LEOs have bled out and died from extremity wounds because no one could stop the bleeding quickly enough.

It’s always possible to think of “What if …?” scenarios that would be better handled by something we don’t have. I would be curious to know how many people, even members here, carry any sort of IFAK every minute when they’re nowhere near a more comprehensive kit. Good on those who do, but I’d bet a nickel it’s far less than 5%.

And we should also keep in mind that sometimes “better than nothing” simply isn’t. If the situation demanded a tourniquet, I would be running as fast as I could to my car a couple of blocks away to grab a proper one rather than trying to make do with a substitute that happened to be at hand and that I knew wasn’t going to work.

I don’t know if it applies to all SF or just Army SF, but all carry a tourniquet in the exact same place, right thigh pocket.

quote:

Originally posted by RogueJSK:
If you're going to have TQs on hand, make sure that you get trained on how to use them, and practice applying them not only to someone else, but applying them to yourself, including one-handed. Like any skill, don't wait until it's life-or-death to try to figure out how to do it.

THIS

TQs have been popular items to merchandise in stores and online tactical shops, unfortunately knowledge has not been as popular. Get training, get knowledge on its usage. Just remember not every injury requires a tourniquet, get training and be familiar with how to assess an injury; gauze & seals are equally important, just need to know which tool to use.

Lots of people who've had 1st Aid training from the 60-90's were told to avoid using a tourniquet as loss of limb was a significant possibility. The last 20+ years of combat trauma care has turned that standard on its head, as medical care is every evolving and changing, the use of a TQ is an important tool.

There is a valid place for tourniquets. A very good friend of my grandson (both Green Berets) lost his leg from injuries sustained in an insider attack. The tourniquet saved his life. Could not save his leg because the damage was so severe. Major blood vessels damaged beyond repair, hours by chopper from required medical treatment, etc. Doctors said that had that tourniquet not been applied he would have bled out in minutes. Last I heard he was still on active duty as a Green Beret.

There is something to be said for common sense, especially in major medical emergencies! Yes, pressure should be released to save tissue damage, but coupled with common sense.

I’ll add that proper pressure points can be as effective as the most expensive tourniquet you don’t have, and can stop bleeding that tourniquets would not work on.

Few classes really get into them, or show their effectiveness. Id been a paramedic for 14+ years and had taken and taught hundreds of hours of TacMed classes before I had it explained/shown to me in a way that stopped me in my tracks by its effectiveness (both the instruction and the real world results).

The SWAT-T works well on someone else but you have to practice. It will shut down a bleed as well and as quickly as any band restriction tourniquet, except on a real thick thigh. When I’m working I carry a CAT and then a pack of compressed gauze with a SWAT-T wrapped around it in my pocket, and a tiny roll of duct tape. Covers every base for most holes. Plus a couple of grand worth of trauma crap in my patrol car...but those few things are my primary mainstays for day to day.

And if someone starts talking about plugging holes with tampons, just walk out and ask for your money back.


We still get push back from Doctors/Medical Directors. In 2020. Particularly over “packing” wounds with gauze. It’s annoying. The program I’m teaching now evidently got the attention of the local trauma center though (GSW patients showing up with bleeding stopped), and they were asking to come sit through a class.

quote:

Originally posted by chongosuerte:
And if someone starts talking about plugging holes with tampons, just walk out and ask for your money back.

Ah yes... That old BS. You see it on the forum from time to time too.

"You should stock your trauma kit with tampons and feminine pads to stop bleeding."

No. Just no.

If someone is bleeding and all you have are tampons and pads, then yeah, it's better than nothing, and potentially better than using your t-shirt. But it's not a 1st choice, and it's not something to specifically base your plan around. Buy and stock your kit with real trauma supplies, coupled with real trauma training on wound dressing/packing.

Training in TQ use is paramount...as has been said, when your coworker is bleeding out is NOT the time to be using one for the first time...or worse yet, when you yourself are in danger of letting all the red stuff out of your body!
I’ve been a medic for 30 plus years, got tapped by the regional SWAT team for the past 15 and continue to work with them. My team is used to train “active shooter” to regular patrol officers in all the towns we serve, didn’t do it this year due to Covid but in years past during a two week class we have 180 officers participate in the training. Always very positive feedback....I get a block of time just for TQ considerations/usage/tricks and stole a good 5 round drill from Sig Academy which is an eye opener. The drill forces you to shoot weak hand only, apply TQ to dominate arm, reload/charge pistol weak hand and shoot again...the tricks I’ve learned with TQ storage/application shaves seconds off proper application which increases your chance of survival. They are good tricks not offered up by the manufacturer. Anyone in LE that wants to see them I’d be happy to work something out....I’d do a video and post but I’m technologically retarded

I came back to the military after a 10-year marital hiatus ( ) to find that the OLD first aid training (i.e. dressing/pressure dressing/tourniquet, in that order) had changed drastically. What once was considered a last resort is now the "go-to" solution.

And don't get me started on nasal pharyngeal airways. LOL

Seriously though, it has been very cool to see things change over the years.

quote:

Originally posted by chongosuerte:


... and a tiny roll of duct tape...

hell yes -- duct tape baby !

but seriously -- like anything else -- lots depends on the situation as you mention

i hate to use the cliche -- but it's 'tools in the tool bag'

medicine is often like a pendulum -- sometimes things swing into favor then eventually out of favor and then back...

just look at the use of mechanical ventilators to treat severe COVID patients

bottom line -- with significant bleeding its good to have / know your options when assessing your patient and treat appropriately given the evacuation reality -- the 'Golden Hour' is a thing

-----------------------------

quote:

Anyone in LE that wants to see them I’d be happy to work something out....I’d do a video and post but I’m technologically retarded

Why for only LE? Civilians bleed & train too...

My first training (in 1978) was an Advanced First Aid course from the Red Cross. Bleeding control was (in order) direct pressure, elevation if possible, pressure point, then tourniquet. If a tourniquet was used, we were instructed to not remove it (no matter what!) and to mark "TQ" or "TK" on the patient's forehead along with the time of application. We were taught that a tourniquet should only be removed at the hospital - preservation of life over limb.

Nothing had really changed when I became an EMT in 1980 and then a Paramedic in 1983. At no time in any of my pre-hospital courses (even PHTLS & BTLS) was removing a tourniquet EVER endorsed; no matter who applied it. Even when I became an RN in 1992 & an ER Nurse in '93 was removing a tourniquet without a surgeon & an OR even considered.

Just realized ... I'm OLD.

quote:

Originally posted by l33571:

quote:

Anyone in LE that wants to see them I’d be happy to work something out....I’d do a video and post but I’m technologically retarded

Why for only LE? Civilians bleed & train too...

Good point....typing fast and I’m used to teaching LE....open to anyone...didn’t mean to slight anyone, unintentional

So an effective life saving method was taken out of favor and replaced with less effective methods that resulted in increased blood loss and more deaths because someone thought that it would be overused and damage savable limbs? And it took lots of extremity injuries, and deaths due to blood loss to relearn what was already known from many years of combat experience? I remember in first aid in health class in the 80's, and 90's for college and work hearing the TQ only if absolutely necessary and other methods don't work.

The older I get and more I observe "medical science" the less convinced I am that they actually understand how to use the scientific method. This stuff should not swing so far back and forth. The human body hasn't changed (except people are fatter). Perhaps makeshift TQ's did cause enough tissue damage that something had to be done, but that means use a proper TQ.

I have them in every vehicle and every range bag, first aid kit, go bag, etc. Israeli bandages and TQ's. Stopping the bleeding is the first and most important step.

quote:

Originally posted by Lefty Sig:
So an effective life saving method was taken out of favor ...?

When was it taken out of favor, or perhaps when was it in favor before the last couple of decades at most? What are you referring to?

As you mentioned, what I do remember going back some 60 years or so was that it was discouraged and considered a last resort method, with the admonition that a tourniquet had to be loosened periodically (every 45 minutes as I recall). And as the article pointed out, that idea was prevalent during the Vietnam War. Another thing I learned in one combat trauma class was that the US WW II tourniquets weren’t very effective because of their poor design. Rather than having a windlass to permit a high degree of compression, most were cinch straps with toothed buckles of the sort that I once used to compress my sleeping bags or other gear. As pictured here, some were even labeled directly with the warning about loosening them periodically.

Speaking with former military and some current PAs and docs that are in the reserves and have been overseas in combat hospitals/bases they all have said NOT to loosen a TQ after applied....one of the docs is a vascular surgeon and confirmed there is no permanent damage from a TQ if the injured party gets definitive medical attention in under 6 hours. This is the newest info I have gotten with more recent combat injury experiences than what the school of thought was with WWII or Viet Nam era.

2003.

The year I became a police. Tourniquets were still a no-go and QuikClot was still a bag of powder that burned the shit out of everything it touched. Everything wet, anyway.

Being at war for the last almost twenty years has done amazing stuff for field trauma intervention.

You can loosen a TQ. Before you do you have to place a second one. So the first is a hasty placed as close to the torso as possible. The next one is placed closer to the injury. Then you can loosen the hasty(1st one placed). A quarter turn at a time.

I just completed the army trauma training center course in August in Miami at Ryder trauma. I completed it as a member of an FRST and physician

I've applied TQs twice-one was improvised from an Ace bandage and a highlighter on a cutter suicide attempt; the second was a SofTT-W Tourniquet at a motorcycle accident with an amputation of his left leg below the knee.
The improvised one worked well enough that the EMTs left it in place when they arrived and transported the guy.
I still wear an ankle band carrier with a TQ, Izzy bandage, gloves and a seatbelt cutter-window breaker.

I've got a couple CAT's floating around and I've been carrying a Revmedx T2 around in my range bag; you can practice with it.