Which Tourniquet do you carry?

[longball]

I carry 2 SOFT-W TQ's with me all the time & I keep 4 CAT's in my trauma kit in my car. I'm a retired Army medic, TC3 instructor, am currently an EMT for a 9-11 service, and a paramedic student. The modern CAT AND SOF-T-W are my go to choices for life threatening hemorrhage control. In theater I have seen the CAT AND SOF-T left in place or replaced by cleaner TQ's by surgeons until they have achieved hemostasis in the Operating Room. Sacrificing a limb for a life has been dispelled by observations and studies by the Comitee on Tactical Combat Casualty Care. Civilian pre hospital care providers (ER Physicians and EMS agencies nationwide) have adopted some of the principles of TC3, specifically that manufactured or improvised TQ are the method of choice and a best practice for life threatening bleeding.

I understand and do not disagree. Not knowing who people behind these screen names are, what I was trying to convey is that more options are better. I have seen people reach for a TQ when they are hours from a hospital for a bleed that was controlled with a handful of 4x4s and stretch gauze. Call me crazy but that's not a situation where I want a TQ on my limb.


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[ST911]

I understand and do not disagree. Not knowing who people behind these screen names are, what I was trying to convey is that more options are better. I have seen people reach for a TQ when they are hours from a hospital for a bleed that was controlled with a handful of 4x4s and stretch gauze. Call me crazy but that's not a situation where I want a TQ on my limb.

That's reasonable. The key is to not dither with other methods when indication for a TQ is obvious. That was common in legacy methods, and early in the TQ revival of recent years. Still is, in some places.

[longball]

Absolutely. If I came across as discouraging their use when indicated I apologize. If there is a need cinch that thing down.


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[TacMedic556]

SOF-T and CAT.

[hotrodder636]

SOF-T in my range bag with my IFAK. I would like to get another or a couple CATs

[Mr. Goodtimes]

I keep a couple CAT's in the truck medical bag and I keep a CAT in my hiking pack. They're free from work.


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[Mr. Goodtimes]

I understand and do not disagree. Not knowing who people behind these screen names are, what I was trying to convey is that more options are better. I have seen people reach for a TQ when they are hours from a hospital for a bleed that was controlled with a handful of 4x4s and stretch gauze. Call me crazy but that's not a situation where I want a TQ on my limb.


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It's from a lack of education and/or field experience. Your average tactical Timmy who reads forums and watches movies sees how heavily it's recommended to keep a TQ, combined with a lack of field experience in seeing what actual serious bleeding is, and you get someone throwing a TQ on a leg with a laceration that resulted in some capillary or venous bleeding.

I get it... if someone is shooting blood from their femoral artery and we're 30 min from a trauma center, I'll probably skip to a TQ but short of that, I'm at least going to try some direct pressure and gauze. But people who have never seen blood before see a little red shit on the ground and a hole in someone and all of a sudden it's "ERMAGERD TQ TQ TQ, QUICKCLOT QUICKCLOT QUICKCLOT!!!!!!"

Many people also don't realize the huge difference in field medicine CONUS vs OCONUS in somewhere like Afghanistan. Rural areas sometimes being an exception.

The order i was taught in school was direct pressure, elevation, pressure point, quick clot, TQ, although that was about five years ago. Obviously, that's also a guideline, and street medicine happens in a different order when indicated, but it's a good guideline nonetheless. People need to really consider what's actually appropriate treatment for what they're treating before they toss QC in a wound or slap a TQ on.

I would consider the type of bleeding and how much, mechanism of injury, location of injury and location of nearest appropriate hospital/transport time and go from there.




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[ST911]

It's from a lack of education and/or field experience. Your average tactical Timmy who reads forums and watches movies sees how heavily it's recommended to keep a TQ, combined with a lack of field experience in seeing what actual serious bleeding is, and you get someone throwing a TQ on a leg with a laceration that resulted in some capillary or venous bleeding.

Blood pours help with that. Many have never seen more than a few cc's outside of the body, nor do they realize how much you can lose.

The order i was taught in school was direct pressure, elevation, pressure point, quick clot, TQ, although that was about five years ago. Obviously, that's also a guideline, and street medicine happens in a different order when indicated, but it's a good guideline nonetheless.

That guideline has hung on in some basic first aid curriculums, but it's mostly gone otherwise. Where did you encounter it? When studied the elevation and pressure points weren't found to do much of anything, and had students getting stuck in algorithms rather than treating patients. See also: elevating legs for shock = gone. Current is direct pressure via manual or mechanical application (pressure dressing, pack), following by a TQ for an extremity. That's it.

A big reason direct pressure fails is that people are generally doing it wrong. Direct pressure isn't holding a dressing in place, it's sustained aggressive pressure and compression to bleeding tissues. Done correctly, it works more often than most would believe.

[Mr. Goodtimes]

Blood pours help with that. Many have never seen more than a few cc's outside of the body, nor do they realize how much you can lose.



That guideline has hung on in some basic first aid curriculums, but it's mostly gone otherwise. Where did you encounter it? When studied the elevation and pressure points weren't found to do much of anything, and had students getting stuck in algorithms rather than treating patients. See also: elevating legs for shock = gone. Current is direct pressure via manual or mechanical application (pressure dressing, pack), following by a TQ for an extremity. That's it.

A big reason direct pressure fails is that people are generally doing it wrong. Direct pressure isn't holding a dressing in place, it's sustained aggressive pressure and compression to bleeding tissues. Done correctly, it works more often than most would believe.

EMT-B course in 2012. I start EMT-P in fall though so I would be interested to see if it's still in the book, from what you say it doesn't sound like it.

Like I said too, it's the order I learned in class however, it's not the order I do things in on the street. If It's an extremely and I can't control it with direct pressure, it's going to get a TQ. Where I work were never more than 30min from a trauma center.


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[VARIABLE9]

I currently have on my person or vehicle (most all times) SWAT-T, however with my firearms gear (range, bump in the night) a SOF-TTW. I read through the post, it definitely seems CAT and SOF are the preference. Any thoughts on the SWAT? I have limited training, however do practice with each - I know I need more medical training though and am loking into that. TIA