Tourniquets, Misuse

[2A_Tom]

Rep malfunctioned that was supposed to be +10.

 

[Denny347]

I've had a couple of friends/co workers who self applied their C.A.T.'s after being shot then continued taking care of business. We had a former Army Ranger turned Medic for IEMS teach us TEMS. He came up with a phrase to help us remember what to do. "Tourniquet anything that Terminates with a Toe or a Thumb, Pack anything in the Pit or the Penis, Cover anything in the Chest". Simple and easy to remember. Part of our firearms inservice, twice a year, is shooting then finding cover to apply a CAT on a downed officer or self apply. Just because a leg wound is not bleeding externally, does not mean it's not bleeding out inside. I've watched someone shot in the leg, very little blood and a tiny bullet hole, die from bleeding out inside. You got a bullet wound to a limb, TQ that immediately.

 

[nad63]

I've had a couple of friends/co workers who self applied their C.A.T.'s after being shot then continued taking care of business. We had a former Army Ranger turned Medic for IEMS teach us TEMS. He came up with a phrase to help us remember what to do. "Tourniquet anything that Terminates with a Toe or a Thumb, Pack anything in the Pit or the Penis, Cover anything in the Chest". Simple and easy to remember. Part of our firearms inservice, twice a year, is shooting then finding cover to apply a CAT on a downed officer or self apply. Just because a leg wound is not bleeding externally, does not mean it's not bleeding out inside. I've watched someone shot in the leg, very little blood and a tiny bullet hole, die from bleeding out inside. You got a bullet wound to a limb, TQ that immediately.

Some superb information and food for thought.j You made it on my top ten INGO posts list

 

[rhino]

IBDs and 4x4s have been my go-to in most shooting situations I have found myself a part of. I carry a TQ on my belt with several more in the car, and two IBDs in my BDU pocket. I have had the very obvious need for a TQ a couple times and, again, it was very obvious that is what was needed. Beyond that, being able to seal wounds to the chest cavity is important and an IBD nor TQ will work for that. I also keep a couple chest seals in my grab-bag, knowing that one will probably be enough to use to seal holes, especially if cut in half, then using the wrapper itself to seal multiples if there are a lot. The knowledge and calm ability to choose the right one, in a situation like that, is arguably more valuable than the gear itself.

You can also use the IBD wrappers to make chest seals (if you have some good tape).

 

[Brad69]

Note: You must use good tape crappy tape or old brittle tape will not stick to blood covered skin.

Warning:
Do not use
Tourniquets for head wounds!

 

[Young William]

Here is a nice illustration to go along with what Denny was saying.

I took the Dark Angel Medical class over the summer. The class covers the following things:
Physiological and Psychological reactions to environmental stress
The importance of having the proper Combat Mindset
Basic Anatomy and Physiology of life-sustaining systems
H, A, B, C’s—Hemorrhage, Airway, Breathing and Circulation
Breakdown and usage of Individual Med Kit components
Proper stowage and employment of the IMK
Hands-on application of the IMK
Basic and Advanced Airway management -treating and monitoring tension pneumothorax, sucking chest wound and flail chest
Airway adjunct device placement-Nasopharyngeal Airway
Basic First Aid and Advanced wound care
Application of Bandages and Hemostatic Agents
Application of tourniquets
Recognition and Treatment of various injuries (Gunshot, Laceration, Burn, Airway, Head, Orthopedic, Environmental)
Recognition and treatment of hypovolemic (hemorrhagic) shock
Moving and positioning victims with various injuries
Response to active shooter situation
Proper use of cover and cover vs. concealment
Casualty recovery in an Active Shooter situation
Mass casualty triage procedure
Emergency Medical Dialect/Lingo (911 protocol, cooperation with LE, Fire and EMS and First Responders)

The class is being offered in Muncie Nov. 3 and 4 2018. It is well worth the time and money.
Dark Angel Medical - Tactical IFAK and Trauma Kits - Every Day Carry Med Kits

 

[rhino]

Note: You must use good tape crappy tape or old brittle tape will not stick to blood covered skin.

Warning:
Do not use
Tourniquets for head wounds!

Yep, and maybe a longer strip than you thought you needed if it won't stick well to bloody skin!

Gorilla Tape for the win!

 

[Sylvain]

[video=youtube;bdPO4aun8aQ]https://www.youtube.com/watch?v=bdPO4aun8aQ[/video]

 

[inchrisin]

Tourniquets have been applied and slowly loosened to regain use of the limb after being applied for up to 24 hours. There are a lot of variables. Wet ground, blood soaking into clothing, not knowing the exact source of the blood, and many other factors that would make me want to pull a SWAT or CAT before applying direct pressure. If someone has a foot in a lawn mower or if someone is shot then my first thought is for a tourniquet. The EMS and MDs can sort it out after a hospital visit. At least the patient gets a hospital visit this way, right?

 

[VUPDblue]

In a big city setting, I don’t think a TQ is ever really the wrong answer to stop traumatic bleeding. Even if bleeding in an extremity could theoretically be stopped with direct pressure and/or an IBD, slapping on a quick TQ will stop it too, and damage to the limb doesn’t need to be such a major consideration because hospital care is minutes away and not hours or days.

 

[rhino]

In a big city setting, I don’t think a TQ is ever really the wrong answer to stop traumatic bleeding. Even if bleeding in an extremity could theoretically be stopped with direct pressure and/or an IBD, slapping on a quick TQ will stop it too, and damage to the limb doesn’t need to be such a major consideration because hospital care is minutes away and not hours or days.

Just something else to consider:

Applying a tourniquet is painful. By some people's standards, it's very painful. I think if the injured person is conscious, you can't disregard that especially if it's not a situation where a tourniquet is actually needed. Putting a tourniquet on one of your colleagues may be no big deal in that regard, but it very well could be to some kid who is already going to be under extreme stress. If direct pressure will work and you have the option of doing it, I think it should always be the first line of treatment.

 

[actaeon277]

I looked in on the thread, cause I saw rhino had posted.
I thought we were getting an After Action Report.

I don't know if I'm happy we aren't, or disappointed.

 

[2A_Tom]

 

[rhino]

I did cut myself (left middle finger, near the tip) today. That's the first wound that has drawn blood in a long time! I did not apply a tourniquet!