Deaths are generally classified in 3 sometimes 4 groups when it comes to TCCC (Tactical Combat Casualty Care):

1-Non-preventable death on the battlefield, meaning that no matter what medical interventions were made immediately after injury the patient would have died. Examples: complete transection of the thorax, decapition or massive open head wounds.

2-Preventable deaths on the battlefield, meaning that the patient/soldier/etc could have reasonably been saved with combat level interventions applied appropriately immediately after injury. Examples: arterial bleeding stopped by a tourniquet, occluded airway fixed by either positioning, nasal airway, tracheal airway (ET tube, King airway, or other), or surgical cric, decompression or a tension pneumothorax. Those three are the leading causes of preventable death on the battlefield at this time.

3-Non-preventable deaths due to injuries incurred on the battlefield, meaning injuries that were so severe that even with extensive capabilities being available or applied either at battalion aid stations or forward surgical teams they still die, just not on the battlefield. Examples: severe head injuries, massive internal injuries to essential organs (heart, lungs, liver being the leaders).

4-Preventable deaths due to injuries incurred on the battlefield, meaning that the patient/soldier could have lived had steps been taken throughout the spectrum of care after the care under fire phase. Examples being antibiotic therapy, surgical procedures, etc.

On a separate note:

Tourniquets should not be a tool of last resort. Assigning it that title means that you will use other steps first even when you know that a tourniquet is appropriate. Tourniquets are tools just like any other item in medicine and just as I wouldnt use a tongue depressor to splint a broken leg, it is misguided to recommend against using a tourniquet as a first line intervention in an obvious arterial bleed in an extremity. Being realistic in your training and understanding when and when NOT to use a tourniquet will keep you on the right path. If the bleed is squirting and not just dripping or oozing you can try with a single pad/gauze/etc and pressure to stop it, should that fail you need to go immediately to a TQ. Particularly in a remote environment where literally every drop of blood is priceless and it will be a good bit of time before you can replace it.

As a combat medic for a security team in Iraq I used tourniquets for any extremity squirters. As a civilian Paramedic in the states my protocol is to apply pressure with a gauze pad and failing that transition to a tourniquet. Many people have died relearning these lessons and I hope we dont soon forget them again.


Some pointers on TQ use:

-Use a premanufactured device, I recommend the SOFT-T, SWAT TQ, and TK4/TK4L based on my experience and testing. Belts dont work as well as you would think. I literally just ran a gun shot wound call where a guy had shot himself in the leg and tried to use a belt as a tourniquet. For one, he didnt need a tourniquet and for two, it was completely ineffective at applying pressure. The TK4 costs less than $10 and weighs less than 2oz.
-Know how to use it, that means get a couple and dedicate one to training and practice applying it with your strong hand and weak hand on all extremities.
-Dedicate one to training, many after action reports (AARs) from the military revealed early failures of TQs and it was found that this was due to people repeatedly using them in training and then putting them on their gear for operational use. They were not designed for this as they are single operational use items. So dont set yourself up for failure.
-Get training on when and when NOT to use it. As good as online forums are they are no replacement for hands on, structured training from a professional.

I know that was kind of long winded but hopefully that will answer some questions.

Mike