here on Amazon and at many medical distributors as well.


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Bryan Black
Bryan Black

Hi Michkin, Thanks for the feedback on the bandages. However, both the NAR and Olaes bandages are made in China.

Michkin
Michkin

Thanks for this post. More than twenty years ago when I was in the service the personal issue item was the old standby Dressing, First Aid, Field, Camouflaged. On SAR missions we carried Cederroth Bloodstoppers in our trauma kit. The Israeli bandage seems like an improvement over both of those dressings. However, there are two Made-in-the-USA alternatives to the Israeli bandage that are worth having a look at. An article in the Journal of Emergency Medical Services compares the NAR bandage favorably to the Israeli bandage:

"Compression bandages are widely used throughout the military. Several new commercial products represent a significant improvement over older, non-compression style bandages. ...

"The Emergency Trauma Dressing by North American Rescue (NAR) represents a significant design improvement over older devices. This elastic compression wrap is a tighter weave and generates greater compressive force. The wrap’s “Quick Grip” feature (Velcro® enclosures equally spaced along the wrap) prevents the entire wrap from unrolling prematurely if the wrap is accidentally dropped during application."

But I think the Olaes Modular Bandage by Tactical Medical Solutions is superior to the Israeli or the NAR bandages. No, I'm not on the payroll of any of these companies. Just adding my two cents.

Michkin
Michkin

Thanks for this post. More than twenty years ago when I was in the service the personal issue item was the old standby Dressing, First Aid, Field, Camouflaged. On SAR missions we carried Cederroth Bloodstoppers in our trauma kit. The Israeli bandage seems like an improvement over both of those dressings. However, there are two Made-in-the-USA alternatives to the Israeli bandage that are worth having a look at. An article in the Journal of Emergency Medical Services compares the NAR bandage favorably to the Israeli bandage: "Compression bandages are widely used throughout the military. Several new commercial products represent a significant improvement over older, non-compression style bandages. ... "The Emergency Trauma Dressing by North American Rescue (NAR) represents a significant design improvement over older devices. This elastic compression wrap is a tighter weave and generates greater compressive force. The wrap’s “Quick Grip” feature (Velcro® enclosures equally spaced along the wrap) prevents the entire wrap from unrolling prematurely if the wrap is accidentally dropped during application." But I think the Olaes Modular Bandage by Tactical Medical Solutions is superior to the Israeli or the NAR bandages. No, I'm not on the payroll of any of these companies. Just adding my two cents.

Matt P.
Matt P.

It's great to see various equipment I have used while in country are being pushed to the civilian world. These bandages work great, I highly recommend having them readily available.

ian McDevitt
ian McDevitt

Just read "Fail's" comments. He's dead right with everything. Must be a good Medic. Stay safe Brother.

ian McDevitt
ian McDevitt

Guys, Is the ETD or "Israeli" billed as an improvised or make-shift TQ ? If it is, was their ever any type of organized study done? Any info anywhere other than that company generated as to it's efficacy? I'd love to see that if anyone can send it to me....Always willing to learn.

Doc E
Doc E

Good article with info people don't usually even think about, especially with occlusive dressings missing from the new Army issued IFAKs from RFI. I tell all my soldiers to remove their ETB from the package and to store it behind to use as an occlusive, or even two occlusives if you separate the two sides before hand. As you said, seconds save lives, especially in putting pressure on wounds and sealing penetrating chest trauma.

Erik Brown
Erik Brown

Oh! ... and don't feed the trolls...

Erik Brown
Erik Brown

Got the point across in the video. Gave me the info I need to know I can use it quickly in an emergency without needing to know a ton of first aid skills. Could save my life or my hunting partners life when chasing game. Hopefully I won't ever have to use it. Looks like a great product, I'll be ordering it.

Keep on keepin on!

Erik Brown
Erik Brown

Got the point across in the video. Gave me the info I need to know I can use it quickly in an emergency without needing to know a ton of first aid skills. Could save my life or my hunting partners life when chasing game. Hopefully I won't ever have to use it. Looks like a great product, I'll be ordering it. Keep on keepin on!

Fails
Fails

I hope you cleared this article with the 18D that designed your ETA kit. I did not watch the video, I only read the article.

Yes, ok, fine, we all know that you can have more patients than kit, and you are sure to run out of that one thing you need before you run out of everything else in your aid bag. Skilled medics have made all sorts of stuff do things it wasn't designed to do.

The "Israeli bandage as tourniquet" is bothersome. It's a pressure dressing, not a tool for stopping massive bleeding, if you can get it TQ tight, great, but given that a lot of TQs are not applied tight enough, and have to have other TQs applied above them, or the patient continues to massively bleed unnoticed...I would not carry an Israeli bandage for that purpose.

Checking for a distal pulse is nice in training, but is not likely to be effective in the real world, and practicing with it develops poor habits. The blood loss from the massive bleeding can make the distal pulse sufficiently faint that 'not finding it' could be a false indicator that you have successfully stopped the bleeding when in fact you have not.

Also as far as 'sterility' goes, a war wound will need extensive irrigation, debridement, and antibiotics as soon as reasonably possible. Dropping something that will contact the wound on the ground is bad, but it is far from a show-stopper if you only have the one piece of kit.

tldr: If you're screwing with this instead of a TQ 'under fire', you are doing it wrong, if you are screwing with it while the patient is still massively bleeding, and you have a TQ/direct pressure available, you are probably doing it wrong. If you are not under fire, and the massive bleeding has stopped, you have time to carefully apply the Israeli bandage pressure dressing for its' intended purpose.

Fails
Fails

I hope you cleared this article with the 18D that designed your ETA kit. I did not watch the video, I only read the article. Yes, ok, fine, we all know that you can have more patients than kit, and you are sure to run out of that one thing you need before you run out of everything else in your aid bag. Skilled medics have made all sorts of stuff do things it wasn't designed to do. The "Israeli bandage as tourniquet" is bothersome. It's a pressure dressing, not a tool for stopping massive bleeding, if you can get it TQ tight, great, but given that a lot of TQs are not applied tight enough, and have to have other TQs applied above them, or the patient continues to massively bleed unnoticed...I would not carry an Israeli bandage for that purpose. Checking for a distal pulse is nice in training, but is not likely to be effective in the real world, and practicing with it develops poor habits. The blood loss from the massive bleeding can make the distal pulse sufficiently faint that 'not finding it' could be a false indicator that you have successfully stopped the bleeding when in fact you have not. Also as far as 'sterility' goes, a war wound will need extensive irrigation, debridement, and antibiotics as soon as reasonably possible. Dropping something that will contact the wound on the ground is bad, but it is far from a show-stopper if you only have the one piece of kit. tldr: If you're screwing with this instead of a TQ 'under fire', you are doing it wrong, if you are screwing with it while the patient is still massively bleeding, and you have a TQ/direct pressure available, you are probably doing it wrong. If you are not under fire, and the massive bleeding has stopped, you have time to carefully apply the Israeli bandage pressure dressing for its' intended purpose.

Eric Pinola
Eric Pinola

Thanks for bringing this great piece of possibly life saving gear into my sphere of knowledge! I do like those Pepperidge Farms Cookies!

Alan
Alan

Since no one else will say it, I will. Ric, you're an idiot. Clearly, you can't see the forest for the trees. First off, this bandage is available to anyone—not just medics! To wit, you are assuming too much in thinking that everyone walks around with a knife, scissors, seat belt cutter etc.—especially the average person.

From your narrow-minded observation, it is clear "YOU" would rather have someone die, than to employ what ever means at your disposal, because you did not have, "so called", proper tools to open up a two cent wrapping.

That being said, the simple fact you are suggesting a medic would have simple tools to open up a package is sending a clear message that a medic, without his tools, can't open up a simple package, such as this battle dressing... Are you suggesting medics are stupid and incapable of dealing with simple tasks without the use of tools? Or, are you suggesting that unless you have said tools no one should attempt to open simple packages without said tools? Perhaps you're suggesting the manufacturer should not make it more efficient to open up a simple package to help save a life?

Ric, thank you for encouraging me to reexamine my own procedures when it comes to handling casualties.

Question for ya. Is Barney really a purple dinosaur, or is he a combination of RGB values, maybe even CMYK? Seriously, this question has really been bothering me since my kids first starting watching it

Alan
Alan

Since no one else will say it, I will. Ric, you're an idiot. Clearly, you can't see the forest for the trees. First off, this bandage is available to anyone—not just medics! To wit, you are assuming too much in thinking that everyone walks around with a knife, scissors, seat belt cutter etc.—especially the average person. From your narrow-minded observation, it is clear "YOU" would rather have someone die, than to employ what ever means at your disposal, because you did not have, "so called", proper tools to open up a two cent wrapping. That being said, the simple fact you are suggesting a medic would have simple tools to open up a package is sending a clear message that a medic, without his tools, can't open up a simple package, such as this battle dressing... Are you suggesting medics are stupid and incapable of dealing with simple tasks without the use of tools? Or, are you suggesting that unless you have said tools no one should attempt to open simple packages without said tools? Perhaps you're suggesting the manufacturer should not make it more efficient to open up a simple package to help save a life? Ric, thank you for encouraging me to reexamine my own procedures when it comes to handling casualties. Question for ya. Is Barney really a purple dinosaur, or is he a combination of RGB values, maybe even CMYK? Seriously, this question has really been bothering me since my kids first starting watching it

waykno
waykno

Well, let me chime in also--"any medic worth..." and the rest of it--a trained medic would not need to view this vid or any other as he is a "trained medic." I don't think Bryan was trying to make us all certified medical personnel but trying to enlighten us. Obviously some have more training than others. Personally, I like it. Thanks for all the tips. I have several Israeli bandages.

Greg Hudgins
Greg Hudgins

I liked the video. I like the new thread in the bandage (the drop stop). Great info, as always. Keep it up.

Ric Carvalho
Ric Carvalho

BTW-Any Medic worth his salt, carries a knife, seatbelt cutter and trauma shears. Getting thru that packaging is a non issue.

Adam
Adam

Just got mine in the mail yesterday and they are going in my range bag. Never know when someone might pull the trigger a little early on their draw and it can't hurt to have them at LaRue's Range Day either!

Ric Carvalho
Ric Carvalho

You demonstrated only one method of using the dressing, that of applying the pressure bar. And you also did not give any warnings to avoid using it as an inadvertent tourniquet by applying too much pressure to the pressure bar, nor to check for distal pulses once it is applied. Nor did you mention to avoid touching the gauze pad or overlapping the edges of the gauze pad to prevent contamination.

Knee cap? That was well below the knee cap. Also, if you were applying the Emergency Trauma Dressing to a knee cap, you would apply the dressing and immobilize the joint.

Overall, I'd give this video a C rating. You should've gotten an experienced Army Medic to demonstrate the proper use.

Ric Carvalho
Ric Carvalho

You demonstrated only one method of using the dressing, that of applying the pressure bar. And you also did not give any warnings to avoid using it as an inadvertent tourniquet by applying too much pressure to the pressure bar, nor to check for distal pulses once it is applied. Nor did you mention to avoid touching the gauze pad or overlapping the edges of the gauze pad to prevent contamination. Knee cap? That was well below the knee cap. Also, if you were applying the Emergency Trauma Dressing to a knee cap, you would apply the dressing and immobilize the joint. Overall, I'd give this video a C rating. You should've gotten an experienced Army Medic to demonstrate the proper use.

Eric Palmer
Eric Palmer

I think I am going to recommend this for my fire department! This looks perfect for our purposes!

Matt P.
Matt P.

Excellent point Fails, this is often overlooked with CLS training.

J
J

@ Ric, While you brought up a couple good points - ITS's purpose is always about being positively helpful and providing valuable information. It's clear they succeed at this on a regular basis. Maybe in the future you can try to follow a similar nature. It's clear that you have valuable knowledge as well. This is a community of friends here - all trying to help each other.

I'm not trying to sound condescending, just think with your knowledge set, that you probably have a lot of positive and helpful info to contribute so perhaps a more positive tone in your future comments would help us all out.

Keep it up Bryan, love love love all you bring to the community.

J
J

@ Ric, While you brought up a couple good points - ITS's purpose is always about being positively helpful and providing valuable information. It's clear they succeed at this on a regular basis. Maybe in the future you can try to follow a similar nature. It's clear that you have valuable knowledge as well. This is a community of friends here - all trying to help each other. I'm not trying to sound condescending, just think with your knowledge set, that you probably have a lot of positive and helpful info to contribute so perhaps a more positive tone in your future comments would help us all out. Keep it up Bryan, love love love all you bring to the community.

Brad Carvalho
Brad Carvalho

Just FYI to all of you other ITSers out there... I am in no way related to or affiliated with this douche canoe!! Bryan thanks for the info, great job as usual!!!

Kaja
Kaja

I aggree on most of what you've said, but:

"to check for distal pulses once it is applied." -IIRC, this is recommended only for people with adequate training, as "civvies" may have problem with finding distal pulse anyway (mentioned even in new CPR guidelines even for medical personnell)

"You demonstrated only one method of using the dressing"- There are MANY ways, and it would have to be loong vid to mention them all- you can find many more on YT :)

"avoid touching the gauze pad or overlapping the edges" -well, for GSW or any other trauma where you may have to use ETD, the wound may be very well already contamined (all GSWs are...) and in civilian setting you have plenty of time to deal with that (pill pack for soldiers, quick debridement and antibiotics in wilderness)

BTW: I keep mine in both wrappings, I can get to them just quickly enough (I'll use TQ/direct pressure in between...)

Still, I prefer OLAES O:-)

Bryan Black
Bryan Black

Ric, you're right. I only demonstrated one method. I wanted to keep the video short and to the point. I appreciate your additional info on ensuring not to apply too much pressure and turning it into a tourniquet. I did note that it could be used as a field expedient tourniquet, but you make a good point in ensuring it doesn't if that's not what's intended.

Checking for a distal pulse once applied isn't always convenient, especially if you're trying to quickly stop the bleeding and evacuate a casualty. I'd hope that keeping your booger hooks off of a sterile gauze pad would be common knowledge, but you're right that it should have been addressed too. You also bring up a good point on ensuring not to overlap the edges and compromise the sterility of the pad.

I did say the wrong thing when I mentioned my knee cap, but just as you did, I'm sure everyone could tell it wasn't on my knee cap. The point of the video was to show it doesn't take an "Experienced Army Medic" to be able to apply an Israeli bandage.

Thanks for being a hater and choosing to call me out rather than to simply add to what we were trying to accomplish with the article. As for your secondary comment on "any medic worth his salt" carrying a knife, seatbelt cutter and trauma shears. This video's purpose was obviously lost on you.

Kaja
Kaja

I aggree on most of what you've said, but: "to check for distal pulses once it is applied." -IIRC, this is recommended only for people with adequate training, as "civvies" may have problem with finding distal pulse anyway (mentioned even in new CPR guidelines even for medical personnell) "You demonstrated only one method of using the dressing"- There are MANY ways, and it would have to be loong vid to mention them all- you can find many more on YT :) "avoid touching the gauze pad or overlapping the edges" -well, for GSW or any other trauma where you may have to use ETD, the wound may be very well already contamined (all GSWs are...) and in civilian setting you have plenty of time to deal with that (pill pack for soldiers, quick debridement and antibiotics in wilderness) BTW: I keep mine in both wrappings, I can get to them just quickly enough (I'll use TQ/direct pressure in between...) Still, I prefer OLAES O:-)

Bryan Black
Bryan Black

Ric, you're right. I only demonstrated one method. I wanted to keep the video short and to the point. I appreciate your additional info on ensuring not to apply too much pressure and turning it into a tourniquet. I did note that it could be used as a field expedient tourniquet, but you make a good point in ensuring it doesn't if that's not what's intended. Checking for a distal pulse once applied isn't always convenient, especially if you're trying to quickly stop the bleeding and evacuate a casualty. I'd hope that keeping your booger hooks off of a sterile gauze pad would be common knowledge, but you're right that it should have been addressed too. You also bring up a good point on ensuring not to overlap the edges and compromise the sterility of the pad. I did say the wrong thing when I mentioned my knee cap, but just as you did, I'm sure everyone could tell it wasn't on my knee cap. The point of the video was to show it doesn't take an "Experienced Army Medic" to be able to apply an Israeli bandage. Thanks for being a hater and choosing to call me out rather than to simply add to what we were trying to accomplish with the article. As for your secondary comment on "any medic worth his salt" carrying a knife, seatbelt cutter and trauma shears. This video's purpose was obviously lost on you.

Marty Bryce
Marty Bryce

To try to keep this civil, What rick fails to understand is the a very common occurrence and something that I see all the time, especially on any forum such as ITS which attracts a mixture of readers all from various backgrounds of med training.

With a .mil backround someone like Bryan is clearly going to be working a trauma from a TCCC style of care. since that is where his trauma training and medical experience is born from. "The most important treatment during Combat trauma is fire superiority!" and so forth. This always always turns ugly whenever the discussion of a pressure dressing/hermostat or gasp TQ use comes up in conversation. Having been trained both on the street and in TCCC I obviously understand where the immediate need for TQ use, or rapid stabilazation folowed quickly by casevac is the obvious choice. On the Street an in the hospital however, when nobody is trying to kill me (usually) while administering care I think that the use of a TQ by anyone other than an Hos staffer in a controlled environment with the exception of potential loss of life is almost criminal. I never allow TQ use ever on the street.

Things like BSI, scene safety, ABC, Med control , the so called golden rules of First response, obvioulsy mean exactly shit while in combat. You think a medic is gonna go look for a distal pulse on an 11b who just got blew up and is now under fire... hmm we just took an IED and now hadj is opening up on us from cover witha bunch of AK's, should I A: get out my shears and start cutting down into Joe's boot for a fucking pulse, of maybe instead worry a little more about trying to get anotherr gun into the fight. get a clue dude.

Also the Izzy bandage is designed to specifically work as an improvised tornqiuet if applied in a specific way, making use of the torsion bar as Bryan demonstrated is not that way, nor will that be able to cause the damage that a true tq fixture could.Finally depending on teh mechanism of injury, the izzy bandage wont work to do anything for a femur fract. for instance except apply pressure, in the event of immobilization, the tail end of the bandage is what is used after the torsion bar is clipped off, which was entirely possible in the demonstration.

Marty Black
Marty Black

A "C" rating? Lighten up partner, he was demonstrating, not teaching a medic class. You expressed negatively that which was covered at the very beginning of the video. Again, it was a demonstration, not a lightning tutorial. We should be thankful for this since getting any info even close to whats offered here is almost non-existent. LEO, Fire, & EMS are notoriously tight lipped about anything useful to the average Joe.

Marty Bryce
Marty Bryce

To try to keep this civil, What rick fails to understand is the a very common occurrence and something that I see all the time, especially on any forum such as ITS which attracts a mixture of readers all from various backgrounds of med training. With a .mil backround someone like Bryan is clearly going to be working a trauma from a TCCC style of care. since that is where his trauma training and medical experience is born from. "The most important treatment during Combat trauma is fire superiority!" and so forth. This always always turns ugly whenever the discussion of a pressure dressing/hermostat or gasp TQ use comes up in conversation. Having been trained both on the street and in TCCC I obviously understand where the immediate need for TQ use, or rapid stabilazation folowed quickly by casevac is the obvious choice. On the Street an in the hospital however, when nobody is trying to kill me (usually) while administering care I think that the use of a TQ by anyone other than an Hos staffer in a controlled environment with the exception of potential loss of life is almost criminal. I never allow TQ use ever on the street. Things like BSI, scene safety, ABC, Med control , the so called golden rules of First response, obvioulsy mean exactly shit while in combat. You think a medic is gonna go look for a distal pulse on an 11b who just got blew up and is now under fire... hmm we just took an IED and now hadj is opening up on us from cover witha bunch of AK's, should I A: get out my shears and start cutting down into Joe's boot for a fucking pulse, of maybe instead worry a little more about trying to get anotherr gun into the fight. get a clue dude. Also the Izzy bandage is designed to specifically work as an improvised tornqiuet if applied in a specific way, making use of the torsion bar as Bryan demonstrated is not that way, nor will that be able to cause the damage that a true tq fixture could.Finally depending on teh mechanism of injury, the izzy bandage wont work to do anything for a femur fract. for instance except apply pressure, in the event of immobilization, the tail end of the bandage is what is used after the torsion bar is clipped off, which was entirely possible in the demonstration.

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