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A tourniquet can save your life. GRAPHIC, NSFW, lots of blood

This topic can be found at:
https://sigforum.com/eve/forums/a/tpc/f/320601935/m/4180013044

April 12, 2018, 07:07 AM
tacfoley
A tourniquet can save your life. GRAPHIC, NSFW, lots of blood
The only time [thankfully] I needed a CAT, not only did I not have one [it was in the early 80's], but the site of the injury precluded the use of one.

The young man had taken fragments through the neck, including the carotid artery. In these cases you do what you can, but it is only delaying the inevitable. My buddy and I both looked as though we'd been hosed down with blood as we took turns holding the ends of the 'tube', but the victim died as got through the ER door.

Even though I'm a civilian now and a range shooter, rather than a field shooter, I have one ready-looped for use on my range bag grips.

tac
April 12, 2018, 06:42 PM
bendable
I feel the need to get one and throw it in the Med bag in the vehicle, for personal use.
Might look in to obtaining one





Safety, Situational Awareness and proficiency.



Neck Ties, Hats and ammo brass, Never ,ever touch'em w/o asking first
April 12, 2018, 07:35 PM
Gustofer
Everyone's experience is different, to be sure, but after 30+ years in the medical field including 15 as a paramedic, there has never been one time, in thousands of calls/rescues, when I, personally, needed a tourniquet. The only call that came close was a severed carotid and EJ that I had to hold closed with my fingers until we got into the OR. It is just something that is not common, despite what you might see in a video and expect to happen every day with every GSW.

I don't mean to say don't be prepared, but don't go hog wild and carry one on your person every day, put one in your glove box, your range bag, your wallet, around your ankle, etc..., expecting to need it, because you won't. If you want, have one accessible...somewhere.

If you don't carry one, then use a belt, a shoelace, a T-shirt, a strap of some kind, or anything else if needed...which it probably won't be (all of which will work fine). If you do carry one...knock yourself out. Keep in mind that the vast majority of bleeding can be controlled effectively with direct pressure alone.

Keep in mind also, that all bleeding stops. Wink


________________________________________________________
"Great danger lies in the notion that we can reason with evil." Doug Patton.
April 12, 2018, 09:08 PM
slosig
Gustofer, thanks for your insights. I am sure that you are right and it is extremely unlikely that I’ll ever need the AFAK I wear daily. That said, it is probably even less likely that I’ll ever need a defensive firearm, but I carry one of those and a spare mag everyday. I don’t expect to ever need either one, but I rather have them and not need them...
April 13, 2018, 04:02 AM
tacfoley
quote:
Originally posted by Gustofer:The only call that came close was a severed carotid and EJ that I had to hold closed with my fingers until we got into the OR.


Our problem was that the victim had been bleeding for a while before we got to him. As 'interested persons' we got to see the autopsy report, and it transpired that even if we'd stopped the bleeding long enough to contain life-level capacity, another fragment had gone through his eyeball and into the brain. He would have been a vegetable anyhow. Didn't make us feel any better.

tac
April 13, 2018, 07:24 AM
parabellum
OK, so there you go, gents. You don't need a tourniquet. People just don't bleed to death.

You don't need seatbelts, either, and your firearms do not require safeties.

I can't wait until the next thread where I am trying to do something beneficial, only to have it derailed because one member never needed whatever item is in question.

Because that's the way the world works- EMTs are the only ones who ever encounter injured people. Therefore, their experience overrides everyone else's. Hell, come to think of it, I've never even seen an injured person. Have you? Probably not.

Oh, and the crook about to bleed to death in that clip? Never happened. It's all CGI. Why, a man could go, oh, say, 30 years without ever seeing a thing like that, therefore, it never happens.
April 13, 2018, 07:39 AM
sigfreund
The first question I have for someone who has never seen the need for a tourniquet is How does he know what works? The instructor for the last class I took made it clear with graphic examples that something like a shoelace or other thin cord doesn’t work well in situations when they are required (for example, traumatic amputations). With just a quick Internet search and reading a few discussions, we can see that ideas have changed over the past several decades and I’ve see that myself.

The “I’ve never needed one” argument is just like “My grandma smoked four packs of unfiltered Camels a day and lived to 90,” or “My big brother drinks two cups of sugar in sweet tea a day and hasn’t developed diabetes yet.” I probably won’t start carrying a tourniquet on a daily basis, but I have them in my car and especially when I go to the range even though I realize I’ll probably never need one. I’ve never needed the fire extinguishers in my home or the gun I carry daily either, but I still keep them handy.




6.4/93.6

“Wise men talk because they have something to say; fools, because they have to say something.”
— Plato
April 13, 2018, 09:43 AM
chongosuerte
quote:
Originally posted by sigfreund:
The first question I have for someone who has never seen the need for a tourniquet is How does he know what works? The instructor for the last class I took made it clear with graphic examples that something like a shoelace or other thin cord doesn’t work well in situations when they are required (for example, traumatic amputations). With just a quick Internet search and reading a few discussions, we can see that ideas have changed over the past several decades and I’ve see that myself.

The “I’ve never needed one” argument is just like “My grandma smoked four packs of unfiltered Camels a day and lived to 90,” or “My big brother drinks two cups of sugar in sweet tea a day and hasn’t developed diabetes yet.” I probably won’t start carrying a tourniquet on a daily basis, but I have them in my car and especially when I go to the range even though I realize I’ll probably never need one. I’ve never needed the fire extinguishers in my home or the gun I carry daily either, but I still keep them handy.


Exactly. Especially when people think they are going to be able to construct one under stress. Things like a shoelace, etc. do not make good tourniquets. And even some trained soldiers/police officers have a hard time applying commercial tourniquets when the real thing happens. Someone who has never trained on one will either not be able to effectively apply it, or will have a hell of a time figuring it out on the spot as blood is squirting through the air. We're talking precious seconds in a good femoral bleed.

In EMS we don't use tourniquets often because during the situations where they are needed (shootings, stabbings) we are either enroute or staging for law enforcement to clear the scene in the 2 or 3 minutes it takes for the guy to bleed out. It's like a mortician saying they don't know why anyone needs to know CPR.

My department uses them frequently. In the last few months we used one in my division on a 10 year old that was shot in the arm and had an arterial bleed, and another on an officer that was shot in the leg in an ambush. Those are just two that come to mind without digging to see if there were any others. To say it's 'not needed' is...nuts.




Knowing what one is talking about is widely admired but not strictly required here.

Although sometimes distracting, there is often a certain entertainment value to this easy standard.
-JALLEN

"All I need is a WAR ON DRUGS reference and I got myself a police thread BINGO." -jljones
April 13, 2018, 09:52 AM
Snake207
I can think of at least two videos on Liveleak off the top of my head that graphically show just how fast a femoral bleed will incapacitate/kill you.

It's one thing to hear 1-2 minutes, but seeing it - that 60-90 seconds seemed like 10.


__________________________
www.opspectraining.com
"It pays to be a winner."
April 13, 2018, 12:06 PM
TMats
I had the distinct honor of being invited to accompany a SF unit on a couple of TXs. One exercise was medical in nature. Every unit member carries a tourniquet, and they all carry it in the same pocket, so that should you be bleeding out from a severe wound to an extremity, one of your brothers can immediately access a tourniquet and stop the loss of blood.

I thought you might enjoy seeing a few pictures that give you an idea of the TX.












_______________________________________________________
despite them
April 13, 2018, 12:16 PM
Georgeair
quote:
Originally posted by TMats:

Well, that dummy's not dressed for the weather!



You only have integrity once. - imprezaguy02

April 13, 2018, 12:31 PM
Mars_Attacks
I keep one behind the seat of my truck.


____________________________

Eeewwww, don't touch it!
Here, poke at it with this stick.
April 13, 2018, 12:38 PM
sigfreund
quote:
Originally posted by TMats:
I thought you might enjoy seeing a few pictures that give you an idea of the TX.


Thanks! Nice demonstration of how effective MultiCam is in that environment.
And who has the hog’s leg? Smile




6.4/93.6

“Wise men talk because they have something to say; fools, because they have to say something.”
— Plato
April 13, 2018, 12:47 PM
TMats
quote:
Originally posted by sigfreund:
quote:
Originally posted by TMats:
I thought you might enjoy seeing a few pictures that give you an idea of the TX.


Thanks! Nice demonstration of how effective MultiCam is in that environment.
And who has the hog’s leg? Smile

Hey, if you come to NW Wyoming and you own a big bore revolver—you bring it...right?


_______________________________________________________
despite them
April 13, 2018, 01:50 PM
TigerDore
quote:
Originally posted by TMats:
I had the distinct honor of being invited to accompany a SF unit on a couple of TXs.

Thanks, TMats. Is that 10th Group?

Oh, and what's with the third picture down? Has SF been hanging around SEAL team?



.
April 13, 2018, 02:20 PM
TMats
quote:
Originally posted by TigerDore:
quote:
Originally posted by TMats:
I had the distinct honor of being invited to accompany a SF unit on a couple of TXs.

Thanks, TMats. Is that 10th Group?
No

Oh, and what's with the third picture down? Has SF been hanging around SEAL team?
I don’t understand

BTW, they have some cool medical gear, like a device for delivering IVs that enables fluids to be delivered without the necessity of elevating the IV bag. It is just placed on the chest of the patient and the device applies pressure, maybe warms the fluid too—can’t recall for certain.



.



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despite them
April 13, 2018, 02:25 PM
Rln_21
quote:
Originally posted by 1967Goat:
Man, that was intense. Reason #721 I could never be a cop, having to deal with those shit bags. Mad Sir, I'm dying, I'm dying...

When I took hunters ed, they told us if you choose to use a tourniquet, it is most likely going to happen that that person will lose the limb. Think before you use it. From a hunting perspective, chances are you will be out in the woods and miles from anyone.


This is no longer the case, especially with modern tourniquets. The current training is to err on the side of using the tourniquet. It can cause tissue damage if loft on too long but I doubt many people now lose limbs solely related to to use of a tourniquet.


________________________________________________________________________________________________



April 16, 2018, 03:06 PM
slosig
quote:
Originally posted by Oregon:
quote:
Originally posted by slosig:
They shared that there are records of modern tourniquets being on for sixteen hours without *any* tissue damage.


I would be very curious to see those and the methods that they dealt with necrosis. Do you have access to them?


Sorry for the slow response! I missed this at first, then didn't have the information so I shot Kerry an email. Here is his response:

Hi Nick,

The study was cited here:

https://www.ncbi.nlm.nih.gov/pubmed/17414556

It's open source.

The TQ was on for 16 hours total with a reperfusion incident (TQ loosened up) somewhere along hour 7. The individual was an army pilot and was back on flying status about a year after the incident. There were lots of other circumstances that could've led to him having no complications (altitude, cold, reperfusion, etc) but he did keep his arm.

Hope that helps!

Great to hear from you!! Our best to you and <Mrs. slosig>!

Stay safe,
Kerry
April 16, 2018, 03:30 PM
slosig
quote:
Originally posted by Rln_21:
This is no longer the case, especially with modern tourniquets. The current training is to err on the side of using the tourniquet. It can cause tissue damage if loft on too long but I doubt many people now lose limbs solely related to to use of a tourniquet.


Oh, one of the other things they talked about in the Dark Angel class. Tourniquet conversions.

If someone has an artery firehosing and you try to stop it with quikclot gauze (or other hemostatic agent), you will likely get nowhere as the blood is coming out fast enough to wash away the hemostatic agent before it can do any good.

However, if you are in a situation where it is safe, you can apply the tourniquet, stop the bleeding, then thoroughly pack the wound with hemostatic gauze and hold pressure for at least five minutes. At this point, the hemostatic gauze has had the best chance it is going to have of working. You can loosen the tourniquet (but leave it in place). If the hemostatic agent holds, great. Leave the tourniquet in place until the hospital. If a leak later develops, tightening the windlass is a simple thing. If the hemostatic agent isn't working, just tighten it back up right away.

In my normal life, I can't imagine a circumstance where a conversion would make sense as the hospital is pretty close time-wise. Still, it is another tool to have in the toolbag.
April 17, 2018, 11:21 AM
MWG
Wanted to bump this back up...

I've been carrying a tourniquet, Combat Gauze and Halo seals in my vest for several years know, a great reminder on the importance of why we do/should.