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Combat Application Tourniquet (C-A-T)


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#1 ASTINvlogs

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Posted 27 February 2015 - 07:31 PM

Anyone carry it?

 

When I'm on the road I carry it JIC

 

My actual fear is getting a compound fracture. " I know I know why are you carrying a tourniquet for a fracture " Well my thought being is that if I bust an artery or somthing I need to stop the bleeding prior to working on a splint. Not to mention I don't think I'm going to far with a compound fracture anyway or even be able to craft a splint and I would hope that someone would see I dropped my bike and is going to lend a helping hand to my issues ( 911 )

I don't want to bleed out before EMS gets there and the break I can worry about later. ( years of theropy )

RvR


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#2 Stupendous Walrus

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Posted 27 February 2015 - 09:52 PM

As I am unfamiliar with this product for the most part, is it better than say, Quik-Clot?
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#3 coldwater

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Posted 27 February 2015 - 10:23 PM

As I am unfamiliar with this product for the most part, is it better than say, Quik-Clot?

They come in a couple different name forms. It's basically a fancy cuff with a rod attachment to use as a cinch. To me, It's something to be avoided unless you have a pretty intimate knowledge of when it has to be used. Once those babies are deployed, you're gonna kill that limb and  it's gone. We have them in the shop, without the combat name on it. (peace time shop :) ) But it's a pretty good bet that when you get wrapped up in one of those machines, the least you're gonna need is a tourniquet, so the use will be clear and present. 


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#4 Stupendous Walrus

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Posted 27 February 2015 - 10:26 PM

They come in a couple different name forms. It's basically a fancy cuff with a rod attachment to use as a cinch. To me, It's something to be avoided unless you have a pretty intimate knowledge of when it has to be used. Once those babies are deployed, you're gonna kill that limb and  it's gone. We have them in the shop, without the combat name on it. (peace time shop :) ) But it's a pretty good bet that when you get wrapped up in one of those machines, the least you're gonna need is a tourniquet, so the use will be clear and present.


Gotcha. Thanks for the explanation. I looked up a picture, but that makes more sense. So again, how does a clotting agent stack up? They're both designed for roughly the same thing, but as you pointed out, this device is a bit risky when the limb is involved.
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#5 coldwater

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Posted 27 February 2015 - 10:44 PM

I keep blood clotter in my pack. It's a miraculous blood stopper that will save a life in a pinch. If you have the stomach to pack the wound, it will actually stop arterial bleeding in a liver. I prefer to take that step before resorting to a tourniquet. I'm no surgeon or medic, and I would hate to be faced with being responsible for the loss of a limb because I acted inappropriately. And, If faced with an amputation of severely mangled limb, I can improvise pretty quickly. 


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#6 Stupendous Walrus

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Posted 27 February 2015 - 10:52 PM

Fair enough.
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#7 ASTINvlogs

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Posted 28 February 2015 - 04:53 AM

On the note of loosing the limb, They teach that nowadays in some aid classes( Civilian )  but with tech as far as it has gone( Taught to me by CLS and other Army Aid classes then again that is army aid classes lol ) . That's not really so true any more. Nowadays they can save that limb even after a few hours of it being in place.


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#8 coldwater

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Posted 28 February 2015 - 07:59 AM

That can certainly be the case, but the use of a tourniquet is a pretty weird science, and way better left to a surgeon. In the field to someone conscience, the pain is unbearable, and unless the limb is gone or beyond repair, best use of a tourniquet is quick and temporary to stem bleed out until the wound can be stabilized. I keep Quick clot in it's various forms in the shop, by 72 hour bag, my truck, and my EDC. Whatever saves a life is good, and some people may be comfortable with using a tourniquet, but even they may not stop a bleed out in a crush trauma. And, there are places where they simply can't be used. I'm not saying your approach is in any way wrong, just playing devils advocate, pro / con kind of thing.


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#9 Stupendous Walrus

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Posted 01 March 2015 - 01:06 PM

Great info guys.


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#10 Tim

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Posted 01 March 2015 - 09:37 PM

I have experience working in emergency medicine, and have had to apply a tourniquet in emergency's several times, and I would strongly recommend that one is not applied unless you find yourself in the most dire of circumstances. In the majority of situations you find yourself in it is not necessary to apply one because a higher level of care is available in a short period of time. The only time I would recommend applying one is if a higher level of care is more than an hour away, and you feel that the patient will bleed out before that time. For everyday carry at home, in the work place, and out and about in the town a quick clot, or even basic gauze packs are more that sufficient to stem almost any injury you will face, or will at least suffice until higher level of care arrive. 


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#11 Micke Stenstrom

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Posted 08 March 2015 - 03:50 PM

In the army we use the tourniquet for lost limbs and critical bleedings in arms and legs. I have never had to use it in a real situation but just training. But from what I've heard they are really good. But you should not use it if you don't know how, then you risk doing more harm than good.
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#12 coldwater

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Posted 08 March 2015 - 03:53 PM

In the army we use the tourniquet for lost limbs and critical bleedings in arms and legs. I have never had to use it in a real situation but just training. But from what I've heard they are really good. But you should not use it if you don't know how, then you risk doing more harm than good.

Exactly.


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#13 Nathan A

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Posted 13 March 2015 - 09:55 PM

Use of tourniquets has been re-established in the State of Tennessee Protocol a few years back. However, it is not recommended to keep it in place for more than 6 hours. Too long, and the nerves and tissue begin to die off. Never had to put one on... hopefully never have to.
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#14 Nathan A

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Posted 14 March 2015 - 06:54 PM

2 hours with minimal damage to nerves and muscle. 6 hours would be prone to amputation. I apologize.
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#15 browcs

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Posted 15 March 2015 - 12:10 AM

I have on one of my IFAKs which I wear with my body armor.


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#16 KCARF

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Posted 22 March 2015 - 11:18 AM

Tourniquets have made a complete 180 from a decade ago. They are no longer the the last ditch effort to stop severe bleeding in an extremity. Both the National Registry of Emergency Medical Technicians (NREMT) in their testing and the National Association Of Emergency Medical Technicians (NAEMT) recognize that the application of a tourniquet is so vital that if direct pressure does not work, you put a tourniquet on. You no longer do elevation or pressure points in the Bleeding Control/Shock Management skills.

 

Even with prolonged application, in some cases over 6 hours, there is very little chance of any tissue or nerve damage. The point is you put the tourniquet on and stop the bleeding, that is goal number one in severe extremity hemorrhage. After the bleeding is stopped you asses the wound and determine if another treatment can be performed in place of the tourniquet. This would be wound packing, preferably with Hemostatic Agents. This is one change in the newest Tactical Combat Casualty Care (TCCC) Guidelines. 

 

In the Denver Metro there have been three CAT Applications on Law Enforcement Officers in the past year. All had severe injuries and were at the Level I Trauma Center in under 20 minutes. You can bleed out in 2-4 minutes from a severe femoral artery injury, waiting even a minute can decrease your probability of survival drastically. Get the TQ on, stop the bleeding.

 

The Return of the Tourniquet - Study done with Boston EMS

Practical Use of Tourniquets - Study looking at TQ Use (Read the Results on the fist page)

TCCC Guidelines

 

 

USAISR Hemostatic Agent Study - For Hemostatics refer to this chart as to why you should get rid of the QuickClot ACS, Sport, First Response, etc. and only use Combat Gauze, Celox Gauze, or ChitoGauze (The current three recommended by TCCC)

 

Stay Safe


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#17 Stupendous Walrus

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Posted 22 March 2015 - 12:44 PM

That is some fantastic information KCARF. If you have some time, check in on our First Aid Kit thread and share your knowledge!


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#18 armydoc

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Posted 11 October 2015 - 05:25 PM

I served in the Army as a Combat Medic, and I would always carry several on the outside of my aid bag.  As Kcarf has stated the use of them as a last resort has changed. When I was in medic school in San Antonio Texas, I had a Special Forces Physician Assistant teach the Combat Medic side of our course. This was in 2004, he said he was always fighting with the conventional side with the hospital at Fort Sam. He taught us to use them first, and if we were busy setting it up we would use a knee to compress the artery to slow the bleed in the meantime.

 

You need to learn how and where to apply a tourniquet. You want to apply in maybe 2 inches above the laceration/amputation. You don't have to worry about losing the limb because of blood restriction for several hours, however before then the person could incur some nerve damage. When you apply it you want to make sure it is not over any clothing as clothes can cause the tourniquet to slip especially if they are blood soaked.

 

For a fracture of the femur/ thigh bone it is in fact possible to bleed to death internally with no outward sign of bleeding. With that type of break the muscles will retract the lower part of the break and it is possible to shear the femoral artery so in that case after 911 is called or you have more than one person around you want to apply manual traction and keep it on there until EMS arrives.

 

If you guys don't care to walk around with a medical grade tourniquet on your person, I would suggest a large bandana or two and pen or flash light for tightening down on the limb. The second bandana one would be used to tie off whatever you used for a stick to stop the bleeding. Always think multiple uses for the items you carry as you can only carry so much.

 

You also want to make sure you physically write a time on the person with a marker as to when you applied the tourniquet. We would write a time on their forehead like this for example "T-15:00 or T-3:00PM". The newer tourniquets have a place to write on them, however blood could obscure that or take off the ink.

 

Lastly I would suggest those interested in advanced First Aid should take a class at their local community college. You can become an EMT-Basic in one semester, and the knowledge you will learn is empowering.



#19 Shaun D

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Posted 12 October 2015 - 04:19 AM

You need to learn how and where to apply a tourniquet. 

 

In the last 18 months as a paramedic and the proceeding 3 years as a ambulance volunteer i have applied one of these 0 times. I do however have to prove im able to do so randomly during the year in order to keep my qualification. Despite this i have seen about 11 of these applied, 7 were not required at all but due to risks such as compartment syndrome we were unable to remove and the other 4 were either not tight enough to do anything or in totally the wrong location.

 

To me they are a great tool for the control of significant bleeding caused by trauma. Applying them for anything else and your an idiot and i will enjoy cutting the thing in half right in front of you. Life ive said before...if you wana use it...learn how to first.


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#20 armydoc

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Posted 12 October 2015 - 07:58 AM

In the military, the scope of what we do and the environment which we work in as a Combat Medic is different than civilian side of things. The military teaches their Medics the use of temporary tourniquets.

 

Tourniquets are also of value with snake bites.

 

We certainly agree that nothing should go in your kit unless you know how to use it.






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