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#211157 - 11/10/10 09:50 PM Re: US Mil Medics Use Old & New Techniques [Re: Lono]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
Originally Posted By: Lono

There is the possibility of a pendulum shift, that with broader acceptance of TQ use some wahoos out there may apply unnecessary or unsafe tourniquets. That can only come from folks who aren't trained or experienced.


Isn't that the situation that led to a conservative attitude with respect to tourniquets in the first place? I think you are right about the pendulum...
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#211179 - 11/11/10 01:10 PM Re: US Mil Medics Use Old & New Techniques [Re: Dagny]
oldsoldier Offline
Old Hand

Registered: 11/25/06
Posts: 742
Loc: MA
I am actually attending a combat medical course next weekend in CT, as a guest. The instructors are current & ex mil and LE. I was on another forum, discussing TQs, and recent experiences a buddy related to me regarding the types of TQs they use in SF. The person PMed me & invited me to the course. Specifically, he is one of the people who helped develop the current SOF-T tourniquet, and they are working on other developments. I am excited to participate in this, and plan on doing a write-up post-course, provided I am allowed to by the guy who invited me.
But, yes, the military has moved back to the TQ being the primary way to treat blood loss on the extremeties during the "care under fire" phase. So much so, that a lot of soldiers actually wear a TQ on each appendage, so that they can quickly stop blood flow themselves, if needed. I believe that the studies indicate that, when a TQ is applied properly, they can be left in place as long as 6 hours, and the limb is still recoverable. Now, the key word is PROPERLY. One that is cranked down WILL cause a lot of damage. But applying one properly, tightening it until blood flow stops, then securing it, will not cause permanent damage if its on there only an hour or so.
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#211188 - 11/11/10 02:34 PM Re: US Mil Medics Use Old & New Techniques [Re: hikermor]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
Originally Posted By: hikermor
Originally Posted By: Lono

There is the possibility of a pendulum shift, that with broader acceptance of TQ use some wahoos out there may apply unnecessary or unsafe tourniquets. That can only come from folks who aren't trained or experienced.


Isn't that the situation that led to a conservative attitude with respect to tourniquets in the first place? I think you are right about the pendulum...


One thing that's encouraging this time around is the ready availability of a good tourniquet supply - SOF-T, CAT and some other types are out there, being tested in real life conditions. They're relatively cheap, $15-30. And good TQ designs are winning on predictable grounds - patient survival, and viability of limbs after applying the TQ. Folks have come to understand there are limits to TQ, as old soldier says approx 6 hours, properly applied. Not that I was actively looking, but before the Iraq War I couldn't find real TQs, which meant you could be tempted to use anything from a belt (Rambo) to surgical tubing. I recall one dark, hushed conversation in an old WFA class where we talked about using webbing in a real pinch, in hopes of stopping the bleed, but at the sure cost of the limb. If folks can stay within their training and not improvise and choose poor TQ materials, mostly we'll be okay.

Medicine and medical care advances, the pendulum swings are almost always for the better. I grew up next door to a vascular surgeon who made his bones in the Viet Nam war, pioneering new surgical techniques in battlefield conditions, saving arms, legs, hands and and feet that once would have been amputated. He passed away some years back, years later I stayed in a hotel in Dublin where they were having a medical conference in vascular surgery, I mentioned his name, he was thought of as a God. As it should be.

Which reminds me, god bless all you veterans out there, I'm thinking of you today.


Edited by Lono (11/11/10 02:48 PM)

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