Tourniquets No Longer Considered Last Resort Treatment for Life-Threatening Bleeding
By Shawn Whittington, Senior Instructor
An injury on a shooting range, a motor vehicle accident, a child running through a plate glass door, and even an animal bite are all injuries I have personally experienced in the field that required aggressive bleeding control to save the victim’s life. When I got started in EMS over two decades ago, we were taught that tourniquets were only to be used as a last resort. Once applied, the tourniquets had to be loosened every five minutes to restore blood flow to the affected limb to prevent extensive tissue necrosis – death of most or all organ tissue cells due to blood loss. The time of application was to be written on the patient’s forehead, in blood if need be.
Those days are long gone and tourniquets are now at the top of the list as the recommended treatment for life-threatening bleeding from an extremity. Bleeding to death from an extremity remains a leading cause of death on the battle field—one that is preventable with swift and appropriate treatment by the application of a tourniquet. These injuries don’t only happen in combat.
Numerous medical studies have shown that commercial tourniquets can be left on for several hours without causing permanent damage to the affected limb. The same cannot be said of improvised tourniquets. Research shows improvised tourniquets to be less effective and more damaging. This is mostly due to the improvised tourniquet not being constructed and applied properly. If you find yourself in a situation where the only option is to improvise a tourniquet, it must be done correctly.
There are several good commercial tourniquets available on the market. 88 Tactical stocks the Combat Application Tourniquet (CAT). This tourniquet is approved for US military use and has been tested and proven in the field. Anytime I am participating in a high-risk activity (shooting, hunting, etc.), I have a tourniquet either on my person or within reach. I also keep extras stocked in my med kit.
Proper tourniquet use is covered in 88 Tactical’s multiple levels of Tactical Medicine (TACMED) courses – offered to both civilians and law enforcement/military personnel. Like any piece of gear, you must take the tourniquet out of the package and practice with it. You must be proficient in training first if you expect to apply a tourniquet successfully under the stress of a real-life incident.