Mom, who believes we need a bunch of tourniquets, is concerned about the $30 price tag on the C-A-T. She looks into cheaper, generic tourniquets with the same design and discovers the Recon Medical Tourniquets.

https://www.reconmedical.com/tourniquets/gen-3-tourniquets/

Her arguments include, which of the two is better: Have just a few name-brand tourniquets and run out or use the generic tourniquets and not run out? Mom has the money. If she believes we need more tourniquets, she can afford them. I don't want to trust my life or the lives of others to Chinese counterfeits. She points out that this tourniquet, reviewed by 1,833 customers, got 97% positive feedback if you add up the four and five-star reviews.

https://www.amazon.com/Recon-Medical-BLK...customerReviews

Am I just being a purest as Mom implies or do I have a legitimate concern? She will buy one for now and see how it compares to the C-A-T trainer that I have.

Jeanette Isabelle

Why?

To have tourniquets in different locations.

Jeanette Isabelle

I bought the recon brand along with the swat T , for pressure bandage
MTC YMMV

I would not trust my life to a counterfeit TQ. Sure, lots of positive reviews but I bet not one in fifty of those reviewers ever actually used it for real, probably far less. TQs are absolutely necessary very often but if you really need one and it breaks, whoever you're putting it on may well die.

I read somewhere that if the patient doesn´t scream with pain then the tourniquet is not tight enough.

Thanks for the vote of confidence, now to convince Mom of that.

She plans to order one Recond tourniquet (if she has not already) to see how it compares with my C-A-T trainer. Hopefully, the proof will be in the pudding.

Jeanette Isabelle

MTC is not among the list of acronyms. What does this one stand for? We need to add it to the list.

Jeanette Isabelle

A review by someone without actual experience is worthless. For something as potentially critical as a TQ, a price differential of less than twenty bucks is inconsequential.

What is a human life worth???

I think we have that well established. The problem is to convince Mom of that.

Jeanette Isabelle

“Penny Wise, Pound Foolish” comes to mind.

MTC. My Two Cents

Thank you. The administration needs to add that to "ETS Acronyms," which is a locked thread.

http://forums.equipped.org/ubbthreads.php?ubb=showflat&Number=182658#Post182658

Jeanette Isabelle

Well, its a tourniquet, not a defibrillator. This is not improved technology on display, but aggressive marketing. Black dyed tactical toilet tissue is not more functional than Charmin.


We used tourniquets professionally, occasionally to be sure, in the ER. Usually used a blood pressure cuff, but occasionally improvised with fabric and a big kelly clamp, if the blood pressure cuffs leaked and lost pressure. We used a cuff because applying less pressure over a wider area of the artery was less likely to traumatize the vessel. But there is no magic involved: a loop of 550 cord, a piece of webbing, tightly wrapped coban, ace bandage or duct tape can all be or direct digital pressure can be perfectly effective in slowing or stopping arterial bleeds.
Tourniquets buy some time to definitively treat the wound by ligating the artery and cleaning and dressing the defect. While the tourniquet is in place, all of the tissue that is perfused by the arteries involved is dying. Better to lose a limb than a life, but one has to have a plan for care of the patient after the tourniquet is applied.

Anyway, lots of money is made in the marketing of tacticool equipment. Not all of the items sold perform their function better than traditional methods: be a wise shopper.

Nursemike, your comments are most enlightening.

My experience has been that the most generally useful item in my FAK has been a 3" or 4" Ace bandage - good for splinting, direct pressure, and all sorts of applications. This has been in non-urban situations where access to an ER was sketchy, to say the least. Although I routinely carried and used a BP cuff on SAR missions, I never had to use one as a TQ. Direct pressure almost always sufficed.

our typical victim had incurred massive trauma, usually from a fall or slip. Gunshot wounds were far less common, and I imagine a TQ would be more generally useful in that situation.

Our plan was to convey the victim to the ER ASAP, where definitive care and expertise awaited. Rapid helicopter transport saved a lot of lives. Only so much you can do in a field situation.

We tested a number of counterfeit tourniquets to destruction, along with real CATs and others.

I wouldn't buy these.

"Black dyed tactical toilet tissue is not more functional than Charmin."

What if they were in camo?

I have not evaluated camo TP, and therefore have no opinion.

Obviously a daunting task, since they would be hard to see

Concur, Hikermor.

If I were to chose a single product to oversupply for teotwawkistan scenarios, it would be an assortment of 3,4 and 6 inch ace wraps. A generous combination of kerlix and ace can control bleeding or immobilize a limb, and look darn good doing it. Safety pins, too cuz I don't trust velcro or those pokey little ace clips to secure elastic bandages, tho coban does a nice job.

The question really becomes is my life, the life of my friends, family members and anyone else I may need to use a TQ on only worth a second-rate product? The Recon Medical TQ is a second rate product, a cheaper adaptation of a couple of proven (tested) TQ.

The Recon Medical TQ has gained some popularity due to its price and to be fair it works better than many of the alternatives TQs on the market. I know of a legitimate save using a Recon Medical TQ. I have also seen more than one fail in training with a single application. They are also somewhat more difficult to self-apply compared to a SOF-T or CAT.

At work and in my personal kits my primary TQs are either SOF-T(W) (prefered) or CAT (gen 6 or 7) while I do have some SWAT-T elastic band "TQs" I keep them mostly for there versatility as pressure dressing and for use on little people.

All of these I have used with success on real patients. All of these we have trained on heavily and regularly. Both the CATs and SOF-T(W) have a significant amount of data supporting their capabilities from studies done by third parties.

I will never recommend any product I would not choose to use myself. I would not personally buy or choose to carry a Recon Medial TQ because I cannot trust them.

A TQ alone does not make a IFAK or a bleeding control kit.
Any TQ is worthless if it isn't with you.
Most medical equipment is nearly worthless without training,

It is great to hear from thoseof us with actual experience. Thank you very much.

Why would you want to limit yourself to one product?

Jeanette Isabelle

I'm not an expert at all but one of my best friends is an EMT. He also said the Recon TQs have broken in a single application. He only carries CAT and SWAT TQs.

A note about the SWAT TQ, while I do like them and believe they have their place as a secondary TQ because of how well they work on smaller people and as a pressure bandage. I cannot recommend them as a primary TQ; they are much more difficult to self-apply than a CAT or SOF-T.

First, I'll say there's absolutely zero (zilch, nada) reason for a real CAT tourniquet to cost as much as it does. We mass produce far more complicated things for far cheaper -- it costs as much as it does because that's what the market will bear, especially when a lot of your customers are Government (local, state, federal)

Tourniquets aren't rocket science, nor do patients have to scream to have them on correctly -- they need to be tight enough to occlude the artery and stop the bleeding, which you can simulate in practice by tightening them up enough that you no longer feel a distal pulse. It's not particularly comfortable but for most of the population certainly not unbearable.


I only use the real CATs in my kits, and plan to even if it's something I have to acquire over time due to cost. However, in all likelihood, the generic tourniquet listed will work just fine -- the real danger with improvised tourniquets is using something too thin which may cause lasting tissue damage. As a CAT knockoff, we know the width (which matches that of the CAT) is sufficient for safe use, so really as long as the thing doesn't break, there's no reason it shouldn't work. That boils down to their QC, consistency, the strength of the plastic buckles, windlass, susceptibility to UV or other environmental damage, etc. That's a call you'll have to make after an assessment of your needs, risks and what you can afford.

You are correct. A tourniquet is not rocket sience. However, It needs to work 100% even in unforgiving environments, even when the user is under duress.

It's like buying a parachute. A Chinese parachute may get a 98% rating on Amazon; the 2% who gave it a thumbs down are from family members of deceased skydivers.

Jeanette Isabelle

Just a voice from the peanut gallery. There is a lot more involved in reasonably competent first aid than administration of a TQ. Detection and proper treatment of a possible spinal injury, for instance....

No disagreement, that's why I only use the real ones and don't advocate that others use anything but the real ones either.

We could reframe the question, though -- if you didn't have a CoTCCC recommended tourniquet with you (Let's say because of expense, you could only budget for one or two and they're in the car or at home), or exhausted your supply, and have to improvise, what are you going to use?

Non CoTCCC recommended tourniquet that you happen to also have (like SWAT-T)? What about a Crevat and stick? Blood pressure cuff that might leak air slowly? 550 cord that we know will cause lasting damage? A belt that can't get tight enough and we have to hold onto? All could work to save someone's life, but may not. The question isn't "is a knockoff tourniquet as good as the real deal" the question might be: is it better than whatever improvised tourniquet you'll use instead?

Amazon reviews are hard to go by because of those 1,800+ people almost 0 of them have used them in a life or death situation as you point out.

It's possible the Recon Tourniquet has fundamental flaws that makes it even worse than improvising a tourniquet. It's also possible that the Recon Tourniquet is as good or even better than a CAT, which itself has seen 7 generations of changes and improvements... we just don't know. The catch 22 is it's very difficult to introduce a new tourniquet to the market because of liability, and institutions want to go with what is proven through years (if not decades) of real world use, which means they aren't going to take a chance on something new (why would they?). It's a chicken and egg situation. Nobody will use the new ones until they're proven in the field, but how can they be proven in the field if nobody uses them?

I would always advise to go with what's proven because I certainly don't want to be the guinea pig (if I can help it!), but that's of course up to an individual to make their own decision once they consider the available information.

Sometimes a TQ just won't suffice.

My EMT instructor, a former Navy paramedic, once rode with a patient to the ER, his fingers clamping her carotid artery all the while. A TQ would have had bad consequences in that situation.

You probably won't find this procedure in any manual. he was later sued, unsuccessfully, by the patient for facial disfigurement.

No single tool or device can save every patient and not all wounds are survivable.

This is, of course, 100% correct.

I was trained to think about three classes of patient:

• Patients who will survive without any interventions
• Patients who will die no matter what
• Patients who will survive if I execute the correct intervention(s) correctly, quickly enough

That third class patients should be the focus of any “stop the bleed” or trauma-for-non-medical-professionals training. The goal should be to keep them alive to get them to definitive care.

While I’ve been fortunate enough to receive some training for medical treatment in austere conditions (where definitive care is many hours or some days away) it’s long been my desire to take more training in this area.

That's kind of what I was getting at, Chaos. A TQ might not be enough but it's another tool in the tool box, and one I like to keep with me while shooting or in the woods. I really do need to get a bit more training, too.

With no further comment, NOLS Wilderness Medicine Training Courses.

I believe it was author W.E.B. Griffin who said "the true test of another man's intelligence is how much he agrees with you" -- you're obviously very smart.



That's where I'd like to train next for sure.

I keep trauma kits in all our family cars. They each have at least 2 tourniquets each. Additional Ts in EDC and hiking kits. The only ones I use are H & H, TK 4, tourniquets exclusively. Stick simple, easy to self apply, can be flat folded, tests as equal or better than all the other leading brands. Marine and SEAL issue. Less than $10 on Amazon and labeled as an Amazon pick. Problem solved , inexpensively.

FYI, I spent a lot of time in the early- mid 1970s as a volunteer EMT on a very busy Ambulance Squad. We served an extremely dense , Northeastern location with many high rise buildings, 5 major highways ,big commuter bridges, many buses & trains, ( I.e. read pre auto crush zones, few seat belts, no shoulder belts, few crash padded interiors, engines and trans often found in front seats in a head on collision). I answered hundreds of trauma calls in bad muti-vehicle collisions, shootings, stabbings, assaults, etc. in spite of all of those calls, I only had to use a tourniquet in ONE call. It was a head-on bus collision in which the bus dash collapsed , both severing and sealing the driver’s amputated leg. We applied a tourniquet so the firefighters could cut the dash off his leg. He was lucky, well equipped and experienced rescue were quickly on scene , the wound was sealed by the crash and we were close to the hospital. He lived.

I can recount very similar experiences as a volunteer mountain rescue squad member. lots of injuries - mostly fractures and sprains, abrasions and gashes. We were most concerned with occult spinal cord complications that happen during falls and trips. We used backboards a lot.

We did deal with one amputation - a bystander rushed up to "assist" putting his shoulder into the spinning rear rotor of the helo, disabling both him and the bird. The arteries clamped and bleeding was minimal.

Just as well. Where do you apply a tourniquet on the shoulder? Direct pressure worked for the situations we encountered. Never applied a TQ in fifteen active years.

Unfortunately the TK4 is an ineffective design, which is too bad because it is a simple and compact design. CoTCCC removed it as a recommended TQ after it was removed from a study due to mechanical failures. I do not believe that a new version has been evaluated yet. It is no longer issued to US Military units.

The following is directive from Defense Health Agency following a study from Naval Medical Research Unit San Antonio LINK

Alan R., Thanx for citing that study. Clearly I missed it when I did my research. I note that it was a 2011 study and did not evaluate the improved models. The later anecdotal reviews are good. I guess I need to do more research and be prepared to replace my TK 4Ls , if I cannot find substantial improvement over the loner term. Mine worked fine, i.e. held and rendered lower pulse undetectable, when I tried the on myself. But you got my attention big time!

Was that in an S&M magazine or a medical text?

Personally, I wouldn't waste money to buy a high tech tourniquet. If you know the principles of how they work, and they are extremely simple, you can improvise one from so many different things.

Yeah, you're not going to be able to improvise a CAT scanner in an emergency, so go ahead and buy yourself one of those if you want. But a tourniquet should be easily doable with items that are probably within 10 feet of you at this very moment.

In my two decades as a paramedic on an ambulance, not once did I ever even remotely consider applying a tourniquet. Outside of a war zone, they are just not needed very often. Sure, you should learn how to create and use one, because there's a slim chance that you'll have to. But don't confuse the suggestion to learn how with thinking that you'll be using one frequently.

For those who aren't in the medical field, you're going to see a lot of people who are in the medical field saying they rarely used them in their careers.

This is partially because you really don't need them for the vast majority of cases, but also because for a long time it was thought that tourniquets would cause more harm than good if not needed and protocols tended to reflect that.

Through evidence based practice, experiences in combat has changed that mentality over time and slowly some departments started de-stigmatizing them as data regarding how long they can safely be applied has trickled down and become better understood. A properly designed tourniquet, properly placed, will not cause lasting tissue damage over the time periods we will most likely encounter before the patient is handed over to higher medical care. Further, if it turns out a tourniquet is not needed, it can generally be converted in the field to a regular pressure dressing safely (there are some caveats with regards to the time window in which this is considered safe, and how to do it).

I suspect, to a lot of people, it seems like a KISS solution to arrest extremity bleeding, and now that "being prepared" has become in vogue this last decade or so, it's unsurprising that their popularity has risen given their military use and recent proliferation in public safety circles.

We know that a lot of people tend to buy gear over training (unfortunately) and it's become a sort of badge of pride to acquire the cool stuff the Government uses -- but to a layperson who may not have ever really seen significant bleeding before in their lives, any amount of blood could very well be an alarming amount to them, which may result in a trend of tourniquets being used as first line rather than last resort.

Preaching to the choir here of course, but a lot of this can be mitigated through education and I really hope we see a day where the average person becomes literate in basic first aid even out of high school.

Guilty as charged. Well said, burncycle.

The medical professions tend to guard jealously their technology and job descriptions. I started in this line of work before emergency medicine residencies were invented, and witnessed the creation of ACLS, ATLS, paramedics and automated defibrillators. As each of these developed, wars were fought over the advisability of authorizing folks who were not doctors to perform them. The outcomes of pre hospital care have proven the viability of the plan.

I am not older than dirt, but dirt was brand new when I was born

The other mistake medical pros make is that they confuse THEIR context with YOUR context.

The injuries for which a tourniquet (TQ) is the right solution will kill you in 3-10 minutes, depending on the bleed. How long does it take an ambulance to reach you? When EMS and SAR guys say "I've never needed a tourniquet", how likely is it that they had a 3-10 minute response time to the injured party?

I didn't use a TQ in my EMS time either. But that's because by the time we got on scene, the patient had bled out and was dead.

Medical pros do so much work in a rather narrow, well-defined context that they begin to think everyone else's problems will be in that context too. It's just not true.

Consider an arterial bleed in these scenarios:

- pilot crashes, gets gashed by torn sheet metal
- logger slices open his leg with a saw
- hunter gets shot by another hunter who thought he was a buck

In each case, would EMS or SAR have arrived in 3-10 minutes? No. So their TQ usage rate is zero, and they think everyone else's rate will be zero.

Great points, Robert_McCall. A TQ is kind of like a parachute- if you ever need one and don't have one you'll probably never need one again. However rare their application they do save lives, and they're not always easy to improvise. Some of you may recall the logger in Wisconsin that had his leg amputated by a tree; he tried to TQ the stump with his belt but his belt broke! He hobbled to his truck and called 911, then drove as far as he could go before losing consciousness. By a miracle EMS met him halfway and he was saved but the amount of blood he lost was staggering, and there's no way he should have survived. So yeah, he survived without the TQ but I think it was more luck than anything.

In another case I can recall a guy at a public range was blasted through both legs with a .30/06 and survived. There were several guys there to help and improvised TQs were applied (leather belts, natch) and neither was adequate to stop the bleeding.

I carry a lot of things that I have never needed to use: Full coverage insurance on my car, a sidearm and spare mag, etc. Still I know that the fact I haven't used them yet doesn't mean I won't need them in the future.

And the flip side of that is when bystanders confuse a non-emergency with an emergency. They try to help, but not knowing what they are doing, actually do harm.

You see this occasionally - luckily quite rarely - when a bystander with good intentions starts CPR on someone who doesn't need it. Or slathers up a burn victim with their sunscreen cream thinking that will help. Or needlessly drags a person from a car wreck, thinking the car may explode, and paralyses them because they didn't take cervical precautions. Or applies a tourniquet when simple direct pressure would have solved the problem.

IMHO, the solution to the above is training. Everyone should take a basic first aid class. But unfortunately, that will never happen. For every untrained person who successfully apples a tourniquet under appropriate circumstances there will be a matching untrained person who makes a real mess of things and does damage under inappropriate circumstances. So we're stuck between a rock and a hard place.