Medical training

[G.E. Lee]

I took the free 2 hour course called Stop The Bleed. This is a nationwide deal originated by the American College of Surgeons in conjunction with the Committee on Trauma and the Hartford Consensus. The course is offered about once a month in many cities. It is largely hands on training with various tourniquets, wound packing, direct pressure techniques, etc. You practice on a buddy or on a simulated upper leg made out of something like ballistic gelatin. You learn a lot, but it does not cover chest seals or relieving pneumothorax problems.

https://stopthebleedingcoalition.org/

Good places to buy pre-made kits are Skinny Medic, North American Rescue, and Rescue Essentials. In fact, they are not just good, they are all great. You can find many of their videos on YouTube.

I wear cargo shorts in summer, and for EDC it is easy to fit into one cargo pocket a Cat-7, a large Celox hemostatic 9g gauze strip, and a smaller 3g Celox hemostatic 1 inch by 5 ft. ribbon (for narrower wounds of, say, pencil size diameter). I throw in a pair of gloves for my left rear pocket. When hunting I add a vented chest seal. Nobody ever notices that I have these things and they are no trouble at all. It is easy to forget you even have the stuff on you. It is even easier to carry such stuff in the winter when wearing coats...

 

[Buzznrose]

This contains everything I have in my kits. I bought and built mine but I probably didn’t save much since quality components aren’t cheap...

MediTac Premium IFAK Kit - Feat. Trauma Pak, CAT Tourniquet, HyFin Vent Chest Seal, Israeli Bandage https://www.amazon.com/dp/B07CG9HFSF/ref=cm_sw_r_cp_api_i_4jiuDbYRPR9ZS

 

[bearcreek]

Keep in mind fellas, most of us are wearing a tourniquet most of the time anyway.

Take your belt off and use it. A handkerchief can be used in a pinch as well, provided it’s not thigh injury or heavier person. Rip your shirt.

Those are certainly good things to know how to do. I can also improvise a firearm with a steel pipe, pipe cap, a nail and a bicycle inner tube. It's a rather poor idea to rely on that though. Improvising tools is a great skill to have but very rarely works as well as the real deal. Improvised tools also take more practice than the real thing to get good at, so, given that most people who don't care to carry real tools are also less likely to practice with improvised tools, that lowers the chances of them working even more.

I personally don’t dress to accommodate a lot of the gear some guys carry. I wear clothes that fit and don’t wear cargo shorts/pants and the like with 55 pockets in them. I don’t carry a flashlight, tourniquet, IFAK, 3 reloads, a spare gun, etc to to to the bank, Walmart, etc. I don’t wear Hawaiian shirts or vests. Nothing wrong with anyone who does, but it ain’t my style. There’s simply not room for everything that we can all agree would be useful in a time of crisis.

I wear pants like this regularly. I certainly don't claim to be a fashionista but my wife likes them and I don't think they have an excessive number of pockets. Carrying this stuff does take a little extra effort, no doubt about it. It's really not as much effort as a lot of people seem to think though.

All I’m saying, is in a crisis situation, we can absolutely make due for the short period of time it would take EMS to arrive and handle the situation. Use a piece of your shirt and a pen to make a tourniquet while someone holds pressure. Hand your belt to someone and have them PULL. Pressure is great, but sometimes you need more hands.

You may be able to make due, or you may not. I'll deal with the tiny inconvenience of carrying a TQ and keep my belt and gun on. BTW, when you train applying an improvised TQ using your belt, where do you put your gun when the belt comes off?

 

[bearcreek]

Wanna bleed to death? Use your belt as a tourniquet!
https://mymedic.com/blogs/journal/your-belt-is-not-a-good-tourniquet

 

[Trunk Monkey]

Tampons are great bullet-wound-pluggers.

This is incorrect. A tampon will stop the blood from coming out but it does nothing to stop internal bleeding.

Keep in mind fellas, most of us are wearing a tourniquet most of the time anyway.

Take your belt off and use it. A

Any belt stiff enough to be used as a gun belt is too stiff to be used as a tourniquet

 

[Balrog]

Any belt stiff enough to be used as a gun belt is too stiff to be used as a tourniquet

I am a trauma surgeon and don't really understand why you would think that.

 

[Trunk Monkey]

I am a trauma surgeon and don't really understand why you would think that.

Do you think you could make a tourniquet out of a belt with a Kevlar or Steel stiffener in it?

I should have been more clear but I was thinking specifically of purpose-designed gun belts. I don't think that I can make a tourniquet out of my Wilderness Tactical belt unless I used a Baseball Bat for a windlass.

 

[herrwalther]

I am a trauma surgeon and don't really understand why you would think that.

A good gun belt is too stiff to twist being used as a tourniquet.

 

[S&W620]

Those are certainly good things to know how to do. I can also improvise a firearm with a steel pipe, pipe cap, a nail and a bicycle inner tube. It's a rather poor idea to rely on that though. Improvising tools is a great skill to have but very rarely works as well as the real deal. Improvised tools also take more practice than the real thing to get good at, so, given that most people who don't care to carry real tools are also less likely to practice with improvised tools, that lowers the chances of them working even more.

It’s a tourniquet, it’s not exactly rocket surgery. You just need pressure above the bleed. I’m not trying to McGyver a mobile trauma kit out of a pair of tweezer and a Tick Tack here...

I wear pants like this regularly. I certainly don't claim to be a fashionista but my wife likes them and I don't think they have an excessive number of pockets. Carrying this stuff does take a little extra effort, no doubt about it. It's really not as much effort as a lot of people seem to think though.

Glad you and your wife like them, but they’re not my style. Phone, keys, money clip and knife. That’s all I think I can muster in my pockets and that feels cramped at times.

What can I say, I like to live dangerously.

You may be able to make due, or you may not. I'll deal with the tiny inconvenience of carrying a TQ and keep my belt and gun on. BTW, when you train applying an improvised TQ using your belt, where do you put your gun when the belt comes off?

I’d imagine I’d shove the holster down my pants and let the clips hang on the fabric. It works well enough when I’m wearing gym shorts, I’d imagine a stiffer material like denim would be fine.

Or have my wife hold it? Or a friend. Or my kids. Or set it between my legs. I’m guessing most folks will be more concerned about the person actively bleeding than my ccw.

As far as the training, I’ve been an RN for a decade with a background in trauma/burns. I’ve stopped an arterial bleed a time or two and feel comfortable doing so again I’d imagine.

 

[S&W620]

Do you think you could make a tourniquet out of a belt with a Kevlar or Steel stiffener in it?

I should have been more clear but I was thinking specifically of purpose-designed gun belts. I don't think that I can make a tourniquet out of my Wilderness Tactical belt unless I used a Baseball Bat for a windlass.

A good gun belt is too stiff to twist being used as a tourniquet.

I’m not talking about twisting it, I’m talking about running one end of the belt through the hardware and pulling with force against the buckle.

Exactly like this tourniquet.

That said, I wear leather belts. I have an Ares Gear belt I bought on a whim and that wouldn’t work, I agree.

 

[S&W620]

I’d also like to point out that in my original post on the subject I clearly stated these weren’t ideal, just other options that can be used to provide aid in a terrible situation until EMS arrives (a couple of minutes in most cases).

I’m not trying to talk anyone out of carrying a tourniquet or saying your tube sock and penlight is just as effective, they’re not.

My point was more to make sure folks are aware of the ways that can help either themselves or others in a horrific situation when they left their med kit in the car, at home, whatever.

 

[Balrog]

A good gun belt is too stiff to twist being used as a tourniquet.

Don't twist it then, just run through buckle and pull like heck. Its not ideal, but you should be able to occlude a femoral or brachial artery that way.

 

[bearcreek]

Don't twist it then, just run through buckle and pull like heck. Its not ideal, but you should be able to occlude a femoral or brachial artery that way.

The evidence says otherwise, especially around clothes.

 

[Balrog]

The evidence says otherwise, especially around clothes.

Can I see the evidence? I have never heard that. Its simply a matter of applying enough pressure.

 

[bearcreek]

Can I see the evidence? I have never heard that. Its simply a matter of applying enough pressure.

I'll post some things when I get a chance. In a nutshell, the problem with using a belt is, as you mention, "applying enough pressure". That's why all of the CoTCCC (Committee on Tactical Combat Casualty Care) recommended TQ's have some sort of force multiplying mechanism, in most cases a windlass, in a couple cases, a ratchet. Pulling a belt through it's own buckle just doesn't produce enough "squeeze" to be reliable, plus, it's very hard to secure in place, even if it was initially successful in stopping the arterial bleeding. In addition, very stiff belts, the kind that are commonly used as gun belts are even worse because they're too stiff and were never meant to be cinched down as small as the diameter of a leg or arm. Putting the TQ on over clothing just accentuates all of this. Last but not least, trying to figure out where and how to secure your weapon in the midst of a chaotic situation now that you've removed the best method to retain it is just asking for trouble.

 

[Balrog]

I'll post some things when I get a chance. In a nutshell, the problem with using a belt is, as you mention, "applying enough pressure". That's why all of the CoTCCC (Committee on Tactical Combat Casualty Care) recommended TQ's have some sort of force multiplying mechanism, in most cases a windlass, in a couple cases, a ratchet. Pulling a belt through it's own buckle just doesn't produce enough "squeeze" to be reliable, plus, it's very hard to secure in place, even if it was initially successful in stopping the arterial bleeding. In addition, very stiff belts, the kind that are commonly used as gun belts are even worse because they're too stiff and were never meant to be cinched down as small as the diameter of a leg or arm. Putting the TQ on over clothing just accentuates all of this. Last but not least, trying to figure out where and how to secure your weapon in the midst of a chaotic situation now that you've removed the best method to retain it is just asking for trouble.

You are probably correct if you are talking about military situations where evacuation may be prolonged and arrival to definitive treatment may take hours. I can definitely see how a real tourniquet could make a difference there. I was thinking more in terms of civil situations where EMTs will be on scene quickly and transport to hospital is just a few minutes.

 

[bearcreek]

You are probably correct if you are talking about military situations where evacuation may be prolonged and arrival to definitive treatment may take hours. I can definitely see how a real tourniquet could make a difference there. I was thinking more in terms of civil situations where EMTs will be on scene quickly and transport to hospital is just a few minutes.

That is often the case, but not always, particularly in rural areas, or other situations, like an active killer scenario, where EMS response can be delayed significantly. It's common in many areas near me for EMS response times to be 30+ minutes.

 

[bearcreek]

Heck, Balrog, you should do some testing for yourself and let us know how it goes. I'm sure you have the equipment available. Use your belt as a TQ on yourself and see what it takes to eliminate a distal pulse, then try it with a CAT or SOFTT-W.

 

[Balrog]

Heck, Balrog, you should do some testing for yourself and let us know how it goes. I'm sure you have the equipment available. Use your belt as a TQ on yourself and see what it takes to eliminate a distal pulse, then try it with a CAT or SOFTT-W.

Hmmm I think I will take a hard pass on cutting off my circulation and just take your word for it.

 

[herrwalther]

Don't twist it then, just run through buckle and pull like heck. Its not ideal, but you should be able to occlude a femoral or brachial artery that way.

Another point. Some gun belts will not get tight enough to restrict the femoral let alone the brachial artery. I loathe web belts, and that is about the only kind that will work as a TQ in a pinch. So I can either change my belt type and miserably carry a firearm or I can carry a dedicated TQ for much less money. Think I will go for a dedicated tool for the job.

 

[bearcreek]

Hmmm I think I will take a hard pass on cutting off my circulation and just take your word for it.

It's not comfortable, I assure you, but it's not permanent. How are you so confident that a belt will work at all since you apparently have never trained with it? Did you read or hear that from someone who knew what they were talking about?

 

[herrwalther]

You are probably correct if you are talking about military situations where evacuation may be prolonged and arrival to definitive treatment may take hours

Being a supposed trauma surgeon I would expect you would know better, so I will educate you some on a real MASCAL event and training. I have ripped off my mil issue belt to deal with an extremity bleed. It only bought me enough time for someone to go get a TQ out of their kit. Below is the kind of belt I used and it did not work to contain a bleed.

https://www.military1st.com/f560375233-propper-tactical-belt-tan.html

 

[Balrog]

It's not comfortable, I assure you, but it's not permanent. How are you so confident that a belt will work at all since you apparently have never trained with it? Did you read or hear that from someone who knew what they were talking about?

I am not confident, but its an improvisation that would probably stop most bleeding short term. It would certainly control most venous bleeding. I don't doubt a real tourniquet would work better but not many people have those at hand.

 

[Balrog]

Being a supposed trauma surgeon I would expect you would know better, so I will educate you some on a real MASCAL event and training. I have ripped off my mil issue belt to deal with an extremity bleed. It only bought me enough time for someone to go get a TQ out of their kit. Below is the kind of belt I used and it did not work to contain a bleed.

https://www.military1st.com/f560375233-propper-tactical-belt-tan.html

Yes, that is what I am talking about, buying time. The use of tourniquets was frowned upon in civilian trauma back in the 80s and 90s. Its regained acceptance for some injuries, but direct pressure still seems the most common thing I see EMTs around here using to control bleeding.

Maybe we are not completely on the same page. I am not saying a belt is the preferred method to control extremity hemorrhage.

 

[herrwalther]

A belt bought me 5 minutes. And that was stretching it. Better to have the right tools for the job and not rely on TV show medicine.