5 Myths About Tourniquets

5 Myths About Tourniquets

This post was originally published at TraumaMonkeys.com

1. Tourniquets Should Only be Used as a Last Resort

This is a dangerous and antiquated approach to trauma. There is an overwhelming amount of substantiated data that dispel this myth. If you’re attending a class and that’s what you are being told, contact us at Trauma Monkeys ASAP and we will find a course in your area that is teaching the current protocols.

In combat zone, Tactical Setting, Active

shooter, dynamic type event a Tourniquet should be the First choice if there is any suspicion that a casualty is bleeding from an extremity. For many years Extremity Hemorrhage was the number one cause of preventable death on the battlefield it has since been surpassed by junctional hemorrhage (armpit, groin, neck).

Significant improvements in training, coupled with the availability of tourniquets have directly resulted in a marked decrease in mortality. Through education and persistence the military has been able to convince all hands to completely change how they view tourniquets. No easy task considering the how many times we have all been told “only as a last resort”.

2. Placing a Tourniquet (TK) Equals Loss of Limb

The fact is loss of a limb is extremely rare. The risk of hemorrhage far outweighs the minuscule risk of limb damage. The old “Life over limb” adage applies here. There are many well-documented cases of patients that have had commercial tourniquets in place for greater then eight hours, with no loss of limb. In the cases where their have been a loss of limb(s), they are directly attributable to a gunshot wound, blast injury, shrapnel, fragmentation, high velocity trauma and not as a result of restricted blood flow from tourniquet placement.

3. Belts Make Great Tourniquets

This is Utter Nonsense. Belts make terrible tourniquets; it is extremely difficult if not impossible to completely occlude arterial blood flow using a belt. Utilizing a belt and its buckle will never be tight enough and attempting to tighten the belt with a makeshift windlass is problematic due to it’s rigidity. The makeshift windlass would need to be substantial (i.e. leg of a chair) to have any chance of tightening the belt enough. Belts are readily available and certainly work better then nothing, the point here is to promote commercially made Tourniquets or more suitable makeshift tourniquets (cravat / stick).

4. Improvised Tourniquets Are Proper Medical Equipment

Using what you have on hand in extremis is not only acceptable its commendable. There are no shortages of great stories of people doing self-aid or acting as a first responder, I prefer First Care Provider, more on this in future posts). Read more about Brian Ludmer, the schoolteacher shot in the calf in the LAX shooting. Ludmer crawled to a shop, scrambled into a storage room and shut the door. He found a sweatshirt and tied it around his leg to slow the bleeding. Key phrase there “Slow the bleeding”, that’s what makeshift tourniquets do, commercially made tourniquets STOP the bleeding. Hospitals, EMS agencies, Fire Departments, and anyone in the business of saving lives is negligent if they are not equipped with commercially made Tourniquets.

This is what the city of Boston had on standby and utilized in the aftermath of the bombing.  It’s surgical tubing, and a pair of hemostats to secure the tubing after wrapping it circumferentially around an extremity. It’s important to note that 100% of these were found to be ineffective tourniquets and had to be converted to a commercial tourniquet. That’s not to say they did not slow the bleeding and contribute to the high survival rate. Please do not think this is a criticism of those brave folks that responded and undoubtedly saved countless lives.

Boston has since purchased commercial tourniquets and discontinued the tubing policy. When someone is bleeding significantly from an extremity it is hardly the time for arts and crafts. If you are in the business of saving lives then make it your business to have the gear you need to do so.

5. There is a Best Tourniquet Out There

Commercial Tourniquets just like any other piece of gear all have advantages and disadvantages, strengths and weakness, pros and cons. They all have subtle nuances and general rules of thumb regarding their use. I’m often asked what tourniquet I recommend, and my answer is always the question “recommend for who, when, and where?” The Tourniquet that works well for a Marine on his body armor, may not be the best choice for someone doing undercover work. The tourniquet I carry on SWAT missions to treat a wounded Police Officer would be a poor choice in a school shooting with expected pediatric patients. The tourniquet I would use in a controlled emergency room setting would be difficult to use in a low light stressful environment.

Tourniquets come in all different shapes, sizes, colors, and accomplish the job in a myriad of ways. As with any other job, task, or mission the sensible answer is to choose the right tool for the job.

This post was originally published at TraumaMonkeys.com

Survivalist

Craig Burr is the founder and editor of UK Survival Guides.He has a passion for emergency preparedness and survival that he wants to share with others through the use of articles and gear reviews.Stay safe!

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