Ankle Med Kit
- Thread starter Back40
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https://www.phlsterholsters.com/shop/flatpack-tourniquet-carrier/
I carry one of those in a pocket, at the very least.
I carry one of those in a pocket, at the very least.
From that study:
"The critical location specified by the military is the thigh with an 80% success rate desired...Combining the minimal training and postadditional training results, we observed a 77% mid-thigh Doppler success rate when the SWAT-T was properly stretched"
"This study had several limitations. First, there was an attempt to have conditions favoring Doppler success: low stress, well-lit indoor environment with no blood, dirt, or sand on the tourniquet and no thick, full length pants or long-sleeved shirts on recipients"
I'd imagine those point to the lack of CoTCCC approval. Plus, the difficulty of self application with the SWAT-T.
It's certainly better than nothing, just saying there are devices out there that work much better.
"The critical location specified by the military is the thigh with an 80% success rate desired...Combining the minimal training and postadditional training results, we observed a 77% mid-thigh Doppler success rate when the SWAT-T was properly stretched"
"This study had several limitations. First, there was an attempt to have conditions favoring Doppler success: low stress, well-lit indoor environment with no blood, dirt, or sand on the tourniquet and no thick, full length pants or long-sleeved shirts on recipients"
I'd imagine those point to the lack of CoTCCC approval. Plus, the difficulty of self application with the SWAT-T.
It's certainly better than nothing, just saying there are devices out there that work much better.
We have fairly recently transitioned to requiring our recruits to carry a training TQ in the academy. They are issued after initial training in tac med, then the recruits are expected to have them on them at all times. Any staff may approach any recruit at any time, point to a limb on them or another recruit, and start the timer. Anything longer than 35 seconds earns some pushups.
Since instituting that, we are seeing a huge increase in officers carrying tq's, and a massive increase in tq saves. Our ER staff in the area frequently mentions the fact that they love how often they are seeing tq's used by our officers. If we use the tq on the street, we just hit up one of the medics on an ambulance, and get a new one.
We have also started instituting tq use in scenarios at the range, on qual days.
Quick aside - the last OIS I was onscene for, the dude had a tq on him within 40 seconds of getting shot. He still lost his balls, but he lived
Since instituting that, we are seeing a huge increase in officers carrying tq's, and a massive increase in tq saves. Our ER staff in the area frequently mentions the fact that they love how often they are seeing tq's used by our officers. If we use the tq on the street, we just hit up one of the medics on an ambulance, and get a new one.
We have also started instituting tq use in scenarios at the range, on qual days.
Quick aside - the last OIS I was onscene for, the dude had a tq on him within 40 seconds of getting shot. He still lost his balls, but he lived
I'm a bit of a blunt asshole, according to my wife - and often come across like I am attacking folks for their choices. Just so we are clear, that wasn't my intent - I genuinely wish the SWAT-T was a better option. My EDC could handle the slimming down. And like I said, it is definitely better than nothing. I'm just really judgy when it comes to what I'll carry
As one of you so succinctly pointed out, there are a number of significant issues that need to be understood here.
First, as I said previously, in the current state of things in the "civilized" locations in the country (such as seen in the above videos as well as American Armed Forces logistical support) the use of a tourniquet has undoubtedly saved lives. That was NEVER in question. It's use and efficacy are unquestioned even by an old fart like me. However, it totally depends on having that ready fleet of helicopters, pilots, EMT/Paramedic qualified personnel supported by a qualified surgical team who is perhaps only confronted with one, and MAYBE two patients. After that, all bets may come off the table. Trauma surgery is not the "rule" but seems to be more the "exception" unless you are in a large, well equipped facility such as would be found in a university hospital setting.
Secondly, the reason I brought this up in the first place had nothing to do with situations like the videos above where the evacuation time is sufficiently short to make the use of a tourniquet not only useful but mandatory. I get that and always have. I did NOT fail to read the literature up until the time I "crossed the gangway" for the last time. I spent a lot of time with the USMC until that moment at their TBS and OCS field clinic/dispensary where injuries were common. Admittedly, I spent a significant number of hours treating heat injuries, including heat "stroke" and the literature to which our efforts contributed was well received by the general audience.
However, let us now get back to the situation I described in my original post. We aren't talking about a readily available evacuation option in that case. All of the short timed evacuations would generally end up at adequate surgical facilities such as would be found in the areas seen in the videos above. What about the issue of things going "south" as we have heard about in MANY of the discussions here on THIS forum. There are at least two threads on that very subject.
Many here seem to think that "civil war" is imminent. The situation in Virginia certainly leads one to believe that this is a distinct possibility. Further, it leads one to think that the likely scenario is that the Feds would side with the State .gov in such a situation. Now you have anyone facing the communists that have overtaken our country with the possibility of being considered "PUBLIC ENEMY #1" in any situation where they oppose Gov. Northem and his ilk. Perhaps POTUS Trump would take a less friendly approach to Northem's position but who's to say that at the moment? We really don't know exactly how heavily/densely populated deep-stater's are located in the current ".gov!"
These are two very real and different situations. In the first, we will stipulate to the use of a TQ as a first resort. In the second situation when NONE of these "civilized society" options are available and the time to even get to someone who might have a little experience in this kind of wound, may be quite a while. THAT is the situation to which I referred. What do you recommend in THAT situation?
Clearly, there is a disparity of a number of issues in this situation that need to be differentiated. If what is discussed on those other two threads have any possibility of actual occurrence, then the discussion need be entertained. If that is NEVER going to be a problem, then I would be (thankfully) happy to NEVER have to deal with any such situation for the remainder of my natural life. I'm 70 right now. While I have a hard time believing that at times, I have to accept that as a reality.
Being 70 gives one pause to realize that there are more days behind than there are ahead on this earth. No one would argue that (I assume.) It is therefore a heavy consideration to look at what people my age are leaving behind on this earth with regard to the political situation we appear to be facing.
While I continually pray daily that the remainder of my natural life and on beyond, is peaceful and devoid of violence, it is an unfortunate truth that this is NOT the horse I would bet on at the track. The ONLY way out of this would be something that would divert the "energy" of the youth of this nation toward their own mortality/survival.
Just today in the grocery market, I heard two 19 y/o fellas discussing the possibility of getting "drafted." This is the FIRST time I have ever even heard that word mentioned since I was 18. As it appears that the US has taken a dim view of the approach of several of the countries in the middle east such as Iran and have taken steps to show the displeasure in their activities, it is clearly NOT out of the realm of possibility that the "draft" could be re-instated...although even an all out war might not last long enough to see them finish basic training. "But then there was a third possibility that we hadn't even counted upon..." (Arlo Guthrie: Alice's Restaurant) )and that my friends is something that will cause terror in the hearts of ANYONE even the toughest of hard core combat experts. If the Iranians DO have/use a TN device, or the NORKO's USE one of their TN devices, either in the upper atmosphere or at ground level, the rules of the game will change perceptibly and irreversibly for ever (as we know it.)
In that setting we would see either massive numbers of immediate injuries from flying debris to thermal and radiation injuries. Then once the shock of that has abated slightly, the criminal element will begin to exploit the remaining material not destroyed and injure anyone in their way. I don't need to belabor THAT point but I am certain that all of us "GET THAT!"
So now we are dealing with the scenario I discussed initially, complicated by general chaos and destruction of the infrastructure of the entire nation as we know it. NOTHING will ever be the same again. We will see the nation regress into the most depraved situation possible and the criminal element will thrive at the expense of those who they exploit, law or no law.
Since contemplation of such a situation is nearly unfathomable for most of the citizens of this nation, it is clearly a possibility that many have never considered or would even WANT to entertain intellectually. Certainly none of us here want to face such a disaster but then we have been promised that the "NEXT TIME" would NOT be a flood...
Therefore, the anticipatory approach to the considerations I brought up initially might once again be useful as to what to do to help those who have severe wounds and no place to go to get expert, life-saving help. If you have never had to look down at a wound that destroyed a large artery, it is assuredly a daunting experience to which I can relate. YMMV
I will end this with a brief history lesson. During the war of 1861-1865, my great, great, great grandfather was a surgeon in the army of the Potomac. He was cited by then President A. Lincoln with a "letter" (held at the State Archives) stating that he had accomplished the MOST successful amputations of any surgeon in his "command during that war." Whether or not you understand history and the concept of DNA, and the issue of "what is a memory?" and "why do we do the things we do in THIS life?" it is wholly possible that such an issue could possibly have bearing on my opinions and experience today. We ALL have those things in us. Some are more aware of them than others, but if you really dig into your family history, you will find some things that will absolutely astound you about things your family members did and things that YOU do now. And YES, it IS REAL. So say I.
Trim sends
First, as I said previously, in the current state of things in the "civilized" locations in the country (such as seen in the above videos as well as American Armed Forces logistical support) the use of a tourniquet has undoubtedly saved lives. That was NEVER in question. It's use and efficacy are unquestioned even by an old fart like me. However, it totally depends on having that ready fleet of helicopters, pilots, EMT/Paramedic qualified personnel supported by a qualified surgical team who is perhaps only confronted with one, and MAYBE two patients. After that, all bets may come off the table. Trauma surgery is not the "rule" but seems to be more the "exception" unless you are in a large, well equipped facility such as would be found in a university hospital setting.
Secondly, the reason I brought this up in the first place had nothing to do with situations like the videos above where the evacuation time is sufficiently short to make the use of a tourniquet not only useful but mandatory. I get that and always have. I did NOT fail to read the literature up until the time I "crossed the gangway" for the last time. I spent a lot of time with the USMC until that moment at their TBS and OCS field clinic/dispensary where injuries were common. Admittedly, I spent a significant number of hours treating heat injuries, including heat "stroke" and the literature to which our efforts contributed was well received by the general audience.
However, let us now get back to the situation I described in my original post. We aren't talking about a readily available evacuation option in that case. All of the short timed evacuations would generally end up at adequate surgical facilities such as would be found in the areas seen in the videos above. What about the issue of things going "south" as we have heard about in MANY of the discussions here on THIS forum. There are at least two threads on that very subject.
Many here seem to think that "civil war" is imminent. The situation in Virginia certainly leads one to believe that this is a distinct possibility. Further, it leads one to think that the likely scenario is that the Feds would side with the State .gov in such a situation. Now you have anyone facing the communists that have overtaken our country with the possibility of being considered "PUBLIC ENEMY #1" in any situation where they oppose Gov. Northem and his ilk. Perhaps POTUS Trump would take a less friendly approach to Northem's position but who's to say that at the moment? We really don't know exactly how heavily/densely populated deep-stater's are located in the current ".gov!"
These are two very real and different situations. In the first, we will stipulate to the use of a TQ as a first resort. In the second situation when NONE of these "civilized society" options are available and the time to even get to someone who might have a little experience in this kind of wound, may be quite a while. THAT is the situation to which I referred. What do you recommend in THAT situation?
Clearly, there is a disparity of a number of issues in this situation that need to be differentiated. If what is discussed on those other two threads have any possibility of actual occurrence, then the discussion need be entertained. If that is NEVER going to be a problem, then I would be (thankfully) happy to NEVER have to deal with any such situation for the remainder of my natural life. I'm 70 right now. While I have a hard time believing that at times, I have to accept that as a reality.
Being 70 gives one pause to realize that there are more days behind than there are ahead on this earth. No one would argue that (I assume.) It is therefore a heavy consideration to look at what people my age are leaving behind on this earth with regard to the political situation we appear to be facing.
While I continually pray daily that the remainder of my natural life and on beyond, is peaceful and devoid of violence, it is an unfortunate truth that this is NOT the horse I would bet on at the track. The ONLY way out of this would be something that would divert the "energy" of the youth of this nation toward their own mortality/survival.
Just today in the grocery market, I heard two 19 y/o fellas discussing the possibility of getting "drafted." This is the FIRST time I have ever even heard that word mentioned since I was 18. As it appears that the US has taken a dim view of the approach of several of the countries in the middle east such as Iran and have taken steps to show the displeasure in their activities, it is clearly NOT out of the realm of possibility that the "draft" could be re-instated...although even an all out war might not last long enough to see them finish basic training. "But then there was a third possibility that we hadn't even counted upon..." (Arlo Guthrie: Alice's Restaurant) )and that my friends is something that will cause terror in the hearts of ANYONE even the toughest of hard core combat experts. If the Iranians DO have/use a TN device, or the NORKO's USE one of their TN devices, either in the upper atmosphere or at ground level, the rules of the game will change perceptibly and irreversibly for ever (as we know it.)
In that setting we would see either massive numbers of immediate injuries from flying debris to thermal and radiation injuries. Then once the shock of that has abated slightly, the criminal element will begin to exploit the remaining material not destroyed and injure anyone in their way. I don't need to belabor THAT point but I am certain that all of us "GET THAT!"
So now we are dealing with the scenario I discussed initially, complicated by general chaos and destruction of the infrastructure of the entire nation as we know it. NOTHING will ever be the same again. We will see the nation regress into the most depraved situation possible and the criminal element will thrive at the expense of those who they exploit, law or no law.
Since contemplation of such a situation is nearly unfathomable for most of the citizens of this nation, it is clearly a possibility that many have never considered or would even WANT to entertain intellectually. Certainly none of us here want to face such a disaster but then we have been promised that the "NEXT TIME" would NOT be a flood...
Therefore, the anticipatory approach to the considerations I brought up initially might once again be useful as to what to do to help those who have severe wounds and no place to go to get expert, life-saving help. If you have never had to look down at a wound that destroyed a large artery, it is assuredly a daunting experience to which I can relate. YMMV
I will end this with a brief history lesson. During the war of 1861-1865, my great, great, great grandfather was a surgeon in the army of the Potomac. He was cited by then President A. Lincoln with a "letter" (held at the State Archives) stating that he had accomplished the MOST successful amputations of any surgeon in his "command during that war." Whether or not you understand history and the concept of DNA, and the issue of "what is a memory?" and "why do we do the things we do in THIS life?" it is wholly possible that such an issue could possibly have bearing on my opinions and experience today. We ALL have those things in us. Some are more aware of them than others, but if you really dig into your family history, you will find some things that will absolutely astound you about things your family members did and things that YOU do now. And YES, it IS REAL. So say I.
Trim sends
In the case where a tq is needed, nothing else is going to work...whether a hospital is available or not. You get a femoral or brachial bleed, a tampon or kotex isn't going to cut it. You can lay down and fall asleep (die), or, you can roll the bones on being able to find another solution in the extra time that tq buys you.
That solution might very well be amputation and clamps, if there isn't a trauma center available. Whether you can live with that solution, or you would rather die is a choice only you can make.
That solution might very well be amputation and clamps, if there isn't a trauma center available. Whether you can live with that solution, or you would rather die is a choice only you can make.
Ok, so let me answer that succinctly: yes.
If the question is do I think tourniquets have a role in complete chaos civil war rule of law gone medical care unlikely: yes.
Because without one you are dead. End of story. You're no good to me dead.
Now will you die anyways? Maybe/probably.
Can you take out more enemy?
Can we get you to someone like me or you who can try to save the leg or at worse case scenario amputate the leg? I'd rather have one less leg and still do what I can to contribute to the cause.
I guess I don't understand what point you are trying to make other than of course we will have less support? With out that support a lot of injuries go from survivable to much less so. Gut wounds, shrapnel injuries, infections. Is your solution to stop trying to treat anything just cause I don't have a med vac in my back pocket anymore?
P.S. there'd be plenty of surgeons on our side, I know a lot of 2A loving surgeons and CRNAs.
If the question is do I think tourniquets have a role in complete chaos civil war rule of law gone medical care unlikely: yes.
Because without one you are dead. End of story. You're no good to me dead.
Now will you die anyways? Maybe/probably.
Can you take out more enemy?
Can we get you to someone like me or you who can try to save the leg or at worse case scenario amputate the leg? I'd rather have one less leg and still do what I can to contribute to the cause.
I guess I don't understand what point you are trying to make other than of course we will have less support? With out that support a lot of injuries go from survivable to much less so. Gut wounds, shrapnel injuries, infections. Is your solution to stop trying to treat anything just cause I don't have a med vac in my back pocket anymore?
P.S. there'd be plenty of surgeons on our side, I know a lot of 2A loving surgeons and CRNAs.
Also what I'll mention is what our small hospitals are WILLING to handle now vs the capabilities of them during a SHTF is also markedly different, the stuff my surgeons would attempt when outside evac is no longer capable would astound you. And we have faced it at times with snow storms and trauma. I dont feel widespread war would necessarily be different, there would presumably be hospitals under control of your faction as well, unless it is true gorilla warfare. Even then, maybe, even if it is an OR set up in a living room.
Actually, all I am saying is, "HAVE A SOLUTION before you are in a bad situation..."What we are doing now is thinking about how to deal with a bad situation before it happens. That is what will keep us alive and "at the gun" in a setting where things aren't going well anywhere.
I am NOT advocating doing nothing. I am suggesting that the response to the problem be in your mind before the situation presents itself.
We have to look at reality first. Plan for the worst and hopefully, it won't be...
I am NOT advocating doing nothing. I am suggesting that the response to the problem be in your mind before the situation presents itself.
We have to look at reality first. Plan for the worst and hopefully, it won't be...
