Stop The Bleed: Tourniquet Application

all right so I wanted to do a video today on this new bag I've got for my third line gear coming in and some of the things related to that however shipping is gonna be a little bit delayed because of Monday's holiday so I won't be getting that until about next week so this week because I am a medical preparedness youtuber I figured I should probably have a video out there on the cat tourniquet and how to apply tourniquets in Genma so I'm guessing most people on this channel know what a tourniquet is and a lot of you probably know how to apply it but I still see a lot of misinformation online about tourniquets how to put them on what products are available so I want to clear a little bit of that up in this video all of some follow-up videos down the road on tourniquet selection and some of the commercial brands that you should trust with your tourniquet but for this video we're going to be talking about the cat tourniquet now for those of you that don't know a tourniquet is a band that constricts an extremity and keeps blood flow from distal to the extremities so further down this is a great help and cessation of really bad hemorrhage if somebody's shot or wounded on the battlefield or cuts themselves really badly that's when a tourniquets gonna come in we'll get into kind of the indications of a tourniquet later on in the video so for a long time tourniquets were seen as this kind of a scary procedure you know if you put a tourniquet on they're gonna lose that arm or a leg whatever it might be and they've really found in not even recent years since the 90s that tourniquets are actually saving lives and that there are very few instances of an extremity actually being having to be amputated because it's been an eternity too long at least in EMS and Battlefield medicine all right so let's go over types of tourniquets and why I use what I do so the combat application tourniquet is one of three commercial devices that's recommended by T Triple C so tactical combat casualty care to be used for hemorrhage control and the three that are kind of approved by them or vetted by them are the combat application trying to get the cat tourniquet the soft T and the soft T wide and then something called the EMT tourniquet it's really not that great and I've never even seen one so those are the three that are approved I like north can North American rescue so that's what I have for us today so what are some indications of a tourniquet they're going to vary a little bit if you're on the military in a combat side or if you're in civilian EMS or in a situation that isn't as life-threatening so we'll kind of go through those and this is similar to how the needle decompression that it varies depending on where you are so if you're in civilian EMS you have somebody that maybe cut themselves with the chainsaw you there's no ongoing threat to life then your indications for a tourniquet are going to be severe extremity bleeding that does not stop with direct pressure so in that instance you're gonna take a gloved hand maybe a little bit of gauze and you're going to apply direct pressure over that severe bleeding and usually that's going to be an arterial bleed so bright-red spurting blood you're going to hold that pressure and if that pressure doesn't work we're gonna move immediately to a tourniquet so if you're in a combat situation you have an ongoing threat we're not going to stop and do direct pressure and you're going to apply a tourniquet right away whether that's a self aid if you're putting it on your own arm or helping a buddy down there as well now I'll always remember that we're still going to try to neutralize the threat first and foremost and then apply the tourniquet but we don't want to delay tourniquet application if it can be avoided so to apply a tourniquet essentially you just need the tourniquet tight on the arm above the injury so that's called proximal to the injury that's closer to your body so if somebody has a bullet wound through their wrist let's say then you're going to take this and you're gonna put this a couple inches above the wrist tighten it down and you're good to go they used to say that you don't want to put it on the lower arm the lower leg because you have two bones there it's not as effective as compressing now they're telling us that that's actually okay in a combat situation if somebody has long sleeves on you're not quite sure where that wound is we're not going to take a lot of time to expose the wound and then apply the tourniquet obviously the tourniquets always better on skin but if you have to put it over uniform that's okay and in that combat situation you're going to put the tourniquet in and on and you're going to just put it as high on the arm or the leg as you can wrench it down and get it tighten and then when you have time when the scenes more safe you can go back and expose the wound so let's go through the specific steps of actually applying a cat tourniquet so to apply a cat tourniquet the first thing you're only want to make sure is when you're storing it it's stored in the appropriate manner so it's folded up and then you can just open it and that can go around any extremity rapidly you should be able to apply a tourniquet to yourself or a buddy in under 15 seconds that's kind of the standard and that's what you should be shooting for so you're going to take the tourniquet you're gonna put it on the extremity and as you put it up to the extremity you're gonna go just above the wound if you can see it if you can't see the wound you're just going to do high and tight until you get to a point where you can actually expose that wound so once you put it on you're going to tighten the band as tight as you can on the arm the biggest reason the cat tourniquet fails is because that initial tightening of that strap is actually not enough and then you can't turn the windlass enough to take up that slack so you want to make sure that first tightening is as much as you possibly can do once you have the tourniquet tight then you're going to take what's called the windlass and that's the stick that actually pulls in the pressure of the tourniquet and you're gonna start turning that you're gonna turn that until the blood flow ceases and you do not you no longer have a distal pulse on that extremity once you tighten the windlass you're gonna notch that back into the holder provided on the cap and you're gonna move the strap over that all the way around to hold that in then there's a little white tab on the cat tourniquet that you can pull over that opening it holds the windlass in place and it also has a place where you can write the time of tourniquet application always make sure you note the time because that is relevant down the road if it's been on for a long time there's certain cocktails of meds that have to be given prior to the tourniquet coming off and that's going to be important for the emergency room to know and then it's also important that the tourniquet remains visible a lot of these tourniquets are not this fluorescent orange that I'm using and they're black or darker settled colors so you have to make sure that the receiving facility knows that there's a tourniquet in place if you're in civilian EMS and you're not going to be using a tourniquet and tactical environment I honestly would recommend going with fluorescent color just makes it safer for the patient once you have applied a tourniquet it is important that you do not take it off for any reason it should only be taken off by an experienced medical provider sometimes a paramedic mostly that's going to be a physician in the emergency room if they're still bleeding after the first tourniquet supplied try tightening the windless again seeing if that stops the blood flow and if that does not stop that blood flow then you can take a second tourniquet and place that on there as well and that will stop the bleeding if you do not carry tourniquet in your kit I highly recommend you get one my personal recommendation is the cat or the soft deer soft q why'd they both work pretty similarly you have some other devices out there that I'm not as big of a fan of such as the rats tourniquet don't try to make your own I would highly recommend going with a commercial device but ultimately the best tourniquet is the one you have on you so if the rats is what you're gonna carry on you carry your rats I say but grudgingly but I would recommend going with something that T Triple C actually recommends because those have been tested in the pre-hospital environment pretty extensively and have been found to be very effective I want to make it pretty clear I know that I talk a lot about a North American rescue and certain other brands I'm not paid in any way by these companies I get no reimbursement from them and I just want you guys to know that the reason that I type talk highly of all the gear that I review on this channel is because I own this gear I vetted this pretty extensively and I would not trust my life--and or others or somebody else's life to something that I didn't believe in that I haven't done my research on so if I seem like I'm a North American rescue fanboy it's because I've had a lot of their products and they've always worked for me if in the future I ever am being sponsored by somebody I will never take money to say a nice thing about a product I will be happy to review products for a company but I'm always going to be honest about it because ultimately I don't want somebody going out on my advice and buying a product and having it fail and then that coming back on me because that's your life that's your patients life that's at stake and I'm not going to compromise this on this channel so with that being said I appreciate you guys watching I've got a a lot of cool stuff coming up have a couple cool gadgets in the mail so I will see you next week for those videos [Music]

Channel: PrepMedic

Views: 198,029

Rating: 4.954453 out of 5

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Id: wWVne7cUrm8

Length: 10min 3sec (603 seconds)

Published: Fri Sep 07 2018