Who here carries a Tourniquet?

[leVieux]

Good for you.

Phucking Dr god complex. Lol

Condescending and dated come to mind or maybe out of touch. Do you think people put TQs on everything from a splinter to a minor wound?

Again, there is a difference in how Dr in a hospital and lay people in the field address bleeding. Maybe your degree is blinding you to that. The TQ is so we can get to you alive and you can tell us what lucky mouth breathing knuckle daggers we are that we had you to save our lives oblivious to the fact we would have bleed out otherwise.

You sound like the Drs who howled about paramedics killing people at their inception cause they dared to trespass upon your realm.

Well, almost all of the actual life-threatening bleeding I've seen in trauma patients is intrathoracic or intra-abdominal.

Exactly where would your tourniquet go ?
.

 

[candcallen]

No, simply telling years of experience. The ex-Chief Paramedic for Houston FD is a lifelong friend and my Son served was a Paramedic for years.

I'll grant that there is a difference with combat injuries, which I never had to care for acutely.

I listed my experience to show that I do know what I'm talking about.

The stressing of tourniquet use in civilian trauma is overdone.

leVieux

You're medical degrees and experience seemed to impair your ability to listen and think critically.

People are talking about use when appropriate and necessary. No different than any other first aid tool. You act like they want to TQ every splinter and cut.

 

[candcallen]

Well, almost all of the actual life-threatening bleeding I've seen in trauma patients is intrathoracic or intra-abdominal.

Exactly where would your tourniquet go ?
.

Again you cant or wont phucking comprehend what's been written. I specifically said penetrating trauma to the extremities. I mentioned the difference in abdominal and chest trauma. I mentioned that a TQ can be more impactful and easier to apply when appropriate than dealing with pressure and bandages in chest and abdominal trauma.

Everyone else seems to get this but the supposed smartest guy in the room.

Your homework is to reread the thread and quit responding till you understand what has been said.

We also discussed the need to get to higher care and address the obvious. Shooting stabbing cutting. The kill you quick bleeding we see and can easily address is different than demigod surgeons. They dont get to you unless bad stuff is addressed and transport.

Again you dont seem to "Get" were talking about appropriate use of something not apply a TQ to everyone type of thing. I dont know why you cant comprehend that. If you quit talking down to mouth breathing knuckle daggers and consider for a minute you can discuss something on equal terms you might just get it.

First Aid BLS is all about getting someone to higher care alive. No one is putting a TQ on a chest wound. Or sticking a chest seal on an arm with a gunshot wound spurting blood from.an artery or slapping a TQ over the nose on someone with no pulse.

Until you get the fact people are discussing treating life threatening bleeding in an appropriate way, so they can stay alive long enough to win a fight get out of danger all to get to higher care and that may include a TQ or chest seal or pressure bandage which ever us appropriatefor the wound, there is no point in discussing this with you.

You are stuck in "those hillbillies think a TQ is an all inclusive cure for what ever ails ya and need to be taught different" mode.

 

[easy rider]

I have never had to use a tourniquet, but I do have one in my medical kit. I have read and watched videos on how to use them. I certainly like to hear about personal experience or from those with proper training, but the arguing over hypotheticals certainly distracts from from that.

 

[candcallen]

TQs are not remotely necessary in all wounds to extremities that is and should be obvious. In normal situations, even many where there is moderate bleeding, where quick transport by EMS is available bandaging properly is adequate.

The reason they are talked about in situations where fighting may be going on or just ended or a gun shot to an extremity with extreme blood loss or when far from care is because they can quickly stop what's gonna kill you so you can continue to fight or stabilize or care for other wounds. Ofcourse we are only talking where appropriate.

There is no free lunch. You put a TQ on and you start a clock or are deciding you're in a situation of life over limb.

They are a tool. Nothing else and when used properly and when needed are extremely impactful in saving lives. It used improperly can cause serious damage or limb loss.

We could list a hundred scenarios where you would use them and where you wouldnt. Multiple wounds versus one wound, time to transport care available blood loss and the situation your in all come into play.

 

[Axxe55]

No, simply telling years of experience. The ex-Chief Paramedic for Houston FD is a lifelong friend and my Son served was a Paramedic for years.

I'll grant that there is a difference with combat injuries, which I never had to care for acutely.

I listed my experience to show that I do know what I'm talking about.

The stressing of tourniquet use in civilian trauma is overdone.

leVieux

With your attitude towards us mere mortals, you're probably why many people, like myself hate doctors.

You look down you nose at us that didn't go to some fancy college for eight years to get a degree in medicine, and think us as being inferior to you.

Well, bless your little heart.

 

[Axxe55]

I have never had to use a tourniquet, but I do have one in my medical kit. I have read and watched videos on how to use them. I certainly like to hear about personal experience or from those with proper training, but the arguing over hypotheticals certainly distracts from from that.

I too have never used a TQ either. I do understand the theory and function, but never so far have happened upon an injury that required one.

A TQ is not for every injury gushing blood. Sometime pressure, or packing a would is preferable to using a TQ.

 

[easy rider]

I too have never used a TQ either. I do understand the theory and function, but never so far have happened upon an injury that required one.

A TQ is not for every injury gushing blood. Sometime pressure, or packing a would is preferable to using a TQ.

I understand that, it's the in fighting that is pissing me off. I don't mind debates and disagreements, but when you have to resort to name calling, it gets old fast.

 

[candcallen]

Getting talked down to is rather frustrating.

 

[Axxe55]

I find getting talked down to, to be arrogant and condescending.

 

[easy rider]

Getting talked down to is rather frustrating.

I understand, but if you resort to name calling, it makes you appear you have lost the argument.

 

[candcallen]

I thought demigod kinda flattering.

Dr God complex was appropriate. Imho

 

[Axxe55]

I understand, but if you resort to name calling, it makes you appear you have lost the argument.

In most cases of discussion, I would agree..

But to paraphrase my uncle, that sometimes, name-calling, like profanity, applied aptly and appropriately as necessary, convey a very specific message that is crystal clear.

And yes, I do believe that.

 

[BandAidPro]

The stressing of tourniquet use in civilian trauma is overdone.

By "civilian" do you mean lay person or any non military person to include professional responders?

It would certainly be great for a person to understand C-spine immobilization, basic airway maneuvers and adjuncts, pocket mask/BVM ventilation, occlusive dressings, direct pressure, wound packing, and tourniquet use, but at that point, we're pretty much talking about an EMT.

There's really not that much for the lay person to do for a patient with life threatening head trauma or intrathoracic or intraabdominal bleeding... but they can definitely save a life with direct pressure and/or a tourniquet.

 

[easy rider]

^^^ See? Now that was a much better response to the argument.

 

[cycleguy2300]

Well, almost all of the actual life-threatening bleeding I've seen in trauma patients is intrathoracic or intra-abdominal.

Exactly where would your tourniquet go ?
.

Dr leVieux is relating his opinion and experience (and rather respectable ones at that).

He isn't wrong, but it may not be the entire picture. As a cop my training, goals, perspective and experience are different. My training is on BASIC combat first aid: direct pressure, TQs, chest seals, and a few other small things like wound packing. My goal is to ensure the causality stays alive until EMS can transport them to a ER or trauma center.

I have seen a number of TQs applied and while the Dr's experience differs, mine has been a TQ is a simple, useful tool that needs very little training to use. I may even agree with the Dr that TQs have been over-pushed in the sense that some may not look past a TQ just like some may not look past their pistol for their EDC.

A TQ is a GREAT tool, but like fists, or a knife, or a pistol, don't think "I've got a TQ, I'm GTG" Kinda like doing nothing but 1/reload/1 drills it leaves you with holes in your training and methods.

***
The angry drunk that stomped a glass coffee table and lac'd some artery (posterior tibial?) in the ankle. He had bled so much it looked like someone had poured about a half-gallon of nice, red chocolate milk through the house as they walked. There were pools and puddles EVERYWHERE. He had lost so much blood he passed out. He claimed he was "OK" after the TQ and tried to stand, but passed out before he got much past sitting upright. Direct pressure or manual occlusion likely would have worked, but the TQ did and left our hands free.

***

The drunk who washed a watermelon in REALLY soapy water then without drying or rinsing, tried to cut it with a VERY sharp butcher's knife. Her hand slipped and the melon rolled and her knife sliced the underside of her left wrist to the bone from about the base of the thumb and about a 30° angle. Iirc Radius and Ulna were visibl, but here was nothing humerus about it because the knife got the Radial, or Ulnar artery (it may have been both) the subj had what looked like an entire roll of paper towels appling direct pressure and they were completely soaked. I applied a TQ to the upper arm which stopped the bleeding. EMS arrived, checked her out, moved the papertowels and had me SLOWLY loosen the TQ, it started squirting blood. "Yup, thats a good one" they said and told me to tighten it back up.

***

These and a K9 that tore a brachial artery on a agg assault suspect (because he kept trying to yank his arm from the dogs mouth) are the more memorable TQ applications for me, but are anecdotal as is my lack of memory of any need or application of anything but positional airway management by officers although I have applied or seen applied a few chest seals, but that is the R of MARCH not the A...

TQs are great, but don't let them be the end of your training or abilities.


Sent from your mom's house using Tapatalk

 

[Axxe55]

Simple fact is, if a victim doesn't make it to the ER alive, the best doctor or surgeon in the world is useless. And it's very likely that in the real world, in some sort of accident or trauma event, that the people nearest that victim, are not going to have eight years of medical school training. Many are likely just to have the very basic of first aid skills if that.

I think most of us would do the very best we can, and that's all we can do.

 

[JColumbus]

Carried one since before I was a gun owner since I'm on blood thinners for life. I've since staged a couple in the house and car now that my family is around guns all the time.

For those of you who keep quick clot, be careful what you use it on. Some wounds seem to bleed a ton but can be pretty superficial, although ugly. It can cause more damage that good, as it has to be cut out of the tissue. Learn where the arteries are and never use quick clot in places that aren't right next to those arteries. Bleeding can always be real bad but as long as there is a hospital within 10 miles or so, there is no need for quick clot. People can lose A LOT of blood before going into shock or having heart issues, so don't be afraid to let them bleed. In fact, it's more beneficial to administer fluids to replace the blood loss, than it is to stop even a VERY bloody wound.

So in short, quick clot should almost never be used. If the wound is on top of an artery, or right next to one, pack gauze-apply pressure till pros get there, if you're unsure, to help. Only use the QC if you KNOW the artery has been nicked or torn, and even then, factoring in hospital proximity, or how long the bleed has gone on.

It's good to want to help but sometime things can make things worse for those who arrive after us witnesses and "helpers".

 

[Axxe55]

Carried one since before I was a gun owner since I'm on blood thinners for life. I've since staged a couple in the house and car now that my family is around guns all the time.

For those of you who keep quick clot, be careful what you use it on. Some wounds seem to bleed a ton but can be pretty superficial, although ugly. It can cause more damage that good, as it has to be cut out of the tissue. Learn where the arteries are and never use quick clot in places that aren't right next to those arteries. Bleeding can always be real bad but as long as there is a hospital within 10 miles or so, there is no need for quick clot. People can lose A LOT of blood before going into shock or having heart issues, so don't be afraid to let them bleed. In fact, it's more beneficial to administer fluids to replace the blood loss, than it is to stop even a VERY bloody wound.

So in short, quick clot should almost never be used. If the wound is on top of an artery, or right next to one, pack gauze-apply pressure till pros get there, if you're unsure, to help. Only use the QC if you KNOW the artery has been nicked or torn, and even then, factoring in hospital proximity, or how long the bleed has gone on.

It's good to want to help but sometime things can make things worse for those who arrive after us witnesses and "helpers".

Sometimes, if a person knows nothing about first aid care, they can still be useful by calling 911, and giving accurate directions and information to the dispatcher.

If there is someone there with some medical training or first aid skills, they can at least open their ears and assist that person, with being an extra set of hands, getting something needed, or even just a calming voice to keep the victim comforted.

 

[leVieux]

Dr leVieux is relating his opinion and experience (and rather respectable ones at that).

He isn't wrong, but it may not be the entire picture. As a cop my training, goals, perspective and experience are different. My training is on BASIC combat first aid: direct pressure, TQs, chest seals, and a few other small things like wound packing. My goal is to ensure the causality stays alive until EMS can transport them to a ER or trauma center.

I have seen a number of TQs applied and while the Dr's experience differs, mine has been a TQ is a simple, useful tool that needs very little training to use. I may even agree with the Dr that TQs have been over-pushed in the sense that some may not look past a TQ just like some may not look past their pistol for their EDC.

A TQ is a GREAT tool, but like fists, or a knife, or a pistol, don't think "I've got a TQ, I'm GTG" Kinda like doing nothing but 1/reload/1 drills it leaves you with holes in your training and methods.

***
The angry drunk that stomped a glass coffee table and lac'd some artery (posterior tibial?) in the ankle. He had bled so much it looked like someone had poured about a half-gallon of nice, red chocolate milk through the house as they walked. There were pools and puddles EVERYWHERE. He had lost so much blood he passed out. He claimed he was "OK" after the TQ and tried to stand, but passed out before he got much past sitting upright. Direct pressure or manual occlusion likely would have worked, but the TQ did and left our hands free.

***

The drunk who washed a watermelon in REALLY soapy water then without drying or rinsing, tried to cut it with a VERY sharp butcher's knife. Her hand slipped and the melon rolled and her knife sliced the underside of her left wrist to the bone from about the base of the thumb and about a 30° angle. Iirc Radius and Ulna were visibl, but here was nothing humerus about it because the knife got the Radial, or Ulnar artery (it may have been both) the subj had what looked like an entire roll of paper towels appling direct pressure and they were completely soaked. I applied a TQ to the upper arm which stopped the bleeding. EMS arrived, checked her out, moved the papertowels and had me SLOWLY loosen the TQ, it started squirting blood. "Yup, thats a good one" they said and told me to tighten it back up.

***

These and a K9 that tore a brachial artery on a agg assault suspect (because he kept trying to yank his arm from the dogs mouth) are the more memorable TQ applications for me, but are anecdotal as is my lack of memory of any need or application of anything but positional airway management by officers although I have applied or seen applied a few chest seals, but that is the R of MARCH not the A...

TQs are great, but don't let them be the end of your training or abilities.


Sent from your mom's house using Tapatalk

Thank you, and I don't disagree EXCEPT that most of what you describe sounds like it could have been better managed by better DIRECT COMPRESSION control of bleeding, which is much simpler and less dangerous.

One caveat is that the pressure must be applied ABOVE the obvious bleeding, or as we say, "between the heart and the bleeding", and must be maintained until direct control of the bleeder is achieved. Lay folks often try to compress where they see the blood coming out of the skin wound, which is usually ineffective.

OTOH, I have seen numerous instances of immediate airway "clearing" and/or respiratory assistance being immediately needed to save a life.

Once more, a battlefield can be very, very different from civilian trauma. Of course, battlefield medics should be equipped with tourniquets, and be prepared to use them.

leVieux