Saturday, January 26, 2019

Some More on Tourniquets

A few weeks ago, I had published a post entitled "Ratchet Tourniquets?" where I tried to summarize some of the latest thoughts on what were the best tourniquets to use. One of my readers corresponded with me and shared with me some more information  on the subject, including a couple of useful videos.

"Special Forces Medic Reviews Tourniquets"--Tactical Rifleman (10 min.)

In the foregoing video, the host, Karl, discusses the CAT tourniquet, the SOFTT, and the TK4. He notes that you are fine with using any tourniquet approved by the Committee on Tactical Combat Casualty Care (COTCCC). However, his recommendations are for the newest CAT (Gen. 7) because it remedies deficiencies in the windlass and tabs found in the earlier generation. It is also his pick for self-application.

Similarly, Karl recommends the latest generation of the SOFTT, the SOFTT Wide (or SOFTT-W) because it also remedied some deficiencies in the in the earlier models. While great for casualty care, it takes additional movements to pull it tight that make it less desirable for self-application.

The TK4 is an old tech tourniquet that he recommends only because the CAT and SOFTT are too large to be used on a child or canine.

Karl also discusses some recommendations on using a tourniquet under combat conditions, to-wit: he recommends that the tourniquet be quickly applied as high up on the limb as possible, over the uniform or clothing, before moving the casualty to cover. Once under cover, the limb can be exposed and a tourniquet applied closer to the wound.

My friend also recommended this other video:

The foregoing video covers a lot more than just tourniquets, but Paisley, who had been a SOF medic, has some recommendations on tourniquets and their use. Of course, he indicates that you should use tourniquets approved by the Committee on TCCC. For the civilian, he doesn't see a need to repackage your tourniquets or other items to make them quicker to access; it is more important to leave them in their original packaging to prevent them from getting contaminated or otherwise deteriorating. He also recommends that tourniquets be applied initially to any wounded limb, and then replaced with a pressure bandage if it is determined that is all that is needed.

Paisley covers a lot of other topics, including chest seals, intubation, and so on, so watch the whole video.

My friend noted that for self-application he actually preferred the RevMedx TX tourniquets, which are a ratcheting type. I had read of some problems with ratcheting tourniquets with clothing/skin/blood getting stuck in the ratcheting mechanism. But my friend indicated that he had never had this as an issue when practicing with it, at least no more than the blood blisters and bruising he'd received when practicing with the CAT or SOFTT. So, even though it is not COTCCC approved, he keeps a RevMedx tourniquet under his belt for self-application, and a SOFTT-W on the outside of his IFAK.

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