I’m not a medical professional, although I have stayed at a Holiday Inn Express. With that important disclosure, I would suggest that the inclusion of tourniquets in “kits” and “packs” are overstated and over-emphasized. Tourniquets are used for a very specific purpose and under rare circumstances. The vast majority of people who have tourniquets have zero training and have the tourniquet simply because you’re not a real “prepper” or “operator” unless you have one. Don’t get me wrong – there are circumstances in which a tourniquet must be applied or end-of-life is likely. There are also circumstances in which severe blood loss is occurring and pressure is all that is required to stop the bleeding. In many of these circumstances applying a tourniquet will cause more damage than using constant pressure. Damage? I’m talking about severe nerve and muscle damage.
Food for thought. While what I’m saying may not be the most popular opinion I believe the inclusion of a compression bandage – such as the Israeli Battle Dressing – is more valuable than simply having a tourniquet.
Rourke
Take a look at the Olaes bandage as well… a useful variant
GG58
I couldn’t agree more! A Israeli bandage was made to replace a tourniquet, it is in fact a tourniquet except it it also so much more, it can be used as a tourniquet, a compression bandage, a sling, it is designed to use any where on the body, and it’s approximately the same size!! So why I’m the world would you carry anything else??? People in the prepper community are so coughs up in trying to imitate the military when our needs and load outs are the exact opposite!!! For example, people will carry six mags and one in the gun like a military patrolmen, well he can call in a Blackhawk helicopter for resupply when he runs out what are you going to do? Or how when you cut off circulation with a tourniquet you have two hours until it’s causing permanent damage to your muscle and nerves, (what you have a Blackhawk coming for you? Guess that tourniquet isn’t worth it’s weight it is far better have been trying to stop the bleeding rather than being a complete dum ass, if we can’t figure this stuff out now, chances are we never will later, don’t get caught up in the cool kids jumping off the bridge, remember they have military parachutes WE DO NOT!!!
Muscle damage is nearly complete by 6 hours, with likely required amputation. Numerous studies have been performed to determine the maximum duration of tourniquet use before complications. The general conclusion is that a tourniquet can be left in place for 2 h with little risk of permanent ischaemic injury.
I’m going to have to partially disagree with you. Having a tq is a great thing to have and not part of the tactical cool kid crowd one bit however it needs to be a proper one. Not a knockoff or a RATs. It’s many of the improvised tq’s that will cause muscle and nerve damage even in short term use. Belts, phone cords, wire, rope are the most likely used items that have negative consequences. Izzy and oleas bandages make great compression bandages but are not a replacement for a tq. Heck a tq and a piece of clothing can be used as a pressure dressing too if one wants to improvise. There is a lot of 2005 thinking going on here and needs to be brought up to 2021 thinking. YMMV however I will continue to carry a soft-t wide or a CAT on me and in my medical bags. Especially in my range bag.
We can agree to disagree. I’ll say that but guess what is in my glove box? A tourniquet! It’s not that tourniquets are not useful and life-saving in different situations, it’s they are overvalued. When I hear prepper’s say it’s not a real first aid kit unless there’s a tourniquet – I shake my head and solidify my position that they are overvalued. Should there be a tourniquet in a range bag? Absolutely! Tactical vest? Absolutely!
Saving Lives with Tourniquets: A Review of Penetrating Injury Medical Examiner Cases
C Bonk et al. Prehosp Emerg Care. Jul-Aug 2020.
There were 409 (26.9%) concurrent extremity and central penetrating injuries. The vast majority of extremity wounds were amenable to tourniquet placement (92.1%). Extrapolating nationally to 16,187 annual penetrating injury related homicides in 2016, an estimated 235 (1.45%) isolated extremity injury related deaths could be prevented and an additional estimated 4,354 (26.9%) concurrent extremity and central injury related deaths could potentially receive enhanced care with early tourniquet placement. Conclusion: Among urban ME cases, both isolated extremity cases and concurrent extremity-central injuries exist that may be amenable to life-saving tourniquet use. Extrapolating our findings nationwide suggests that many lives could be saved with early tourniquet use. Considering these findings, tourniquet availability and early placement may have a prominent role in reducing injury deaths from penetrating trauma.
I suspect those in disagreement with my premise fail to understand my premise. I apologize for not being able to communicate it clearly enough. Tourniquets are clearly important, valuable, and needed in wartime and combat situations. I can provide studies that show misuse by paramedics and EMT’s in pre-hospital settings. Not needed. I am merely suggesting that tourniquets are needed far less than what preppers deem necessary. In a grid down, SHTF situation I believe they would be used in situations where not needed thus creating injury that otherwise would not have existed. A compression wrap/bandage would be the correct and more beneficial treatment.
I hear you JR and others. Maybe information about when and how a tourniquet should be used would be beneficial for those of us who have never been in the circumstances to have to use on. Maybe Dr. Joe Alton could add to this discussion.Arlene
Take a “Stop the bleed” class it is 60 to 90 mins depending on class size, and hands on.
https://nationalstopthebleedday.org/get_trained/
JR,
Could you link the studies you refer to ? Without knowing the time and parameters of the studies, the results are not much use.
I have to stress there is a big difference battlefield medicine and civilian pre hospital medicine. Our prehospital care in the US has its roots in the military field care and that continues through today. Please keep that in mind.
There is a difference between placing and applying a TQ. I have placed TQs on disentanglement jobs, WITHOUT tightening it down, incase the disentanglement resulted in uncontrolled arterial bleed. Strictly speaking, if no arterial bleed presented, placing the TQ could be viewed as misuse. I have also applied them to a few arterial bleeds from gunshot and stab wounds. They work.
Compression bandages could be used to “improvise” a TQ, not replace one. Without mechanical advantage “improvised TQs” are far less effective. TQs are designed for one job, stemming arterial bleeding.
Pre hospital TQ use has its roots in battlefield medicine, chiefly the explosive amputations from IED’s and artillery. Not a likely injury in the civilian world. There was a study within the last five to seven years comparing mass shooting wounds to battlefield wounds. The result, battlefield wounds were largely massive extremity wounds while the mass shooting wounds were largely head and chest wounds. Why the difference in wound pattern ? Body armor worn by the troops protected the core. The study concluded multiple Chest Seals were more likely to be needed in the civilian setting.
With all that said, GET TRAINING on your medical preps. Digital learning only goes so far.
Here is one: https://www.wmpllc.org/ojs/index.php/ajdm/article/view/1549
Again – people far too often view a first aid kit as “crap” simply due to not having a tourniquet. Prepper’s far and large view the tourniquet as the “end all” piece of first aid equipment. Similar to someone buying a gun, a box of ammo – and putting it in their dresser and believing they now can defend themselves having never pulled the trigger.