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#293871 - 10/17/19 01:11 AM Re: Recon Medical Tourniquets [Re: Jeanette_Isabelle]
Phaedrus Offline
Pooh-Bah

Registered: 04/28/10
Posts: 2417
Loc: Big Sky Country
No single tool or device can save every patient and not all wounds are survivable.
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“You can tell whether a man is clever by his answers. You can tell whether a man is wise by his questions.” Naguib Mahfouz

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#293873 - 10/17/19 03:36 AM Re: Recon Medical Tourniquets [Re: Phaedrus]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3216
Loc: USA
Originally Posted By: Phaedrus
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.

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#293875 - 10/17/19 06:42 AM Re: Recon Medical Tourniquets [Re: Jeanette_Isabelle]
Phaedrus Offline
Pooh-Bah

Registered: 04/28/10
Posts: 2417
Loc: Big Sky Country
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.
_________________________
“You can tell whether a man is clever by his answers. You can tell whether a man is wise by his questions.” Naguib Mahfouz

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#293876 - 10/17/19 12:25 PM Re: Recon Medical Tourniquets [Re: Phaedrus]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5227
Loc: SOCAL
With no further comment, NOLS Wilderness Medicine Training Courses.
_________________________
Better is the Enemy of Good Enough.
Okay, what’s your point??

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#293877 - 10/17/19 02:53 PM Re: Recon Medical Tourniquets [Re: Phaedrus]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3216
Loc: USA
Originally Posted By: Phaedrus
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.


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.

Originally Posted By: Russ
With no further comment, NOLS Wilderness Medicine Training Courses.


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

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#293888 - 10/19/19 03:50 AM Re: Recon Medical Tourniquets [Re: Jeanette_Isabelle]
acropolis5 Offline
Enthusiast

Registered: 06/18/06
Posts: 358
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.


Edited by acropolis5 (10/19/19 03:53 AM)

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#293890 - 10/19/19 01:38 PM Re: Recon Medical Tourniquets [Re: acropolis5]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7054
Loc: southern Cal
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.
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Geezer in Chief

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#293904 - 10/21/19 07:12 AM Re: Recon Medical Tourniquets [Re: acropolis5]
Alan_Romania Offline

Addict

Registered: 06/29/05
Posts: 618
Loc: Arizona
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

Quote:
The NAMRU-SA study demonstrated:

(1) the poor performance of the TK-4,

(2) the significant risk to the casualty and the First Responder due to catastrophic TK-4 failures,

(3) that the DoD is already moving away from this device, and

(4) that there are much safer and effective, CoTCCC-approved extremity TQs available to warfighters.

Disposition/Instructions:
Remove tourniquet from all Service assemblages and dispose of per Service policy. Replace with CoTCCC approved tourniquet (CAT or SOFT-T tourniquet).
_________________________
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke

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#293918 - 10/23/19 05:15 AM Re: Recon Medical Tourniquets [Re: Jeanette_Isabelle]
acropolis5 Offline
Enthusiast

Registered: 06/18/06
Posts: 358
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!

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#293927 - 10/24/19 04:04 AM Re: Recon Medical Tourniquets [Re: Herman30]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2098
Loc: Colorado
Originally Posted By: Herman30
I read somewhere that if the patient doesn´t scream with pain then the tourniquet is not tight enough.

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.

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