Who here carries a Tourniquet?

[Tex929rr]

I'm too old for the tacticool crowd. Decades ago as a scout and later soldier I was taught when a tourniquet was necessary and how to improvise and apply one. Later the Red Cross began teaching not to use them. We were taught they were only to used in life or death situations as loss of a limb, was better than loss of life. I don't carry one -if i need it, I'll do it.

The thing is, what you were taught decades ago (as was I) in the military has been proven to be wrong, mostly as a result of what we have learned since 2001. The lessons learned from the war in Iraq and Afghanistan changed all the protocols for tourniquets.

 

[Tex929rr]

Do they sell them at Walmart or CVS ? Or is this mail order exotic ?

Amazon. For a while there were cheap Chinese copies (with fake labels) around but I think they are pretty mush out of the supply chain. Search for CAT tourniquet.

 

[BandAidPro]

On the job, yes.

Day to day... no.

Not that its a bad idea.

 

[Aus_Schwaben]

My latest addition to my ifak is a pack of quick clot treated gauze. It is easier to pack into over a wound.

 

[leVieux]

>

As an ex US Army Medical Officer, Surgeon, Emergency Physician, & Med School Professor; I cannot understand y'all's fascination with tourniquets.

Tourniquets are very rarely actually useful in real life. They may be terribly harmful.

I suggest stressing airway skills, which are often needed and frequently used to resolve immediately life-threatening situations.

Please carry some type of airway assist device instead.

leVieux
.

 

[HKaltwasser]

I carry two CATS. My combat medic buddy convinced me that two is always good to have on hand. Either to double the same limb for heavy bleeding, or to apply on two victims or two different limbs on yourself.

Remember the cops that were ambushed in LA? That lady cop saved her partner from bleed out after being wounded herself, with a tourni.

 

[HKaltwasser]

>

As an ex US Army Medical Officer, Surgeon, Emergency Physician, & Med School Professor; I cannot understand y'all's fascination with tourniquets.

Tourniquets are very rarely actually useful in real life. They may be terribly harmful.

I suggest stressing airway skills, which are often needed and frequently used to resolve immediately life-threatening situations.

Please carry some type of airway assist device instead.

leVieux
.

Why one or the other? Why not have a trauma kit that helps with both? You know what they say about wishing when you don't have what you need.

 

[candcallen]

>

As an ex US Army Medical Officer, Surgeon, Emergency Physician, & Med School Professor; I cannot understand y'all's fascination with tourniquets.

Tourniquets are very rarely actually useful in real life. They may be terribly harmful.

I suggest stressing airway skills, which are often needed and frequently used to resolve immediately life-threatening situations.

Please carry some type of airway assist device instead.

leVieux
.

Probably because it's the one thing you can do to save a life in modern society where emergency healthcare largely mitigates the limb loss timing issues but where bleeding out is a real danger in penetrating trauma to extremities.

Most people wont get training for airway management beyond head positioning but can easily figure out a TQ. And everyone who Carrys professionally has seen TQs save lives in training or real life. Again your gonna get to the trama center fast enough to save a limb and most definitely to save a life.

Theres only so much the everyday person with basic first aid can do that's impactful in that time between injury and higher care and a TQ is one of them that's easily accessible or improvised.

People by all means should get advanced training but, while people may have more advanced supplies in certain situations....range hunting work, most arent gonna add a IFAK to on person carry for everyday use. It will be in a car or office but they can easily carry a TQ without trouble.

. I'm not a Dr emt or the like but I was state certified Basic life support instructor and cpr trainer. A TQ is extremely impactful in situations where there may be penetrating trauma to extremities. Probably more so than pressure and bandages to chest abdominal trauma, which is where lay people would find themselves. Meaning ensure they can quickly stop the bleeding.

Some quickclot would also be something to add as its ability to remove the water/fluid from blood and clot will absolutely save lives but again it has to be positioned properly and in situations where you're dealing with a small entery wound you need trauma care.

So that's why stop the bleed classes and emphasis on TQs, it can save lives effectively and keep you in the fight.

 

[leVieux]

Probably because it's the one thing you can do to save a life in modern society where emergency healthcare largely mitigates the limb loss timing issues but where bleeding out is a real danger in penetrating trauma to extremities.

Most people wont get training for airway management beyond head positioning but can easily figure out a TQ. And everyone who Carrys professionally has seen TQs save lives in training or real life. Again your gonna get to the trama center fast enough to save a limb and most definitely to save a life.

Theres only so much the everyday person with basic first aid can do that's impactful in that time between injury and higher care and a TQ is one of them that's easily accessible or improvised.

People by all means should get advanced training but, while people may have more advanced supplies in certain situations....range hunting work, most arent gonna add a IFAK to on person carry for everyday use. It will be in a car or office but they can easily carry a TQ without trouble.

. I'm not a Dr emt or the like but I was state certified Basic life support instructor and cpr trainer. A TQ is extremely impactful in situations where there may be penetrating trauma to extremities. Probably more so than pressure and bandages to chest abdominal trauma, which is where lay people would find themselves. Meaning ensure they can quickly stop the bleeding.

Some quickclot would also be something to add as its ability to remove the water/fluid from blood and clot will absolutely save lives but again it has to be positioned properly and in situations where you're dealing with a small entery wound you need trauma care.

So that's why stop the bleed classes and emphasis on TQs, it can save lives effectively and keep you in the fight.

I hear you, but what are your credentials and background to assert this?

How many actual "limbs & lives" have you actually seen "saved" by tourniquets in the civilian world ?

I spent some 12 years on Emergency Trauma services & over 35 years on Vascular Interventional services at some very large hospitals like Charity, Ben Taub, Jeff Davis, LBJ, Hermann Memorial, Saint Luke's, The Methodist, Saint David's, Midland Memorial, Valley Regional, John Sealy, Brook Army, & UMC New Orleans, etc; and haven't seen ONE !

And, in many of those places, I was the guy they called to stop "uncontrollable" bleeding!

leVieux
.

 

[toddnjoyce]

…
How many actual "limbs & lives" have you actually seen "saved" by tourniquets in the civilian world…
.

Zero. How many Low Titer O whole blood transfusions have you performed in a combat zone?

CATs solve a lot of problems produced by field expedient tourniquets; the likelihood of a first responder, much less the average person encountering a scene where a tourniquet of any type is critical to life safety of a patient is low which is why I treat these conversations as mental masturbation.

But it’s a cheap addition to any kit…which most people don’t have to begin with. So, in this instance I think the Boy Scouts got it right with Be Prepared.

 

[mountainbull]

20 years as a ff-emt, not trying to be a dick, BUT, we found that docs and surgeon's that showed up on trauma calls, gsw and car wrecks were not used to "first responder" tactics and needs to get vics to the hospital alive.
My goal was to keep patients alive till they could be handed off to more advanced med treatment.
Docs and surgeon's[ we had a few in the rural community I served] were helpful but ya have to get the vic to a hospital in the "Golden hour", sometimes you got to move quickly, not "by the book"

 

[cycleguy2300]

I hear you, but what are your credentials and background to assert this?

How many actual "limbs & lives" have you actually seen "saved" by tourniquets in the civilian world ?

I spent some 12 years on Emergency Trauma services & over 35 years on Vascular Interventional services at some very large hospitals like Charity, Ben Taub, Jeff Davis, LBJ, Hermann Memorial, Saint Luke's, The Methodist, Saint David's, Midland Memorial, Valley Regional, John Sealy, Brook Army, & UMC New Orleans, etc; and haven't seen ONE !

And, in many of those places, I was the guy they called to stop "uncontrollable" bleeding!

leVieux
.

I am including chest seals and decomp needles in airway management here. And let me start by saying airway management is important

I have seen a number of incidents where TQs were used to good effect to stop life threatening bleeding. Gunshots, car crashes, home accidents... Airway management shouldn't be neglected, but in my experience it has been needed less commonly than a TQ.

Without the rapid application of a TQ someone can bleed before EMS can arrive and they dont have the ability to reverse the effects. Airway can be ignored for a minute or two until bleeding is under control (assuming a 1-man response). In short bleeding can kill you faster than not breathing.

Also, if a TQ is placed on a limb where it really wasnt needed the risks are pretty low. It will likely be evaluated by EMS and then again in the ER. If it's not needed it comes off with no ill effects.

Police can't carry everything, we don't drive around a bus full of tools and toys like Fire or EMS and for police, military and most folk's EDC kit a TQ is a highly effective way to stop a preventable death. I have a nasalpharyngal tube in my IFAK because it is a small, easy to use, low risk item, along with chest seals, but airway management comes after making the scene safe and managing bleeding.

I've seen a lot of traumatic injuries that needed immediate care before EMS arrived. Of those I have treated or beennonnscene for 90%+ were controlling bleeding and the rest were a few chest seals, and a few instances of CPR. In instances without riots or something slowing EMS's response time, by the time I get to airway they are taking over.

Sent from your mom's house using Tapatalk

 

[Axxe55]

I have had basic first aid many years ago. Also CPR and mouth to mouth resuscitation as well. I don't claim to be a doctor, an EMT, or even a volunteer firefighter. But what I am, is person that absent anyone else better than myself, and the first person arriving when someone is hurt or injured, I'm going to do whatever, to the best of my knowledge to help that person.

I could not stand by and not do something. Would I feel badly if that person died because of my help? Damn right I would, but I think I would more badly about myself had I done nothing at all to try and help them.

 

[toddnjoyce]

…
I've seen a lot of traumatic injuries that needed immediate care before EMS arrived…

I agree making the scene safe is job #1.

I haven’t seen a lot, but enough. Most GSWs we saw in OEF/OIF that weren’t a plate hit ended up being through and throughs; those got plugged and a compression bandage. The only thing that got a CAT was arterial or veinous bleeds unless it was an obvious bleed out such as partial/full amputation. There were other things we had to deal with that I expect the average US-based guy doesn’t.

Tactics, Techniques, and Procedures should evolve to the situation. In my mind, the golden hour concept that applies to combat is much less relevant in *most* US-based trauma scenes. Where that model flips it’s head is that a lot of US trauma scenes don’t require a full level 1 trauma capability, yet they exist at a rate of 4x what we had overseas.

 

[mountainbull]

ABC---airway, breathing,circulation.
Take care of those 3 things in order and you will make a difference!
#1 your safety first, don't become a victim.

 

[Axxe55]

I agree making the scene safe is job #1.

I haven’t seen a lot, but enough. Most GSWs we saw in OEF/OIF that weren’t a plate hit ended up being through and throughs; those got plugged and a compression bandage. The only thing that got a CAT was arterial or veinous bleeds unless it was an obvious bleed out such as partial/full amputation. There were other things we had to deal with that I expect the average US-based guy doesn’t.

Tactics, Techniques, and Procedures should evolve to the situation. In my mind, the golden hour concept that applies to combat is much less relevant in *most* US-based trauma scenes. Where that model flips it’s head is that a lot of US trauma scenes don’t require a full level 1 trauma capability, yet they exist at a rate of 4x what we had overseas.

Also, trauma injuries in the civilian world are much different than trauma injuries in a combat environment where enemy fire is occurring.

It would be interesting to see just how calm and collected many would be under enemy fire in battlefield.

 

[candcallen]

I hear you, but what are your credentials and background to assert this?

How many actual "limbs & lives" have you actually seen "saved" by tourniquets in the civilian world ?

I spent some 12 years on Emergency Trauma services & over 35 years on Vascular Interventional services at some very large hospitals like Charity, Ben Taub, Jeff Davis, LBJ, Hermann Memorial, Saint Luke's, The Methodist, Saint David's, Midland Memorial, Valley Regional, John Sealy, Brook Army, & UMC New Orleans, etc; and haven't seen ONE !

And, in many of those places, I was the guy they called to stop "uncontrollable" bleeding!

leVieux
.

Good for you.

Phucking Dr god complex. Lol

Condescending and dated come to mind or maybe out of touch. Do you think people put TQs on everything from a splinter to a minor wound?

Again, there is a difference in how Dr in a hospital and lay people in the field address bleeding. Maybe your degree is blinding you to that. The TQ is so we can get to you alive and you can tell us what lucky mouth breathing knuckle daggers we are that we had you to save our lives oblivious to the fact we would have bleed out otherwise.

You sound like the Drs who howled about paramedics killing people at their inception cause they dared to trespass upon your realm.

 

[mountainbull]

I would be s@#$%ing my pants!
Never had to work on anyone with incoming fire, just traffic

 

[toddnjoyce]

ABC---airway, breathing,circulation.
Take care of those 3 things in order and you will make a difference!
#1 your safety first, don't become a victim.

Not always in order.

I would be s@#$%ing my pants!
Never had to work on anyone with incoming fire, just traffic

Which is why we make the scene safe first Seriously, whether it’s combat, wilderness, roadside, bedside, if the scene isn’t safe for the responder, then the patient can’t be made safe.

 

[BandAidPro]

I hear you, but what are your credentials and background to assert this?

How many actual "limbs & lives" have you actually seen "saved" by tourniquets in the civilian world ?

I spent some 12 years on Emergency Trauma services & over 35 years on Vascular Interventional services at some very large hospitals like Charity, Ben Taub, Jeff Davis, LBJ, Hermann Memorial, Saint Luke's, The Methodist, Saint David's, Midland Memorial, Valley Regional, John Sealy, Brook Army, & UMC New Orleans, etc; and haven't seen ONE !

And, in many of those places, I was the guy they called to stop "uncontrollable" bleeding!

leVieux
.

C'mon Doc... although airway and breathing interventions are indeed far more common than TQ's being placed, TQ placement in the prehospital environment happens pretty regularly.