Israel trauma drsg.

[Chief1C]

SOF-T is alright, but we use CAT Tournakits (Combat Application Tournikits).

Cost. Can't put a price on a life, but you gotta be able to afford equipment, in bulk.

[Richard B the EMT]

The training films in the link have been removed by the originator, so I was unable to watch.

There is reference to a "Miss Piggy" film. Is that the old films of a pig, goat, or sheep that is shot, and the would-be first responder having to keep it alive for a set period of time with "First Aid" skills and supplies? If it is what I remember, if the animal is kept alive for that period, the animal is shot again, and the responder has to keep it alive for another set period, following which, if the critter is still alive, is then euthanized. You know PETA is involved in stopping that style training.

[Doc D]

I dare say that caution with tourniquet application would be the prudent pathway to follow. I would even go so far to say that most injuries can be managed with a pressure dressing. If a tourniquet is needed, so be it; however, it seems many providers treat nearly any wound as a nail that can only be treated with the sledgehammer of a tourniquet.

Well my friend, the tournakit is meant to control arterial bleeds, which are life threatening. If someone tries to use one to control venous or capillary bleed's, so be it. It will do the trick, it maybe a bit too serious for such a simple injury, but it will still do the trick.

Cost. Can't put a price on a life, but you gotta be able to afford equipment, in bulk.

The main issue i see, is wheneever we move on to the higher escheloes of care they CUT the tournakits off with trauma shears instead of just unbuckeling them, thus wasting a 40$ tournakit used once.

[tskstorm]

Well my friend, the tournakit is meant to control arterial bleeds, which are life threatening. If someone tries to use one to control venous or capillary bleed's, so be it. It will do the trick, it maybe a bit too serious for such a simple injury, but it will still do the trick.

Sure. I could amputate it too, would also do the trick but it maybe a bit too serious.

Come on now...

[chbare]

Doc D, I think you missed my point. I am not arguing against tourniquet use, I am saying we need to be careful, thoughtful and use the tourniquet when it's indicated. As I attempted to emphasise, there is a delta between a non-permissive environment and say the "typical" civilian setting. Again, I believe in many cases a properly placed pressure dressing can control external haemorrhage. My point being, not every seriously bleeding wound will require a tourniquet.

Take care,

chbare.

Edit: "wound"

Edited June 3, 2010 by chbare

[Chief1C]

If it's a simple device to remove, then there would be no reason to cut it. If it's loose enough to get a shear blade under, maybe it's not tight enough?

[tskstorm]

If it's a simple device to remove, then there would be no reason to cut it. If it's loose enough to get a shear blade under, maybe it's not tight enough?

Hmm, interesting thought that makes a lot of sense! Who would have thought you could make sense?

[Doc D]

Sure. I could amputate it too, would also do the trick but it maybe a bit too serious.

Come on now...

It takes 6 hours for a tournakit to do tissue damage, and 8 for it to cause nerve damage

Doc D, I think you missed my point. I am not arguing against tourniquet use, I am saying we need to be careful, thoughtful and use the tourniquet when it's indicated. As I attempted to emphasise, there is a delta between a non-permissive environment and say the "typical" civilian setting. Again, I believe in many cases a properly placed pressure dressing can control external haemorrhage. My point being, not every seriously bleeding wound will require a tourniquet.

Take care,

chbare.

Edit: "wound"

Yes, an arterial bleed from a limb is its indicated use. Then again, you work Civilian EMS where there is protocols, in combat medicine there arent many and our wounds are different then yours

If it's a simple device to remove, then there would be no reason to cut it. If it's loose enough to get a shear blade under, maybe it's not tight enough?

Flight medics cut everything off and throw it away, its their protocol. Wow this thread has really hurt my reputation...lol combat medicine is substantially different then civlian EMS

[tskstorm]

It takes 6 hours for a tournakit to do tissue damage, and 8 for it to cause nerve damage

I wasn't making a comment about the damage a tourniquet can cause, I was commenting on your gross over treatment.

Yes, an arterial bleed from a limb is its indicated use. Then again, you work Civilian EMS where there is protocols, in combat medicine there arent many and our wounds are different then yours

If I'm not mistaken CH spent his time in the sandbox. Be careful what you say and who you say it to around here. Remember you're the new guy, we've been around.

Flight medics cut everything off and throw it away, its their protocol. Wow this thread has really hurt my reputation...lol combat medicine is substantially different then civlian EMS

You hurt your own reputation by running your mouth about things. This last statement in particular. Show me 100 sets of protocols for flight medics that says cut everything I will show you 2000 sets which say cut only whats needed.

[chbare]

I want to preface this post by saying that yes I have worked in both Afghanistan and Iraq; however, I would never compare these experiences to that of a soldier.

Doc D, I do understand your point; however, you must understand there is a big world beyond the four months or so you spent in San Antonio. I appreciate your energy and willingness to discuss your point of view with us; however, as you continue in your medical career and education, you will find that the one way you have been told does not always apply. I hope you would at least take my points into consideration. Again, I do not oppose tourniquet use; however, like any modality at our disposal, we must be careful and thoughtful when considering the use of the said modality. Again, I believe it is appropriate to consider using a pressure dressing trial before transitioning to a tourniquet in many cases. Clearly, the situation may dictate immediate tourniquet use however.

Take care,

chbare.