It can be a pain to carry all the stuff we "need" on a daily basis, but the weight and bulk can add up. If it becomes too much, we start looking for stuff to leave at home based on nothing in particular other than, "What do I use the least?" While this has some merit to it, maybe we should rethink the things we leave at home in terms of how critically important they could be in the rare situation we find ourselves needing them. If you're not carrying a tourniquet on a daily basis, we hope we can convince you to change your mind.
The question, “Should I carry a tourniquet?” is one we get asked quite frequently and the answer is a resounding, YES. But, as important as it is to carry a tourniquet or TQ, you should also know why. Why should I carry a tourniquet is the question most often answered when making a case as to the importance, especially when related to civilian use versus military or law enforcement.
According to the World Health Organization, uncontrolled post-traumatic bleeding is the leading cause of potentially preventable death among trauma patients. Things like falling, motor vehicle accidents, stab wounds, gunshot wounds, terrorist attacks, natural disasters, etc., are all potential causes. A person can bleed to death from a complete femoral artery and vein disruption in 2-4 minutes. The good news is there are options civilians can take advantage of to help deal with life-threatening extremity hemorrhage. Tourniquets are one of the tools used to do this, especially if direct pressure is ineffective or impractical.
It’s easy for a lot of folks to comprehend the need for members of our law enforcement and military communities to carry TQ’s. It’s sometimes harder for these same folks to see the civilian application. In a new study, Civilian Prehospital Tourniquet Use is Associated with Improved Survival in Patients with Peripheral Vascular Injury, published in the Journal of the American College of Surgeons, researchers make the case for prehospital tourniquet use and the direct relationship it has to drastically increase a person's odds for survival.
The study spanned across 11 Level I trauma centers from January 2011 through December 2016. The conclusion of this study was a 6-fold reduction in mortality in patients with peripheral vascular injuries when prehospital tourniquets were utilized. “This is the first time that we were actually able to prove the survival benefit of using the tourniquet in the civilian population,” said lead study author and trauma surgeon Pedro G. R. Teixeira, MD, FACS, of the University of Texas at Austin, Dell Medical School.
In another study, Tourniquet Use for Civilian Extremity Trauma, published in the Journal of Trauma and Acute Care Surgery, the conclusion was much the same. “Tourniquet use in the civilian sector is associated with a low rate of complications. With the low complication rate and high potential for benefit, aggressive use of this potentially lifesaving intervention is justified.” Keep in mind, the average time the tourniquet was on the patients in both of these studies was approximately 75 minutes.
According to Peter T. Pons, MD, FACEP, who wrote the article Stop the Bleed: 8 pitfalls to avoid in hemorrhage control published on www.trauma-news.com, there are 8 pitfalls to avoid in hemorrhage control:
- Not using a tourniquet or waiting too long to apply it for life-threatening extremity bleeding.
- Not making a tourniquet tight enough to obliterate the distal pulse
- Not using a second tourniquet
- Periodically loosening a tourniquet
- Using an improvised tourniquet
- Packing a wound with a hemostatic gauze product and assuming you are done
- Letting the victim’s discomfort and pain interfere with what you need to do
- Doing nothing when a tourniquet or wound packing supplies are not available
The bottom line is adequate hemorrhage control is vitally important in prehospital environments. We are in the position to provide immediate care to ourselves and those around us prior to professional intervention. A lot of time can lapse between injury, first responder, and hospital care. It’s what you do with this time that can make all the difference in the world.
When it comes to purchasing a tourniquet to carry, be sure to buy one recommended by the Committee on Tactical Combat Casualty Care (CoTCCC). Also, if you want to know How to Carry a Tourniquet be sure to check out our article on one practical solution. Above all, seek out qualified instruction with current information in regards to massive hemorrhage control!