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Author Topic: Combat tourniquets?  (Read 704 times)
MillCreek
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« on: January 07, 2017, 07:17:16 PM »

http://www.usatoday.com/story/news/nation-now/2017/01/07/ex-seal-battlefield-medical-techniques-needed-civilian-shootings/96293394/?utm_source=feedblitz&utm_medium=FeedBlitzRss&utm_campaign=usatoday-newstopstories

So the thinking on tourniquets has done a 180 degree turn in recent years.  This was not covered at all in my paramedic training 30 plus years ago. 

Does anyone have current knowledge on tourniquets and can recommend some training materials?  I am pondering buying one for the house and each car to have on hand.
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« Reply #1 on: January 07, 2017, 07:29:49 PM »

I like the SOF-T wide model

So long as you get the victim to a hospital within a reasonable amount of time (preferably within the hour and at least within 4 hours from what I've heard) is that damage will be minimal

Plenty of people who still believe that TQ use means automatic loss of the limb. Obviously combat experience has proven this wrong

TQs are not only applicable to shootings but are good for industrial/logging accidents. Nobody in these fields gives any thought to more advanced medical care than a basic first aid kit. I know of lives that could have been saved had TQs been available along with Israeli bandages
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Andiron
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« Reply #2 on: January 07, 2017, 07:50:39 PM »

CAT for the win.

https://www.amazon.com/Application-Tourniquet-Improved-Version-American/dp/B00MA6XVVC

Simplicity itself.

I don't have manuals, but my training was slap the CAT on a limb squirting blood, scribble T and time somewhere visible and call CASEVAC. 
« Last Edit: January 07, 2017, 08:22:06 PM by Andiron » Logged

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Unisaw
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« Reply #3 on: January 07, 2017, 08:42:29 PM »

I'm researching them, too.  It seems that CAT and RATS are both good choices.  However, I have no personal experience.
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Fly320s
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« Reply #4 on: January 08, 2017, 01:52:46 AM »

SOF-T and CAT are both good.  Those seem to be the go to brand these days.  I'm not familiar enough with the RAT, but I have heard it is good to go.

AS for training, there are plenty of good options.  Books, videos, YouTube are available at low cost.  For hands on training, see if your local EMS people have any recommendations.  If you want gunshot wound specific training, look to Dark Angel Medical.  They have travelling classes.

http://darkangelmedical.com/
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Devonai
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« Reply #5 on: January 08, 2017, 05:57:58 AM »

The US Army Combat Lifesaver manual is good for a reference that is beyond basic first aid, but of course not as extensive as full blown medic training.

Last year I got an Individual First Aid Kit from Midway USA for $50 which included the CAT (but not the Quik-Clot). Unfortunately they are out of stock right now but you can sign up for an email alert if they get more.
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« Reply #6 on: January 08, 2017, 06:25:21 AM »

I prefer the SOF-T or SOF-T wide but it's just a personal preference as for all practical purposes I don't think it works any better or worse than a CAT. IMO the wider the better as it is more effective at stopping bleeding and less likely to cause damage to vessels and nerves at the application site.

That said versions like RATS do have an advantage in that they travel well. I'm highly considering having SOF-T's stashed or in med bags where there is room, while something like a RAT would be good for more compact bags or carrying around at a quick range trip and such.
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« Reply #7 on: January 08, 2017, 07:33:18 AM »

Dark Angel Medical sells several along with ready to go kits.

http://darkangelmedical.com/tourniquets/
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MillCreek
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« Reply #8 on: January 08, 2017, 08:34:01 AM »

So the Combat Lifesaver manual was an excellent suggestion.  In Googling, I found several locations and downloaded the PDF for review.
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« Reply #9 on: January 08, 2017, 08:46:17 AM »

I have Israeli bandages and Quik Clot sponges, but no tourniquets. I need to change that, but just saw a bajillion choices for CAT tourniquets on Amazon. Is any one manufacturer better than the others?

Yes I will check out the combat lifesaver manual and other training sources before just buying one and sticking it in my kit. Smiley
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HankB
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« Reply #10 on: January 08, 2017, 10:48:45 AM »

I have no medical training, but I've heard that nosebleeds can be stopped by a tourniquet around the neck . . .






(OK, that was my bandwidth waste for the day.)
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Devonai
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« Reply #11 on: January 08, 2017, 11:37:50 AM »

I'm glad the manual was easy to find. I took the course (40 hours) back in 2006.

I have Israeli bandages and Quik Clot sponges, but no tourniquets. I need to change that, but just saw a bajillion choices for CAT tourniquets on Amazon. Is any one manufacturer better than the others?

Yes I will check out the combat lifesaver manual and other training sources before just buying one and sticking it in my kit. Smiley

I just pulled out the one in my kit, it is made by North American Rescue, Inc. NSN 6515-01-521-7976.
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« Reply #12 on: January 08, 2017, 02:59:11 PM »

Thanks Devonai.
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« Reply #13 on: January 08, 2017, 03:48:22 PM »

SOF-T Wide rides on my gun belt for classes etc.

Double check where you buy a SOF-T or CAT from. There's Chinese copies around for the Airsoft market.

Israeli trauma bandages are good too because they provide good compression and have the plastic pressure bow that can be used either to press the bandage onto the wound, or twist the wrapping as a pseudo-tourniquet.
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« Reply #14 on: January 08, 2017, 04:40:34 PM »

I have no medical training, but I've heard that nosebleeds can be stopped by a tourniquet around the neck . . .






(OK, that was my bandwidth waste for the day.)


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« Reply #15 on: January 08, 2017, 06:41:28 PM »

I highly recommend the SOF-T. Only one I had personal experience with, putting it on another person. Easy to apply, secure. It can be applied with one hand, which is important. You can tell if it's real, they're strong as hell.

Rule of thumb, if shooting/squirting blood, severed major vein/artery or significant limb mangling, use a tourniquet. Get to a hospital immediately. Or EMTs. Longer time goes on, more likely of damage. 4 is the shortest time for losing limb, but routinely many times that. 8 is more common. Generally you really don't want to loosen up a tourniquet after applying it. It is/can be done, but by medical folks, not any of us.

Apply at least two, three inches above wound (ie towards torso). Below the elbow or knee is better than above it when possible.
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MechAg94
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« Reply #16 on: January 09, 2017, 07:03:45 AM »

https://www.studentofthegungear.com/collections/medical-gear/products/enhanced-pocket-life-saver-3-0?variant=6076684549
I listened to an interview with this guy.  He sells pocket kits with tourniquets.  I think he does training also.  I have no idea what the types are.  That is training I would like to do some day.
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« Reply #17 on: January 09, 2017, 12:52:47 PM »

First time I was taught about tourniquets was when I took a wilderness first aid course before going on high adventure trip as a Boy Scout.  This was in the 80s.  Lesson was that you only do that as a last resort to stop major bleeding.  They taught that application of a tourniquet meant loss of limb, which is why it should only be done as a last resort.  Fast forward to the ALICE training I sat through last year (which was surprisingly good).  The medic kept it simple.  If you can tell the victim's heart is beating from watching how the blood pulses/spurts out of the wound, it's tourniquet time.  He explained to me that blood loss is more of a concern than damage caused by a tourniquet, much of which can be repaired if the victim gets to surgery quick enough. 

That said, I need to get a few.  Car kits, go bag, and one to donate to the Scout troop, just in case.
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« Reply #18 on: January 10, 2017, 11:43:43 AM »

I heard that's how democrats are made........ Popcorn Tinfoil Hat Smiley

Some, ayep. Word of warning, keep tightening though and eventually you'll turn into a Republican.   grin  Wink


https://www.studentofthegungear.com/collections/medical-gear/products/enhanced-pocket-life-saver-3-0?variant=6076684549
I listened to an interview with this guy.  He sells pocket kits with tourniquets.  I think he does training also.  I have no idea what the types are.  That is training I would like to do some day.

Any tacticool website will sell medical gear for ridiculously hideous pricing. Sometimes, if you get lucky or they're oddly honest, you'll merely pay hideously ridiculous pricing instead.

Seriously, I've seen individual disposable sterile #11 scalpels on tacticool sites for between $2 and $5. Occasionally more, but only if they can somehow get it in tacticool colors. Non-tacticool pricing? $0.60 per in low volume orders. Medical places probably don't even pay half of that. If you really want your mind blown, look up pre-packaged trays or kits. Medline EKits or similar.

Treat EMT stores with a skeptical eye too. Lot of them have tacticool tax included as well.
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Unisaw
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« Reply #19 on: January 10, 2017, 05:49:46 PM »

RevDisk, do you have any recommendations re: where to shop to get better value?
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« Reply #20 on: January 11, 2017, 07:55:35 AM »

RevDisk, do you have any recommendations re: where to shop to get better value?

Any medical supply places on the internet that mostly act as resellers for all the major 'generic' healthcare products used by doctors, dentists, hospitals, etc. The only issue is, they tend to sell in bulk packaging. Though I've often bought boxes of say, ten scalpels for the price of two tacticool scalpels. That's why I try to look at the kits or trays unless I don't mind the bulk.
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« Reply #21 on: January 11, 2017, 09:50:12 AM »

REV, any links you can share of places you previously purchased from.

I'm also looking to upgrade first aid kits and such for my vehicle and bug out bags which are in the process of being re-evaluated.
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« Reply #22 on: January 11, 2017, 11:07:06 AM »

Again, please price compare if you find a product you like. The prices can vary widely and change.

http://www.medicalsupplydepot.com/Wound-Care-Products-1/
http://www.healthproductsexpress.com/Wound-Care/
https://www.mooremedical.com/index.cfm?


Examples of trays that I've been happy with:
https://www.mooremedical.com/index.cfm?/MooreBrand%AE-Incision-and-Drainage-Pack/&PG=CTL&CS=MCO&FN=ProductDetail&PID=14890&zone_id=PDZ1&spx=1
https://www.mooremedical.com/index.cfm?/Laceration-Tray-With-Saf-Shield%E2%84%A2-Irrigation-Splash-Guard/&PG=CTL&CS=HOM&FN=ProductDetail&PID=8580&spx=1
https://www.mooremedical.com/index.cfm?/Incision-and-Drainage-Tray-With-Wire-Instruments/&PG=CTL&CS=HOM&FN=ProductDetail&PID=20443&spx=1
https://www.onlinemedicalsupply.com/p-7645-tray-incisiondrainage-sterile.aspx

I love them because pretty much all inclusive.

I usually package them in Pelican knockoff cases if I'm taking them out or leaving them in the car: http://www.mcmelectronics.com/browse/Weatherproof/0000001435 They have deep sales every so often and I stocked up. If anyone wants pics, lemme know. Also, they sell the foam inserts separately at rates that don't give you a nosebleed. At home, I use cheap clear plastic tubs from Walmart.


Widely off topic from tourniquets, I suppose. Back on topic. Here's a pretty good medical website: http://tourniquets.org/
An excellent article, but unless you want to pay or have med journal access, here is just the brief overview: https://www.ncbi.nlm.nih.gov/pubmed/16263675

"The Combat Application Tourniquet (North American Rescue Products, Inc.), the Emergency & Military Tourniquet (Delfi Medical Innovations, Inc.), and the Special Operations Forces Tactical Tourniquet (Tactical Medical Solutions, LLC) were all found to be 100% effective in elimination of distal arterial pulse in both the arm and the leg in all subjects."

They tested seven different types of tourniquets. Three passed. My personal favorite, the SOFTT. Delfi Emergency & Military Tourniquet, which is probably the absolute BEST tourniquet, but large and $300. CAT works very well and is pretty much same price as SOFTT: http://www.rescue-essentials.com/tourniquets-holders/

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