Tourniquets in Contemporary Settings

https://www.newyorker.com/magazine/2019/..._term=TNY_Daily

[censored] in thinking about the use of TQs these days and the situations in which they are required.

I have already included a TQ in my FAK, as a result of discussions on this forum. Hope I never have to use it, but I wouldn't bet on that...

Interesting article! I have two TKs but since moving I can't locate them. Time to pick up some more!

Interesting article. Since teachers are always going to be first at the scene of a school shooting or stabbing, it makes sense that they should have more than a little first aid training. A tourniquet and training on how to use it would be very useful.

C-A-T and SWAT-T tourniquets are different enough that I carry one of each in my larger FAK’s. My walking around kit has a SWAT-T.

My kits include:

• A full trauma kit with two CATs in the cabin of my car
• A full trauma kit with one CAT in the emergency kit kept in the trunk of my car
• A TSA-safe (no decompression needle) trauma kit with a CAT in my laptop bag
• Two full trauma kits in my range bag, each with a CAT, one to stay with my range bag and one that goes on my person, whenever I’m on the range
• A minimalist trauma kit on my bicycle, with a SWAT-T

The SWAT-T is better than nothing, but I would definitely not want to be using one for self aid on an upper extremity — it truly requires two hands. I’ve also broken them in training after more than one use (personally, I’ve never seen one break on first use, and your training TKs should NEVER be carried).

The SOFTT-W is excellent for buddy aid and a bit tougher to deploy for self-aid.

The CAT is excellent for self aid and for buddy aid. I’ve been told that it’s a little tougher to get full occlusion with it on a large muscular leg than the SOFTT-W.

I think that the SAM XT will be approved by CoTCCC, and when it is I expect that I’ll slowly start replacing my CATs with it. In training it’s even easier to apply correctly than the CAT.

The RATS device is not approved by CoTCCC and while I can’t speak for them I suspect it never will be. Two trainers I’ve worked with (separately) served in uniform as medics in combat and then later served as paramedics, and neither of them recommend it. That’s good enough for me.

While I’m on my soapbox, the most important thing is the willingness to act to save your own life or that of another. The next most important thing is situational awareness, knowing what’s going on around you so that you can act appropriately if needed. After that comes knowing which intervention to use and knowing how to use it. Last and least is having the right equipment at hand. So if you haven’t trained on this, that would be my suggestion as your next step before buying any kit.

after the Columbine shootings, I was on our school's committee to re-write our emergency management plan...at the time we addressed the problem by purchasing roll and bandage Kerlix, petroleum gauze, gauze pads, abdominal pads, tampons, chem lights, EMT scissors,self adherent and stretch tape in enough amount to outfit 4 Sterilite containers that were pre-positioned around the facility... at the time our RN on staff was against the idea of tourniquets

I had a couple of Israeli dressings and a couple of chem lights in a drawer in my desk, but not nearly enough for a mass event...

LesSynder: There are some injuries that are not survivable without the timely use of a tourniquet. I strongly urge you to help your RN change his/her mind. If you’d like me to find references for you to use, I’m glad to help.

Chaos... sorry, I should have prefaced that it was immediately after Columbine in 1999 (pushing 20 years ago)... at the time data learned on battlefield survival from the GWOT on the use of tourniquets was not widely available... and the old "don't use a tourniquet" by un-trained individuals was pretty common... I had good information from a friend at SOCOM at the efficacy of tourniquets, but at least I got the Kerlix included to pack off wounds, and the petroleum gauze for a pneumo thorax... I've been retired 9 years, and I hope they are still in place, and have been upgraded... thank you for your concern

No apology necessary -- I clearly remember being trained that tourniquets were not to be used by non-professionals during those years.

Petrolatum gauze is better than nothing for tension pneumothorax, but I strongly prefer the Hyfin Vent Chest Seal 2-pack.

Interestingly I have been doing a bit of rethinking and re-shuffling of FA Equipment lately, including TQs and other trauma supplies. Originally I carried only 1 Proper TQs in my Mil Belt Kit. Now after much discussion and rethinking I now carry two in my Mil Belt Kit and have moved my SWAT-T into my personal FA hiking kit and my older TQ into the kit in my vehicle (where I sadly did not have one at all. I think we all need to take advantage of the better Trauma supplies that have become available over the last decade and rebuild our FA Kits on a more regular basis.

While we're learning art history and the pythagorean theorem to be "well rounded" and prepare us for life, I'd like to see first responder training taught as a high school class.

I use CATs primarily

I agree. Advanced First Aid, or a rough equivalent, should be a mandatory requirement for high school graduation

at least most of the local PD and Sheriff's deputies (Pasco Co. Fla) have CATs on their duty belts...