First aid techniques

[Deserttech Europe]

Hello gents,

 

as I mentioned in our previous thread, I suggest that we use this space as a learning tool, both for scpecific techniques as well as pointing each other in the direction for more extensive training and knowledge.

 

Can I suggest we start the discussion on the use of Tourniquet.

 

Who would like to kick off the training with how they have been trained to apply said, as well as any particular recommendations on brand etc.

 

regards

 

DTA Europe

[DL.]

It has to be said that tourniquets have come a long way in recent years, the issued CAT (combat application tourniquet) should remain in it packet until used in order to maintain the integrity of the material.

 

During the application of the CAT, the level of pain expirienced by the casualty will be notable, often said to be causing as much pain as the injury its self.

 

A study by the Israelis has shown that the requirement to ease the pressure under the tourniquet may not be as necessary as previously believed, due to casualties being left for a number of hours in the field without serious effect.

 

Disclaimer - if any of you guys kill anyone performing first aid - don't quote me.

 

They look like this :

 

http://www.amazon.com/C-A-T-Combat-Application-Tourniquet-Black/dp/B003IPZRYI

[Deserttech Europe]

In my training, I have been told DO NOT loosen a tournequet once it has been applied, the principle is similar to pressure bandages in that you do not remove them to apply new ones in the field, just keep applying more on top. With the tournequet there is a risk of any clotting formed being flushed by fresh blood when the tournequet is released putting the patient back at square one.

 

regards

 

DTA Europe

[Barrelsniffer]

Yep agree with you once tournequet has been applied do not loosen..my mistake earlier..thats for more qualified personell/medics to loosen..we were told to apply 4 fingers above a wound so it does not slip..and never apply over joints as then you will never cut off the blood..and on forehead or attach bit of paper write down time it was applied to the wound.

 

Medical SOPs..tend to change every 6 to 12 months ive found..from one way to a new way then back to old way..then a totally new way..

 

Mick

[Patriot741]

The thinking on tourniquets used to be to apply them when necessary but to then write on the casualties forehead in black marker pen with a large letter T and time of application. The tourniquet would then be released every 10mins to stop the limb with the blood supply cut off 'dying' from tissue damage. The current thinking is now that once a tourniquets is applied, it stays there until the casualty can have IV access gained and an anti-toxin administered. The problem was that any part of the body which has the blood supply cut off starts to build up toxins in the blood. Once these are released to continue flowing around the body, they effectively put the body into such a toxic shock that the casulty dies within a few minutes. It's for the same reason that if you have a trapped casualty, ie. trapped in a crushed car, under a building in an earthquake zone etc. they need to have IV access and anti-toxins administered prior to release.

[brown dog]

The thinking on tourniquets used to be to apply them when necessary but to then write on the casualties forehead in black marker pen with a large letter T and time of application. The tourniquet would then be released every 10mins to stop the limb with the blood supply cut off 'dying' from tissue damage. The current thinking is now that once a tourniquets is applied, it stays there until the casualty can have IV access gained and an anti-toxin administered. The problem was that any part of the body which has the blood supply cut off starts to build up toxins in the blood. Once these are released to continue flowing around the body, they effectively put the body into such a toxic shock that the casulty dies within a few minutes. It's for the same reason that if you have a trapped casualty, ie. trapped in a crushed car, under a building in an earthquake zone etc. they need to have IV access and anti-toxins administered prior to release.

 

Good point. Not many people know that about release from crush injuries. Wouldn't like to quote the time without checking; but i remember a number that was a fraction of an hour before release from a crush (or tourniquet) becomes dangerous due to toxic shock.

[TC]

Reading this makes me think my First Aid training is due a serious refresher/upgrade ...

 

The last specific training I did was dive related, any recommendations for something civi but higher level than the usual St Johns?

 

Tony

[Patriot741]

Good point. Not many people know that about release from crush injuries. Wouldn't like to quote the time without checking; but i remember a number that was a fraction of an hour before release from a crush (or tourniquet) becomes dangerous due to toxic shock.

 

When I did my first Advanced Firearms Medic course, the consultant lecturing us said that the protocol at the time (which is now changed) was that tourniquets were released every 10mins and that anyone trapped / crushed for an unknown time, or 10mins or longer was to be left until anti-toxin was administered unless their condition was so bad and / or deteriorating that they needed to be released for more intensive life saving treatment.

[Barrelsniffer]

When I did my first Advanced Firearms Medic course, the consultant lecturing us said that the protocol at the time (which is now changed) was that tourniquets were released every 10mins and that anyone trapped / crushed for an unknown time, or 10mins or longer was to be left until anti-toxin was administered unless their condition was so bad and / or deteriorating that they needed to be released for more intensive life saving treatment.

 

Above is correct now i believe tourniquets are to be left without being released which i only found out when this post started by asking a medic out here..you watch next yr it will change back..as procedures seem to change every 6-12 months.

 

Mick