Troops use a tourniquet to stop arterial bleeds quickly while they get the victim out of the immediate danger zone to a safe area where he can be worked on. Usually the TK isn't on that long a period of time, but hey, if the choice is bleed out or use a TK... no brainer.

When I was deployed in 2011, we were required to have a TQ on us at all times, in our upper RT shoulder pocket, red tab facing out. The division surgeon also tried to make us carry quick-clot in a leg pocket, but I think that the battalion and brigade surgeons managed to talk her out of it.

It was fairly common to see the red tab with ALL US troops. So, when you figure each soldier outside the wire has his/her IFAK and another TQ on the shoulder ... I'd say nearly everyone had 2 of them. Most of the medics I had only had a few in their bag, figuring that everyone couldn't need one at the same time. If there was a triple or quad amputee, they could pilfer TQ's from his buddies.

I didn't get much response to the "DIY petroleum gauze"... so I'd like to pose the question... what are others use for a penetrating chest wound where air is entering the pleural cavity?... multiple thoracic penetrations from shrapnel could be a serious problem... world class trauma centers were minutes away in Boston... probably not so close for most of us

My range kit -- my most complete and capable kit -- is designed for a single patient. Because my most-likely treatment scenario is an accidental gunshot victim waiting on an ambulance, I've tailored my kit appropriately. If I do have multiple victims I'll have compression bandages and Combat Gauze, field-expedient TKs and hopefully the other RSOs will come running with their kits.

A chest seal, such as the HALO. It's what I carry. I do have a decompression needle but I've been told very sternly that its beyond my scope of practice.

Chaos... my range kit, and kit I carry with my pistol is for single care, though I too think I could improvise a bit... a good friend is a contractor for SOCOM, and just finished an upgrade project to the Casualty Care program for SOF... their medics reported that from a military view, sweating from body armor, and blood made the chest seals less viable than plain old petroleum gauze... the petroleum gauze is cheap to make, and packs pretty small...I've always carried some for that reason, and just wanted to upgrade the amount...I carry an nasal pharangeal tube in my range kit,...better for you to have the needle than not ... my last motorcycle accident, I had a delayed tension pneumothorax... when the tube went in it sure was nice to breathe easily again... pic of my carry kit which fits in a small outer pocket of a JanSport bag



CAT tourniquet, 4" Israeli dressing, Kerlix gauze, 4' of duct tape, 2 commercial petroleum gauze, Quick Clot, irrigation syringe.. protective pack

"A chest seal, such as the HALO. It's what I carry."

I'll look it up. But if you can elaborate that would be handy. I don't have one.

Pete2

I am speaking outside my expertise or training, but I am told an Asherman chest seal may be more appropriate to the random tension pneumothoraxes you would encounter, say, outside battlefield conditions. A US domestic major bleed may be sweaty, but not body armor in 110 degree heat sweaty. There is no petroleum gel, its sterile, and it won't expire in your bag.

I have an Asherman in my kit but no training on treatment of tension pneumothorax, so only a vague idea of when to apply it. I was told my a local EMT that that's okay, their first step would probably be to evaluate the patient and tear it off, and apply their own treatments. Its a little edgy to apply - and I can rely only on 10 minutes voluntary instruction by a friendly, licensed EMT, but unlike other alternatives and treatments, you can't actually harm the patient by slapping an Asherman on their chest.

Anyone who wants to treat me with decompression needles to my lungs better have the license and certification to do so, that's all I'll say about carrying those.

There are two ways I know about to treat tension pneumothorax in the field. One is to use either a purpose-made or a field-expedient chest seal. Some have a valve-like function to allow trapped air to escape, others just keep more air from entering the thorax.

The other way is to use a decompression needle to remove the trapped air. The first way is something people can be trained on quickly and it would take special talent to make someone worse with one. The decompression needle can easily do significant harm if used incorrectly.

Reading over this thread, it occurs to me that the environment in which the injury occurs makes a big difference. I have mostly deal with blunt force trauma in a wilderness, or at least outdoors, setting, typically the result of falls. I have never encountered a penetrating chest wound, and only one limb amputation, in something like 200 or so cases. But if I were in a combat,range, or other firearms intensive environment, the PCW would be a lot more common. Tailor your kit to fit your circumstances. The injury profile associated with a bombing or combat will be very different from what you will see out in the woods. Study up on improvisation - there are always exceptions to every trend.