Improvised Tourniquets: A Bad Idea

TQ_Post Accident_2


Quick Points:

    1. Improvised tourniquets are a bad idea
    2. The most common reasons for not having a tourniquet are unsound
    3. Learn the basics and you can improvise if forced

The above picture is an example of the difficulties in improvising a tourniquet when a wound is severe enough to require one. As the gentleman pictured noted in an email to us, “… [he] received life-threatening injuries to both upper legs as the result of another shooter’s accidental discharge of his weapon. The .30-06 bullet caused very serious injuries to both legs, but the most critical injury was the severing of my left popliteal artery (the largest artery behind the knee)…” To repeat, this injury is secondary to a weapon not being cleared on a range, not a battlefield wound nor a deliberate attempt on his life by a suspect. As you can see, initial attempts to stop the bleeding with a belt were unsuccessful, as illustrated by the ground saturated with blood. Luckily, the Range Master had a kit that contained a SOFTT, which was applied quickly and saved his life.

The point is this: if a manufactured device is available, then have one on-hand. Too many police officers dismiss carrying a tourniquet because “that is the medic’s job.” BULLSHIT! Or, and this is a common one, “I will improvise and use a belt or sling.” Really? Whether an LEO is serving a warrant or issuing a ticket he/she is responsible for his/her life for the time it takes medics to arrive and assist if the scene is safe.

The above-mentioned reasons for not carrying a tourniquet are unfathomable. First, that a team SOP, in the context of a SWAT team, for instance, would be for one to rely on a medic to save one’s life does not make sense. As has been belabored in tactical medicine circles, one can bleed-out in less than 4 min. Are you going to sit and wait for someone else to save your life? The military suffered from that mindset, but have since adopted the care guidelines of self-aid, buddy-aid, and medic-aid. Second, the improvised-when-needed reasoning is not sound. This would be analogous to waiting until you had a weapon pointing at your face, then proceeding to quickly constructing a Zip gun. I assume an LEO would not serve a warrant or stop a suspicious vehicle without having a pistol. Therefore, why would you do the same without a piece of kit that costs approximately the same as a box of 9mm ammunition and has been proven to save lives?

It is not our stance that one should not know how to improvise. In fact, we sponsered a contest to find the best ways to improvise using one piece of kit, of which a tourniquet was one. However, while one ought to have the knowledge to improvise when needed that only comes from learning the basics, choosing to not carry the correct equipment because one plans to improvise is not prudent.

10 replies
  1. mike
    mike says:

    When I teach CLS I ask, if you had to make a hasty improvised tourniquet, what would you use? #1 on everyones list, A BELT! Wrong answer my friends, as seen in the picture above, as a belt does not have enough give to twist when the windlass is applied. A triangular bandage or bandana is one of the best materials for an improvised tourniquet. I have used other materials such as an ETB, and an ACE wrap for a tourniquet also. I’ve been shown that the old BDU tops ripped where the seam is on the front of the shirt. I’ve tried it with an ACU top and it seems to work pretty well too. Couple that with the fact that every vehicle has a seatbelt cutter and voila, you can create a tourniquet out of most fabrics.

    Reply
  2. HGR-Poland
    HGR-Poland says:

    Hello! I think a good solution is to clamp an improvised triangular bandage. when the bottom has a width ok.10cm. if you’re interested I can litter pictures how to do it.

    Reply
  3. Ron
    Ron says:

    One is none, two is one. Never truer here. I carry one CAT in my range bag, but never thought about a bullet going through both legs till now.

    Also a recent lecture I went to on bleeding control said that 2 CATs on a thigh is almost standard procedure on the battlefield because 1 doesn’t always completely stop bleeding.

    Going to carry two from now on.

    Reply
  4. Tigger
    Tigger says:

    I’ve used many forms of tourniquets (improvised, CATS, SOFT-T, Ratchet, etc) some good and some not so good. I personally like using triangular bandages or old bed sheet material ripped in 6″ wide strips and folded into a 2″ wide x 36″ long band . I then use a hemostat as the windless and clamp back on itself. The CATS are good, but I’ve broken quit a few in my days. The SOFT-T is bulky in my mind, but very effective. Most others are not even worth mentioning as they are ineffective or just plane fail. However, I found familiarization with the equipment (even if improvised) and placement is more important than what you use as long as the material is flexible, long enough and wide enough to constrict the vessels, even if it just slows the bleeding so a clot can form. I now always apply a tourniquet high, especially with injuries to the upper calf or thigh. I’m usually more concerned with stopping/slowing the hemorrhage and rejoining the fire fight than making everything look pretty…this is called “Care Under Fire.” Once contact ceases, I always readjust appropriately and dress the wound(s). Treated roughly 60 partial/full amputations in Iraq and never had anyone die or lose more of their extremity because of it. Feedback?

    Reply
  5. Tigger
    Tigger says:

    I’ve used many forms of tourniquets (improvised, CATS, SOFT-T, Ratchet, etc) some good and some not so good. I personally like using triangular bandages or old bed sheet material ripped in 6″ wide strips and folded into a 2″ wide x 36″ long band . I then use a hemostat as the windless and clamp back on itself. The CATS are good, but I’ve broken quit a few in my days. The SOFT-T is bulky in my mind, but very effective. Most others are not even worth mentioning as they are ineffective or just plain fail. However, I found familiarization with the equipment (even if improvised) and placement is more important than what you use as long as the material is flexible, long enough and wide enough to constrict the vessels, even if it just slows the bleeding so a clot can form. I now always apply a tourniquet high, especially with injuries to the upper calf or thigh. I’m usually more concerned with stopping/slowing the hemorrhage and rejoining the fire fight than making everything look pretty…this is called “Care Under Fire.” Once contact ceases, I always readjust appropriately and dress the wound(s). Treated roughly 60 partial/full amputations in Iraq and never had anyone die or lose more of their extremity because of it. Feedback?

    Reply
  6. Dan
    Dan says:

    ALWAYS have, as a minimum, two tourniquets available whenever the possibility of penetrating trauma exists. As an Army medic, I make sure all of my guys have two: one in their IFAK, and one in the lower pocket of their ACUs. We purchased trainer tourniquets, and weekly, we run through TC3 skills. Even inside the wire, all are required to carry at least one tourinquet, even if wearing PT uniform. You never need it, unitl you REALLY need it. Cravats and tongue depressors can be used to make tourniquets; however, these require prparation before the actual moment of use. Lesson is: don’t go unprepared.

    Reply
  7. 1LT Clark Tucker
    1LT Clark Tucker says:

    I am a 1LT here in Afghanistan and I was given a SOF-T tourniquet made by TacMedSolutions and he told me it was the special forces tourniquet. The ones I was given to give my men is the CAT tourniquet. I have heard good things about it but if not properly applied under stressful conditions, the CAT will present more problems that delivered help with the velcro getting caught and the weak ass windlass potentially snapping. I asked my medic, PFC Taylor, what he used and he pulled his SOF-T tourniquet out and said he loved it and never left his hooch without it. I asked him and he gave me one. I keep my SOF-T tourniquet everywhere I go, to include the latrine. You never know. I am a QRF platoon leader here in Afghanistan and when we roll out, things are bad. We always carry tourniquets and train on them weekly. This is one of the most important things/pieces of gear you will EVER own or buy. It weighs nothing. Why would you NOT buy one?! Even when I leave the army down the road, I will always carry a SOF-T tourniquet. You can bet your ass, LT Tucker will not bleed out b/c of a lack of a proven, Army combat tested piece of gear. If its good enough for the SF, its good enough for you. BUY TACMEDICALSOLUTIONS SOF-T tourniquet!

    LT Tucker
    Khost Afghanistan

    Reply
  8. CPl Corey Sagstuen CF
    CPl Corey Sagstuen CF says:

    I have used the SOF-T, CAT and the EMT on Canadian,US,ANSF and LN. not one has failed and countless lives have been saved. training is Key on all devices as well as the prep that needs ot go into it.
    Being wounded myself, i know the importance of this life saving device, it should be part of everyday life…it is in mine!
    God love all of those men and woman out there keeping everyone else safe! You know who you are!!!

    Reply
  9. Monk
    Monk says:

    I work in a federal law enforcement agency and we just had an AD on the range. 40 SW through the femoral, really bad bleeding, a CAT saved my friends life. I applied one on the upper thigh after using my arm (choke hold) on his leg to temporarily stop/slow the bleeding. What a life saver!

    Reply

Trackbacks & Pingbacks

  1. […] had limbs tourniqueted? That is because some people got multiple tourniquets. Here is an example of multiple tourniquets in a civilian case. Shooting accident at the range and guy is shot by the person next to him. The bullet goes through […]

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