Bleeding control

Our CATs come shrink-wrapped...
 
Simple rubber IV tourniquets won't work since you can't get them tight enough to stop arterial flow. They're too narrow and stretch too much, so they can't compress the surrounding tissue enough to stop forward flow.
 
The CAT WILL degrade since it has plastic components. The SOFTT being made of aluminum, is more durable from the sun for obvious reasons. I've been issued both but the CAT is the most widely issued TQ in the DoD. I've met many medics who swear by them and the fact you can manipulate it one handed easily (with a lil practice of coruse) is crucial... I also heard that the defense health agency issued a warning about the Tk4 that it is less effective then other TQ. The SWAT-T is a great idea because it can act kind of like a improvised pressure dressing and they are affordable. This thread wasn't about how to properly apply a TQ or make an improvised one.. But knowing how to and being creative with what material is around if a dedicated TQ isn't present is invaluable... Fact is, nothing can beat a dedicated TQ and you should consider one if you are honestly concerned about it.

On a side note. Since your worried about an active shooter. Consider getting your CCP and then definitely carry a IFAK once you carry a gun daily...
 
WildlandEMT89 said:
I have a cat and a couple of TK4s.
The TK4 is very compact (even more so than a cat) and fits in the palm of your hand. Both are very intuitive and can be used with one hand. One thing I would consider is that the cat will degrade over time when exposed to the elements, whereas the TK4 comes packaged and will be protect and in my mind last longer.
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That TK4 looks absolutely worthless. Would probably stop a decent veinous bleed, but I wouldn't trust it at all for an arterial bleed- especially a lower extremity arterial bleed.
 
VENOUS TK (venipuncture) will speed up bleeding as it is designed to do. SHRINK WRAP slows your response, use a sandwich baggie wrapped with a couple strips of scotch tape. CRAVAT is great if you have time and the means to turn it (i.e., a pen or pencil will break) but not as fast or easy to secure. BP CUFF will do on an extremity it is designed to fit, if it has strong and clean velcro; it can be used to buy time until another TK can be applied. If it is all you have, pump it til the bleeding stops then tape the cuff around a couple times (duct tape ok); if there's a leak at the bulb or tubing, crimp the tubing shut between the cuff and the leak by firmly doubling it over once or twice and taping it (a hemostat may cut the rubber), or use an umbilical clamp over one wrap of tape to protect rubber. TK and airway are your two items needing fast response, don't bury them in your kit.
 
We were recently forced to use a BP cuff after it became clear that a single CAT was not going to be adequate (the patient had some serious muscle definition in his arms). Until another tourniquet could be delivered (don't get me started), a cuff was used. While effective, it had to be constantly monitored as the patient had received a makeshift tourniquet very early on after a volunteer EMT that he was with decided it was the right course (she was right). The patient's BP never dropped below 150 systolic. To keep a well used BP cuff blown up higher than continuously is a labor intensive task.
 
Duct tape rules!
 
Grimes said:
Every ED Doc dislikes you. :P
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Up until recently, I was teaching TCCC. I told my students not to use medical tape. Duct tape was the cure-all, I told them. Sealing chest wounds, securing dressings/ splints, etc. And taping people's mouths shut. As for ED docs, oh well! [emoji24]
 
MackTheKnife said:
Up until recently, I was teaching TCCC. I told my students not to use medical tape. Duct tape was the cure-all, I told them. Sealing chest wounds, securing dressings/ splints, etc. And taping people's mouths shut. As for ED docs, oh well! [emoji24]
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I'm not saying duct tape isn't useless, I'm just saying I wouldn't be securing a tourniquet with tape.
 
Grimes said:
I'm not saying duct tape isn't useless, I'm just saying I wouldn't be securing a tourniquet with tape.
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In the tactical environment, where you might be carrying or dragging your battle buddy, securing a tourniquet with duct tape might be advisable. Perhaps not on the street.
 
Tigger said:
We were recently forced to use a BP cuff after it became clear that a single CAT was not going to be adequate (the patient had some serious muscle definition in his arms). Until another tourniquet could be delivered (don't get me started), a cuff was used. While effective, it had to be constantly monitored as the patient had received a makeshift tourniquet very early on after a volunteer EMT that he was with decided it was the right course (she was right). The patient's BP never dropped below 150 systolic. To keep a well used BP cuff blown up higher than continuously is a labor intensive task.
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True that. In actuality a pneumatic tourniquet such as is used in operating rooms is different than a BP cuff and running a couple turns of good strong tape over the bp cuff to hold the velcro shut is a work-around. It is one expedient alternate measure though.

I also as a rookie carried a rubber penrose drain as a TK in my first EMT ammo box, but I also had a real one from a first aid kit. Luckily the heat turned the rubber drk brown first.

O.R. pnmeumatic TK:
http://jscvs.umin.ac.jp/syujutusyugitokaisetu_kekkan/images/2_(3)_figure3.jpg
And an article on "Tourniquets.org". (Wow, go figure!)
http://www.tourniquets.org/non_pneumatic.php


T, glad the case you cited worked out.
 
MackTheKnife said:
In the tactical environment, where you might be carrying or dragging your battle buddy, securing a tourniquet with duct tape might be advisable. Perhaps not on the street.
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That's why the Army invented it!
The medics in my company use duct tape as well (one was with the 2nd ranger battalion for 5 years and is very experienced). They also use tape with 3M adhesive that works pretty well, but duct tape works better...
 
As others have said, a normal IV tourniquet wouldn't work. I've never seen someone apply a cravat one-handed while frightened and bleeding, and I wouldn't expect them to, it's not very practical outside of testing purposes. Not to mention trying to find a windlass strong enough. I've attempted CATs a couple times with varied success, never played with the TK4s. Some units in the military were using ratchet straps, due to needing something heavyduty that could fit around (and pressure through) large muscle mass. So if you're looking for something to use in all possible situations one-handed and strong, I'd suggest a ratchet or two.
 
samiam said:
If you want it to fit in a cargo pocket this is kinda cool. Its waterproof too (until you open it)

http://www.globalindustrial.com/p/s...gclid=CIfLxvmku8ACFeg7MgodOCcAJA&gclsrc=aw.ds
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If you carry pouches or anything like that in your pockets (or even in those out of the way compartments) over time, first put them in a freezer ziplock polyethylene "baggie" then use some tape to seal it and wrap it closely conformal to the inner pouch. You will avoid breaching the factory seal because the freezer bag (not a regular bag) will take the abrasion. Remember you will be tearing it open, so don't tape it so securely you can't get into it!
 
mycrofft said:
If you carry pouches or anything like that in your pockets (or even in those out of the way compartments) over time, first put them in a freezer ziplock polyethylene "baggie" then use some tape to seal it and wrap it closely conformal to the inner pouch. You will avoid breaching the factory seal because the freezer bag (not a regular bag) will take the abrasion. Remember you will be tearing it open, so don't tape it so securely you can't get into it!
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If I recall correctly the pack I listed was double sealed. So for sterility you should be ok but for water a double bag is a good idea
 
samiam said:
If I recall correctly the pack I listed was double sealed. So for sterility you should be ok but for water a double bag is a good idea
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It also keeps the printing from rubbing off. You can put a slip of paper on each side inside your baggie with the date for required inspection or replacement. If you turn in a ticket to central supply off of an opened item to get a replacement, put the ticket in there instead of taping itn to the item.
 
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