Tech Tip - Tuesday - Mountain First Aid - Tourniquet
With Colorado elk season kicking off in just a few days, I figured we should sit down and talk about something that we often miss. We are always busy talking about boots, tents, packs, stoves, food, and well, you get the idea; the list goes on and on.
Nevertheless, one thing we rarely talk about is First Aid. By this time, I'm sure everybody here has heard of a tourniquet, but how many people know when and where and how to apply one? Is the TQ the best option?
Now since we are talking about first aid and whatnot, a little disclaimer. S.C.O. is not responsible for anything that may or may not occur to you in the backcountry or during the application of any of the below listed objects. (I just have to say it.)
However, what makes me qualified to speak on this topic? Well, I spent over a decade carrying a firearm professionally, deploying to Afghanistan multiple times. As a Law Enforcement Officer, I was awarded Life Saving medals for stuff that we are going to talk about here. So not only have I been through years of training, I have had to employ some of the tips and tricks we will discuss here.
So first, your kit. What all needs to be in a basic First Aid Kit?
- Gloves - non-latex - you never know who could be allergic.
- Tourniquet - One is none. (always carry at least 2)
- Roller Gauze - One is None
- Israeli Bandages - Again one is none
- 4 x 4 Gauze Pads - One is none - Are you starting to see a pattern?
- Sam Splint - Yep. you guessed it...
- Elastic Bandages - See above pattern
- Chest Seal - One is None
- Liquid IV - Or some sort of hydration powder.
- Garmin InReach - Or any Sat Comm device.
Now I know I've missed a few items, but these are some of the basics that can help stop the bleed.
You might be thinking, well how do I know when or how to apply each of the items listed above. You may find yourself in a situation where you may need to be utilizing several of these items to help control the bleeding.
I was working a single-vehicle accident where the female driver left the roadway and rolled her vehicle. During this process, she slid back across the roadway with her arm out of the window. During the roll, the vehicle landed on the driver's side. The vehicle skidded across the roadway severing her arm. It also caused a MASSIVE laceration to her head from her right eyebrow to her hairline deep enough to where the skin just flapped, and you could see bone. It was a pretty gnarly scene.
Well, which one is important to address? This is where it knowing what you are looking at comes into play.
After assessing my female patient, she was conscious, and she was breathing. Her left arm was completely gone from just above the elbow. A tourniquet was placed before my arrival by another Officer.
Keep in mind that tourniquets were very new at my agency, and not a lot of people had real-world experience with them. And our victim continued to spurt blood from her wound because, well, her arm was gone. While the head trauma was severe, it was not arterial bleeding.
A very important thing to keep in mind for both the patient and for yourself is to remain calm. Breathe, and think. The other Officer (who again was new to this type of situation) wanted to remove the tourniquet. NEVER REMOVE. Add a second tourniquet if the blood continues to flow.
Now, in this case, a second one is needed. Remember, one is none. The area where you apply a second tourniquet is ABOVE THE FIRST ONE.
There are several trains of thought for TQ placement, "high and tight" or approximately 2" above the wound. High and tight meaning as close to the next joint, so in this particular case it would be close to the armpit. For this scenario I went with 2" above the first TQ to give us some more room to work with in case we needed to add an additional tourniquet.
Once you've got the tourniquet into position, against bare skin. (hence the sheers) you will tighten it as much as possible before turning the windless. Think of tightening a belt.
Remind your patient that this next step is going to hurt like hell. But that's okay. It means they're still alive. If you have to apply one to yourself, understand that this is going to hurt. Nevertheless, it is better to be hurt than dead.
Once you have secured the strap to itself after pulling the tourniquet as tight as possible, you are going to tun that windlass rod UNTIL THE BLEEDING STOPS.
Here is a good video that demonstrates how to apply a tourniquet.
Remember, folks; this takes practice to do and to do effectively. I would encourage everyone to purchase a training tourniquet. Why? If you continue to tighten the windless, it loses its integrity over time. Tourniquets are a one-shot kind of deal. So get a training one, mark it as training and only use it for training. Work on getting proficient placing it and working that windless.
Please let u know what you think of this topic. Is it worth it to explore the other tools in your kit? Leave us a comment below!