Tourniquets - Back in Fashion

MedicDelta

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Hey guys,

What are your thought on tourniquets? Personally, I couldn't support them more. And I believe that if you don't then you probably need to get some more education on them or you have a out of date thought process. Tourniquets are back in fashion, and are not just for tactical medicine. Studies have proven their effectiveness and that it would take 4 hours or more for a limb not getting any blood to actually have to be amputated. Most modern tourniquet protocols involve removing the tourniquet every 20 minutes or so anyways. So what's your take on tourniquets? Does your EMS agency carry them on their rigs? I personally have 2 in my own kit, they're one of the most important pieces of equipment out there in my opinion.

Here's an awesome video by an EMT-P/SWAT medic about tourniquets. If you don't know much about them, want to know more, or don't believe in them I encourage you to watch this video.
 

DesertMedic66

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We carry them but don't get used often at all. In 3+ years I have never needed to apply one. Direct pressure works wonders when applied correctly.
 

TransportJockey

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Used three of them in the last six months. I'm a big fan of them
 

Akulahawk

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A good friend of mine really introduced me to tourniquets as a method of bleeding control. Although I had been introduced to them back in EMT school way back when, it really wasn't until a few years ago that I came to appreciate the CAT and similar tourniquets. He's a Corpsman and a good one at that. He teaches first aid and then some... I have to say that the "newer" commercial tourniquets are generally easier to use and apply and usually will stop someone from bleeding out... well at least from extremity wounds. As a result of what I've learned from him, I'm much more likely to use a tourniquet early on than I used to be.
 

chaz90

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Yep. Used them 2x in my career so far and they've worked where pressure alone did not both times. On each occasion I've also utilized a hemostatic dressing. Our agency carries one commercial tourniquet in each set of gear, meaning there are 2x per truck. Every BLS ambulance has a few available as well.
 
OP
MedicDelta

MedicDelta

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We carry them but don't get used often at all. In 3+ years I have never needed to apply one. Direct pressure works wonders when applied correctly.
Absolutely, it usually does in the civilian pre-hospital world where GSWs and major trauma are more rare than in a combat environment. But hey, if you ever need them then they're there.
 

TransportJockey

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Tqs work amazingly well in industrial accident type settings. Oil rig accidents are two of the three times I've used them.
 
OP
MedicDelta

MedicDelta

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A good friend of mine really introduced me to tourniquets as a method of bleeding control. Although I had been introduced to them back in EMT school way back when, it really wasn't until a few years ago that I came to appreciate the CAT and similar tourniquets. He's a Corpsman and a good one at that. He teaches first aid and then some... I have to say that the "newer" commercial tourniquets are generally easier to use and apply and usually will stop someone from bleeding out... well at least from extremity wounds. As a result of what I've learned from him, I'm much more likely to use a tourniquet early on than I used to be.
That's awesome man, they really are a very effective tool that could potentially save someone's life. Life over limb any day.
 

TransportJockey

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Does your agency carry the Combat Application Tourniquet(CAT)?
Yep. We carry four of the orange CAT TQs on each truck. Two in our first in bag and two on the truck
 
OP
MedicDelta

MedicDelta

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Yep. Used them 2x in my career so far and they've worked where pressure alone did not both times. On each occasion I've also utilized a hemostatic dressing. Our agency carries one commercial tourniquet in each set of gear, meaning there are 2x per truck. Every BLS ambulance has a few available as well.
Hemostatic agents can really work like a charm as well. Stuff like QuikClot or Celox has really advanced over the years.
 

STXmedic

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OP, have you messed with the IT Clamp at all for moderate bleeds or in conjunction with Combat Gauze?
 
OP
MedicDelta

MedicDelta

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Yep. We carry four of the orange CAT TQs on each truck. Two in our first in bag and two on the truck
4 is a good number. I'm a firm believer when something is that important, 2 is 1 and 1 is none. Meaning if it's that important, carry 2... Or 4, even better.
 
OP
MedicDelta

MedicDelta

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OP, have you messed with the IT Clamp at all for moderate bleeds or in conjunction with Combat Gauze?
No I haven't used something like that, I actually had to look up what that was. Hemostatic agents like QuikClot Combat Gauze I'm familiar with though.
 

STXmedic

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We're about to start trialing it where I'm at. Just had to sit through a train the trainer program a few days ago. If it works like they claim it does, it sounds interesting.
 
OP
MedicDelta

MedicDelta

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We're about to start trialing it where I'm at. Just had to sit through a train the trainer program a few days ago. If it works like they claim it does, it sounds interesting.
Is it for BLS and ALS providers?
 

STXmedic

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Is it for BLS and ALS providers?
It's simple enough for BLS providers, but our initial contract is only outfitting our ambulances, which run dual paramedics. The rep voiced several times though that the USMC was in the process of signing a contract to get them put in all of their soldier's IFAKs.
 
OP
MedicDelta

MedicDelta

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It's simple enough for BLS providers, but our initial contract is only outfitting our ambulances, which run dual paramedics. The rep voiced several times though that the USMC was in the process of signing a contract to get them put in all of their soldier's IFAKs.
Ahh I see. Well if the military is looking at them they must be fairly effective. I'll have to do some more research on them, find out more about them.
 

Handsome Robb

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We carry the SWAT-T. Used it more than a few times. My favorite part is if you don't need it as a TQ it makes an awesome pressure bandage to free up hands.

I'll try to find the source but a military helicopter pilot went down and had a TQ on his "cyclic" arm for like 16+ hours before he was rescued and delivered to a surgical center. Took ~ two years but he's flying again with no deficits in that arm.

Does anyone carry junctional TQs?
 

EpiEMS

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We carry the SWAT-T. Used it more than a few times. My favorite part is if you don't need it as a TQ it makes an awesome pressure bandage to free up hands.

I'll try to find the source but a military helicopter pilot went down and had a TQ on his "cyclic" arm for like 16+ hours before he was rescued and delivered to a surgical center. Took ~ two years but he's flying again with no deficits in that arm.

Does anyone carry junctional TQs?
Glad to hear you like the SWAT-T, I've never had occasion to use it, but it seems like a very convenient option (small, cheap, and multipurpose).

I'm definitely a fan of the MAT, has a nice ratcheting action -- I find it to be easier to place (at least, in practicing with it) than the CAT. Curious if anybody uses the MAT.
 

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