Tourniquets Can Save Lives

Many years ago in a far off land I was caught in a battle. My friend next to me got hit by a bullet. I did all I could do to stop the bleeding in his neck when the medic took over. He too worked on him but was unsuccessful. I’ve lost my Mom to old age and my Dad to a blood clot, but watching my friend die and not being able to do anything gave me more loss and grief than my own family passing away. Don’t put yourself in a position where you will have that kind of grief. Learn first aid skills one of them being how to use a tourniquet. When I was learning first aid as a Boy Scout, tourniquets were discouraged. As we learned from the war in Iraq, tourniquets save lives. Here are the basics of how to use a tourniquet. I am not a health professional. Take medical training to give you the proper skills. Step 1: Make sure your surroundings are safe, and keep yourself safe by wearing gloves. Depending on the situation, you need to make sure you have the freedom to treat someone without becoming a victim yourself. Nitrile gloves are pretty common, especially with this COVID 19 virus outbreak. Keep a few pair in your vehicle and in your kits. Step 2: Expose the open wound. My son, an EMT, says there is a saying in emergency medicine: “A happy trauma patient is a naked trauma patient.” You just don’t know what’s wrong with them if you can’t see it. Remove the clothing over the injury. Nothing fancy to it: tear the pant leg or shirtsleeve out of your way. If their clothes are too tough to rip by hand, carefully start the cut with scissors or a knife. Step 3: Apply firm, direct pressure to the wound site. Use gauze, or whatever may be available, directly on the wound. If there is no gauze, use a towel or washcloth or a rag torn from a shirt. Try to avoid having to use this homemade dressing unless it’s an emergency situation. Non-sterile bandages can cause further unnecessary infection. Keep in mind that if you’re a long distance from a hospital or facility, it is better to contain the wound with only a few germs than leave it exposed to all germs. If the pressure does not stop the bleeding, and the dressing becomes soaked with blood, you will need to apply a tourniquet. Much of what you think you know about bleeding control may be based on outdated knowledge. For decades, standard emergency medical services (EMS) controlled bleeding using a series of six steps. The tourniquet was used only in a last ditch effort to stop bleeding. The aversion to the tourniquet was based on the belief that by completely stopping blood flow to a limb, tissue around the limb would start to die, which would result in the patient having to undergo amputation. Unfortunately, by following traditional bleeding control steps and leaving tourniquets as a procedure of last resort, people lost more blood, and even their lives, than was necessary. Unlike civilian EMS, military medicine practices have long called for tourniquet application much earlier in the treatment for blood loss. Recent research in military hospitals in Iraq and Afghanistan have shown that, contrary to popular belief, using a tourniquet doesn’t guarantee limb amputation or even nerve loss. Many civilian EMS teachers and practitioners are starting to encourage tourniquet use much sooner. Necrosis of muscle tissue doesn’t onset until after 2 hours without blood flow, and can even last 5-8 hours without consequences resulting in amputation; so you can keep the tourniquet on for a while. You want to get the victim help as soon as possible. Now with that FYI under your belt, let’s move on to choosing and applying that tourniquet. Step 4: Choose a tourniquet. In today’s military, all soldiers are issued tourniquets to accompany their armor and weapons, and every soldier is trained and proficient at applying his tourniquet, even one-handed, on their own arm. The common tourniquet used by the army, the combat action tourniquet (CAT tourniquet), is made for single-handed application; they run around $30 and aren’t practical for a civilian to carry around in his pocket every day. Luckily you don’t need a dedicated tourniquet to save a life. Look around you, there are tourniquets everywhere. Are you wearing a belt? Tourniquet! Have laces on your shoes? Tourniquet! Long sleeve shirt, bicycle inner tube, backpack strap, or a female observer’s brassiere? All tourniquets! You can fashion this lifesaving device out of anything your mind can conceive as a tourniquet. (You might consider rope or a survival bracelet first if you have them handy.) In order to tighten your tourniquet, you’ll also need a torsion device. This can be anything long and stick-like. If you’re in the woods I recommend using, well, a stick. If there are absolutely no sticks or stick-like objects around you, then close your knife’s blade, or put the sheath on it, and give it up for a good cause. It’s now your torsion device. For me I carry a hank of paracord and a tactical pen. Those two items will work. Step 5: Apply the tourniquet. First, so we’re all on the same page: Tourniquets are ONLY applied on limbs! , here are the steps of applying a tourniquet: Step 6: Assess for shock. So you’ve saved this person from bleeding out with a handy-dandy tourniquet. They’re not home free yet. Make sure they’re still breathing. Seems obvious, but if you fail to do so you’ve wasted a tourniquet. You’ve probably heard the adage: Look, listen, and feel! Put your ear near their mouth and listen and feel for breathing while looking at their chest to make sure it rises and falls. If it doesn’t, make it. Here is where you apply CPR. After you’ve made sure your patient is indeed still breathing, check for signs of shock. If you’ve placed a tourniquet on the patient, it’s very likely they’ll suffer hypovolemic shock. Don’t freak out, it’s a big sounding word, but it basically means: “too little volume.” They’ve just given up a lot of blood volume, so it’s kind of a given, though not a guarantee. Signs of hypovolemic shock include: • Cool, clammy skin (moist, cool, and pale skin) • Cyanosis (big word, but it means blue skin) • Weakness • Confusion • Rapid breathing • Unconsciousness To treat shock, first lay the patient down flat on his back. You may have once learned to elevate their feet, dismiss this practice! Research has shown this can cause pooling of blood in the organs and brain and other damage. Next cover the person to keep them warm: employ blankets, coats, and clothes, whatever you can offer, just keep them warm! (That old hypothermia technique of huddling for heat can come in handy here too.) Step 7: If 911 has not been called yet, make sure it has happened or tell someone specifically to do so now. If rescue workers cannot get to you where you are, or there is no phone service, never leave the victim alone to look for help, grab them and go. Be prepared to do the fireman’s carry. There are also many ways to improvise a litter that you can drag if you have the time and the means. I’ve seen a tourniquet save a leg and two other guys arms, along with saving their lives. I’ve had the distinct opportunity of applying this technique in an emergency situation and can tell you it does work. It is a simple thing but like CPR, should be practiced. Semper Paratus Check 6 Burn