Something else to consider would be the old ratchet-style. Big, bulky, but relatively easy to use and no confusing if you have to thread the TQ once or twice. Down side is cost, size and knowing how to thread a ratchet. You don't mention which university (ie, something trade=school would probably be have students more familiar with it). Back in the late 90's I was involved my campus EMS and we had a Chevy Astro decked out as a MCI vehicle. If you want to talk, you can PM me.
To fit all of your needs, cost being a big factor, I would go with the CAT. That way you can get a few extra to train with.
In no way do I make any money from anyone related to the firearms industry.
"I have never heard anyone say after a firefight that I wish that I had not taken so much ammo.", ME
"Texas can make it without the United States, but the United States can't make it without Texas !", General Sam Houston
The CAT is the easiest to use and cost effective option. If you are truly training idiots this is the only way to go.
The one way valve on a chest seal is mostly a mute point. Not placing a chest seal will kill the patient a whole lot faster than a TPX. A TPX from penetrating injuries develops slowly when compared to blunt or blast trauma. Also the one way valves all occlude with blood in semi short order. Also it would be completely unacceptable to place any chest seal and NOT BE REASSESSING the patient every few minutes, even in the setting of an MCI.
In my experience working with folks who have had little to no training the CAT has always been what ended up working the best. Ive taught a fair number of classes where we put the CAT and SOF-T against one another and, although performance to the TQs themselves were similar, most students preferred the ease of use that the CAT offered.
Thanks again to everyone for your input. We will definitely be using CATs at this point.
Things are actually moving along pretty well. I'm going to order TQs, chest seals, etc. for our students from what research shows to be a good company to deal with. Waiting for information from them on bulk pricing. In the mean time, is there a resource for old CATs that I can use for the training portion of the course at a lower cost than new? I'd rather not have the students train with the same ones they'll actually carry out of concern for wear and tear on the windlass, etc. Should I be checking the government liquidation sales I hear about? I don't care if they are old, have UV damage, or other problems since they would only be for training the students and never used in life threatening situation. I've found CAT training versions that are blue, but they cost the same as real TQs so I'd rather avoid those if possible.
Thanks for any further input. I'll try to provide more information as things progress and if anyone else is interested in developing a similar program at their place of work or schools, if the university allows it, I'll share slide decks and notes on the program once this first round of training is complete.
Last edited by EMT4hire; 02-23-14 at 11:13. Reason: Grammar
I've been in EMS for a few years now, and I'm trying to convince my employer to switch to the CAT as well. As stated, it's darn near idiot proof. Personally, I keep one in my range kit. It's easy to store, and for the cost, you can't beat it.
"If you aren't part of the solution, you're part of the problem."
CAT tq is probably the best and most effective. Just remember when its placed correctly, the tab will point towards the patient, not away. A couple twists and you're gtg.
A man with a gun is a citizen. A man without a gun is a subject.
I have to apologize both for resurrecting an old thread and also because this is way overdue. I can't give quantitative results but overall things worked out fairly well. We added and subtracted some things to the initial idea and just in case there is any interest, here are some of the things I took away from this since I just found my old notes. Sadly funding never materialized so after the pilot program I had to move on to greener pastures, but still got the initial group set up to handle some pretty serious injuries should the worst happen. And hopefully this has some value to someone else on the forum here as well.
Lessons learned that I can share:
New in wrap CATs sometimes hard to open under stress, but unwrapped (but still folded up) CATs in a ziploc or vacuum sealed package with easy tear cuts make things much quicker and easier for people understress. (Similar problem found with self-cling packaging but not as big a time concern so those were kept sealed)
Applying them became fairly easy for students within 2 weeks of biweekly evening meetings. While the rate of success is likely higher due to limited means of adding significant stress, After a couple weeks, we were about 88% correct applications under cold start conditions (So no practice or anything like that before sending them in to the room with the test dummy) Still above 80% correct applications after no meetings for a month. Though checking in with students in the last few weeks makes me think that number would be lower now, not everyone has been practicing with any regularity. (Any other organizations considering implementing something like this would definitely want to have some sort of routine in-service training to maintain competency)
We dropped chest seals from these kits as I discovered, even the kit I kept in my bag where I tried to take care of it got fairly beat up after about 2 months. I have very little hope that they would survive being bounced around in a student's backpack with books, laptop, etc. for any meaningful amount of time.
Wound packing skills and materials lasted in at least once case. The various Z-fold gauze packs and coban seemed to withstand the abuse of backpacks. I met with one student about a year on and asked to see the shape of his kit. CAT, self cling and gauze were all still in reasonable shape. Student could still demonstrate the ability to pack as much gauze as possible and then secure with no difficulty. anecdotal but I'd like to think the comparative simplicity would mean other students would still be able to perform this skill as well.
The big takeaway for me was this is much easier to get going when you have motivated students. They all came to the program from an extra-curricular organization focused on medicine, so I would say that if anyone else was interested in developing a program along this idea, look for these motivated groups. Given a limited budget, I'd say they make up the best starting point for something like this. I wish I could have had a true control group of randomly selected students and staff to actually back up that assertion but that just wasn't in the cards.
The big takeway for everyone reading this is that not all millenials are a lost cause. And that with very little investment, if you are a motivated individual, you too can invest a small amount of time and money to be much better prepared for dealing with the medical aftermath of an active shooter. I guess I'm preaching to the choir on this sub-forum but it's not a bad message to pass on to friends and family. Actually I ended up putting a similar kit together for a family member who does a lot of travel to industrial sites in various developing nations and he really appreciated it.
Last edited by EMT4hire; 09-19-17 at 17:00. Reason: typo and clarity.
Since it wasn't mentioned I wanted to throw in the RMT (ratcheting medical tourniquet) into the mix for consideration of the members. I've training with and carrying one for a few months and I am most likely going to be switching over to RMT's exclusively going forward. They are about as "idiot proof" as it gets. They have a bite strap for one handed operation, the ratchet is sturdy and works well and the RMT comes in several different sizes including a pediatric size. Standard adult TQ's do not work on children or animals, so having a specific TQ for them is essential in my opinion. The best part is that the RMT is designed for training and use without having to purchase a "training" version or something like that. The one you train with is the one you can carry.
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