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Top three Tourniquets?
- Thread starter Milf Dots
- Start date
Yes those two still seem to be on top except it’s the SOFT wide that seems to be preferred/recommended. SWAT-T is another one you hear of but I have reservations about that one.
CAT
SoF
EQT for small form factor.
www.snakestaffsystems.com
SoF
EQT for small form factor.
ETQ (Everyday Carry Tourniquet) — Snakestaff Systems
There are a lot of great tourniquets on the market but their size can make them awkward or difficult to carry, especially in a daily or concealed fashion directly on your person. The Everyday Carry Tourniquet (ETQ™) is compact, roughly the size of a small multi-tool, and fits comfortably into your
www.snakestaffsystems.com
The ETQ is my goto now, used the others listed but this one is #1 on my list
CAT
CAT
And CAT
(Based off ease of use and commonality of use in my area)
Oh, and the SOF T Wide is good.
There is a new one recommended by the ACS Committee on Trauma, but cant remember the name of the top of my head.
That EQT look interesting.
Dig the size.
Will look into their testing and data before I make a full judgement of my own.
100% would love one the size of a G19 mag.
CAT
And CAT
(Based off ease of use and commonality of use in my area)
Oh, and the SOF T Wide is good.
There is a new one recommended by the ACS Committee on Trauma, but cant remember the name of the top of my head.
That EQT look interesting.
Dig the size.
Will look into their testing and data before I make a full judgement of my own.
100% would love one the size of a G19 mag.
My range medic kit came with a RATS tourniquet, I’m looking at replacing it with a CAT. Thoughts?
CAT gen 7, but anything on the current CoTCCC recommended list should be good to go.
RATS is better than nothing but recommended minimum strap width is 1.5" to minimize localized nerve and tissue damage.
RATS is better than nothing but recommended minimum strap width is 1.5" to minimize localized nerve and tissue damage.
How much of a concern is this for typical civilian use (read: <1hr to major trauma care center)?
Still a concern. IF you need a TQ, you 100% want it to work.
Im not sure the RATS will actually STOP blood flow.
they have a link to a study done that says it will at the same % at a CAT gen7, I wish the “publication” had more info, such as how many “participants”, what artery was occluded, etc. I will look for it later when I have time.
I also have concerns about added increase in pain with how one tightens it, as well as the very narrow design and increased soft tissue or nerve damage.
Pretty easy to just use the ones recommended by COT or CoTCCC noted above (they work together) IMO.
Interestingly, the key reason the RATs site says for why they made it was ease of use and speed, and in the study link, they were still slower than the CAT 7 by a hair.
Im not sure the RATS will actually STOP blood flow.
they have a link to a study done that says it will at the same % at a CAT gen7, I wish the “publication” had more info, such as how many “participants”, what artery was occluded, etc. I will look for it later when I have time.
I also have concerns about added increase in pain with how one tightens it, as well as the very narrow design and increased soft tissue or nerve damage.
Pretty easy to just use the ones recommended by COT or CoTCCC noted above (they work together) IMO.
Interestingly, the key reason the RATs site says for why they made it was ease of use and speed, and in the study link, they were still slower than the CAT 7 by a hair.
Belt with a stick is my favorite because I don’t have to carry extra gear and sticks are pretty easy to find in desert battlefields.
Ounces are pounds and pounds are pain etc.
I am also a liar.
-Stan
Ounces are pounds and pounds are pain etc.
I am also a liar.
-Stan
It's not. People have been using cravats as a TQ for over a hundred years. Even tip of the spear guys like Pat Mac still carry and run them which means it's part of their toolbox.
Anything that stops the bleed is better than dying. Worrying about TQ width in modern civilization is stupid. Like you said with advanced care, will negate the differences. I worry more about a complicated TQ that is not intuitive and hard to use more than the strap width. Can my kid or wife with no training use it? And you have to rung what you bring so a compact tq your carry is 1000% more valuable than a perfect one you don't.
Obsolete chart was obsolete when it came out. Now 4 years later...even more so. If your going to go off latest trends....it's not going to be in some bureaucratic pub. New products and TTPs come out all the time.
- Nov 3, 2010
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Part of the toolbox and primary tool are different things though. Always nice to have a backup plan.
Hell, they used to teach us how to make modified neck/head immobilizers with boots and sand/dirt/rock. Doesn’t mean I want my medic to carry an extra set of boots instead of a collar.
And a guy who does not work in trauma medicine is again the expert. Seems thats his MO in about everything.
You should probably teach Frank how to shoot and Mike R how to build rifles too.
It 100% matters.
I heard a story of a guy who very nearly died and he could SEE the trauma center.
Transport isnt all “pull up the bus, load, and go”.
sometimes takes a while to get a patient out, unstuck (cut from a car, lift a bus they went under), or down from a steep hill covered in loose rock and they have an active bleed from an open femur.
Just guesses to possibilities.
Not cases I have actually dealt with in the field or a trauma center…..
You should probably teach Frank how to shoot and Mike R how to build rifles too.
It 100% matters.
I heard a story of a guy who very nearly died and he could SEE the trauma center.
Transport isnt all “pull up the bus, load, and go”.
sometimes takes a while to get a patient out, unstuck (cut from a car, lift a bus they went under), or down from a steep hill covered in loose rock and they have an active bleed from an open femur.
Just guesses to possibilities.
Not cases I have actually dealt with in the field or a trauma center…..
Close Friend of the family saved a kids life a few nights ago with a belt. He blew his hand off making a pipe bomb. Was choppered to John's Hopkins. No one gives a fuck what model or sku or nsn TQ they used. It's 5000 year old technology.....stop trying to make it sound like more than it is.
My combat medicine experience is about 20 years old but the TQ you have is better than the one you don't. I carried a trauma bag in Iraq for over a year, and got to use it more than once. EQT makes a wide version to placate the spec nerds but even they say in clinical testing there is no/little difference.
It's OK to admit you are behind the curve too. Unless you work in a level 1 trauma center, you are.
My combat medicine experience is about 20 years old but the TQ you have is better than the one you don't. I carried a trauma bag in Iraq for over a year, and got to use it more than once. EQT makes a wide version to placate the spec nerds but even they say in clinical testing there is no/little difference.
It's OK to admit you are behind the curve too. Unless you work in a level 1 trauma center, you are.
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You understand Powda works in a trauma center, right? You might want to STFU and go check your ego at the door.
Would you rather bleed out and die because you didn't have a tourniquet or use a tourniquet that could potentially cause muscle or nerve injury? Between two tourniquets of similar form factor and price, do you choose the one that has a long history of usage and clinical trials supporting efficacy or the new kid on the block that could be just as good? Choice is yours. Guideline is pretty simple if you have a choice, 1.5" webbing minimum and easy one handed application.
Always a risk of nerve injuries, especially with high pressure gradients. Since emergency tourniquets are non-pneumatic, you can't control pressure gradients except with width and the pressure gradient may cause more damage than ischemia (lack of oxygen) alone. Muscle damage from metabolic changes is evident 30-60 minutes after tourniquet use. Upper extremities more susceptible than lower extremities.
Tourniquet-induced nerve compression injuries are caused by high pressure levels and gradients – a review of the evidence to guide safe surgical, pre-hospital and blood flow restriction usage
Tourniquet compression nerve injuries are typically transient, and resulting symptomatology is mild to moderate [14]. However, when the applied pressure gradient is high, there is a risk of axonal injury with subsequent axonal degeneration and accompanying target muscle fibre atrophy [14]. If this happens recovery may be prolonged (lasting weeks or even months). Further, because of potential mal-innervation, recovery may be incomplete with functionally impaired fractionation of movement and/or permanent sensory deficit. This is especially true when the upper limb is involved. Because upper extremity nerves are closer to the skin surface, or adjacent to bone they are more susceptible to direct compression injury [1, 4]. Upper extremity nerve injuries are more commonly reported than in the lower limb, with the radial nerve being the most vulnerable [1, 15, 16]. Thus location of tourniquet placement is also significant for reducing the risk of direct nerve compression [1, 8, 15].
Muscle injury
After tourniquet application there is progressive cellular hypoxia, acidosis, and cooling in the occluded limb [19]. This progressively decreases tissue pH and pO2, and increases pCO2, K+, and lactate [19, 20]. Muscle is susceptible to these metabolic changes, and histological evidence of muscle damage is evident 30–60 min after tourniquet inflation [21]. These changes are generally mild and well tolerated. There is increased microvascular permeability with reperfusion, resulting in swelling and tissue oedema, which in some patients can cause a “post-tourniquet syndrome” especially if inflation time has been prolonged. Post-tourniquet syndrome is characterized by a swollen, stiff, pale limb with weakness developing 1–6 weeks after the tourniquet application. High tourniquet pressure levels and applied pressure gradients combined with ischemia may induce more profound damage to muscle than ischemia alone [10, 19].Management of Tourniquet-Related Nerve Injury (TRNI): A Systematic Review
This wide variation is thought to be due to under-diagnosis of nerve injury, the complexity of the clinical setting, presence of pain at the site of surgery, concurrent limb weakness postoperatively from muscle injury as well as the often-rapid recovery of the affected nerve(s) [12]. Studies have shown a higher frequency of nerve injuries in the upper extremities versus lower extremities, with the radial nerve being more prone to tourniquet-associated injury than the ulnar nerve while the median nerve is the least susceptible [4,7,8,13]. The most commonly injured nerve of the LE is the sciatic nerve [14]. Mechanical pressure seems to be more important in the mechanism of nerve injury than distal ischemia [15].
- Nov 3, 2010
- 9,701
- 20,390
I do
For over 20 yrs
And used to do prehospital stuff too.
We are at the front of things. Flying patients with REBOA for instance (little different when you clear 12,000 ft regularly in rotor wing)
Loads of studies and research.
And was 100% a belt TQ was replaced with a CAT of SOF T Wide by the helo team.
By all means, use any resource available if the best isnt on hand.
But dont stock your kit with inferior stuff.
When I teach, I tell people to use a shop rag or whatever (paper towels are last, last resort) to pack a wound if needed. Something is better than nothing.
And we can wash wounds out well.
For over 20 yrs
And used to do prehospital stuff too.
We are at the front of things. Flying patients with REBOA for instance (little different when you clear 12,000 ft regularly in rotor wing)
Loads of studies and research.
And was 100% a belt TQ was replaced with a CAT of SOF T Wide by the helo team.
By all means, use any resource available if the best isnt on hand.
But dont stock your kit with inferior stuff.
When I teach, I tell people to use a shop rag or whatever (paper towels are last, last resort) to pack a wound if needed. Something is better than nothing.
And we can wash wounds out well.
(1) The one you have with you
(2) The one you have with you
(3) The one you have with you
While brand of tourniquets may be important (I will just say "I have no clue") its like a gun: The best one is the one that you always have available AND HAVE TRAINED WITH. Best gun in the world is worthless on you desk at home when needed. Best tourniquet is the one you have on your person/bag 100% of the time.
Some may be better than others. A poor one is still better than none.
I know we all hate doctors but maybe in the area of trauma: LISTEN TO A FUCKING TRAUMA DOCTOR and remember the "no tourniquets" for a long time was "tip of the spear". When you take your "Stop the Bleed Class" ask them (and you DID take the class!), don't ask the internet. Its full of bullshit.
Also consider you may be using someone else's kit: Matches and ranges often have better first aid kits. Its not about the brand: is one available, can you apply it effectively.
(2) The one you have with you
(3) The one you have with you
While brand of tourniquets may be important (I will just say "I have no clue") its like a gun: The best one is the one that you always have available AND HAVE TRAINED WITH. Best gun in the world is worthless on you desk at home when needed. Best tourniquet is the one you have on your person/bag 100% of the time.
Some may be better than others. A poor one is still better than none.
I know we all hate doctors but maybe in the area of trauma: LISTEN TO A FUCKING TRAUMA DOCTOR and remember the "no tourniquets" for a long time was "tip of the spear". When you take your "Stop the Bleed Class" ask them (and you DID take the class!), don't ask the internet. Its full of bullshit.
Also consider you may be using someone else's kit: Matches and ranges often have better first aid kits. Its not about the brand: is one available, can you apply it effectively.
When a bunch of JSOC and SAD/GRS dudes reccomend a product and say they carry it everyday; it's probally wise to take notice as well.
One size doesn't fit all and there are plenty of situations where a small form factor TQ is going to be much better than not carrying the giant CAT or Soft. No one said it's superior to them, it's a good tool have.
Is your wife more likely to carry a full size or half size in her purse?
Are you more likely to throw a full size or half size in your pocket or cargo pants?
Something that fits in a g19 mag pouch is more likely to take up one of those mag pouches than a 3rd or 4th mag.
Worrying about possible nerve damage down the road is the last concern in getting the PT stabalized for movement.
No one said the smaller TQ is superior, just people shitting on it due to insignificant concerns.
If you could carry an entire trama center in your backpocket....that would be even better. But such is the world of compromises.
One size doesn't fit all and there are plenty of situations where a small form factor TQ is going to be much better than not carrying the giant CAT or Soft. No one said it's superior to them, it's a good tool have.
Is your wife more likely to carry a full size or half size in her purse?
Are you more likely to throw a full size or half size in your pocket or cargo pants?
Something that fits in a g19 mag pouch is more likely to take up one of those mag pouches than a 3rd or 4th mag.
Worrying about possible nerve damage down the road is the last concern in getting the PT stabalized for movement.
No one said the smaller TQ is superior, just people shitting on it due to insignificant concerns.
If you could carry an entire trama center in your backpocket....that would be even better. But such is the world of compromises.
Best, not if you have a full size option BUT I have several of the mini-TQs from Snakestaff. Way I look at it is, it’s better than nothing. I’ve had several 18Ds tell me these is no way that thing is going to stop a leg bleed on me, but we haven’t put one on and used the scope to check for blood flow yet so….. better than nothing.
Fits nicely in the bottom of a small LuLuLemon Fanny pack, right under a G43
, a pack of hemostatic gauze, a few bandaids, AirPods and my wallet. Not bad for a tiny pack. Has the added benefit of being diversionary. Doesn’t screen gun any louder than it screams fag.
Fits nicely in the bottom of a small LuLuLemon Fanny pack, right under a G43
, a pack of hemostatic gauze, a few bandaids, AirPods and my wallet. Not bad for a tiny pack. Has the added benefit of being diversionary. Doesn’t screen gun any louder than it screams fag.
Out of curiosity, have you heard anything about the impending approval of Traumagel, and it's efficacy?
I havent kept up with trials and stuff, but yes, super excited to see it.
ETA: posted 4 days ago, they got 2nd FDA clearance for it for external use.
can see it being very beneficial for long extrications and remote stuff.
ETA: I am even more excited for the similar stuff I have heard about for internal bleeding.
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@FatBoy
Im gonna look at a couple of those Snakestaff ones.
Have you put one on and monitored your pulse or anything?
I may even apply them and do a little color doppler test on a few willing buddies and myself, to see.
And compare with the CAT.
At home of course.
I love the idea of small and easy, IF they work well.
And yes to the hipster gay looking fanny pack for concealment.
I do the g19, some goods, and an anaphylaxis kit (everyone at the gym eating bananas and I am severely allergic).
Grey Man is a good way to be IMO.
Im gonna look at a couple of those Snakestaff ones.
Have you put one on and monitored your pulse or anything?
I may even apply them and do a little color doppler test on a few willing buddies and myself, to see.
And compare with the CAT.
At home of course.
I love the idea of small and easy, IF they work well.
And yes to the hipster gay looking fanny pack for concealment.
I do the g19, some goods, and an anaphylaxis kit (everyone at the gym eating bananas and I am severely allergic).
Grey Man is a good way to be IMO.
@FatBoy
Im gonna look at a couple of those Snakestaff ones.
Have you put one on and monitored your pulse or anything?
I may even apply them and do a little color doppler test on a few willing buddies and myself, to see.
And compare with the CAT.
At home of course.
I love the idea of small and easy, IF they work well.
No, I’m closest to FTCKY and my medic buddies are currently in 1st and 7th, so when I do see them it's generally not around a place they can do the test. I keep a CAT5 in the truck, in my range bag, on my PC (moving to my belt/holster) and in a raid nut ruck I use as a first aid dangler sometimes. If I know I’m going to be around gunfire I have a TQ I am sure will work. For everyday shit, there is a 0% chance these baby TQs are not better than a belt, and they are small enough that I have them on me most of the time.
Thats a logical response.
My truck bag and shooting gear is same.
And I do want to test them.
Im not sure I have time, and may look at doing a study……
Compare them to some of the ones CoTCCC and COT recommend and see.
Hmmmmm
Lemme talk to our research peeps
My truck bag and shooting gear is same.
And I do want to test them.
Im not sure I have time, and may look at doing a study……
Compare them to some of the ones CoTCCC and COT recommend and see.
Hmmmmm
Lemme talk to our research peeps
Talks with Brian Litz about ballistics
Expert on Education
Expert on metallurgy
Expert on trauma care.
Talks Regularly with Spec Ops about first aid.
For a midpack shooter, you are an expert at everything and know everyone....
So what kinda of tampon does your JSOC friends recommend?
Which brand of midol works best for PMS? (Take some)
Shitty parenting is the root cause. Little shit tried to make a muzzleloader with condiut, FFG black powder and marbles. Its amazing he is still alive. Blew half his hand off, one eye and shrapnel all up and down his body.
Yeah, apparently it's been used by Veterinarians for years, under a different name, and has performed very well. It'll be interesting to see how well it performs on things like gunshot wounds and stab wounds. Seems like another easy button type thing; stick the nose of the tube into the wound, and then mash down the plunger to inject the stuff, deep into the wound, so that it can clot everything up quickly. I could see big green and the Corps buying that stuff by the case load....
Yep
So far “for external use” from quick glance.
Could be great for our S&R teams here.
Sometimes takes quite a while.
Tougher if they get cold and coagulopathic.
Found some interesting video of the animal version in use (vetigel). Looks pretty impressive... (video at the bottom of the page)
Is that like a refined Celox?
I'm trying to find where I saw something similar to what you're referring to. It looked amazing.
I couldn't help but think of when my son and I would play HALO years ago where the ODST and SPARTANs had a biofoam injector in their IFAKs. Sci Fi becomes reality again.
At one time I learned what they consider the wall thickness to bore diameter ratio of a safe blackpowder device to be and marble : conduit definitely isn't it. But there are also people shooting bowling balls out of gas cannisters who to my knowledge are still alive so who knows.
Many of us have done "questionable" things when were were kids (especially in the 50s and 60s) and somehow survived, some still do dumb things and somehow survive.
Back to the topic though, that Traumagel Looks like the real solution.
Terry,
As I understand it, it's a totally different matrix, made from algae and fungi (or some such). Apparently it has the consistency of hummus. They even joke about it being the real life version of biofoam, so yeah, scifi becomes reality...again.
I'm just wondering about the shelf life, and how it deals with extreme temps. Might be worth having a tube or two in the home trauma kit...
Very, very good to know.
Since I seemingly live under a rock, I am counting on some of you guys to chatter about it when it becomes available. 100% will add to every kit I have scattered about.
Still a concern. IF you need a TQ, you 100% want it to work.
Im not sure the RATS will actually STOP blood flow.
they have a link to a study done that says it will at the same % at a CAT gen7, I wish the “publication” had more info, such as how many “participants”, what artery was occluded, etc. I will look for it later when I have time.
I also have concerns about added increase in pain with how one tightens it, as well as the very narrow design and increased soft tissue or nerve damage.
Pretty easy to just use the ones recommended by COT or CoTCCC noted above (they work together) IMO.
Interestingly, the key reason the RATs site says for why they made it was ease of use and speed, and in the study link, they were still slower than the CAT 7 by a hair.
Thanks much for the feedback. If the thing doesn't work, then there's no use worrying about what injury it may or may not cause.
FWIW, informal testing (read: sitting around the campsite with nothing else to do) suggests that the CAT is easier to apply one-handed than the RAT, at least for this poorly-trained individuals. The RAT does seem to carry a bit easier in a cargo pants pocket, but once again that doesn't matter if there's reason to think it won't stop bleeding.
I will take this opportunity to say thank you, and fade away again. I came here a long time ago, longer than my profile indicates, thirsting for knowledge from people who know better. That insight has been invaluable over the years, in this case specifically regarding the application and use of CAT’s. That is still my go-to TQ first because of the knowledge you have shared, and second because it works. Glad to see that’s still the expert consensus.
I will also share a quote from a great SSgt. He once told me, “son, you can learn something from everyone, even stupid people. They can show you what not to do, and are probably dead a short time after they do it”.
I will also share a quote from a great SSgt. He once told me, “son, you can learn something from everyone, even stupid people. They can show you what not to do, and are probably dead a short time after they do it”.
