Anyone carry a tourniquet?

[chrisjpainter]

Anyone in the forces/emergency response or somesuch carry a CAT on their person? Do you use a case for it and if so, what type? My pouch completely disappeared, which is annoying. Any recommendations would be appreciated. I have the CAT just not the pouch. If it attaches to a belt, that'd be useful, because right now the CAT's just got to sit in my first aid kit and I'd like it more easily accessible than that.

Edited November 8, 2021 by chrisjpainter

[Ultrastu]

My cat tends to sit either on the windowsill or in front of the fire  😉.

But seriously  I don't have a tourniquet  in my first aid box  but a zip tie may do in a pinch .

[chrisjpainter]

19 minutes ago, Ultrastu said:

My cat tends to sit either on the windowsill or in front of the fire  😉.

But seriously  I don't have a tourniquet  in my first aid box  but a zip tie may do in a pinch .

Depends on whether or not it's a chainsaw doing the pinch! 🤣

[ph5172]

I have a few models

C-A-T and some American types that look like a large bracelet with a cycle helmet type ratchet wheel (I can’t recall the brand now) that are a lot more expensive than the C-A-T

 

C-A-T do a specific pouch but it isn’t cheap. 
 

I have seen them tied with fishing line to belts or the outside of bags so a decent pull will snap the line. 

[CaptC]

We had a Gun's dog sever an artery last Saturday, blood squirting everywhere and the First Aid kit half a mile away. Cornish ingenuity came to the fore, one of the beaters cut strips out of the Guns breeks making a tourniquet. Lesson learned - carry the First Aid kit at all times! The dog survived with a hefty bill for the owner.

[mgsontour]

I don't carry a tourniquet but carry on me NSAID's, mars bar, a dog lead, knife, shooting stick and a mobile with the what3words app on it ( essential for anywhere that doesn't have a postcode and house number) when either in the field, fishing or simply walking the dogs.

In the my van I have for bleeding:

A packet of blood clot granules, a bog roll, cohesive tape and a disposable medical stapler. All of which are cheap to buy and have I must say

As above a hat, gloves, breeks, underpants or whatever is to hand works until you get to the car and mountain rescue arrives

[old man]

I carry Celox granules.

[chrisjpainter]

29 minutes ago, mgsontour said:

I don't carry a tourniquet but carry on me NSAID's, mars bar, a dog lead, knife, shooting stick and a mobile with the what3words app on it ( essential for anywhere that doesn't have a postcode and house number) when either in the field, fishing or simply walking the dogs.

In the my van I have for bleeding:

A packet of blood clot granules, a bog roll, cohesive tape and a disposable medical stapler. All of which are cheap to buy and have I must say

As above a hat, gloves, breeks, underpants or whatever is to hand works until you get to the car and mountain rescue arrives

What I love about the CAT is it's so usable and easy to teach. If you're the casualty and need to teach someone how to use it on you, it's so straightforward and if it's an arterial cut, even Celox struggles. Venal stuff's fine, but nothing beats a tourniquet if the air's getting sprayed red.

What's odd is the holders seem to be more expensive to replace than the CAT! 

[mgsontour]

21 minutes ago, chrisjpainter said:

What I love about the CAT is it's so usable and easy to teach. If you're the casualty and need to teach someone how to use it on you, it's so straightforward and if it's an arterial cut, even Celox struggles. Venal stuff's fine, but nothing beats a tourniquet if the air's getting sprayed red.

What's odd is the holders seem to be more expensive to replace than the CAT! 

I see odd things more and more ( must be getting older ) but when the air turns red it's time for a white owl cigar and a stiff drink mate!

On a more serious note, the reason I opted for my kit for bleeding rather than a tourniquet was I had the dog lead with me which may not be a CAT but I recon it would work to some degree for most serious bleeds but obviously not in the deep end if you get what I mean

[Jonty]

I have one in all three of my first aid kits.  I can genuinely see the practicality of a belt pouch if you’re doing chainsaw work etc but for me bumbling about the hills etc, all of my first aid stuff is packed way in a pouch/kit.

If folks are carrying Celox when they are out and about shooting, consider the impregnated gauze rather than the granules - Sod’s law will dictate it will be peeing it down and blowing a hoolie when you want to use it and the gauze will be far more forgiving in that kind of environment.

[HantsRob]

Sadly it's either in the car boot, or in a molle vest. It is definitely one of those things that's a pain to carry until you need it. Then you need it.

I found that carrying an "unbreakable pen" really useful. You can use it with any strip of material as a windlass, and is useful as a pen. Not as good as a CAT but a cat bleed doesn't need a nice tool. 

TBH I usually cuss more I don't have a felt tip pen to write on someones head things like blood group etc when they're still conscious. I appreciate that wouldn't have helped with the dog! 

[Agriv8]

No I don’t but I a rarely without a belt or a sock that I would  sacrifice if the need arose. I know these are not perfect but if a dogs or persons life depended on it I recon it would work.

I do carry a small first aid kit in my game bag bandages and dressings ! 

atb Agriv8

[Bigbob]

I carry a first aid kit in the back of the car but i thought a tourniquite was frownd on now unless used by a trained medic as not used correctly it could do more harm than good . We where instructed you could use up to 3 pressure banages to stop the blood flow while waiting on help ??

[Hicky]

37 minutes ago, Bigbob said:

I carry a first aid kit in the back of the car but i thought a tourniquite was frownd on now unless used by a trained medic as not used correctly it could do more harm than good . We where instructed you could use up to 3 pressure banages to stop the blood flow while waiting on help ??

Depends on the situation and the knowledge of the first aid giver.

If the bloods flowing(arterial) then you want that stopping quick smart. Worry about any damage later.

[chrisjpainter]

3 hours ago, Bigbob said:

I carry a first aid kit in the back of the car but i thought a tourniquite was frownd on now unless used by a trained medic as not used correctly it could do more harm than good . We where instructed you could use up to 3 pressure banages to stop the blood flow while waiting on help ??

First Aid advice has changed these days and they're encouraged in the right situation; as @Hickysays it's if there's arterial bleeding but only arterial bleeding. If an artery's been cut, nothing's going to be stopping that except a correctly applied tourniquet and the CAT's a doddle to use. Place 2 or 3 inches above the wound on the passage to/from the heart, do the strap up and tighten with the windlass until the flow stops. It really is that simple. 

With any tourniquet there is a chance you'll kill the limb. But as my instructor said, sod the limb, save the life. Get it on and crank the pressure. Your patient is much more likely to make it to the operating table with a tourniquet than without, especially with the femoral artery. With all that muscle and tissue, getting effective pressure even with pressure bandages is difficult. 

Taking off a tourniquet is where it's possible to do more harm than good and should be done by a professional. With the release in pressure you run the risk of flooding the body with an awful lot of nasty toxins floating around in the dying limb, as well as the risk of undoing all the good work of stopping the massive blood loss. But if you've got your person to that point, then as first aider, you've done your job, it's up to the professionals to do theirs when it's time to take it off.

Edited November 9, 2021 by chrisjpainter

[Hicky]

The general guidance is bang a CAT-T on, then the bandages....over 10 mins release the CAT and check for bleeding out(more than likely unless you're the character Wolverine).

To make them work effectively you really need to crank the windlass especially if the limb is a two bone affair ie lower limb.

Venous bleed should be ok with emergency bandage depending on the severity.

As for pouches etc look to Jayjays/Dixies corner or for an ifak pouch if its MTP you want.

Edited November 9, 2021 by Hicky

[HantsRob]

8 hours ago, Hicky said:

The general guidance is bang a CAT-T on, then the bandages....over 10 mins release the CAT and check for bleeding out(more than likely unless you're the character Wolverine).

I just want to say a massive NO THAT IS WRONG to this based on current thinking. 

Once a CAT is on, you leave it. You NEVER take it off. You put a note on it to when you applied it, but you do NOT take it off.

Older thinking was to release and reapply to prevent toxic shock. Only allow the hospital to do this, DO NOT TAKE IT OFF. All you are going to do is remove even more blood from the system. You're best off saving a life and losing a limb, than losing a life from loss of blood. A CAT is applied due to a catastrophic bleed, the word catastrophic should emphasise.

You would have been right several years ago with that thinking, but Police, ambo, firearms etc (and even my meagre St Johns 3 day first aid at work course) say do not remove it. The only time (and assuming you've not done it on a joint) you look at it not working, is when you apply a second CAT, above the first.

 

Please don't remove a CAT. I have sadly seen people die roadside from this old school thinking.

Again, Hicky, not having a go. Current best practice is put it on and leave it on. There are a few weird exceptions, mostly for medical professionals, around travel time to a hospital and what other injuries there are. As I would assume most people are within an hour of treatment rooms and not days away from climbing, it's easier to just say leave it on unless directed by a doctor.

 

Leave it on
Call all the nines
Hope they get there PDQ

Edited November 9, 2021 by HantsRob

[chrisjpainter]

10 minutes ago, HantsRob said:

 

Once a CAT is on, you leave it. You NEVER take it off. You put a note on it to when you applied it, but you do NOT take it off

Yeah this is what I've been taught and it makes sense. Yes, leaving it on risks losing a limb, but so be it. It's a worse risk to start the bleeding again. And it's bad that you're killing a limb, but it's far worse to allow the toxic shock to flood the system. That can lead to multiple organ failure and ultimately a fatality. I'd be able to look an amputee in the eye if I'd caused the amputation, but saved their life. I'm not sure I could do the same to their relatives if I'd saved them with a CAT, then killed them through removing it. 

[Hicky]

14 hours ago, HantsRob said:

I just want to say a massive NO THAT IS WRONG to this based on current thinking. 

Once a CAT is on, you leave it. You NEVER take it off. You put a note on it to when you applied it, but you do NOT take it off.

Older thinking was to release and reapply to prevent toxic shock. Only allow the hospital to do this, DO NOT TAKE IT OFF. All you are going to do is remove even more blood from the system. You're best off saving a life and losing a limb, than losing a life from loss of blood. A CAT is applied due to a catastrophic bleed, the word catastrophic should emphasise.

You would have been right several years ago with that thinking, but Police, ambo, firearms etc (and even my meagre St Johns 3 day first aid at work course) say do not remove it. The only time (and assuming you've not done it on a joint) you look at it not working, is when you apply a second CAT, above the first.

 

Please don't remove a CAT. I have sadly seen people die roadside from this old school thinking.

Again, Hicky, not having a go. Current best practice is put it on and leave it on. There are a few weird exceptions, mostly for medical professionals, around travel time to a hospital and what other injuries there are. As I would assume most people are within an hour of treatment rooms and not days away from climbing, it's easier to just say leave it on unless directed by a doctor.

 

Leave it on
Call all the nines
Hope they get there PDQ

I'm go with current taught practice, no offence taken pal.🙂

My knowledge is from a CMT1 in the forces(so clearly not aimed at joe bloggs in the street) and as you say there are caveats you touch upon which I should of put on my original post.

Edited November 10, 2021 by Hicky

[Smudger687]

Interesting thread, I had the impression that tourniquets had fallen out of favour and been replaced by compression bandages. 

[chrisjpainter]

2 hours ago, Smudger687 said:

Interesting thread, I had the impression that tourniquets had fallen out of favour and been replaced by compression bandages. 

Compression bandages/emergency bandages/Israeli dressings are good for venal bleeds, but they don't give enough pressure to stop an arterial bleed quickly enough. being elastic they have a certain amount of stretchiness that makes it hard to clamp down successfully, particularly if it's the femoral artery that's been severed. All that bone and muscle gets in the way and because the compression is spread out over a wider area, you don't get that direct, specific crushing needed to close the artery.

They also have the disadvantage of being designed to cover the wound. That makes it harder to tell if it's still bleeding, so your patient could be bleeding out either inside the bandage or inside the body without you necessarily being aware of it. 

You can use them in series - one on top of the other - but that takes a lot of time and faffing and makes you one, two, three etc. dressings down should you need them for anything else. The CAT is far quicker and guarantees achieving its goal, whilst leaving you free to use your Israeli dressings for other injuries. 

That said, in their place, Israeli dressings are brilliant, particularly for big, messy injuries that don't include a severed artery. It's best to have both if you're thinking you'll be in a situation where you can conceivably recognise an injury occurring. The likelihood is you'll never need a CAT. but if it ever happens, they're as close to genius as something so simple can get. The company behind them claim that since its introduction in 2005, they've decreased fatalities due to extreme blood loss in the US army by 85%.

[Jonty]

On 09/11/2021 at 10:57, Hicky said:

The general guidance is bang a CAT-T on, then the bandages....over 10 mins release the CAT and check for bleeding out(more than likely unless you're the character Wolverine).

I’m sorry but that’s not general guidance or current thinking. The only time a tourniquet that is effectively stemming arterial bleeding should be removed is when the casualty is in hospital.  

[redial]

Who sells such items.

[HantsRob]

20 hours ago, Smudger687 said:

Interesting thread, I had the impression that tourniquets had fallen out of favour and been replaced by compression bandages. 

There's some amazing things out, from israeli, to russell chest seals, to haemostatic dressings which are the nuts!

As for tourniquets, when you need one.... nothing else will work. You'll know when you need one!

On 10/11/2021 at 10:24, Hicky said:

I'm go with current taught practice, no offence taken pal.🙂

My knowledge is from a CMT1 in the forces(so clearly not aimed at joe bloggs in the street) and as you say there are caveats you touch upon which I should of put on my original post.

Good job! Also yes, the forces work differently and often due to distance/time it'll take to get to base etc. I'm hoping your skills are rusty from lack of requirement to use, and long may that be the case!

[chrisjpainter]

29 minutes ago, redial said:

Who sells such items.

You mean the CAT? You can get them off ebay. I think amazon sell them as well and they're pretty cheap. I'd get one that is actually made by CAT® not one of the Chinese knock off ones. If you're in a situation where only a tourniquet can stem the bleeding on a patient, but the knock-off's windlass snaps off mid tension, you're going to be a bit miffed and your patient's going to be a bit dead.