University of Texas Dell Medical Center Study on Tourniquet use by Civilians

[Esq.]

https://www.trauma-news.com/2018/04/...-in-mortality/


Not NEW information but to the extent that you still have people who question the use of tourniquets, I can't think of a more authoritative source nor relevant study.

[chuckman]

https://www.trauma-news.com/2018/04/...-in-mortality/


Not NEW information but to the extent that you still have people who question the use of tourniquets, I can't think of a more authoritative source nor relevant study.

Conventional trauma management is still behind the times, by about 5 years. The gold standard courses--ATLS for physicians, TNCC for nurses, and PHTLS for everyone else--still cling to the old ways. I am trying to change this in my institution, but it's largely jousting at windmills.

[EvanDuffy]

Conventional trauma management is still behind the times, by about 5 years. The gold standard courses--ATLS for physicians, TNCC for nurses, and PHTLS for everyone else--still cling to the old ways. I am trying to change this in my institution, but it's largely jousting at windmills.

In what aspects it is behind times? just interested.

[chuckman]

In what aspects it is behind times? just interested.

It is still largely driven by ABCDE instead of MARCH, still 2 large-bore IVs, it treats permissive hypotension as something to consider rather than the current doctrine. It's the nature of institutional medicine plus textbooks/curricula that hasn't caught up to research and current practice. It will in the next iteration, but it takes forever.

[SBRSarge]

It seems some still cling to the belief that once you put a tourniquet on, the patient will loose the limb.

I still thought that until I got some training (Dark Angel) and got a new, updated perspective.

[SpencerDixon]

Any change in any industry is always time-consuming.


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[Esq.]

Conventional trauma management is still behind the times, by about 5 years. The gold standard courses--ATLS for physicians, TNCC for nurses, and PHTLS for everyone else--still cling to the old ways. I am trying to change this in my institution, but it's largely jousting at windmills.

Here's what's funny to me about that- in Major surgeries, physicians regularly clamp off blood flow etc...and think nothing of it....How is a tourniquet any different?

[chuckman]

Here's what's funny to me about that- in Major surgeries, physicians regularly clamp off blood flow etc...and think nothing of it....How is a tourniquet any different?

It's really not; in fact, it (TQ) is actually safer. It's a whole paradigm shift in a way of thinking that is over 75 years old. As the current generation of providers age and move out, and the curriculum catches up, it will be good.

How's this to blow your mind: in my institution, only physicians--not nurses, not paramedics who work in the ED, not mid-level providers--can put on a tourniquet.

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[okie]

Nice. I just started putting together a small IFAK, and this makes me feel slightly less silly in doing so. I've narrowed it down to tourniquet, combat gauze, chest seals, trauma shears, nasopharyngeal, and pneumothorax. If there's room left, I'll add an Israeli bandage and maybe a space blanket.