Improvisation isn't necessarily slower. I understand the stethoscope was invented by a modest British physician who did not wish to place his ear on a woman's chest to determine heart sounds and rhythms.

So, if you are in a situation where you don't have a stethoscope handy, just use your ears...It's better than nothing.

By the way, Russ, I just placed an order for two (2)! SWAT tourniquets, thanks to your recent post, ending a long time aversion to the use of T's and reversing my earlier training.

Now you don’t need to worry about your favorite belt getting trashed by an ER nurse.

FWIW, the SWAT-T I bought from REI in-store is orange, but the ones available on-line are black.

Earlier in the thread we discussed “improvisation” and that’s always good, but improvisation takes time and sometimes that’s time the victim does not have available. A dedicated tourniquet is easier and quicker to deploy if you have one, and you don’t need to worry about your favorite belt being trashed when it arrives at the ER (you ain’t getting it back). [/quote]

A dedicated tourniquet is also more effective than most improvised ones.

The SWAT-T is good, but more difficult to stop arterial bleeding with. I prefer the CAT and the SOF Tactical Tourniquet. I do carry a SWAT-T, but do not rely on it as the primary tourniquet.

The SWAT appeals to me because it seems somewhat more versatile. What about it makes it more difficult to retard arterial bleeding?

This is intriguing; I was trained during a phase when tourniquets were regarded askance; they are now currently in favor. I have stopped a lot of bleeding and I think it is time to include a T in my kit. A lot of this seems to be due to gunshots (Montenaro's ) vs mine (almost no gunshots, just blunt trauma).

Direct pressure will probably work for the majority of serious bleeding wounds and for those I like the SWAT-T’s 4” width which happens to be the width of a 4x4 gauze pad or a 4x3 non-stick pad. Apply direct pressure to stop the bleeding and then you get your hands back.

Self-adherent wraps apply some pressure, but with the SWAT-T you can dial it up to the point of constriction if necessary. Not sure a self-adherent wrap will get that tight without failing.

The CAT otoh is a dedicated tourniquet, if I decide to go with that option, my intent is no pulse below the TQ.

There are places on the body where no pulse past a certain point means you kill the patient; it’s really really bad form to kill the patient. For those situations, DP is the only way to go — think neck wounds.

The only place a tourniquet will kill the patient is on the neck, and EVERYBODY knows you do not put a tourniquet on the neck

The SWAT-T is great for pressure dressings, also a good elastic bandage. These are also very helpful when you need to put pressure on the femoral artery high up in the groin area, where a tourniquet will not work.

The CAT is very light and packs small, where the SOF tourniquet is a bit heavier and bulkier. The CAT can fail in the plastic bar you use to torque the pressure (the windlass), it can break, but the newer ones are stronger. It usually only happens if it is used multiple times (such as training). I have never seen a new one fail.

For torso wounds, obviously, a tourniquet will not work and direct pressure, a clotting agent or surgical methods are the only options.

Just so you know, despite the picture on the REI SWAT-T page which shows packaging for the black SWAT-T, they shipped orange which is a good thing imo.

Got a couple of orange ones today and just finished watching the training videos - looks like the SWAT-T will be a useful addition.

About where to apply a tourniquet, or not, my first EMT instructor mentioned a time when he rode in the mbulance with the victim, clamping the carotid artery with his fingers until they got to the ER.He was later sued because of excessive facial disfigurement (unsuccessfully).

Thinking hard about adding a CAT....